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SB 3473

MEDICAID-SAFETY-NET HOSPITALS

104th Regular Session Introduced by Mike Simmons-Gessesse and 1 co-sponsor

Extends Safety-Net Hospital eligibility to preserve past rate-year qualifications through 2028 (and 2026 for rural centers), stabilizing Medicaid safety-net funding.

Rule 3-9(a) / Re-referred to Assignments
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Bill Summary · SB 3473

Summary of SB3473 (104th General Assembly, Illinois)

Overview

  • Bill title: MEDICAID-SAFETY-NET HOSPITALS
  • Intent: Extend eligibility criteria to designate more hospitals as Safety-Net Hospitals (SNHs) for Medicaid-related purposes, by preserving or broadening certain historic qualification periods. The change largely affects which Illinois hospitals can be recognized as SNHs for rate-setting and related program interventions.
  • Effective date: Immediate upon becoming law.

Purpose and intent

  • The bill amends the Medical Assistance Article of the Illinois Public Aid Code to extend the period during which a hospital would be considered a Safety-Net Hospital if it would have qualified for a specific past rate year (October 1, 2011 or October 1, 2012). The goal is to ensure that hospitals meeting legacy SNH criteria retain SNH status into the current and future rate years, improving stability in funding and eligibility for safety-net-related supports.

Key provisions and changes

Definition and eligibility of Safety-Net Hospitals

  • Defines a Safety-Net Hospital as:
    • Licensed by the Department of Public Health as a general acute care or pediatric hospital; and
    • A disproportionate share hospital (as described in Section 1923 of the federal Social Security Act) as determined by the Department; and
    • Meets one of:
    • MIUR (Medicaid Inpatient Utilization Rate) ≥ 40% and charity percent ≥ 4%, or
    • MIUR ≥ 50%.
  • Important terms:
    • Charity percent: Ratio of charity charges to total Illinois hospital charges (per OBRA form).
    • MIUR: Inpatient days billed to Medicaid (excluding certain categories) divided by total inpatient days (with specified exclusions).
    • OBRA form (HFS-3834): Data collection form used for the rate year.

Eligibility extension for past rate years

  • Primary extension (c): From July 1, 2012 through December 31, 2028, a hospital that would have qualified for the rate year beginning October 1, 2011 or October 1, 2012 shall be a Safety-Net Hospital. This effectively preserves SNH status for hospitals based on those past qualification periods.
  • Additional extension (c-5): From July 1, 2020 through December 31, 2026, a hospital that would have qualified for the rate year beginning October 1, 2020 and was designated a federal rural referral center under 42 CFR 412.96 as of October 1, 2020 shall be a Safety-Net Hospital.

Administrative and regulatory provisions

  • OBRA form submission: By August 15 preceding each rate year, each hospital must submit the OBRA form to the Department.
  • Department notices: Prior to October 1, the Department shall notify each hospital whether it has qualified as a Safety-Net Hospital.
  • Rulemaking authority: The Department may promulgate rules to implement the section.
  • Relationship to rate reforms: Nothing in this section limits the Department’s ability to include SNHs in hospital rate reform initiatives mandated elsewhere in the Public Aid Code (and implemented by administrative rulemaking).

Affected entities

  • Hospitals in Illinois: General acute care and pediatric hospitals that are disproportionate share hospitals and meet specified MIUR and charity-percent thresholds (or meet the broader historical criteria through the extended eligibility windows).
  • Department of Public Health (DPH) and the Illinois Department of Healthcare and Family Services (HFS): Responsible for designating SNH status, collecting OBRA forms, notifying hospitals, and implementing rule changes.

Procedural and timeline aspects

  • Data reporting deadline: OBRA form submission due by August 15 preceding each rate year.
  • Notification deadline: Department must notify hospitals of SNH qualification prior to October 1 of the rate year.
  • Rate year alignment: The eligibility windows reference rate years beginning October 1 of specific years (historical thresholds) and extend through specified end dates (December 31 of 2028 or 2026, depending on the provision).
  • Effective date: Immediate upon enactment.

Potential impact

  • Stability for hospitals: Extending SNH eligibility for past rate-year criteria may preserve or expand eligibility for Medicaid-related safety-net funding and related rate reforms.
  • Financial planning: Hospitals that qualify under the extended criteria could expect continued access to safety-net support, potentially affecting financial sustainability and uncompensated care offsets.
  • Administrative burden: Hospitals must continue timely OBRA reporting and anticipate Department notification cycles to confirm SNH status each rate year.

If you’d like, I can add a brief glossary of terms (MIUR, charity percent, OBRA form) or compare these provisions to current SNH criteria.

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

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