Sec. 40. Rate adjustments for quality measures.

354 words·~2 min read·/il/chapter-210/act-155/40

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(a)The Department may adjust the LTAC supplemental per diem rate calculated under Section 35 of this Act based on the requirements of this Section.

(b)After the first year of operation of the Program established by this Act, the Department may reduce the LTAC supplemental per diem rate calculated under Section 35 of this Act by no more than 5% for an LTAC hospital that does not meet benchmarks or targets set by the Department under paragraph

(2)of subsection

(b)of Section 50.

(c)After the first year of operation of the Program established by this Act, the Department may increase the LTAC supplemental per diem rate calculated under Section 35 of this Act by no more than 5% for an LTAC hospital that exceeds the benchmarks or targets set by the Department under paragraph

(2)of subsection

(a)of Section 50.

(d)If an LTAC hospital misses a majority of the benchmarks for quality measures for 3 consecutive years, the Department may reduce the LTAC supplemental per diem rate calculated under Section 35 of this Act to zero.

(e)An LTAC hospital whose rate is reduced under subsection

(d)of this Section may have the LTAC supplemental per diem rate calculated under Section 35 of this Act reinstated once the LTAC hospital achieves the necessary benchmarks or targets.

(f)The Department may apply the reduction described in subsection

(d)of this Section after one year instead of 3 to an LTAC hospital that has had its rate previously reduced under subsection

(d)of this Section and later has had it reinstated under subsection

(e)of this Section.

(g)The rate adjustments described in this Section shall be determined and applied only at the beginning of each rate year.

(h)On and after July 1, 2012, the Department shall reduce any rate of reimbursement for services or other payments or alter any methodologies authorized by this Act or the Illinois Public Aid Code to reduce any rate of reimbursement for services or other payments in accordance with Section 5-5e of the Illinois Public Aid Code.