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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 5-2b and by adding Section 5-30a as follows: | ||||||
| 6 | (305 ILCS 5/5-2b) | ||||||
| 7 | Sec. 5-2b. Medically fragile and technology dependent | ||||||
| 8 | children eligibility and program. Notwithstanding any other | ||||||
| 9 | provision of law except as provided in Section 5-30a, on and | ||||||
| 10 | after September 1, 2012, subject to federal approval, medical | ||||||
| 11 | assistance under this Article shall be available to children | ||||||
| 12 | who qualify as persons with a disability, as defined under the | ||||||
| 13 | federal Supplemental Security Income program and who are | ||||||
| 14 | medically fragile and technology dependent. The program shall | ||||||
| 15 | allow eligible children to receive the medical assistance | ||||||
| 16 | provided under this Article in the community and must maximize, | ||||||
| 17 | to the fullest extent permissible under federal law, federal | ||||||
| 18 | reimbursement and family cost-sharing, including co-pays, | ||||||
| 19 | premiums, or any other family contributions, except that the | ||||||
| 20 | Department shall be permitted to incentivize the utilization of | ||||||
| 21 | selected services through the use of cost-sharing adjustments. | ||||||
| 22 | The Department shall establish the policies, procedures, | ||||||
| 23 | standards, services, and criteria for this program by rule.
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| 1 | (Source: P.A. 97-689, eff. 6-14-12; 98-104, eff. 7-22-13.) | ||||||
| 2 | (305 ILCS 5/5-30a new) | ||||||
| 3 | Sec. 5-30a. Exemptions from managed care enrollment; | ||||||
| 4 | children. Notwithstanding any other provision of law, the | ||||||
| 5 | Department shall not require any of the following children to | ||||||
| 6 | enroll in or transition to the State's managed care medical | ||||||
| 7 | assistance program: | ||||||
| 8 | (1) Children who are authorized by the Department to | ||||||
| 9 | receive in-home shift nursing services as required by the | ||||||
| 10 | federal Early and Periodic Screening, Diagnostic and | ||||||
| 11 | Treatment (EPSDT) provisions under 42 CFR 441.50 et seq. | ||||||
| 12 | (2) Children made eligible for medical assistance | ||||||
| 13 | through any home and community-based services waiver | ||||||
| 14 | program for medically fragile and technology dependent | ||||||
| 15 | children authorized under Section 1915(c) of the Social | ||||||
| 16 | Security Act. | ||||||
| 17 | Any children who meet the criteria under paragraph (1) or | ||||||
| 18 | (2) and who are enrolled in the State's managed care medical | ||||||
| 19 | assistance program on or before the effective date of this | ||||||
| 20 | amendatory Act of the 100th General Assembly shall be given the | ||||||
| 21 | option to disenroll from the State's managed care medical | ||||||
| 22 | assistance program and receive medical assistance coverage | ||||||
| 23 | under the State's traditional fee-for-service program.
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