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SB 1509

MEDICAID ACCESS ADJUSTMENT

104th Regular Session Introduced by Sara Feigenholtz

Raises Medicaid Access Adjustment to $5.75 per day for eligible nursing facility resident days beginning 7/1/2025, boosting payments and access to care.

Rule 3-9(a) / Re-referred to Assignments
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Bill Summary · SB 1509

Summary — SB 1509: Medicaid Access Adjustment

Status: Introduced (Illinois) — Amends Illinois Public Aid Code (305 ILCS 5/5‑5.2)
Primary sponsor (introduced): Sen. Sara Feigenholtz
Introduced: Early February 2025
Title shown in docket: MEDICAID ACCESS ADJUSTMENT

Main purpose

The bill increases the Medicaid Access Adjustment payment that Medicaid pays to nursing facilities. The change is intended to raise the per‑diem add‑on that helps support access to long‑term care services for Medicaid beneficiaries in nursing homes.

Key provision(s)

  • For dates of service beginning July 1, 2025, the Medicaid Access Adjustment is increased to $5.75 per day.
  • The bill is written as an amendment to Section 5‑5.2 of the Illinois Public Aid Code (305 ILCS 5/5‑5.2).
  • The synopsis states the change is “effective immediately” (i.e., upon enactment the statutory language is changed, but the increased payment applies to services beginning July 1, 2025).

Who is affected

  • Primary recipients: Medicaid‑participating nursing facilities / long‑term care providers in Illinois — they will receive the higher per‑diem Medicaid Access Adjustment for eligible Medicaid resident days beginning 7/1/2025.
  • Payers: Illinois Medicaid (the Department of Healthcare and Family Services) — the change will increase state Medicaid program expenditures (and any corresponding federal matching payments).
  • Indirectly affected: Medicaid beneficiaries in nursing facilities (potentially improved facility resources) and state budget planners.

Procedural / timeline notes

  • The stated effective window: payment increase applies to dates of service beginning July 1, 2025.
  • The bill amends existing reimbursement law (305 ILCS 5/5‑5.2) and the summary indicates immediate statutory effect upon enactment.
  • The text package provided includes additional, more detailed reimbursement provisions (relating to PDPM transition, staffing add‑ons, and case‑mix rules) in the longer draft; interested readers should consult the full engrossed bill as filed to confirm whether other reimbursement methodology changes are included in the final text.

Potential impact

  • Short term: direct increase in Medicaid payments to nursing facilities equal to $5.75 per eligible Medicaid resident day starting 7/1/2025.
  • Budget impact: higher state Medicaid spending (offset partially by federal Medicaid matching funds); the fiscal magnitude depends on the number of Medicaid resident days statewide.
  • Policy impact: may help nursing facilities cover costs and preserve access to care for Medicaid residents; interacts with broader nursing reimbursement rules (see note above).

Note: The document package provided contains text from other unrelated measures and versions (including material from other states and unrelated Arizona provisions). This summary focuses on the Illinois Medicaid Access Adjustment change described in the bill materials. For enactment status and exact fiscal estimates, consult the official bill text and fiscal notes from the Illinois General Assembly or the Department of Healthcare and Family Services.

Compiled from official sources — confirm details with the bill’s official record.

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