Bill
HB 3384
Requires Illinois HFS to provide a Medicaid add-on of at least $35 million per year to Safety-Net Hospitals that are Level 1 Trauma centers.
Status and sponsorship
- Bill: HB 3384 (Introduced February 18, 2025; filed Feb 26, 2025)
- Sponsors: Rep. Elizabeth “Lisa” Hernandez (primary), Rep. Allen (primary), Rep. Michael Crawford (co‑sponsor), Rep. Lisa Davis (co‑sponsor)
- Committee status (most recent): In committee upon adjournment (6/28/2025). Passed first reading and referred to multiple committees (Rules; Appropriations‑Health & Human Services; Public Education).
Purpose
- Amend Section 5‑5e.1 of the Illinois Public Aid Code to require the Department of Healthcare and Family Services (HFS or “the Department”) to create a Medicaid add‑on payment for hospitals designated both as Safety‑Net Hospitals and as Level 1 Trauma centers. The add‑on must be at least $35,000,000 per hospital per year.
Key provisions
- Definition of “Safety‑Net Hospital”: an Illinois hospital that
- is licensed as a general acute care or pediatric hospital, and
- is a disproportionate share hospital (per federal Social Security Act §1923), and
- meets either (A) a Medicaid Inpatient Utilization Rate (MIUR) ≥ 40% and a “charity percent” ≥ 4%, or (B) MIUR ≥ 50%.
- Definitions:
- “MIUR” uses inpatient days in the hospital fiscal year ending three years prior to the rate year: numerator = inpatient days to Medicaid‑eligible patients; denominator = total inpatient days in that period (excluding certain federal categories).
- “Charity percent” is the ratio of charity care (uninsured/indigent) charges to total Illinois hospital charges reported on the OBRA (HFS‑3834) form.
- “Rate year” = 12‑month period beginning October 1.
- Reporting and administration:
- Hospitals must submit the OBRA form to the Department no later than August 15 preceding the rate year.
- The Department must notify hospitals whether they qualify as Safety‑Net Hospitals prior to October 1 for the rate year and may promulgate rules to implement the Section.
- The statute includes temporary/transition provisions that previously specified qualification periods (e.g., July 1, 2012–Dec 31, 2026; special provision for certain rural referral centers for 2020–2026).
- New requirement (subsection g): HFS shall create an add‑on payment for Safety‑Net Hospitals that have a Level 1 Trauma designation, at a minimum amount of $35,000,000 per hospital, per year.
Who is affected
- Direct beneficiaries: Illinois hospitals that meet the Safety‑Net Hospital criteria and hold a Level 1 Trauma designation — these hospitals would receive the mandated Medicaid add‑on.
- Indirectly affected: HFS/State Medicaid program (budgetary/fiscal implications); Medicaid beneficiaries and uninsured patients could see effects via hospital capacity/financial stability and trauma care access.
Potential fiscal and policy impact
- The mandated floor ($35 million per hospital annually) represents a substantial per‑hospital payment; total state cost depends on how many hospitals qualify. The bill does not specify a funding source — implementation would affect HFS’s Medicaid expenditures and likely require appropriation or budget adjustments.
- Intended policy effect: bolster funding for high‑acuity, safety‑net Level 1 trauma hospitals to support trauma care capacity and hospitals serving large shares of Medicaid/uninsured patients.
Procedural notes / timeline
- Introduced Feb 18, 2025; multiple committee referrals and a public hearing were held. As of June 28, 2025, the bill remained in committee upon adjournment. If enacted, the reporting and rate‑year framework (OBRA filing by Aug 15; rate year starting Oct 1) would govern operational timing.
Compiled from official sources — confirm details with the bill’s official record.
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