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Bill > HB2507

IL HB2507

IL HB2507
MEDICAID-NURSING PAYMENTS

summary

Introduced
02/03/2025
In Committee
03/21/2025
Crossed Over
Passed
Dead

Introduced Session

104th General Assembly

Bill Summary

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that for the calendar year beginning January 1, 2026, and each calendar year thereafter, a nursing facility must spend at least 90% of its adjusted total revenue on resident care and other resident-related costs, as defined. Requires each nursing facility to provide as part of its financial reporting information necessary for the Department of Healthcare and Family Services to administer and enforce the provisions of the amendatory Act. Provides that such information shall be subject to audit provisions and comply with any applicable uniform standards under the Code. Provides that all non-allowable costs, related party adjustments, or compensation to owners reported shall be excluded from the calculation of the amount spent on resident care and other resident-related costs. Requires 25% of costs associated with contract nursing staff to be deducted from the amount spent on resident care and other resident-related costs. Provides that for the calendar year beginning January 1, 2027, and each calendar year thereafter, the Department shall use the required financial reporting submissions to determine whether each nursing facility has met the minimum resident care percent requirement. Provides that if a facility has not met the minimum resident care percent requirement, the amount defined by the facility's total adjusted revenue shall be treated as a vendor overpayment. Requires the Department to recover the full amount of any vendor overpayment by reducing future payments, requiring direct payment to the Department, or any other method permitted under the Code. Requires the Department to adopt rules.

AI Summary

This bill amends the Illinois Public Aid Code to establish a new requirement for nursing facilities regarding their spending on resident care. Starting in January 2026, nursing facilities must spend at least 90% of their adjusted total revenue on resident care and related costs. These costs include direct care by nurses and nursing assistants, support services like food, laundry, housekeeping, and activities, as well as ancillary medical services. The bill specifically excludes administrative costs, capital expenses, debt service, taxes, depreciation, and rent from this calculation. Nursing facilities must submit detailed financial reports to the Department of Healthcare and Family Services, which will be subject to audit. The bill mandates that certain costs, such as non-allowable expenses, related party adjustments, and 25% of contract nursing staff costs, will be subtracted from the resident care calculation. For the calendar year beginning January 1, 2027, the Department will review these financial submissions to determine if facilities meet the 90% spending requirement. If a facility fails to meet this threshold, the amount will be treated as a vendor overpayment, which the Department can recover through reduced future payments or direct repayment. The bill requires the Department to adopt rules to implement these provisions.

Committee Categories

Budget and Finance

Sponsors (34)

Last Action

Added Co-Sponsor Rep. Edgar González, Jr. (on 04/23/2025)

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