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IL HB3273

IL HB3273
DHFS-HOSPITAL RATE PAY SYSTEM


summary

Introduced
02/06/2025
In Committee
03/21/2025
Crossed Over
Passed
Dead

Introduced Session

104th General Assembly

Bill Summary

Amends the Hospital Services Trust Fund Article of the Illinois Public Aid Code. In provisions concerning the hospital rate reform payment system, provides that reimbursement for inpatient general acute care services shall utilize the All Patient Refined Diagnosis Related Grouping (APR-DRG) software, version 30, distributed by Solventum previously known as 3MTM Health Information System. Provides that Solventum shall be the exclusive provider of this software unless the Department of Healthcare and Family Services determines that Solventum is unable to meet the required operational or contractual terms. Provides that only under such circumstances may an alternative authorized provider of the software be considered. Adds corresponding provisions regarding software used to process reimbursements for outpatient services.

AI Summary

This bill amends the Hospital Services Trust Fund Article of the Illinois Public Aid Code to modify how hospitals are reimbursed for inpatient and outpatient services. Specifically, the bill requires the use of All Patient Refined Diagnosis Related Grouping (APR-DRG) software, version 30, for inpatient services and Enhanced Ambulatory Procedure Grouping (EAPG) software, version 3.7, for outpatient services, both distributed exclusively by Solventum (previously known as 3M Health Information System), unless Solventum is unable to meet operational or contractual terms. The bill establishes that the Department of Healthcare and Family Services will set Medicaid weighting factors, standardized amounts, and various adjusters for hospital reimbursements. It also introduces a hospital and health care transformation program to provide financial assistance to hospitals, with a focus on addressing health care disparities in underserved communities. The program aims to support innovative partnerships that improve healthcare delivery, access, and equity, particularly in areas disproportionately affected by COVID-19, with an annual transformation funding pool of up to $150 million pending federal matching funds.

Committee Categories

Health and Social Services

Sponsors (1)

Last Action

Rule 19(a) / Re-referred to Rules Committee (on 03/21/2025)

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