IL HB4443

Establishes a Nursing Facility Oversight Committee composed of 12 voting members appointed by the 4 legislative leaders to oversee nursing facility reimbursement, bed assessments, and long-term care services, with authority to approve Department actions before State Plan amendments and administrative rules are filed.

Requires the Department of Healthcare and Family Services to provide nursing facilities with no less than 60 days' notice before modifications to reimbursement methodologies and bed assessment procedures take effect, with detailed information allowing facilities to challenge data accuracy and formulas.

Redesigns direct care reimbursement to include quarterly per diem rates with multiple components: case mix protocol (transitioning from RUGs to PDPM-based model), regional wage adjuster, base per diem rate with $5 addition, variable staffing add-ons, special care needs add-ons, Medicaid access add-ons, and quality incentive add-ons and lump sum awards.

Replaces existing bed tax with a single quarterly non-Medicare occupied bed varied tax assessment ranging from $7 to $22.40 per bed day based on annual Medicaid bed days, projected to generate approximately 6% of revenues annually for nursing facility funding.

Mandates managed care organizations pay nursing facilities no less than Medicaid fee-for-service rates and requires quarterly Department audits; violations subject to $20,000 per incident sanctions (doubling for repeat violations) and potential program termination, with fines deposited into Long-Term Care Provider Fund.