DHFS-BEHAVIORAL HLTH SAFTY-NET

Illinois General Assembly - Full Text of HB4846

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB4846

Introduced , by Rep. Lindsey LaPointe

SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-5e.1

Amends the Medical Assistance Article of the Illinois Public Aid
Code. Provides that a safety-net hospital includes a behavioral health
safety-net provider that: (i) is licensed or certified by the Department
of Human Services, or otherwise authorized under State law, to provide
behavioral health or substance use disorder treatment services; (ii) meets
specified federal requirements for being designated a disproportionate
share hospital, as defined by the Department of Healthcare and Family
Services; (iii) accepts admissions 24 hours a day, 7 days a week, with no
blackout periods; (iv) accepts patients who only need mental health or
substance use disorder treatment; and (v) has a MIUR of at least 40% and a
charity percent of at least 4%, or a MIUR of at least 50%.
LRB104 19791 KTG 33241 b

A BILL FOR

HB4846
LRB104 19791 KTG 33241 b
1

AN ACT concerning public aid.

2

Be it enacted by the People of the State of Illinois,
3
represented in the General Assembly:

4

Section 5.
The Illinois Public Aid Code is amended by
5
changing Section 5-5e.1 as follows:

6

(305 ILCS 5/5-5e.1)
7

Sec. 5-5e.1.
Safety-Net Hospitals.
8

(a) A Safety-Net Hospital is an Illinois hospital that:
9

(1) is licensed by the Department of Public Health as
10

a general acute care or pediatric hospital; and
11

(2) is a disproportionate share hospital, as described
12

in Section 1923 of the federal Social Security Act, as
13

determined by the Department; and
14

(3) meets one of the following:
15

(A) has a MIUR of at least 40% and a charity
16

percent of at least 4%; or
17

(B) has a MIUR of at least 50%.
18

(a-5) "Safety-Net Hospital" includes a behavioral health
19
safety-net provider. A behavioral health safety-net provider
20
is a provider that:
21

(1) is licensed or certified by the Department of
22

Human Services, or otherwise authorized under State law,
23

to provide behavioral health or substance use disorder

HB4846
- 2 -
LRB104 19791 KTG 33241 b
1

treatment services;
2

(2) meets the requirements of subsection (b) of
3

Section 1923 of the federal Social Security Act for being
4

designated a disproportionate share hospital, as defined
5

by the Department of Healthcare and Family Services;
6

(3) accepts admissions 24 hours a day, 7 days a week,
7

with no blackout periods;
8

(4) accepts patients who only need mental health or
9

substance use disorder treatment, and do not need
10

hospitalization or medical assistance for any other
11

reason; and
12

(5) meets one of the following:
13

(A) has a MIUR of at least 40% and a charity
14

percent of at least 4%; or
15

(B) has a MIUR of at least 50%.
16

(b) Definitions. As used in this Section:
17

(1) "Charity percent" means the ratio of (i) the
18

hospital's charity charges for services provided to
19

individuals without health insurance or another source of
20

third party coverage to (ii) the Illinois total hospital
21

charges, each as reported on the hospital's OBRA form.
22

(2) "MIUR" means Medicaid Inpatient Utilization Rate
23

and is defined as a fraction, the numerator of which is the
24

number of a hospital's inpatient days provided in the
25

hospital's fiscal year ending 3 years prior to the rate
26

year, to patients who, for such days, were eligible for

HB4846
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LRB104 19791 KTG 33241 b
1

Medicaid under Title XIX of the federal Social Security
2

Act, 42 USC 1396a et seq., excluding those persons
3

eligible for medical assistance pursuant to 42 U.S.C.
4

1396a(a)(10)(A)(i)(VIII) as set forth in paragraph 18 of
5

Section 5-2 of this Article, and the denominator of which
6

is the total number of the hospital's inpatient days in
7

that same period, excluding those persons eligible for
8

medical assistance pursuant to 42 U.S.C.
9

1396a(a)(10)(A)(i)(VIII) as set forth in paragraph 18 of
10

Section 5-2 of this Article.
11

(3) "OBRA form" means form HFS-3834, OBRA '93 data
12

collection form, for the rate year.
13

(4) "Rate year" means the 12-month period beginning on
14

October 1.
15

(c) Beginning July 1, 2012 and ending on December 31,
16
2026, a hospital that would have qualified for the rate year
17
beginning October 1, 2011 or October 1, 2012 shall be a
18
Safety-Net Hospital.
19

(c-5) Beginning July 1, 2020 and ending on December 31,
20
2026, a hospital that would have qualified for the rate year
21
beginning October 1, 2020 and was designated a federal rural
22
referral center under 42 CFR 412.96 as of October 1, 2020 shall
23
be a Safety-Net Hospital.
24

(d) No later than August 15 preceding the rate year, each
25
hospital shall submit the OBRA form to the Department. Prior
26
to October 1, the Department shall notify each hospital

HB4846
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LRB104 19791 KTG 33241 b
1
whether it has qualified as a Safety-Net Hospital.
2

(e) The Department may promulgate rules in order to
3
implement this Section.
4

(f) Nothing in this Section shall be construed as limiting
5
the ability of the Department to include the Safety-Net
6
Hospitals in the hospital rate reform mandated by Section
7
14-11 of this Code and implemented under Section 14-12 of this
8
Code and by administrative rulemaking.
9
(Source: P.A. 101-650, eff. 7-7-20; 101-669, eff. 4-2-21;
10
102-886, eff. 5-17-22.)

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