SB1521 Summary

• Amends Section 14-12 of the Illinois Public Aid Code to make a technical correction changing "The" to "The" in the hospital rate reform payment system section (corrects grammatical redundancy).

• Establishes inpatient hospital reimbursement using APR-DRG (All Patient Refined Diagnosis Related Grouping) software version 30 effective July 1, 2014, with Department-established Medicaid weighting factors and statewide-standardized amounts.

• Establishes outpatient hospital reimbursement using E-APG (Enhanced Ambulatory Procedure Grouping) software version 3.7 effective July 1, 2014, with service-specific standardized amounts adjusted by Medicare wage index.

• Requires Department to develop rate adjusters for critical Medicaid providers, safety-net hospitals, trauma services, transplantation, perinatal care, and Graduate Medical Education (GME).

• Allocates transitional hospital access pool of at least $290,000,000 annually during transition period (July 1, 2014 through June 30, 2018) to ensure orderly transition and preserve hospital access.