summary
Introduced
02/05/2026
02/05/2026
In Committee
02/05/2026
02/05/2026
Crossed Over
Passed
Dead
Introduced Session
104th General Assembly
Bill Summary
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that, beginning on and after October 1, 2026, for rate year 2027 and thereafter, the Medicaid inpatient utilization rate used in the determination of eligibility for inpatient adjustment payments provided under the Code shall be modified to exclude from both the numerator and denominator all days of care funded by the U.S. Department of Veterans Affairs at a hospital approved to conduct its operations from more than one location within contiguous counties under a single license, if at the time of its licensing application the hospital was located in a county with fewer than 125,000 inhabitants and the hospital's second facility is located in a contiguous county with fewer than 235,000 inhabitants. Provides that, for purposes of the amendatory Act, days of care funded by the U.S. Department of Veterans Affairs include authorized VA community care provided at non-VA hospitals. Effective immediately.
AI Summary
This bill, effective immediately, modifies how certain hospitals are reimbursed by Medicaid, specifically for inpatient services starting October 1, 2026. It changes the calculation of the "Medicaid inpatient utilization rate," which is a measure of how many hospital days are for Medicaid patients compared to total patient days. For specific hospitals that operate from multiple locations within contiguous counties under a single license, and which were initially licensed in a county with fewer than 125,000 residents with a second facility in a contiguous county with fewer than 235,000 residents, days of care funded by the U.S. Department of Veterans Affairs (VA) will be excluded from both the numerator and denominator of this calculation. This exclusion also applies to authorized VA community care provided at non-VA hospitals. This change aims to adjust the reimbursement calculation for these particular hospitals by not counting VA-funded patient days, which are not paid for by Medicaid.
Sponsors (1)
Last Action
Referred to Assignments (on 02/05/2026)
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