Bill
HB 2858
Illinois HB 2858 raises Medicaid nursing facility payments by updating the support component base for inflation (CPI-U) from Sept 2016 to Sept 2025, effective 1/1/2026.
Status and sponsors
- Primary sponsor: Rep. Robert “Bob” Rita. Numerous co-sponsors listed (including Ryan Spain, Jay Hoffman, Kevin Schmidt, Marcus Evans Jr., Kam Buckner, Elizabeth “Lisa” Hernandez, and others).
- Introduced: February 6, 2025 (House). Reported out of committee and passed the Illinois House on February 26, 2025; transmitted to the Senate. (Legislative history includes committee hearings, calendar placement, and multiple co‑sponsor additions through spring 2025.)
- Bill amends Section 5-5.2 of the Illinois Public Aid Code (Medical Assistance Article). Effective dates: the statutory change is effective immediately, but the specified reimbursement change is set to begin January 1, 2026, subject to federal approval.
Purpose / intent
- To adjust Medicaid reimbursement for the “support component” of nursing facility rates (for facilities licensed under the Nursing Home Care Act as skilled or intermediate care facilities and for facilities licensed under the Specialized Mental Health Rehabilitation Act of 2013) by updating the rate base to reflect inflation between September 2016 and September 2025.
Key provisions
- Reimbursement change formula: Beginning January 1, 2026 (subject to federal approval), the support component reimbursement rate for covered nursing facilities shall equal the rate in effect on June 30, 2024, increased by the percent change in the Consumer Price Index for All Urban Consumers (CPI‑U) from September 2016 to September 2025.
- The bill contains/edits statutory language concerning the nursing services reimbursement methodology and Patient Driven Payment Model (PDPM)‑based implementation, including references to:
- Transition/implementation timing for PDPM-based reimbursement,
- Annual rebasing and quarterly case‑mix index updates,
- Regional wage adjustors and minimum adjustor floors,
- Use of federal staffing data (Payroll Based Journal / Provider Information File) to calculate per‑diem staffing add‑ons,
- Phased adjustments to staffing calculations and specified per‑diem staffing add‑on amounts for facilities meeting staffing thresholds (text includes phased percentages and example per‑diem amounts up to $25.77).
(Note: the bill text as released is extensive and partially truncated in the source; the core, clear change in the synopsis is the CPI‑based increase to the support component beginning 1/1/2026.)
Who is affected
- Directly affected: Medicaid‑participating nursing facilities licensed under the Nursing Home Care Act and facilities licensed under the Specialized Mental Health Rehabilitation Act (i.e., providers of skilled and intermediate long‑term care).
- Indirectly affected: Illinois Medicaid program finances and beneficiaries in nursing facilities (through provider payment levels and potential effects on access/quality).
Implementation & fiscal notes
- The increase is formulaic (based on CPI‑U) rather than a fixed dollar appropriation; the fiscal impact depends on the computed CPI change and the number of Medicaid resident days subject to the support component.
- Changes take effect January 1, 2026 only if federal (CMS) approval is obtained for the reimbursement changes; the statute is declared effective immediately.
- The bill also references operational and technical PDPM implementation details (rebasing, staffing add‑ons, data sources) that will affect how rates are calculated and distributed.
Other
- The source file contained unrelated text from an Arizona appropriation bill for a Glendale road project; that text is not part of Illinois HB 2858 and is unrelated to the nursing facility reimbursement provisions.
Compiled from official sources — confirm details with the bill’s official record.
Sign in to ask a question.
