§ 12-4.53 — Prospective Payment System (PPS) rates

Illinois § 12-4.53

• Jurisdiction: Illinois
• Topic: HUMAN NEEDS
• Ch. 305: PUBLIC AID
• Act 305 ILCS 5/: Illinois Public Aid Code.
• Art.: Article XII - Administration

Text

Effective January 1, 2021, and subsequent years, based on specific appropriation, the Prospective Payment System (PPS) rates for FQHCs shall be increased based on the cost principles found at 45 Code of Federal Regulations Part 75 or its successor. Such rates shall be increased by using any of the following methods: reducing the current minimum productivity and efficiency standards no lower than 3500 encounters per FTE physician; increasing the statewide median cost cap from 105% to 120%, a one-time re-basing of rates utilizing 2018 FQHC cost reports, or another alternative payment method acceptable to the Centers for Medicare and Medicaid Services and the FQHCs, including an across the board percentage increase to existing rates.

Legislative History

(Source: P.A. 101-636, eff. 6-10-20; 101-655, eff. 3-12-21.)