Bill
SB 2407
Illinois nursing facility Medicaid adopts a PDPM-based reimbursement, with quarterly estimated CNA payments (overtime, benefits) and a phased PDPM staffing add-on.
Note up front: the bill metadata you supplied (title about pharmacist reimbursement and a “Died In Committee” status) conflicts with the bill text included. The text of SB 2407 here amends Section 5-5.2 of the Illinois Public Aid Code and deals principally with nursing facility Medicaid reimbursement (PDPM adoption, staffing add-ons, and certified nursing assistant compensation), not pharmacist provider status. The legislative-action timeline in your file also contains conflicting entries (including readings, passage, and an effective date). Recommend verifying the official bill record on the Illinois General Assembly website. The summary below describes the substance of the provided bill text.
Purpose and intent
- Convert Illinois nursing-facility Medicaid reimbursement to a Patient Driven Payment Model (PDPM)-based methodology and clarify how Medicaid pays nursing facilities for certified nursing assistant (CNA) compensation (tenure increments, overtime, benefits, agency hours).
- Establish quarterly estimated payments to facilities for CNA compensation and require end-of-quarter reconciliation.
- Define staffing add-on methodology tied to federal Payroll-Based Journal/provider staffing data and transition rules for implementation.
Key provisions and changes
- PDPM adoption: directs that the new PDPM-based nursing services reimbursement take effect when fully operationalized; specifies July 1, 2022 as the target implementation date if CMS approves corresponding changes and Department rules are filed by June 1, 2022 (otherwise delayed to Oct 1, 2022).
- Payment methodology: replaces prior rulemaking requirement for tenure wage increment payments with a requirement that the Department pay each facility, at the beginning of each quarter, Medicaid’s share of the facility’s estimated CNA hours (employee and agency workers), estimated overtime, and estimated benefits and taxes. Payments must be reconciled at quarter end.
- Tenure compensation schedule: requires calculations that include (i) regular CNA hours; (ii) overtime at time-and-a-half; and (iii) benefits and taxes calculated at 25%. Promotions that qualify are to be paid on an estimated quarterly basis and reconciled later.
- Staffing add-on (PDPM STRIVE): establishes a facility-specific staffing percentage based on the facility’s Reported Total Nurse Staffing Hours Per Resident Per Day divided by a PDPM STRIVE Staffing Target (derived from Illinois-adjusted case-mix hours and national staffing means). Provides phased rules for the denominator used in staffing calculations for quarters from Oct 1, 2024 through mid-2025. (Text is truncated in provided document; full bill may include further implementation detail.)
Who is affected
- Nursing facilities (Medicaid-enrolled) — payment calculations, cash flow (quarterly estimates), reporting expectations.
- Certified nursing assistants (CNAs) — wage/increment, overtime, benefits and promotion compensation mechanisms.
- Staffing agencies providing CNA hours — included in estimated hours paid and reconciled later.
- Illinois Department of Healthcare and Family Services (administration and rulemaking).
- Medicaid long-term care residents (indirectly) and state Medicaid budget (funding distribution and reconciliation).
Procedural/timeline aspects
- The bill text ties PDPM effective dates to CMS approval and Department rule filings (June 1, 2022 target; fallback Oct 1, 2022).
- Staffing add-on transition begins Oct 1, 2024 with phased denominator adjustments through July 1, 2025.
- Quarterly estimated payment and reconciliation cadence for CNA compensation is required.
- The provided document is truncated and contains internal cross-references; consult the final enrolled bill or official legislative record for complete timelines and statutory text.
Recommendation
- Because of inconsistencies in the provided metadata (title and status) and the truncated text, verify SB 2407 against the official Illinois General Assembly bill page or the enrolled act to confirm final language, current status, and effective dates.
Compiled from official sources — confirm details with the bill’s official record.
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