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HB 3432

Revising the statutes to clarify and separate duties identified in the code between the Division of Emergency Management and the West Virginia Department of Environmental Protection

2025 Regular Session Introduced by David Kelly

HB 3432 clarifies Safety-Net Hospital criteria and grants temporary grandfathering to preserve Medicaid-related payments for targeted Illinois hospitals through specified end dates.

On 2nd reading, House Calendar
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Bill Summary · HB 3432

Summary — HB 3432 (104th General Assembly, 2025-2026)

Note on bill title: The bill packet provided lists a title about "redemption of beverage containers at wineries," but the bill text and synopsis amend the Illinois Public Aid Code (305 ILCS 5/5-5e.1) concerning the definition and temporary designation of Safety‑Net Hospitals. This summary covers the actual text of the bill as introduced.

Main purpose

HB 3432 amends Section 5-5e.1 of the Illinois Public Aid Code to (1) clarify the statutory definition and qualifying criteria for a "Safety‑Net Hospital" and (2) provide temporary/extended grandfathered designations so certain hospitals that would have qualified in prior rate years are treated as Safety‑Net Hospitals for specified time periods. The change is intended to preserve Medicaid-related safety‑net status (and attendant rate treatment) for targeted hospitals through specified end dates.

Key provisions and changes

  • Defines a Safety‑Net Hospital as an Illinois hospital that:
    • Is licensed by the Department of Public Health as a general acute care or pediatric hospital;
    • Is a disproportionate share hospital as described in federal Social Security Act §1923 (as determined by the Department); and
    • Meets either:
    • MIUR (Medicaid Inpatient Utilization Rate) ≥ 40% and charity percent ≥ 4%; or
    • MIUR ≥ 50%.
  • Clarifies definitions:
    • “MIUR” — Medicaid Inpatient Utilization Rate calculated using inpatient days in the hospital fiscal year ending 3 years prior to the rate year (numerator: inpatient days for Medicaid-eligible patients as specified in federal/state law; denominator: total inpatient days excluding certain categories).
    • “Charity percent” — ratio of charity services provided to the hospital’s Illinois total hospital charges as reported on OBRA form HFS-3834.
    • “Rate year” — 12-month period beginning October 1.
  • Temporary/transition provisions (grandfathering):
    • Provides that, beginning on the bill’s effective date and ending December 31, 2025, a hospital that would have qualified for the rate year beginning October 1, 2024 shall be a Safety‑Net Hospital (per the synopsis).
    • The bill text also references hospitals that would have qualified for rate years beginning October 1, 2011 or October 1, 2012 being treated as Safety‑Net Hospitals through specified end dates.
    • A separate clause (c-5) provides that hospitals that would have qualified for the rate year beginning October 1, 2020 and were designated federal rural referral centers under 42 CFR 412.96 as of October 1, 2020 shall be Safety‑Net Hospitals from July 1, 2020 through December 31, 2026.
  • Administrative procedures:
    • Hospitals must submit OBRA form HFS-3834 to the Department no later than August 15 preceding the rate year.
    • The Department may promulgate rules to implement the Section.
  • Relationship to other law: The Section states it does not limit the Department’s ability to include Safety‑Net Hospitals in hospital rate reform mandated under Sections 14-11 and 14-12 of the Code.
  • Effective date: The Act takes effect upon becoming law (immediate effect).

Who is affected

  • Illinois hospitals that meet (or would have met) MIUR and charity-percent thresholds and disproportionate share criteria — especially those that would have qualified in the specified prior rate years (Oct 2011, Oct 2012, Oct 2020, Oct 2024) and certain federal rural referral centers. Designation as a Safety‑Net Hospital affects Medicaid-related payment treatment and participation in rate reforms administered by the Department of Healthcare and Family Services (HFS).

Procedural status and timeline

  • Introduced: Rep. Anthony DeLuca (filed Feb 7, 2025; first reading Feb 18, 2025).
  • Committee referrals include Rules, Appropriations–Health & Human Services, Elections, and others.
  • Latest recorded status: In committee upon adjournment (June 28, 2025).
  • If enacted, the Act is effective immediately upon becoming law; specific grandfathering provisions expire on the dates noted (Dec 31, 2025 and/or Dec 31, 2026 as specified).

Potential impacts

  • Maintains or extends Safety‑Net Hospital designation for targeted hospitals, which could preserve higher Medicaid reimbursements or eligibility for special payments meant to support hospitals serving high shares of Medicaid and uninsured patients.
  • Administrative impacts on HFS (rulemaking, OBRA data processing) and on hospitals that must submit required OBRA forms and document eligibility.

If you want, I can: (1) extract the specific statutory language changes line‑by‑line, (2) prepare a short fiscal/estimated budgetary impact outline, or (3) track subsequent committee activity and amendments.

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

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