HB5597 102ND GENERAL ASSEMBLY

LRB102 21968 KTG 31095 b

102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB5597

Introduced 1/31/2022, by Rep. Mary E. Flowers

SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-2.03
305 ILCS 5/5-45 new

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services, in collaboration with the Department of Human Services, to update its eligibility verification and enrollment processing system to allow for the automatic enrollment of all eligible uninsured childless adults into the medical assistance program. Provides that under the updated processing system, hospitals, community-based organizations, and other entities approved by the Departments shall be authorized to screen and identify for medical assistance uninsured childless adults aged 19 or older, but younger than 65, who otherwise meet the eligibility requirements for medical assistance. Provides that a hospital, community-based organization, or other approved entity shall inform a Medicaid-eligible uninsured childless adult that the adult is presumptively eligible for medical assistance and offer to submit an electronic application for medical assistance on the adult's behalf. Requires the electronic application to be no longer than 2 pages in length as prescribed by the Department of Human Services. Requires the Department of Human Services to designate staff to receive and review completed electronic applications for medical assistance from hospitals, community-based organizations, or other approved entities. Requires the designated staff to verify, as soon as practical, the uninsured childless adult's eligibility for medical assistance based on the information provided in the adult's completed electronic application and without requesting additional information or attestations from the uninsured childless adult. Provides that the uninsured childless adult shall be enrolled in the medical assistance program upon verification of eligibility. Grants the Departments rulemaking authority. Requires the Department of Healthcare and Family Services to apply for any federal waivers or approvals necessary to implement the amendatory Act. Provides that implementation is subject to federal approval.

A BILL FOR

AN ACT concerning public aid.

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

Section 5. The Illinois Public Aid Code is amended by changing Section 5-2.03 and by adding Section 5-45 as follows:

(305 ILCS 5/5-2.03)

Sec. 5-2.03. Presumptive eligibility. Beginning on the effective date of this amendatory Act of the 96th General Assembly and except where federal law requires presumptive eligibility, no adult may be presumed eligible for medical assistance under this Code and the Department may not cover any service rendered to an adult unless the adult has completed an application for benefits, all required verifications have been received, and the Department or its designee has found the adult eligible for the date on which that service was provided. Nothing in this Section shall apply to pregnant women, to childless adults as provided in Section 5-45, or to persons enrolled under the medical assistance program due to expansions approved by the federal government that are financed entirely by units of local government and federal matching funds.

(Source: P.A. 96-1501, eff. 1-25-11; 97-687, eff. 6-14-12.)

(305 ILCS 5/5-45 new)

Sec. 5-45. Automatic enrollment; uninsured childless adults. The Department of Healthcare and Family Services, in collaboration with the Department of Human Services, shall update its eligibility verification and enrollment processing system to allow for the automatic enrollment of all eligible uninsured childless adults into the medical assistance program. Under the updated processing system, hospitals, community-based organizations, and other entities approved by the Departments shall be authorized to screen and identify for medical assistance uninsured childless adults aged 19 or older, but younger than 65, who otherwise meet the eligibility requirements for medical assistance under paragraph 18 of Section 5-2. Once a hospital, community-based organization, or other approved entity identifies a client as an eligible uninsured childless adult, the hospital, community-based organization, or other approved entity shall inform the adult that the adult is presumptively eligible for medical assistance and offer to submit an electronic application for medical assistance on the adult's behalf. The electronic application must be no longer than 2 pages in length as prescribed by the Department of Human Services. The Department of Human Services shall designate staff to receive and review completed electronic applications for medical assistance from hospitals, community-based organizations, or other approved entities. As soon as practical, the designated staff shall verify an uninsured childless adult's eligibility for medical assistance with the information provided in the adult's completed electronic application and without requesting additional information or attestations from the uninsured childless adult. Upon verification of an uninsured childless adult's eligibility for medical assistance, the adult shall be fully enrolled in the medical assistance program and receive coverage for the Health Benefits Service Package as that term is defined in subsection (m) of Section 5-1.1 of this Code.

The Department of Healthcare and Family Services and the Department of Human Services may adopt any rules necessary to implement the provisions of this Section. The Department of Healthcare and Family Services shall apply for any federal waivers or approvals necessary to implement this Section. Implementation of this Section is subject to federal approval.