Sec. 5-5b.1. Reimbursement rates; Fiscal Year 2015 reductions.

406 words·~2 min read·/il/chapter-305/act-5/5-5b-1

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

(a)Except as provided in subsection (b), notwithstanding any other provision of this Code to the contrary, and subject to rescission if not federally approved, providers of the following services shall have their reimbursement rates or dispensing fees reduced for the remainder of State fiscal year 2015 by an amount equivalent to a 2.25% reduction in appropriations from the General Revenue Fund for the medical assistance program for the full fiscal year:

(1)Nursing facility services delivered by a nursing facility licensed under the Nursing

Home Care Act.

(2)Home health services.

(3)Services delivered by a facility designated as a Children's Habilitation Center.

(4)Services delivered by a supportive living facility as defined in Section 5-5.01a.

(5)Services delivered by a specialized mental health rehabilitation facility licensed

under the Specialized Mental Health Rehabilitation Act of 2013.

(6)Ambulance services.

(7)Pharmacy services.

(8)Services delivered by a federally qualified health center as defined in Section 1905

(l)(2)(B) of the federal Social Security Act.

(9)Services delivered by a Managed Care Entity, with the exception of the rate paid to

Managed Care Entities for services attributed to hospitals.

(10)Services for the treatment of hemophilia.

(11)Primary care physician services.

(12)Dental services.

(13)Optometric services.

(14)Podiatry services.

(15)Hospice care, including routine home care, continuous home care, inpatient respite

care, and general inpatient care.

(16)Laboratory services or services provided by independent laboratories.

(17)Durable medical equipment and supplies.

(18)Renal dialysis services.

(19)Birth Center Services.

(20)Emergency services other than those offered by or in a hospital.

(b)No provider shall be exempt from the rate reductions authorized under this Section, except that, rates or payments, or the portion thereof, paid to a provider that is operated by a unit of local government that provides the non-federal share of such services shall not be reduced as provided in this Section.

(c)To the extent practical and subject to rescission if not federally approved, the reductions required under this Section must be applied uniformly among and within each group, class, subgroup, or category of providers listed in this Section.

(d)In order to provide for the expeditious and timely implementation of the provisions of this Section, emergency rules to implement any provision of this Section may be adopted by the Department in accordance with subsection

(s)of Section 5-45 of the Illinois Administrative Procedure Act.