2023 Illinois Compiled Statutes › Chapter 305 - PUBLIC AID › 305 ILCS 5/ - Illinois Public Aid Code. › Article V-B - Long-Term Care Provider Funding

(305 ILCS 5/Art. V-B heading)
ARTICLE V-B.  
		
		LONG-TERM CARE PROVIDER FUNDING
(305 ILCS 5/5B-1) (from Ch. 23, par. 5B-1)
Sec. 5B-1. Definitions. As used in this Article, unless the
context requires otherwise:
"Fund" means the Long-Term Care Provider Fund.
"Long-term care facility" means (i) a nursing facility, whether
public or private and whether organized for profit or
not-for-profit, that is subject to licensure by the Illinois Department
of Public Health under the Nursing Home Care Act, the ID/DD Community Care Act, or the MC/DD Act, including a
county nursing home directed and maintained under Section
5-1005 of the Counties Code, and (ii) a part of a hospital in
which skilled or intermediate long-term care services within the
meaning of Title XVIII or XIX of the Social Security Act are
provided; except that the term "long-term care facility" does
not include a facility operated by a State agency or operated solely as an intermediate care
facility for the mentally retarded within the meaning of Title
XIX of the Social Security Act.
"Long-term care provider" means (i) a person licensed
by the Department of Public Health to operate and maintain a
skilled nursing or intermediate long-term care facility or (ii) a hospital provider that
provides skilled or intermediate long-term care services within
the meaning of Title XVIII or XIX of the Social Security Act.
For purposes of this paragraph, "person" means any political
subdivision of the State, municipal corporation, individual,
firm, partnership, corporation, company, limited liability
company, association, joint stock association, or trust, or a
receiver, executor, trustee, guardian, or other representative
appointed by order of any court. "Hospital provider" means a
person licensed by the Department of Public Health to conduct,
operate, or maintain a hospital.
"Occupied bed days" shall be computed separately for
each long-term care facility operated or maintained by a long-term
care provider, and means the sum for all beds of the number
of days during the month on which each bed was occupied by a
resident, other than a resident for whom Medicare Part A is the primary payer. For a resident whose care is covered by the Medicare Medicaid Alignment initiative demonstration, Medicare Part A is considered the primary payer.
(Source: P.A. 98-651, eff. 6-16-14; 99-180, eff. 7-29-15.)
(305 ILCS 5/5B-2) (from Ch. 23, par. 5B-2)
Sec. 5B-2. Assessment; no local authorization to tax.
(a) For the privilege of engaging in the occupation of long-term care
provider, beginning July 1, 2011 through June 30, 2022, or upon federal approval by the Centers for Medicare and Medicaid Services of the long-term care provider assessment described in subsection (a-1), whichever is later, an assessment is imposed upon each long-term care provider in an amount equal to $6.07 times the number of occupied bed days due and payable each month. Notwithstanding any provision of any other Act to the
contrary, this assessment shall be construed as a tax, but shall not be billed or passed on to any resident of a nursing home operated by the nursing home provider.
(a-1) For the  privilege of engaging in the occupation of long-term care  provider for each occupied non-Medicare bed day, beginning  July 1, 2022, an assessment is imposed upon each long-term care provider in an amount varying with the number of paid Medicaid resident days per annum in the facility with the following schedule of occupied bed tax amounts. This assessment is due and payable each month. The tax shall follow the schedule below and be rebased by the Department on an annual basis. The Department shall publish each facility's rebased tax rate according to the schedule in this Section 30 days prior to the beginning of the 6-month period beginning July 1, 2022 and thereafter 30 days prior to the beginning of each calendar year which shall incorporate the number of paid Medicaid days used to determine each facility's rebased tax rate.
(1) 0-5,000 paid Medicaid resident days per annum,     $10.67.
(2) 5,001-15,000 paid Medicaid resident days per     annum, $19.20.
(3) 15,001-35,000 paid Medicaid resident days per     annum, $22.40.
(4) 35,001-55,000 paid Medicaid resident days per     annum, $19.20.
(5) 55,001-65,000 paid Medicaid resident days per     annum, $13.86.
(6) 65,001+ paid Medicaid resident days per annum,     $10.67.
(7)  Any non-profit nursing facilities without     Medicaid-certified beds or any nursing facility owned and operated by a county government, $7 per occupied bed day. The changes made by this amendatory Act of the 102nd General Assembly to this paragraph (7) shall be implemented only upon federal approval.
Notwithstanding any provision of any other Act to the contrary, this assessment shall be construed as a tax but shall not be billed or passed on to any resident of a nursing home operated by the nursing home provider.
For each new calendar year and for the 6-month period beginning July 1, 2022, a facility's paid Medicaid resident days per annum shall be determined using the Department's Medicaid Management Information System to include Medicaid resident days for the year ending 9 months earlier.
(b) Nothing in this amendatory Act of 1992 shall be construed to
authorize any home rule unit or other unit of local government to license
for revenue or impose a tax or assessment upon long-term care providers or
the occupation of long-term care provider, or a tax or assessment measured
by the income or earnings or occupied bed days of a long-term care provider.
(c) The assessment imposed by this Section shall not be due and payable, however, until after the Department notifies the long-term care providers, in writing, that the payment methodologies to long-term care providers required under Section 5-5.2 of this Code have been approved by the Centers for Medicare and Medicaid Services of the U.S. Department of Health and Human Services and that the waivers under 42 CFR 433.68 for the assessment imposed by this Section, if necessary, have been granted by the Centers for Medicare and Medicaid Services of the U.S. Department of Health and Human Services.
(Source: P.A. 102-1035, eff. 5-31-22; 102-1118, eff. 1-18-23.)
(305 ILCS 5/5B-3) (from Ch. 23, par. 5B-3)
Sec. 5B-3. 
		Exemptions. 
		A long-term care provider which is a
county with a population of more than 3 million that makes
intergovernmental transfer payments as provided in Section 15-3 of
this Code shall be exempt from the assessment imposed by Section
5B-2 unless the exemption is adjudged to
be unconstitutional or otherwise invalid, in which case the
county shall pay the assessment imposed by Section 5B-2 for all
assessment periods beginning on or after July 1, 1992,
and the assessment so paid shall be creditable against the
intergovernmental transfer payments.
(Source: P.A. 87-861.)
(305 ILCS 5/5B-4) (from Ch. 23, par. 5B-4)
Sec. 5B-4. Payment of assessment; penalty.
(a) The assessment imposed by Section 5B-2 shall be due and payable monthly, on the last State business day of the month for occupied bed days reported for the preceding third month prior to the month in which the tax is payable and due. A facility that has delayed payment due to the State's failure to reimburse for services rendered may request an extension on the due date for payment pursuant to subsection (b) and shall pay the assessment within 30 days of reimbursement by the Department.
The Illinois Department may provide that county nursing homes directed and
maintained pursuant to Section 5-1005 of the Counties Code may meet their
assessment obligation by certifying to the Illinois Department that county
expenditures have been obligated for the operation of the county nursing
home in an amount at least equal to the amount of the assessment.
(a-5) The Illinois Department shall provide for an electronic submission process for each long-term care facility to report at a minimum the number of occupied bed days of the long-term care facility for the reporting period and other reasonable information the Illinois Department requires for the administration of its responsibilities under this Code. Beginning July 1, 2013, a separate electronic submission shall be completed for each long-term care facility in this State operated by a long-term care provider. The Illinois Department shall provide a self-reporting notice of the assessment form that the long-term care facility completes for the required period and submits with its assessment payment to the Illinois Department. To the extent practicable, the Department shall coordinate the assessment reporting requirements with other reporting required of long-term care facilities.
(b) The Illinois Department is authorized to establish
delayed payment schedules for long-term care providers that are
unable to make assessment payments when due under this Section
due to financial difficulties, as determined by the Illinois
Department. The Illinois Department may not deny a request for delay of payment of the assessment imposed under this Article if the long-term care provider has not been paid by the State or the Medicaid managed care organization for services provided during the month on which the assessment is levied.
(c) If a long-term care provider fails to pay the full
amount of an assessment payment when due (including any extensions
granted under subsection (b)), there shall, unless waived by the
Illinois Department for reasonable cause, be added to the
assessment imposed by Section 5B-2 a
penalty assessment equal to the lesser of (i) 5% of the amount of
the assessment payment not paid on or before the due date plus 5% of the
portion thereof remaining unpaid on the last day of each month
thereafter or (ii) 100% of the assessment payment amount not paid on or
before the due date.  For purposes of this subsection, payments
will be credited first to unpaid assessment payment amounts (rather than
to penalty or interest), beginning with the most delinquent assessment payments. Payment cycles of longer than 60 days shall be one factor the Director takes into account in granting a waiver under this Section.
(c-5) If a long-term care facility fails to file its assessment bill with payment, there shall, unless waived by the Illinois Department for reasonable cause, be added to the assessment due a penalty assessment equal to 25% of the assessment due. After July 1, 2013, no penalty shall be assessed under this Section if the Illinois Department does not provide a process for the electronic submission of the information required by subsection (a-5).
(d) Nothing in this amendatory Act of 1993 shall be construed to prevent
the Illinois Department from collecting all amounts due under this Article
pursuant to an assessment imposed before the effective date of this amendatory
Act of 1993.
(e) Nothing in this amendatory Act of the 96th General Assembly shall be construed to prevent
the Illinois Department from collecting all amounts due under this Code
pursuant to an assessment, tax, fee, or penalty imposed before the effective date of this amendatory
Act of the 96th General Assembly.
(f) No installment of the  assessment imposed by Section 5B-2 shall be due and payable until after the Department notifies the long-term care providers, in writing, that the payment methodologies to long-term care providers required under Section 5-5.2 of this Code have been approved by the Centers for Medicare and Medicaid Services of the U.S. Department of Health and Human Services and the waivers under 42 CFR 433.68 for the assessment imposed by this Section, if necessary, have been granted by the Centers for Medicare and Medicaid Services of the U.S. Department of Health and Human Services. Upon notification to the Department of approval of the payment methodologies required under Section 5-5.2 of this Code and the waivers granted under 42 CFR 433.68, all installments otherwise due under Section 5B-4 prior to the date of notification shall be due and payable to the Department upon written direction from the Department within 90 days after issuance by the Comptroller of the payments required under Section 5-5.2 of this Code.
(Source: P.A. 101-649, eff. 7-7-20; 102-1035, eff. 5-31-22.)
(305 ILCS 5/5B-5) (from Ch. 23, par. 5B-5)
Sec. 5B-5. Annual reporting; penalty; maintenance of records.
(a)  After December 31 of each year, and on or before
March 31 of the succeeding year, every long-term care provider subject to
assessment under this Article shall file a report with the Illinois
Department.  The report shall be in a form and manner prescribed by the Illinois Department and shall state the revenue received by the long-term care provider, reported in such categories as may be required by the Illinois Department, and other reasonable information the Illinois Department requires for the administration of its responsibilities under this Code.
(b) If a long-term care provider operates or maintains
more than one long-term care facility in this State, the provider
may not file a single return covering all those long-term care
facilities, but shall file a separate return for each
long-term care facility and shall compute and pay the assessment
for each long-term care facility separately.
(c) Notwithstanding any other provision in this Article, in
the case of a person who ceases to operate or maintain a long-term
care facility in respect of which the person is subject to
assessment under this Article as a long-term care provider, the person shall file a final, amended return with the Illinois
Department not more than 90 days after the cessation reflecting
the adjustment and shall pay with the final return the
assessment for the year as so adjusted (to the extent not
previously paid). If a person fails to file a final amended return on a timely basis, there shall, unless waived by the Illinois Department for reasonable cause, be added to the assessment due a penalty assessment equal to 25% of the assessment due.
(d) Notwithstanding any other provision of this Article, a
provider who commences operating or maintaining a long-term care
facility that was under a prior ownership and remained licensed by the Department of Public Health shall notify the Illinois Department of any change in ownership regardless of percentage, and shall be responsible to immediately pay any prior amounts owed by the facility. In addition, beginning January 1, 2023, all providers operating or maintaining a long-term care facility shall notify the Illinois Department of all individual owners and any individuals or organizations that are part of a limited liability company with ownership of that facility and the percentage ownership of each owner. This ownership reporting requirement does not include individual shareholders in a publicly held corporation. Submission of the information as part of the Department's cost reporting requirements shall satisfy this requirement.
(e) The Department shall develop a procedure for sharing with a potential buyer of a facility information regarding outstanding assessments and penalties owed by that facility.
(f) In the case of a long-term care provider existing as a
corporation or legal entity other than an individual, the return
filed by it shall be signed by its president, vice-president,
secretary, or treasurer or by its properly authorized agent.
(g) If a long-term care provider fails to file its return
 on or before the due date of the return,
there shall, unless waived by the Illinois Department for
reasonable cause, be added to the assessment imposed by Section
5B-2 a penalty assessment equal to 25%
of the assessment imposed for the year. After July 1, 2013, no penalty shall be assessed if the Illinois Department has not established a process for the electronic submission of information.
(h) Every long-term care provider subject to assessment
under this Article shall keep records and books that will
permit the determination of occupied bed days on a calendar year
basis.  All such books and records shall be kept in the English
language and shall, at all times during business hours of the
day, be subject to inspection by the Illinois Department or its
duly authorized agents and employees.
(i) The Illinois Department shall establish a process for long-term care providers to electronically submit all information required by this Section no later than July 1, 2013.
(Source: P.A. 102-1035, eff. 5-31-22.)
(305 ILCS 5/5B-6) (from Ch. 23, par. 5B-6)
Sec. 5B-6. 
		Disposition of proceeds. 
		The Illinois Department
shall pay all moneys received from long-term care providers under
this Article into the Long-Term Care Provider Fund.  Upon certification by
the Illinois Department to the State Comptroller of its intent to withhold
from a provider under Section 5B-7(b), the State Comptroller shall draw a
warrant on the treasury or other fund held by the State Treasurer, as
appropriate.  The warrant shall state the amount for which the provider is
entitled to a warrant, the amount of the deduction, and the reason therefor
and shall direct the State Treasurer to pay the balance to the provider,
all in accordance with Section 10.05 of the State Comptroller Act. The
warrant also shall direct the State Treasurer to transfer the amount of the
deduction so ordered from the treasury or other fund into the Long-Term
Care Provider Fund.
(Source: P.A. 87-861.)
(305 ILCS 5/5B-7) (from Ch. 23, par. 5B-7)
Sec. 5B-7. 
		Administration; enforcement provisions.
(a) To the extent practicable, the Illinois Department shall administer
and enforce this Article and collect the assessments, interest, and penalty
assessments imposed under this Article, using procedures employed in its
administration of this Code generally and, as it deems
appropriate, in a manner similar to that in which the Department
of Revenue administers and collects the retailers' occupation tax
under the Retailers' Occupation Tax Act ("ROTA").   Instead
of certificates of registration, the Illinois Department shall
establish and maintain a listing of all long-term care providers
appearing in the licensing records of the Department of Public
Health, which shall show each provider's name, principal place of business,
and the name and address of each long-term care facility operated or
maintained by the provider in this State.  In addition, the following
provisions of the Retailers' Occupation Tax Act are incorporated by
reference into this Section, except that the Illinois Department
and its Director (rather than the Department of Revenue and its Director)
and every long-term care provider subject to assessment measured by
occupied bed days and to the return filing requirements of this Article
(rather than persons subject to retailers' occupation tax measured by gross
receipts from the sale of tangible personal property at retail and to the
return filing requirements of ROTA) shall have the powers, duties, and
rights specified in these ROTA provisions, as modified in this Section or
by the Illinois Department in a manner consistent with this Article and
except as manifestly inconsistent with the other provisions of this Article:
(1) ROTA, Section 4 (examination of return; notice of     correction; evidence; limitations; protest and hearing), except that (i) the Illinois Department shall issue notices of assessment liability (rather than notices of tax liability as provided in ROTA, Section 4); (ii) in the case of a fraudulent return or in the case of an extended period agreed to by the Illinois Department and the long-term care provider before the expiration of the limitation period, no notice of assessment liability shall be issued more than 3 years after the later of the due date of the return required by Section 5B-5 or the date the return (or an amended return) was filed (rather within the period stated in ROTA, Section 4); and (iii) the penalty provisions of ROTA, Section 4 shall not apply.
(2) ROTA, Section 5 (failure to make return; failure     to pay assessment), except that the penalty and interest provisions of ROTA, Section 5 shall not apply.
(3) ROTA, Section 5a (lien; attachment; termination;     notice; protest; review; release of lien; status of lien).
(4) ROTA, Section 5b (State lien notices; State lien     index; duties of recorder and registrar of titles).
(5) ROTA, Section 5c (liens; certificate of release).
(6) ROTA, Section 5d (Department not required to     furnish bond; claim to property attached or levied upon).
(7) ROTA, Section 5e (foreclosure on liens;     enforcement).
(8) ROTA, Section 5f (demand for payment; levy and     sale of property; limitation).
(9) ROTA, Section 5g (sale of property; redemption).
(10) ROTA, Section 5j (sales on transfers outside     usual course of business; report; payment of assessment; rights and duties of purchaser; penalty).
(11) ROTA, Section 6 (erroneous payments; credit or     refund), provided that (i) the Illinois Department may only apply an amount otherwise subject to credit or refund to a liability arising under this Article; (ii) except in the case of an extended period agreed to by the Illinois Department and the long term care provider prior to the expiration of this limitation period, a claim for credit or refund must be filed no more than 3 years after the due date of the return required by Section 5B-5 (rather than the time limitation stated in ROTA, Section 6); and (iii) credits or refunds shall not bear interest.
(12) ROTA, Section 6a (claims for credit or refund).
(13) ROTA, Section 6b (tentative determination of     claim; notice; hearing; review), provided that a long-term care provider or its representative shall have 60 days (rather than 20 days) within which to file a protest and request for hearing in response to a tentative determination of claim.
(14) ROTA, Section 6c (finality of tentative     determinations).
(15) ROTA, Section 8  (investigations and hearings).
(16) ROTA, Section 9 (witness; immunity).
(17) ROTA, Section 10 (issuance of subpoenas;     attendance of witnesses; production of books and records).
(18) ROTA, Section 11 (information confidential;     exceptions).
(19) ROTA, Section 12 (rules and regulations;     hearing; appeals), except that a long-term care provider shall not be required to file a bond or be subject to a lien in lieu thereof in order to seek court review under the Administrative Review Law of a final assessment or revised final assessment or the equivalent thereof issued by the Illinois Department under this Article.
(b) In addition to any other remedy provided for and without sending a
notice of assessment liability, the Illinois Department may collect an
unpaid assessment by withholding, as payment of the assessment,
reimbursements or other amounts otherwise payable by the Illinois
Department to the provider.
(Source: P.A. 87-861.)
(305 ILCS 5/5B-8) (from Ch. 23, par. 5B-8)
Sec. 5B-8. Long-Term Care Provider Fund.
(a) There is created in the State Treasury the Long-Term
Care Provider Fund.  Interest earned by the Fund shall be
credited to the Fund.  The Fund shall not be used to replace any
moneys appropriated to the Medicaid program by the General Assembly.
(b) The Fund is created for the purpose of receiving and
disbursing moneys in accordance with this Article. Disbursements
from the Fund shall be made only as follows:
(1) For payments to nursing facilities, including     county nursing facilities but excluding State-operated facilities, under Title XIX of the Social Security Act and Article V of this Code.
(1.5) For payments to managed care organizations as     defined in Section 5-30.1 of this Code.
(2) For the reimbursement of moneys collected by the     Illinois Department through error or mistake.
(3) For payment of administrative expenses incurred     by the Illinois Department or its agent in performing the activities authorized by this Article.
(3.5) For reimbursement of expenses incurred by     long-term care facilities, and payment of administrative expenses incurred by the Department of Public Health, in relation to the conduct and analysis of background checks for identified offenders under the Nursing Home Care Act.
(4) For payments of any amounts that are reimbursable     to the federal government for payments from this Fund that are required to be paid by State warrant.
(5) For making transfers to the General Obligation     Bond Retirement and Interest Fund, as those transfers are authorized in the proceedings authorizing debt under the Short Term Borrowing Act, but transfers made under this paragraph (5) shall not exceed the principal amount of debt issued in anticipation of the receipt by the State of moneys to be deposited into the Fund.
(6) For making transfers, at the direction of the     Director of the Governor's Office of Management and Budget during each fiscal year beginning on or after July 1, 2011, to other State funds in an annual amount of $20,000,000 of the tax collected pursuant to this Article for the purpose of enforcement of nursing home standards, support of the ombudsman program, and efforts to expand home and community-based services. No transfer under this paragraph shall occur until (i) the payment methodologies created by Public Act 96-1530 under Section 5-5.4 of this Code have been approved by the Centers for Medicare and Medicaid Services of the U.S. Department of Health and Human Services and (ii) the assessment imposed by Section 5B-2 of this Code is determined to be a permissible tax under Title XIX of the Social Security Act.
Disbursements from the Fund, other than transfers made pursuant to paragraphs (5) and (6) of this subsection, shall be by
warrants drawn by the State Comptroller upon receipt of vouchers
duly executed and certified by the Illinois Department.
(c) The Fund shall consist of the following:
(1) All moneys collected or received by the Illinois     Department from the long-term care provider assessment imposed by this Article.
(2) All federal matching funds received by the     Illinois Department as a result of expenditures made from the Fund.
(3) Any interest or penalty levied in conjunction     with the administration of this Article.
(4) (Blank).
(5) All other monies received for the Fund from any     other source, including interest earned thereon.
(Source: P.A. 102-1035, eff. 5-31-22.)
(305 ILCS 5/5B-9) (from Ch. 23, par. 5B-9)
Sec. 5B-9. 
		Applicability. 
		The assessment imposed by Section 5B-2
shall cease to be imposed if the amount of matching federal funds
under Title XIX of the Social Security Act is eliminated or significantly
reduced on account of the assessment.  Assessments imposed prior
thereto shall be disbursed in accordance with Section 5B-8 to the
extent federal matching is not reduced by the assessments, and
any remaining assessments shall be refunded to long-term care
providers in proportion to the amounts of the assessments paid by
them.
(Source: P.A. 87-861.)
(305 ILCS 5/5B-10) (from Ch. 23, par. 5B-10)
Sec. 5B-10. 
		Severability. 
		If any clause, sentence, Section,
exemption, provision, or part of this Article or the application
thereof to any person or circumstance shall be adjudged to be
unconstitutional or otherwise invalid, the remainder of this
Article or its application to persons or circumstances other than
those to which it is held invalid shall not be affected thereby.
This Article V-B is intended to be separate from and independent
of Articles V-A and V-C, and the application and validity of
this Article V-B shall not be affected by the invalidity of one or
more of Articles V-A and V-C.
(Source: P.A. 87-861.)