All Roll Calls
Yes: 467 • No: 85
IllinoisHB2771104th General Assembly (2025–2026)HouseWALLET
DPH-CERTIFICATE FEES
Sponsored By: Camille Y. Lilly (Democratic)
Became Law
state government administrationassignmentsexecutive
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Bill Overview
Analyzed Economic Effects
12 provisions identified: 7 benefits, 1 costs, 4 mixed.
2025 and later payment floors
Starting in 2025, the state sets annual minimums for directed payments by class and service, such as $579.26 million for inpatient safety‑net services and $763.42 million for outpatient safety‑net services. It also sets base per‑unit rates for some classes. These floors apply each year after 2025, once federally approved, and current rates stay in place until approval.
Extra fee-for-service hospital payments
Hospitals get extra fee‑for‑service payments tied to inpatient days and outpatient claims. For July 1, 2020–December 31, 2022, per‑day and per‑claim amounts apply by class, such as safety‑net and critical access hospitals. Starting January 1, 2023, updated per‑day and per‑claim rates apply and are paid monthly. The state may adjust rates to meet federal limits, while keeping total spending by class substantially similar.
Graduate medical education hospital payments
The state pays hospitals for graduate medical education using Medicare cost report data and a cap tied to 120% of the statewide per‑intern average. The payment factor is 22.6% for July 1, 2020–December 31, 2022. From January 1, 2023–December 31, 2026, it is 35% for safety‑net hospitals or those with 100+ FTE residents, and 30% for other qualified hospitals.
Guaranteed 2023 minimums by hospital class
For 2023, the state guarantees minimum total payments for each hospital class. Examples include about $858.26 million for safety‑net hospitals and $86.2 million for critical access hospitals. Other classes like high Medicaid and general acute care also have set floors. The Department sets rates and amounts to meet these floors.
One-time pandemic recovery payments
The state pays a one‑time $460 million pool to hospitals before April 1, 2023. The amounts are based on 2022 directed payments and hospital class. Safety‑net and critical access hospitals get extra consideration.
Directed hospital payments through managed care
The state makes large directed payments to hospitals through MCOs and sets fixed pool and per‑unit rates. MCOs must pay within 7 business days or face a 5% penalty plus 5% more for each 30 days late. The Department may reassign hospital classes and use emergency rules to keep payments compliant. Some pass‑throughs are reduced in 2021–2022 and may be further reduced from January 1, 2024 to meet federal rules. Payments for services on and after July 1, 2020 require federal approval and a permissible tax.
Hospital assessment rates and cuts
Illinois charges hospitals an assessment. For 2009–2018 it is $218.38 per inpatient day (excluding Medicare days). For 2019–2020 it is $197.19 per inpatient day. Outpatient assessments equal 0.008766 of outpatient revenue for 2012–2018 and 0.01358 for 2019–2020. The Department can lower rates by rule, and it cuts total assessments by $240 million by June 30, 2022.
Hospital Provider Fund and transfers
Illinois keeps hospital assessments and related federal match in a Hospital Provider Fund. The Fund pays hospitals, refunds errors, covers admin costs, and makes allowed transfers. Examples: $20 million to the Medicaid Trust Fund and $30 million to the Long‑Term Care Provider Fund in certain years. Transfers to a Provider Relief Fund are set at $325 million (FY2019–2020), $365 million (FY2023–2024/2026), and $505.6 million per year starting 2025 (remaining $365 million until new rates are fully in place).
When assessments stop and law ends
Assessments stop if payments lose federal Medicaid or CHIP matching, or if payment rates fall below set baselines for certain years. When payments stop, remaining fund money is refunded to hospitals based on what they paid. The hospital assessment and payment sections repeal on December 31, 2026.
Help for birthing and rural hospitals
The state sets at least $50 million a year (subject to appropriation) for safety‑net hospitals with perinatal designations to support OB/GYN and specialty care. It also provides at least $10 million a year to critical access hospitals for perinatal, behavioral health, specialty services, and telehealth. The Department sets the distribution rules.
How Illinois collects hospital assessments
The Department calculates assessment adjustments using the prior six months and must give at least 30 days’ notice. Unpaid assessments become a lien on hospital assets, and buyers of hospital property can be liable up to the property’s value. The state can withhold reimbursements, including MCO payments, to collect. Hospitals must enter a repayment plan within 30 days; plans can last up to 36 months (tax deferrals up to six months). Starting September 1, 2025, the state immediately collects any overdue amounts unless a plan is already in place.
Funding for the poison center
The state pays the human poison control center minimum amounts each year if funding is available and the center operates. Examples: $3 million per year for FY2017–FY2020, $3.75 million for FY2021–FY2023, $4 million for FY2024–FY2026 (with $4.5 million in FY2025), and $4.75 million for FY2026 and after. For July 1–December 31, 2026, the minimum is $2 million.
Sponsors & Cosponsors
Sponsor
Camille Y. Lilly
Democratic • House
Cosponsors
Chapin Rose
Republican • Senate
Meg Loughran Cappel
Democratic • Senate
Napoleon Harris, III
Democratic • Senate
Omar Aquino
Democratic • Senate
Roll Call Votes
House vote • 6/1/2025
Motion Prevailed to Suspend Rule
Yes: 74 • No: 38
House vote • 6/1/2025
Senate Committee Amendment No. 1 House Concurs
Yes: 111 • No: 0
House vote • 6/1/2025
Senate Floor Amendment No. 2 House Concurs
Yes: 111 • No: 0
Senate vote • 5/31/2025
Third Reading - Passed;
Yes: 57 • No: 0
House vote • 5/31/2025
Senate Committee Amendment No. 1 Motion to Concur Recommends Be Adopted Rules Committee;
Yes: 5 • No: 0
House vote • 5/31/2025
Senate Floor Amendment No. 2 Motion to Concur Recommends Be Adopted Rules Committee;
Yes: 5 • No: 0
Senate vote • 5/29/2025
Senate Floor Amendment No. 2 Recommend Do Adopt Executive;
Yes: 13 • No: 0
Senate vote • 5/15/2025
Do Pass as Amended Executive;
Yes: 9 • No: 4
House vote • 4/9/2025
Third Reading - Short Debate - Passed
Yes: 76 • No: 40
House vote • 3/19/2025
Do Pass / Short Debate State Government Administration Committee;
Yes: 6 • No: 3
Actions Timeline
Public Act . . . . . . . . . 104-0007
6/16/2025HouseEffective Date June 16, 2025
6/16/2025HouseGovernor Approved
6/16/2025HouseSent to the Governor
6/11/2025HouseAdded as Alternate Co-Sponsor Sen. Meg Loughran Cappel
6/4/2025SenatePassed Both Houses
6/1/2025HouseHouse Concurs
6/1/2025HouseSenate Floor Amendment No. 2 House Concurs 111-000-000
6/1/2025HouseSenate Committee Amendment No. 1 House Concurs 111-000-000
6/1/2025HouseChair Rules placed on Standard debate
6/1/2025HouseMotion Prevailed to Suspend Rule 074-038-000
6/1/2025HouseMotion Filed to Suspend House Rule(s) for Immediate Consideration Rep. Bob Morgan; 15d
6/1/2025HouseSenate Floor Amendment No. 2 Motion to Concur Recommends Be Adopted Rules Committee; 005-000-000
5/31/2025HouseSenate Committee Amendment No. 1 Motion to Concur Recommends Be Adopted Rules Committee; 005-000-000
5/31/2025HouseSenate Floor Amendment No. 2 Motion to Concur Referred to Rules Committee
5/31/2025HouseSenate Committee Amendment No. 1 Motion to Concur Referred to Rules Committee
5/31/2025HouseSenate Floor Amendment No. 2 Motion Filed Concur Rep. Camille Y. Lilly
5/31/2025HouseSenate Committee Amendment No. 1 Motion Filed Concur Rep. Camille Y. Lilly
5/31/2025HouseAdded as Alternate Co-Sponsor Sen. Chapin Rose
5/31/2025SenatePlaced on Calendar Order of Concurrence Senate Amendment(s) 1, 2
5/31/2025HouseArrived in House
5/31/2025HouseThird Reading - Passed; 057-000-000
5/31/2025SenatePlaced on Calendar Order of 3rd Reading
5/31/2025SenateSenate Floor Amendment No. 2 Adopted; Aquino
5/31/2025SenateRecalled to Second Reading
5/31/2025Senate
Bill Text
Engrossed
Enrolled
Introduced
Senate Amendment 1
Senate Amendment 2