HB5646 Summary

• Department of Healthcare and Family Services may contract with third-party vendors to conduct onsite and desk reviews of resident assessment information in the Minimum Data Set (MDS) to verify accuracy for reimbursement rate determinations.

• Amends the Medical Assistance Article of the Illinois Public Aid Code regarding nursing facility payment methodologies under Section 5-5.2.

• Establishes RUG-IV 48 grouper model-based reimbursement system for nursing services effective January 1, 2014, using resident-driven, facility-specific, and cost-based methodology with annual rebasing and quarterly case mix index updates.

• Implements transition rates for nursing homes between January 1-December 31, 2014, with different calculations for facilities whose new rates exceed or fall below rates in effect July 1, 2012.

• Provides per diem add-ons of up to $10,000,000 beginning July 1, 2014 for residents with Alzheimer's Disease, non-Alzheimer's Dementia, and certain physical assistance needs classifications.