2023 Illinois Compiled Statutes › Chapter 305 - PUBLIC AID › 305 ILCS 5/ - Illinois Public Aid Code. › Article XV - County Provider Trust Fund

(305 ILCS 5/Art. XV heading)
ARTICLE XV.
COUNTY PROVIDER TRUST FUND
(Source: P.A. 103-154, eff. 6-30-23.)
(305 ILCS 5/15-1) (from Ch. 23, par. 15-1)
Sec. 15-1. Definitions. As used in this Article, unless the context
requires otherwise:
(a) (Blank).
(a-5) "County provider" means a health care provider that is, or is
operated by, a county with a population greater than 3,000,000.
(b) "Fund" means the County Provider Trust Fund.
(c) "Hospital" or "County hospital" means a hospital, as defined in Section
14-1 of this Code, which is a county hospital located in a county of over
3,000,000 population.
(Source: P.A. 97-687, eff. 6-14-12; 97-689, eff. 6-14-12.)
(305 ILCS 5/15-2) (from Ch. 23, par. 15-2)
Sec. 15-2. County Provider Trust Fund.
(a) There is created in the State Treasury the County Provider
Trust Fund.  Interest earned by the Fund shall be credited to the Fund.
The Fund shall not be used to replace any funds appropriated to the
Medicaid program by the General Assembly.
(b) The Fund is created solely for the purposes of receiving, investing,
and distributing monies in accordance with this Article XV.  The Fund shall
consist of:
(1) All monies collected or received by the Illinois     Department under Section 15-3 of this Code;
(2) All federal financial participation monies     received by the Illinois Department pursuant to Title XIX of the Social Security Act, 42 U.S.C. 1396b, attributable to eligible expenditures made by the Illinois Department pursuant to Section 15-5 of this Code;
(3) All federal moneys received by the Illinois     Department pursuant to Title XXI of the Social Security Act attributable to eligible expenditures made by the Illinois Department pursuant to Section 15-5 of this Code; and
(4) All other monies received by the Fund from any     source, including interest thereon.
(c) Disbursements from the Fund shall be by warrants drawn by the State
Comptroller upon receipt of vouchers duly executed and certified by the
Illinois Department and shall be made only:
(1) For hospital inpatient care, hospital outpatient     care, care provided by other outpatient facilities operated by a county, and disproportionate share hospital adjustment payments made under Title XIX of the Social Security Act and Article V of this Code as required by Section 15-5 of this Code;
(1.5) For services provided or purchased by county     providers pursuant to Section 5-11 of this Code;
(2) For the reimbursement of administrative expenses     incurred by county providers on behalf of the Illinois Department as permitted by Section 15-4 of this Code;
(3) For the reimbursement of monies received by the     Fund through error or mistake;
(4) For the payment of administrative expenses     necessarily incurred by the Illinois Department or its agent in performing the activities required by this Article XV;
(5) For the payment of any amounts that are     reimbursable to the federal government, attributable solely to the Fund, and required to be paid by State warrant;
(6) For hospital inpatient care, hospital outpatient     care, care provided by other outpatient facilities operated by a county, and disproportionate share hospital adjustment payments made under Title XXI of the Social Security Act, pursuant to Section 15-5 of this Code; and
(7) For medical care and related services provided     pursuant to a contract with a county. (Source: P.A. 97-687, eff. 6-14-12.)
(305 ILCS 5/15-3) (from Ch. 23, par. 15-3)
Sec. 15-3. Intergovernmental Transfers.
(a) Each qualifying county shall make an annual intergovernmental transfer
to the Illinois Department in an amount equal to the difference
between the total payments made by the Illinois Department pursuant to subsection (a) of Section 15-5 of this Code
and the total federal financial participation monies received by the fund in
each fiscal year ending June 30.
(b) The payment schedule for the intergovernmental transfer made
hereunder shall be established by intergovernmental agreement between the
Illinois Department and the applicable county, which agreement shall at
a minimum provide:
(1) For periodic payments no less frequently than     monthly to the county provider for inpatient and outpatient approved or adjudicated claims and for disproportionate share adjustment payments as may be specified in the Illinois Title XIX State plan.
(2) (Blank.)
(3) For calculation of the intergovernmental transfer     payment to be made by the county equal to the difference between the amount of the periodic payments to county providers and any amount of federal financial participation due the Illinois Department under Titles XIX and XXI of the Social Security Act as a result of such payments to county providers.
(4) For an intergovernmental transfer methodology     which obligates the Illinois Department to notify the county  in writing of each impending periodic payment and the intergovernmental transfer payment attributable thereto and which obligates the Comptroller to release the periodic payment to the county provider within one working day of receipt of the intergovernmental transfer payment from the county.
(Source: P.A. 95-859, eff. 8-19-08.)
(305 ILCS 5/15-4) (from Ch. 23, par. 15-4)
Sec. 15-4. 
		Contractual assumption of certain expenses. 
		Hospitals may,
at their election, by written agreement between the counties owning and
operating the hospitals and the Illinois Department, assume specified
expenses of the operation of the Illinois Department associated with the
determination of eligibility, direct payment of which expenses by the
Illinois Department would qualify as public funds expended by the Illinois
Department for the Illinois Medical Assistance Program or other health
care programs administered by the Illinois Department.  The Illinois
Department shall open an adequately staffed special on-site office or
offices at facilities designated by the county for the purpose of assisting
the county in ensuring that all eligible individuals are enrolled in the
Illinois Medical Assistance Program.  Each such agreement, executed in
accordance with Section 3 of the Intergovernmental Cooperation Act, shall
describe the operational expenses to be assumed in sufficient detail to
permit the Illinois Department to certify upon such written obligation or
performance thereunder that the hospital's compliance with the terms of the
agreement will amount to the commitment of public funds eligible for the
federal financial participation or other federal funding called for in
Title XIX or Title XXI of the Social Security Act.
(Source: P.A. 91-24, eff. 7-1-99; 92-370, eff. 8-15-01.)
(305 ILCS 5/15-5) (from Ch. 23, par. 15-5)
Sec. 15-5. Disbursements from the Fund.
(a) The monies in the Fund shall be disbursed only as provided in
Section 15-2 of this Code and as follows:
(1) To the extent that such costs are reimbursable     under federal law, to pay the county hospitals' inpatient reimbursement rates based on actual costs incurred, trended forward annually by an inflation index.
(2) To the extent that such costs are reimbursable     under federal law, to pay county hospitals and county operated outpatient facilities for outpatient services based on a federally approved methodology to cover the maximum allowable costs.
(3) To pay the county hospitals disproportionate     share hospital adjustment payments as may be specified in the Illinois Title XIX State plan.
(3.5) To pay county providers for services provided     or purchased pursuant to Section 5-11 of this Code.
(4) To reimburse the county providers for expenses     contractually assumed pursuant to Section 15-4 of this Code.
(5) To pay the Illinois Department its necessary     administrative expenses relative to the Fund and other amounts agreed to, if any, by the county providers in the agreement provided for in subsection (c).
(6) To pay the county providers any other amount due     according to a federally approved State plan, including but not limited to payments made under the provisions of Section 701(d)(3)(B) of the federal Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000. Intergovernmental transfers supporting payments under this paragraph (6) shall not be subject to the computation described in subsection (a) of Section 15-3 of this Code, but shall be computed as the difference between the total of such payments made by the Illinois Department to county providers less any amount of federal financial participation due the Illinois Department under Titles XIX and XXI of the Social Security Act as a result of such payments to county providers.
(b) The Illinois Department shall promptly seek all appropriate
amendments to the Illinois Title XIX State Plan to maximize reimbursement, including disproportionate share hospital adjustment payments, to the county providers.
(c) (Blank).
(d) The payments provided for herein are intended to cover services
rendered on and after July 1, 1991, and any agreement executed between a
qualifying county and the Illinois Department pursuant to this Section may
relate back to that date, provided the Illinois Department obtains federal
approval.  Any changes in payment rates resulting from the provisions of
Article 3 of this amendatory Act of 1992 are intended to apply to services
rendered on or after October 1, 1992, and any agreement executed between a
qualifying county and the Illinois Department pursuant to this Section may
be effective as of that date.
(e) If one or more hospitals file suit in any court challenging any part
of this Article XV, payments to hospitals from the Fund under this Article
XV shall be made only to the extent that sufficient monies are available in
the Fund and only to the extent that any monies in the Fund are not
prohibited from disbursement and may be disbursed under any order of the court.
(f) All payments under this Section are contingent upon federal
approval of changes to the Title XIX State plan, if that approval is required.
(Source: P.A. 97-687, eff. 6-14-12.)
(305 ILCS 5/15-6) (from Ch. 23, par. 15-6)
Sec. 15-6. 
		Annual audit.
(a) Within 120 days after the end of each fiscal year of each county
hospital, the Illinois Department shall conduct an annual audit of the Fund
to determine that amounts received from or paid to county providers were correct.
If such an audit identifies amounts that a county provider
should not have been
required to pay but did pay, a county provider should have
been required to pay
but did not pay, a county provider should not have received
but did receive, or a
county provider should have received but did not receive, the
Illinois Department
shall:
(1) Make required payments to any such county     provider, or
(2) Take action to recover required amounts from any     such county provider, including recoupment from future payments.
(b) Amounts recovered from a county provider shall be
credited to the Fund.  A
county provider is entitled to recover amounts paid to the
Illinois Department
into the Fund and to receive refunds and payment from the Illinois
Department for payments that should have been paid from the Fund only to
the extent that monies are available in the Fund.
(Source: P.A. 87-13; 88-554, eff. 7-26-94.)
(305 ILCS 5/15-7) (from Ch. 23, par. 15-7)
Sec. 15-7. 
		Applicability. 
		The requirements of this Article XV shall
apply only as long as federal funds under Title XIX of the Social Security
Act are available to match the intergovernmental transfer payments made and
disbursed under this Article and only as long as reimbursable expenditures
are matched by the federal government at a rate of at least 50%.  Whenever
the Illinois Department is informed that federal funds are not available
for these purposes, or shall be available at a lower percentage, this
Article XV shall no longer apply and the Illinois Department shall promptly
refund to each county provider the amount of money currently
in the Fund that has
been paid by the county provider, plus any investment earnings
on that amount.
(Source: P.A. 87-13; 87-861; 88-554, eff. 7-26-94.)
(305 ILCS 5/15-8) (from Ch. 23, par. 15-8)
Sec. 15-8. Federal disallowances. In the event of any federal deferral
or disallowance of any federal matching funds obtained through this Article
which have been disbursed by the Illinois Department under this Article
based upon challenges to reimbursement methodologies, the full faith and credit of the county is pledged for
repayment by the county of those amounts deferred or disallowed to the
Illinois Department.
(Source: P.A. 95-859, eff. 8-19-08.)
(305 ILCS 5/15-9) (from Ch. 23, par. 15-9)
Sec. 15-9. 
		Waiver of appropriation procedures. 
		Notwithstanding the
provisions of Sections 6-24001 and 6-24008 of the Counties Code, or any
comparable provision relating to appropriations, the board of commissioners
of qualifying counties may, during each fiscal year, adopt a supplemental
appropriation bill or resolution for expenditures by qualifying counties on
behalf of or by qualifying county hospitals of any funds received hereunder
and the payment of fees to be collected under this Article in an amount
not in excess of any such additional revenue available to that county, or
estimated to be received by that county, subsequent to the adoption of the
annual appropriation bill or resolution for that fiscal year. The
supplemental appropriation bill or resolution shall only affect revenue
that was not available for appropriation when the annual appropriation bill
or resolution was adopted, and the provisions of Section 6-24004 of the
Counties Code or any other comparable provision relating to publication,
notice, and public hearing shall not be applicable to such supplemental
appropriation bill or resolution or to the budget document forming the
basis thereof.
(Source: P.A. 87-13.)
(305 ILCS 5/15-10)
Sec. 15-10. Disproportionate share hospital adjustment payments.
(a) The provisions of this Section become operative if:
(1) The federal government approves State Plan     Amendment transmittal number 08-06 or a State Plan Amendment that permits disproportionate share hospital adjustment payments to be made to county hospitals.
(2) Proposed federal regulations, or other     regulations or limitations driven by the federal government, negatively impact the net revenues realized by county providers from the Fund during a State fiscal year by more than 15%, as measured by the aggregate average net monthly payment received by the county providers from the Fund from July 2007 through May 2008.
(3) The county providers have in good faith submitted     timely, complete, and accurate cost reports and supplemental documents as required by the Illinois Department.
(4) the county providers maintain and bill for     service volumes to individuals eligible for medical assistance under this Code that are no lower than 85% of the volumes provided by and billed to the Illinois Department by the county providers associated with payments received by the county providers from July 2007 through May 2008.  Given the substantial financial burdens of the county associated with uncompensated care, the Illinois Department shall make good faith efforts to work with the county to maintain Medicaid volumes to the extent that the county has the adequate capacity to meet the obligations of patient volumes.
The Illinois Department and the county shall include in an intergovernmental agreement the process by which these conditions are assessed.  The parties may, if necessary, contract with a large, nationally recognized public accounting firm to carry out this function.
(b) If the conditions of subsection (a) are met, and subject to appropriation or other available funding for such purpose, the Illinois Department shall make a payment or otherwise make funds available to the county hospitals, during the lapse period, that provides for total payments to be at least at a level that is equivalent to the total fee-for-service payments received by the county providers that are enrolled with the Illinois Department to provide services during the fiscal year of the payment from the Fund from July 2007 through May 2008 multiplied by twelve-elevenths.
(c) In addition, notwithstanding any provision in subsection (a), the Illinois Department shall maximize disproportionate share hospital adjustment payments to the county hospitals that, at a minimum, are 42% of the State's federal fiscal year 2007 disproportionate share allocation.
(d) For the purposes of this Section, "net revenues" means the difference between the total fee-for-service payments made by the Illinois Department to county providers less the intergovernmental transfer made by the county in support of those payments.
(e) If (i) the disproportionate share hospital adjustment State Plan Amendment referenced in subdivision (a)(1) is not approved, or (ii) any reconciliation of payments to costs incurred would require repayment to the federal government of at least $2,500,000, or (iii) there is no funding available for the Illinois Department's obligations under subsection (b), the Illinois Department, the county, and the leadership of the General Assembly shall designate individuals to convene, within 30 days, to discuss how mutual funding goals for the county providers are to be achieved.
(Source: P.A. 95-859, eff. 8-19-08.)
(305 ILCS 5/15-11)
Sec. 15-11. Uses of State funds.
(a) At any point, if State revenues referenced in subsection (b) or (c) of Section 15-10 or additional State grants are disbursed to the Cook County Health and Hospitals System, all funds may be used only for the following:
(1) medical services provided at hospitals or clinics     owned and operated by the Cook       County Health and Hospitals System;
(2) information technology to enhance billing     capabilities for medical claiming and reimbursement; or
(3) services purchased by county providers pursuant     to Section 5-11 of this Code.
(b) State funds may not be used for the following:
(1) non-clinical services, except services that may     be required by accreditation bodies or State or federal regulatory or licensing authorities;
(2) non-clinical support staff, except as pursuant to     paragraph (1) of this subsection; or
(3) capital improvements, other than investments in     medical technology, except for capital improvements that may be required by accreditation bodies or State or federal regulatory or licensing authorities.
(Source: P.A. 97-687, eff. 6-14-12.)