IL HB0246

Implements Patient Driven Payment Model (PDPM) nursing facility reimbursement system effective July 1, 2022, replacing RUG-IV methodology based on federal Centers for Medicare and Medicaid Services approval.

Establishes statewide PDPM nursing base per diem rate of $92.25 adjusted quarterly for facility case mix index and regional wage adjusters, with minimum wage adjuster of 1.06.

Creates variable per diem staffing add-on ranging from $9 to $38.68 based on facility achievement of staffing benchmarks indicated by STRIVE study, with transition rates protecting facilities through October 1, 2023.

Allocates $70,000,000 annually for quality-based incentive payments to nursing facilities determined by their Centers for Medicare and Medicaid Services Five-Star Quality Rating System performance.

Modifies long-term care provider assessment tax structure effective July 1, 2022 with tiered rates based on facility Medicaid bed days ranging from $7 to $22.40 per occupied bed day, and adds $4 Medicaid access adjustment for facilities with 70% or higher Medicaid occupancy.