reglab/housing_qa huggingface dataset:
305 ILCS 5/5-5.13
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

 (from Ch. 23, par. 5-5.13)Sec. 5-5.13.         The Illinois Department shall establish procedures for the  expedited review, for purposes of inclusion in the Illinois Public Aid  formulary, of any drug for the treatment of acquired immunodeficiency syndrome  (AIDS) which the federal Food and Drug Administration has indicated is subject  to a treatment investigational new drug application.    (Source: P.A. 88-85.)
305 ILCS 5/5-5.14
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-5.14.     (Repealed).     (Source: Repealed by P.A. 88-85.)
305 ILCS 5/5-5.14.5
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-5.14.5. Treatment; substance use disorder and mental health. The Department shall consult with stakeholders and General Assembly members for input on a plan to develop enhanced Medicaid rates for substance use disorder treatment and mental health treatment in underserved communities. The Department shall present the plan to General Assembly members within 3 months of the effective date of this amendatory Act of the 101st General Assembly, which will specifically address ensuring access to treatment in provider deserts. Within 4 months of the effective date of this amendatory Act of the 101st General Assembly, the Department shall submit a State plan amendment to create medical assistance enhanced rates to enhance access to those to community mental health services and substance abuse services for underserved communities.    Subject to federal approval, the Department shall create medical assistance enhanced rates for community mental health services and substance abuse providers for underserved communities to enhance access to those communities.  (Source: P.A. 101-10, eff. 6-5-19.)
305 ILCS 5/5-5.15
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-5.15. (Repealed).        (Source: P.A. 83-1509. Repealed by P.A. 96-1501, eff. 1-25-11.)
305 ILCS 5/5-5.16
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

 (from Ch. 23, par. 5-5.16)Sec. 5-5.16.     (Repealed).     (Source: P.A. 90-372, eff. 7-1-98.  Repealed internally, eff. 7-1-98.)
305 ILCS 5/5-5.17
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

 (from Ch. 23, par. 5-5.17)Sec. 5-5.17. Separate reimbursement rate. The Illinois Department may  by rule establish a separate reimbursement rate to be paid to long term  care facilities for adult developmental training services as defined in  Section 15.2 of the Mental Health and Developmental Disabilities Administrative  Act which are provided to   residents of such facilities who have intellectual disabilities and who receive aid under this Article.  Any such  reimbursement shall be based upon cost reports submitted by the providers  of such services and shall be paid by the long term care facility to the  provider within such time as the Illinois Department shall prescribe by  rule, but in no case less than 3 business days after receipt of the  reimbursement by such facility from the Illinois Department.  The Illinois  Department may impose a penalty upon a facility which does not make payment  to the provider of adult developmental training services within the time so  prescribed, up to the amount of payment not made to the provider.On and after July 1, 2012, the Department shall reduce any rate of reimbursement for services or other payments or alter any methodologies authorized by this Code to reduce any rate of reimbursement for services or other payments in accordance with Section 5-5e. (Source: P.A. 99-143, eff. 7-27-15.)
305 ILCS 5/5-5.18
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-5.18.     Diagnosis accompanying request for reimbursement.     Every  request submitted by a physician for reimbursement under this Article for  services provided to a recipient of aid under this Article shall include the  physician's diagnosis of the recipient's illness or other condition requiring  those services.  The diagnosis shall be either written out or expressed in a  code approved by the Illinois Department.    (Source: P.A. 88-554, eff. 7-26-94.)
305 ILCS 5/5-5.19
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-5.19.     Reimbursement request records.     The Illinois Department shall  file all requests for reimbursement for medical services provided under this  Article  according to both (i) the name of the service provider and (ii) the name of the  recipient of aid under this Article to whom the medical services were  provided.    (Source: P.A. 88-554, eff. 7-26-94.)
305 ILCS 5/5-5.20
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-5.20. Clinic payments. For services provided by federally  qualified health centers as defined in Section 1905 (l)(2)(B) of the federal  Social Security Act, on or after April 1, 1989, and as long as required by  federal law, the Illinois Department shall  reimburse those health centers for those services according to a prospective  cost-reimbursement methodology.On and after July 1, 2012, the Department shall reduce any rate of reimbursement for services or other payments or alter any methodologies authorized by this Code to reduce any rate of reimbursement for services or other payments in accordance with Section 5-5e. (Source: P.A. 97-689, eff. 6-14-12.)
305 ILCS 5/5-5.21
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-5.21. (Repealed).        (Source: P.A. 89-415, eff. 1-1-96. Repealed by P.A. 96-1530, eff. 2-16-11.)
305 ILCS 5/5-5.22
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-5.22. (Repealed).        (Source: P.A. 92-725, eff. 7-25-02. Repealed by P.A. 94-838, eff. 6-6-06.)
305 ILCS 5/5-5.24
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-5.24.  Prenatal and perinatal care. The Department of  Healthcare and Family Services may provide reimbursement under this Article for all prenatal and  perinatal health care services that are provided for the purpose of preventing  low-birthweight infants, reducing the need for neonatal intensive care hospital  services, and promoting perinatal and maternal health.  These services may include  comprehensive risk assessments for pregnant individuals, individuals with infants, and  infants, lactation counseling, nutrition counseling, childbirth support,  psychosocial counseling, treatment and prevention of periodontal disease, language translation, nurse home visitation, and  other support  services  that have been proven to improve birth and maternal health outcomes.  The Department  shall  maximize the use of preventive prenatal and perinatal health care services  consistent with  federal statutes, rules, and regulations.  The Department of Public Aid (now Department of Healthcare and Family Services)  shall develop a plan for prenatal and perinatal preventive  health care and  shall present the plan to the General Assembly by January 1, 2004.  On or before January 1, 2006 and  every 2 years  thereafter, the Department shall report to the General Assembly concerning the  effectiveness of prenatal and perinatal health care services reimbursed under  this Section  in preventing low-birthweight infants and reducing the need for neonatal  intensive care  hospital services.  Each such report shall include an evaluation of how the  ratio of  expenditures for treating  low-birthweight infants compared with the investment in promoting healthy  births and  infants in local community areas throughout Illinois relates to healthy infant  development  in those areas.On and after July 1, 2012, the Department shall reduce any rate of reimbursement for services or other payments or alter any methodologies authorized by this Code to reduce any rate of reimbursement for services or other payments in accordance with Section 5-5e. (Source: P.A. 102-665, eff. 10-8-21.)
305 ILCS 5/5-5.25
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-5.25. Access to behavioral health, medical, and epilepsy treatment services.(a) The General Assembly finds that providing access to behavioral health, medical, and epilepsy treatment services in a timely manner will improve the quality of life for persons suffering from illness and will contain health care costs by avoiding the need for more costly inpatient hospitalization.(b) The Department of Healthcare and Family Services shall reimburse psychiatrists, federally qualified health centers as defined in  Section 1905(l)(2)(B) of the federal Social Security Act, clinical psychologists, clinical social workers, advanced practice registered nurses certified in psychiatric and mental health nursing, and mental health professionals and clinicians authorized by Illinois law to provide behavioral health services to recipients via telehealth. The Department shall reimburse epilepsy specialists, as defined by the Department by rule, who are authorized by Illinois law to provide epilepsy treatment services to persons with epilepsy or related disorders via telehealth. The Department, by rule, shall establish: (i) criteria for such services to be reimbursed, including appropriate facilities and equipment to be used at both sites and requirements for a physician or other licensed health care professional to be present at the site where the patient is located; however, the Department shall not require that a physician or other licensed health care professional be physically present in the same room as the patient for the entire time during which the patient is receiving telehealth services; (ii) a method to reimburse providers for mental health services provided by telehealth; and (iii) a method to reimburse providers for epilepsy treatment services provided by telehealth.(c) The Department shall reimburse any Medicaid certified eligible facility or provider organization that acts as the location of the patient at the time a telehealth service is rendered, including substance abuse centers licensed by the Department of Human Services' Division of Alcoholism and Substance Abuse.(d) On and after July 1, 2012, the Department shall reduce any rate of reimbursement for services or other payments or alter any methodologies authorized by this Code to reduce any rate of reimbursement for services or other payments in accordance with Section 5-5e. (Source: P.A. 101-81, eff. 7-12-19; 102-207, eff. 7-30-21.)
305 ILCS 5/5-5.26
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-5.26. Multiple sclerosis; home services; waiver. The Department of Healthcare and Family Services shall apply for a waiver of federal law and regulations to the extent necessary to claim federal financial participation for medical assistance for services provided under the Department of Human Services' Home Services Program for persons with multiple sclerosis who are (i) over 60 years of age, and (ii) have assets not exceeding $17,500. In determining whether a person's assets meet this requirement, the Department must disregard retirement assets up to a total of $500,000 and disregard all life insurance assets.  (Source: P.A. 95-744, eff. 7-18-08.)
305 ILCS 5/5-5a
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

 (from Ch. 23, par. 5-5a)Sec. 5-5a. Waiver for home and community-based services. The Department  shall apply for a waiver from the United States Health Care Financing  Administration to allow payment for home and community-based services under  this Article.The Department, in cooperation with the Department on Aging, the Department  of Human Services and any other relevant State, local or  federal  government agency, may establish a nursing home pre-screening program to  determine whether the applicant, eligible for medical assistance under this  Article, may use home and community-based services as a reasonable,  lower-cost alternative form of care.  For the purpose of this Section,  "home and community-based services" may include, but are not limited to,  those services provided under subsection (f) of Section 3 of the Rehabilitation of Persons with Disabilities Act and Section 4 of the Illinois Act on the Aging.  (Source: P.A. 99-143, eff. 7-27-15.)
305 ILCS 5/5-5b
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

 (from Ch. 23, par. 5-5b)Sec. 5-5b.     Payment Reductions.(a) Notwithstanding any other Section in this Code establishing a  methodology for determining payment rates or dispensing fees for  non-institutional services provided under this Code, the Illinois  Department is authorized to reduce those payment rates or dispensing fees  with due regard for and subject to budgetary limitations to the extent  permitted by federal law.(b) The Illinois Department may implement this Section as added by  this amendatory Act of 1991 through the use of emergency rules in  accordance with the provisions of Section 5.02 of the Illinois  Administrative Procedure Act. For purposes of the Illinois Administrative  Procedure Act, the adoption of rules to implement this Section as added by  this amendatory Act of 1991 shall be deemed an emergency  and necessary for the public interest, safety and welfare.    (Source: P.A. 87-14.)
305 ILCS 5/5-5b.1
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-5b.1. Reimbursement rates; Fiscal Year 2015 reductions.(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.   (Source: P.A. 99-2, eff. 3-26-15.)
305 ILCS 5/5-5c
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec.  5-5c.         Waiver for home and community-based services for traumatic  brain injury (TBI) patients.  The Department shall apply for a waiver from the  United States Health Care Financing Administration to allow payment for home  and community-based services under this Article for traumatic brain injury  patients.The Department shall submit a Home and Community-Based  Services TBI  Waiver request to the United States Health Care Financing  Administration by January 1, 1998.  The waiver shall be requested pursuant to  Section  1915(c) of the Social Security Act.  The Department shall request a waiver of  Section 1902(a)(10)(B) of the Social Security Act in order to target home and  community-based services to individuals with a traumatic brain injury meeting  the Medicaid eligibility criteria set forth in appendices to the Prototype  Waiver request.Under the waiver, the  Department,  in  cooperation  with  the  Department of Human Services and any other relevant State, local, or federal  government agency, may establish a nursing facility pre-screening program to  determine whether an applicant who is eligible for medical assistance under  this Article and has a traumatic brain injury may use home and community-based  services as a reasonable, lower-cost alternative form of care.  If a waiver  request has not been submitted by  January 1,  1998 the Department shall submit the TBI Prototype Waiver request to the  United States Health Care Financing Administration.    (Source: P.A. 90-335, eff. 8-8-97.)
305 ILCS 5/5-5d
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-5d. Enhanced transition and follow-up services. The Department of Healthcare and Family Services shall apply for any necessary waivers pursuant to Section 1915(c) of the Social Security Act to facilitate the transition from one residential setting to another and follow-up services. Nothing in this Section shall be construed as limiting current similar programs by the Department of Human Services or the Department on Aging.       (Source: P.A. 95-331, eff. 8-21-07.)
305 ILCS 5/5-5e.1
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-5e.1. Safety-Net Hospitals.(a) A Safety-Net Hospital is an Illinois hospital that:(1) is licensed by the Department of Public Health as     a general acute care or pediatric hospital; and(2) is a disproportionate share hospital, as     described in Section 1923 of the federal Social Security Act, as determined by the Department; and(3) meets one of the following:(A) has a MIUR of at least 40% and a charity         percent of at least 4%; or(B) has a MIUR of at least 50%.(b) Definitions. As used in this Section:(1) "Charity percent" means the ratio of (i) the     hospital's charity charges for services provided to individuals without health insurance or another source of third party coverage to (ii) the Illinois total hospital charges, each as reported on the hospital's OBRA form.(2) "MIUR" means Medicaid Inpatient Utilization Rate     and is defined as a fraction, the numerator of which is the number of a hospital's inpatient days provided in the hospital's fiscal year ending 3 years prior to the rate year, to patients who, for such days, were eligible for Medicaid under Title XIX of the federal Social Security Act, 42 USC 1396a et seq., excluding those persons eligible for medical assistance pursuant to 42 U.S.C. 1396a(a)(10)(A)(i)(VIII) as set forth in paragraph 18 of Section 5-2 of this Article,  and the denominator of which is the total number of the hospital's inpatient days in that same period, excluding those persons eligible for medical assistance pursuant to 42 U.S.C. 1396a(a)(10)(A)(i)(VIII) as set forth in paragraph 18 of Section 5-2 of this Article.(3) "OBRA form" means form HFS-3834, OBRA '93 data     collection form, for the rate year.(4) "Rate year" means the 12-month period beginning     on October 1.(c) Beginning July 1, 2012 and ending on December 31, 2022, a hospital that would have qualified for the rate year beginning October 1, 2011 or October 1, 2012 shall be a Safety-Net Hospital.(d) No later than August 15 preceding the rate year, each hospital shall submit the OBRA form to the Department. Prior to October 1, the Department shall notify each hospital whether it has qualified as a Safety-Net Hospital.(e) The Department may promulgate rules in order to implement this Section.(f)         Nothing in this Section shall be construed as limiting the ability of the Department to include the Safety-Net Hospitals in the hospital rate reform mandated by Section 14-11 of this Code and implemented under Section 14-12 of this Code and by administrative rulemaking. (Source: P.A. 100-581, eff. 3-12-18; 101-650, eff. 7-7-20; 101-669, eff. 4-2-21.)
305 ILCS 5/5-5g
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-5g. Long-term care patient; resident status. Long-term care providers shall submit all changes in resident status, including, but not limited to, death, discharge, changes in patient credit, third party liability, and Medicare coverage, to the Department through the Medical Electronic Data Interchange System, the Recipient Eligibility Verification System, or  the Electronic Data Interchange System established under 89 Ill. Adm. Code  140.55(b) in compliance with the schedule below:(1) 15 calendar days after a resident's death;(2) 15 calendar days after a resident's discharge;(3) 45 calendar days after being informed of a change     in the resident's income;(4) 45 calendar days after being informed of a change     in a resident's third party liability;(5) 45 calendar days after a resident's move to     exceptional care services; and(6) 45 calendar days after a resident's need for     services requiring reimbursement under the ventilator or traumatic brain injury enhanced rate.  (Source: P.A. 100-665, eff. 8-2-18.)
305 ILCS 5/5-5h
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-5h. Long-term acute care hospital base rates.(a) The base per diem rate paid to long-term acute care hospitals for Medicaid services on and after January 1, 2020 must be $60 more than the base rate in effect on June 30, 2019.(b) Nothing in this Section shall change the rates authorized under Section 5A-12.6 or the Long-Term Acute Care Hospital Quality Improvement Transfer Program Act.  (Source: P.A. 101-10, eff. 6-5-19.)