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1 | AN ACT concerning public aid.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Illinois Public Aid Code is amended by | ||||||||||||||||||||||||
5 | changing Section 5-2 as follows:
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6 | (305 ILCS 5/5-2) (from Ch. 23, par. 5-2)
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7 | Sec. 5-2. Classes of Persons Eligible. Medical assistance | ||||||||||||||||||||||||
8 | under this
Article shall be available to any of the following | ||||||||||||||||||||||||
9 | classes of persons in
respect to whom a plan for coverage has | ||||||||||||||||||||||||
10 | been submitted to the Governor
by the Illinois Department and | ||||||||||||||||||||||||
11 | approved by him:
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12 | 1. Recipients of basic maintenance grants under | ||||||||||||||||||||||||
13 | Articles III and IV.
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14 | 2. Persons otherwise eligible for basic maintenance | ||||||||||||||||||||||||
15 | under Articles
III and IV but who fail to qualify | ||||||||||||||||||||||||
16 | thereunder on the basis of need, and
who have insufficient | ||||||||||||||||||||||||
17 | income and resources to meet the costs of
necessary medical | ||||||||||||||||||||||||
18 | care, including but not limited to the following:
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19 | (a) All persons otherwise eligible for basic | ||||||||||||||||||||||||
20 | maintenance under Article
III but who fail to qualify | ||||||||||||||||||||||||
21 | under that Article on the basis of need and who
meet | ||||||||||||||||||||||||
22 | either of the following requirements:
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23 | (i) their income, as determined by the | ||||||||||||||||||||||||
24 | Illinois Department in
accordance with any federal | ||||||||||||||||||||||||
25 | requirements, is equal to or less than 70% in
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26 | fiscal year 2001, equal to or less than 85% in | ||||||||||||||||||||||||
27 | fiscal year 2002 and until
a date to be determined | ||||||||||||||||||||||||
28 | by the Department by rule, and equal to or less
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29 | than 100% beginning on the date determined by the | ||||||||||||||||||||||||
30 | Department by rule, of the nonfarm income official | ||||||||||||||||||||||||
31 | poverty
line, as defined by the federal Office of | ||||||||||||||||||||||||
32 | Management and Budget and revised
annually in |
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1 | accordance with Section 673(2) of the Omnibus | ||||||
2 | Budget Reconciliation
Act of 1981, applicable to | ||||||
3 | families of the same size; or
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4 | (ii) their income, after the deduction of | ||||||
5 | costs incurred for medical
care and for other types | ||||||
6 | of remedial care, is equal to or less than 70% in
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7 | fiscal year 2001, equal to or less than 85% in | ||||||
8 | fiscal year 2002 and until
a date to be determined | ||||||
9 | by the Department by rule, and equal to or less
| ||||||
10 | than 100% beginning on the date determined by the | ||||||
11 | Department by rule, of the nonfarm income official | ||||||
12 | poverty
line, as defined in item (i) of this | ||||||
13 | subparagraph (a).
| ||||||
14 | (b) All persons who would be determined eligible | ||||||
15 | for such basic
maintenance under Article IV by | ||||||
16 | disregarding the maximum earned income
permitted by | ||||||
17 | federal law.
| ||||||
18 | 3. Persons who would otherwise qualify for Aid to the | ||||||
19 | Medically
Indigent under Article VII.
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20 | 4. Persons not eligible under any of the preceding | ||||||
21 | paragraphs who fall
sick, are injured, or die, not having | ||||||
22 | sufficient money, property or other
resources to meet the | ||||||
23 | costs of necessary medical care or funeral and burial
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24 | expenses.
| ||||||
25 | 5.(a) Women during pregnancy, after the fact
of | ||||||
26 | pregnancy has been determined by medical diagnosis, and | ||||||
27 | during the
60-day period beginning on the last day of the | ||||||
28 | pregnancy, together with
their infants and children born | ||||||
29 | after September 30, 1983,
whose income and
resources are | ||||||
30 | insufficient to meet the costs of necessary medical care to
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31 | the maximum extent possible under Title XIX of the
Federal | ||||||
32 | Social Security Act.
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33 | (b) The Illinois Department and the Governor shall | ||||||
34 | provide a plan for
coverage of the persons eligible under | ||||||
35 | paragraph 5(a) by April 1, 1990. Such
plan shall provide | ||||||
36 | ambulatory prenatal care to pregnant women during a
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1 | presumptive eligibility period and establish an income | ||||||
2 | eligibility standard
that is equal to 133%
of the nonfarm | ||||||
3 | income official poverty line, as defined by
the federal | ||||||
4 | Office of Management and Budget and revised annually in
| ||||||
5 | accordance with Section 673(2) of the Omnibus Budget | ||||||
6 | Reconciliation Act of
1981, applicable to families of the | ||||||
7 | same size, provided that costs incurred
for medical care | ||||||
8 | are not taken into account in determining such income
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9 | eligibility.
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10 | (c) The Illinois Department may conduct a | ||||||
11 | demonstration in at least one
county that will provide | ||||||
12 | medical assistance to pregnant women, together
with their | ||||||
13 | infants and children up to one year of age,
where the | ||||||
14 | income
eligibility standard is set up to 185% of the | ||||||
15 | nonfarm income official
poverty line, as defined by the | ||||||
16 | federal Office of Management and Budget.
The Illinois | ||||||
17 | Department shall seek and obtain necessary authorization
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18 | provided under federal law to implement such a | ||||||
19 | demonstration. Such
demonstration may establish resource | ||||||
20 | standards that are not more
restrictive than those | ||||||
21 | established under Article IV of this Code.
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22 | 6. Persons under the age of 18 who fail to qualify as | ||||||
23 | dependent under
Article IV and who have insufficient income | ||||||
24 | and resources to meet the costs
of necessary medical care | ||||||
25 | to the maximum extent permitted under Title XIX
of the | ||||||
26 | Federal Social Security Act.
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27 | 7. Persons who are under 21 years of age and would
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28 | qualify as
disabled as defined under the Federal | ||||||
29 | Supplemental Security Income Program,
provided medical | ||||||
30 | service for such persons would be eligible for Federal
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31 | Financial Participation, and provided the Illinois | ||||||
32 | Department determines that:
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33 | (a) the person requires a level of care provided by | ||||||
34 | a hospital, skilled
nursing facility, or intermediate | ||||||
35 | care facility, as determined by a physician
licensed to | ||||||
36 | practice medicine in all its branches;
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1 | (b) it is appropriate to provide such care outside | ||||||
2 | of an institution, as
determined by a physician | ||||||
3 | licensed to practice medicine in all its branches;
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4 | (c) the estimated amount which would be expended | ||||||
5 | for care outside the
institution is not greater than | ||||||
6 | the estimated amount which would be
expended in an | ||||||
7 | institution.
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8 | 8. Persons who become ineligible for basic maintenance | ||||||
9 | assistance
under Article IV of this Code in programs | ||||||
10 | administered by the Illinois
Department due to employment | ||||||
11 | earnings and persons in
assistance units comprised of | ||||||
12 | adults and children who become ineligible for
basic | ||||||
13 | maintenance assistance under Article VI of this Code due to
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14 | employment earnings. The plan for coverage for this class | ||||||
15 | of persons shall:
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16 | (a) extend the medical assistance coverage for up | ||||||
17 | to 12 months following
termination of basic | ||||||
18 | maintenance assistance; and
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19 | (b) offer persons who have initially received 6 | ||||||
20 | months of the
coverage provided in paragraph (a) above, | ||||||
21 | the option of receiving an
additional 6 months of | ||||||
22 | coverage, subject to the following:
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23 | (i) such coverage shall be pursuant to | ||||||
24 | provisions of the federal
Social Security Act;
| ||||||
25 | (ii) such coverage shall include all services | ||||||
26 | covered while the person
was eligible for basic | ||||||
27 | maintenance assistance;
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28 | (iii) no premium shall be charged for such | ||||||
29 | coverage; and
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30 | (iv) such coverage shall be suspended in the | ||||||
31 | event of a person's
failure without good cause to | ||||||
32 | file in a timely fashion reports required for
this | ||||||
33 | coverage under the Social Security Act and | ||||||
34 | coverage shall be reinstated
upon the filing of | ||||||
35 | such reports if the person remains otherwise | ||||||
36 | eligible.
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1 | 9. Persons with acquired immunodeficiency syndrome | ||||||
2 | (AIDS) or with
AIDS-related conditions with respect to whom | ||||||
3 | there has been a determination
that but for home or | ||||||
4 | community-based services such individuals would
require | ||||||
5 | the level of care provided in an inpatient hospital, | ||||||
6 | skilled
nursing facility or intermediate care facility the | ||||||
7 | cost of which is
reimbursed under this Article. Assistance | ||||||
8 | shall be provided to such
persons to the maximum extent | ||||||
9 | permitted under Title
XIX of the Federal Social Security | ||||||
10 | Act.
| ||||||
11 | 10. Participants in the long-term care insurance | ||||||
12 | partnership program
established under the Partnership for | ||||||
13 | Long-Term Care Act who meet the
qualifications for | ||||||
14 | protection of resources described in Section 25 of that
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15 | Act.
| ||||||
16 | 11. Persons with disabilities who are employed and | ||||||
17 | eligible for Medicaid,
pursuant to Section | ||||||
18 | 1902(a)(10)(A)(ii)(xv) of the Social Security Act, as
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19 | provided by the Illinois Department by rule.
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20 | 12. Subject to federal approval, persons who are | ||||||
21 | eligible for medical
assistance coverage under applicable | ||||||
22 | provisions of the federal Social Security
Act and the | ||||||
23 | federal Breast and Cervical Cancer Prevention and | ||||||
24 | Treatment Act of
2000. Those eligible persons are defined | ||||||
25 | to include, but not be limited to,
the following persons:
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26 | (1) persons who have been screened for breast or | ||||||
27 | cervical cancer under
the U.S. Centers for Disease | ||||||
28 | Control and Prevention Breast and Cervical Cancer
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29 | Program established under Title XV of the federal | ||||||
30 | Public Health Services Act in
accordance with the | ||||||
31 | requirements of Section 1504 of that Act as | ||||||
32 | administered by
the Illinois Department of Public | ||||||
33 | Health; and
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34 | (2) persons whose screenings under the above | ||||||
35 | program were funded in whole
or in part by funds | ||||||
36 | appropriated to the Illinois Department of Public |
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1 | Health
for breast or cervical cancer screening.
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2 | "Medical assistance" under this paragraph 12 shall be | ||||||
3 | identical to the benefits
provided under the State's | ||||||
4 | approved plan under Title XIX of the Social Security
Act. | ||||||
5 | The Department must request federal approval of the | ||||||
6 | coverage under this
paragraph 12 within 30 days after the | ||||||
7 | effective date of this amendatory Act of
the 92nd General | ||||||
8 | Assembly.
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9 | 13. Subject to appropriation and to federal approval, | ||||||
10 | persons living with HIV/AIDS who are not otherwise eligible | ||||||
11 | under this Article and who qualify for services covered | ||||||
12 | under Section 5-5.04 as provided by the Illinois Department | ||||||
13 | by rule.
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14 | 14. Non-citizens of the United States who
are residents | ||||||
15 | of Illinois, who are victims of violence as defined
under | ||||||
16 | the federal Violence Against Women Act, and who are not | ||||||
17 | otherwise
eligible for medical assistance under this | ||||||
18 | Article.
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19 | The Illinois Department and the Governor shall provide a | ||||||
20 | plan for
coverage of the persons eligible under paragraph 7 as | ||||||
21 | soon as possible after
July 1, 1984.
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22 | The eligibility of any such person for medical assistance | ||||||
23 | under this
Article is not affected by the payment of any grant | ||||||
24 | under the Senior
Citizens and Disabled Persons Property Tax | ||||||
25 | Relief and Pharmaceutical
Assistance Act or any distributions | ||||||
26 | or items of income described under
subparagraph (X) of
| ||||||
27 | paragraph (2) of subsection (a) of Section 203 of the Illinois | ||||||
28 | Income Tax
Act. The Department shall by rule establish the | ||||||
29 | amounts of
assets to be disregarded in determining eligibility | ||||||
30 | for medical assistance,
which shall at a minimum equal the | ||||||
31 | amounts to be disregarded under the
Federal Supplemental | ||||||
32 | Security Income Program. The amount of assets of a
single | ||||||
33 | person to be disregarded
shall not be less than $2,000, and the | ||||||
34 | amount of assets of a married couple
to be disregarded shall | ||||||
35 | not be less than $3,000.
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36 | To the extent permitted under federal law, any person found |
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1 | guilty of a
second violation of Article VIIIA
shall be | ||||||
2 | ineligible for medical assistance under this Article, as | ||||||
3 | provided
in Section 8A-8.
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4 | The eligibility of any person for medical assistance under | ||||||
5 | this Article
shall not be affected by the receipt by the person | ||||||
6 | of donations or benefits
from fundraisers held for the person | ||||||
7 | in cases of serious illness,
as long as neither the person nor | ||||||
8 | members of the person's family
have actual control over the | ||||||
9 | donations or benefits or the disbursement
of the donations or | ||||||
10 | benefits.
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11 | (Source: P.A. 93-20, eff. 6-20-03; 94-629, eff. 1-1-06.)
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12 | Section 99. Effective date. This Act takes effect upon | ||||||
13 | becoming law.
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