Proposed Changes In Methods And Standards

The Department of Healthcare and Family Services (HFS) proposes to change the methods and standards by which certain services are reimbursed under the Illinois Medical Assistance Program, pursuant to implementation of the Illinois' State fiscal year 2010 budget. These changes are contingent upon approval by the federal government.

Effective for dates of service on or after October 1, 2009, the Illinois Title XIX State plan and relevant waiver documents may be amended to reimburse for long term care services provided by a nursing facility (NF) or a supportive living facility (SLF) owned or operated by an Illinois county or local government at allowable costs incurred in providing the service. Costs shall be certified from the signed annual cost report submitted to the department by the provider. The provider facility will receive an interim payment from the department according to administrative rules applicable to that class of facility. The interim payment for an NF will be made pursuant to 89 Ill. Admin. Code 140.530; that for a supportive living facility will be made pursuant to 89 Ill. Admin. Code 146.225. The county or local government that owns or operates an NF or SLF may receive additional funds pursuant to an intergovernmental agreement with the department.

This change in reimbursement methodology will produce no increase in public expenditures but will increase such expenditures that are matchable under Title XIX of the Social Security Act by an estimated $15 million.

Any interested party may submit comments, data, views, or arguments concerning these proposed changes. All comments must be in writing and should be addressed to:

Bureau of Program and Reimbursement Analysis

Division of Medical Programs

Healthcare and Family Services

201 South Grand Avenue East

Springfield, Illinois 62763-0002

E-mail address: HFS.bpra@Illinois.gov

Interested persons may review these proposed changes on the HFS Public Notices. Local access to the Internet is available through any local public library. In addition, this material may be viewed at the DHS local offices (except in Cook County). In Cook County, the changes may be reviewed at the Office of the Director, Healthcare and Family Services, 100 West Randolph Street, Chicago, Illinois. The changes may be reviewed at all offices Monday through Friday from 8:30 a.m. until 5 p.m. This notice is being provided in accordance with federal requirements found at 42 CFR 447.205.