Labor Committee
Adopted in House Comm. on Mar 04, 2004
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1 | AMENDMENT TO HOUSE BILL 4730
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2 | AMENDMENT NO. ______. Amend House Bill 4730, AS AMENDED, | ||||||
3 | with reference to page and line numbers of House Amendment No. | ||||||
4 | 1, on page 1, by replacing lines 5 and 6 with the following:
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5 | "changing Sections 5-2, 6-1.7, and 12-4.4 and by adding Section | ||||||
6 | 9A-15 as follows:
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7 | (305 ILCS 5/5-2) (from Ch. 23, par. 5-2)
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8 | Sec. 5-2. Classes of Persons Eligible. Medical assistance | ||||||
9 | under this
Article shall be available to any of the following | ||||||
10 | classes of persons in
respect to whom a plan for coverage has | ||||||
11 | been submitted to the Governor
by the Illinois Department and | ||||||
12 | approved by him:
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13 | 1. Recipients of basic maintenance grants under Articles | ||||||
14 | III and IV.
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15 | 2. Persons otherwise eligible for basic maintenance under | ||||||
16 | Articles
III and IV but who fail to qualify thereunder on the | ||||||
17 | basis of need, and
who have insufficient income and resources | ||||||
18 | to meet the costs of
necessary medical care, including but not | ||||||
19 | limited to the following:
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20 | (a) All persons otherwise eligible for basic | ||||||
21 | maintenance under Article
III but who fail to qualify under | ||||||
22 | that Article on the basis of need and who
meet either of | ||||||
23 | the following requirements:
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24 | (i) their income, as determined by the Illinois | ||||||
25 | Department in
accordance with any federal |
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1 | requirements, is equal to or less than 70% in
fiscal | ||||||
2 | year 2001, equal to or less than 85% in fiscal year | ||||||
3 | 2002 and until
a date to be determined by the | ||||||
4 | Department by rule, and equal to or less
than 100% | ||||||
5 | beginning on the date determined by the Department by | ||||||
6 | rule, of the nonfarm income official poverty
line, as | ||||||
7 | defined by the federal Office of Management and Budget | ||||||
8 | and revised
annually in accordance with Section 673(2) | ||||||
9 | of the Omnibus Budget Reconciliation
Act of 1981, | ||||||
10 | applicable to families of the same size; or
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11 | (ii) their income, after the deduction of costs | ||||||
12 | incurred for medical
care and for other types of | ||||||
13 | remedial care, is equal to or less than 70% in
fiscal | ||||||
14 | year 2001, equal to or less than 85% in fiscal year | ||||||
15 | 2002 and until
a date to be determined by the | ||||||
16 | Department by rule, and equal to or less
than 100% | ||||||
17 | beginning on the date determined by the Department by | ||||||
18 | rule, of the nonfarm income official poverty
line, as | ||||||
19 | defined in item (i) of this subparagraph (a).
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20 | (b) All persons who would be determined eligible for | ||||||
21 | such basic
maintenance under Article IV by disregarding the | ||||||
22 | maximum earned income
permitted by federal law.
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23 | 3. Persons who would otherwise qualify for Aid to the | ||||||
24 | Medically
Indigent under Article VII.
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25 | 4. Persons not eligible under any of the preceding | ||||||
26 | paragraphs who fall
sick, are injured, or die, not having | ||||||
27 | sufficient money, property or other
resources to meet the costs | ||||||
28 | of necessary medical care or funeral and burial
expenses.
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29 | 5. (a) Women during pregnancy, after the fact
of pregnancy | ||||||
30 | has been determined by medical diagnosis, and during the
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31 | 60-day period beginning on the last day of the pregnancy, | ||||||
32 | together with
their infants and children born after | ||||||
33 | September 30, 1983,
whose income and
resources are | ||||||
34 | insufficient to meet the costs of necessary medical care to
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1 | the maximum extent possible under Title XIX of the
Federal | ||||||
2 | Social Security Act.
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3 | (b) The Illinois Department and the Governor shall | ||||||
4 | provide a plan for
coverage of the persons eligible under | ||||||
5 | paragraph 5(a) by April 1, 1990. Such
plan shall provide | ||||||
6 | ambulatory prenatal care to pregnant women during a
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7 | presumptive eligibility period and establish an income | ||||||
8 | eligibility standard
that is equal to 133%
of the nonfarm | ||||||
9 | income official poverty line, as defined by
the federal | ||||||
10 | Office of Management and Budget and revised annually in
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11 | accordance with Section 673(2) of the Omnibus Budget | ||||||
12 | Reconciliation Act of
1981, applicable to families of the | ||||||
13 | same size, provided that costs incurred
for medical care | ||||||
14 | are not taken into account in determining such income
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15 | eligibility.
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16 | (c) The Illinois Department may conduct a | ||||||
17 | demonstration in at least one
county that will provide | ||||||
18 | medical assistance to pregnant women, together
with their | ||||||
19 | infants and children up to one year of age,
where the | ||||||
20 | income
eligibility standard is set up to 185% of the | ||||||
21 | nonfarm income official
poverty line, as defined by the | ||||||
22 | federal Office of Management and Budget.
The Illinois | ||||||
23 | Department shall seek and obtain necessary authorization
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24 | provided under federal law to implement such a | ||||||
25 | demonstration. Such
demonstration may establish resource | ||||||
26 | standards that are not more
restrictive than those | ||||||
27 | established under Article IV of this Code.
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28 | 6. Persons under the age of 18 who fail to qualify as | ||||||
29 | dependent under
Article IV and who have insufficient income and | ||||||
30 | resources to meet the costs
of necessary medical care to the | ||||||
31 | maximum extent permitted under Title XIX
of the Federal Social | ||||||
32 | Security Act.
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33 | 7. Persons who are under 21 years of age and would
qualify | ||||||
34 | as
disabled as defined under the Federal Supplemental Security |
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1 | Income Program,
provided medical service for such persons would | ||||||
2 | be eligible for Federal
Financial Participation, and provided | ||||||
3 | the Illinois Department determines that:
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4 | (a) the person requires a level of care provided by a | ||||||
5 | hospital, skilled
nursing facility, or intermediate care | ||||||
6 | facility, as determined by a physician
licensed to practice | ||||||
7 | medicine in all its branches;
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8 | (b) it is appropriate to provide such care outside of | ||||||
9 | an institution, as
determined by a physician licensed to | ||||||
10 | practice medicine in all its branches;
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11 | (c) the estimated amount which would be expended for | ||||||
12 | care outside the
institution is not greater than the | ||||||
13 | estimated amount which would be
expended in an institution.
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14 | 8. Persons who become ineligible for basic maintenance | ||||||
15 | assistance
under Article IV of this Code in programs | ||||||
16 | administered by the Illinois
Department due to employment | ||||||
17 | earnings and persons in
assistance units comprised of adults | ||||||
18 | and children who become ineligible for
basic maintenance | ||||||
19 | assistance under Article VI of this Code due to
employment | ||||||
20 | earnings. The plan for coverage for this class of persons | ||||||
21 | shall:
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22 | (a) extend the medical assistance coverage for up to 12 | ||||||
23 | months following
termination of basic maintenance | ||||||
24 | assistance; and
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25 | (b) offer persons who have initially received 6 months | ||||||
26 | of the
coverage provided in paragraph (a) above, the option | ||||||
27 | of receiving an
additional 6 months of coverage, subject to | ||||||
28 | the following:
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29 | (i) such coverage shall be pursuant to provisions | ||||||
30 | of the federal
Social Security Act;
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31 | (ii) such coverage shall include all services | ||||||
32 | covered while the person
was eligible for basic | ||||||
33 | maintenance assistance;
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34 | (iii) no premium shall be charged for such |
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1 | coverage; and
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2 | (iv) such coverage shall be suspended in the event | ||||||
3 | of a person's
failure without good cause to file in a | ||||||
4 | timely fashion reports required for
this coverage | ||||||
5 | under the Social Security Act and coverage shall be | ||||||
6 | reinstated
upon the filing of such reports if the | ||||||
7 | person remains otherwise eligible.
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8 | 9. Persons with acquired immunodeficiency syndrome (AIDS) | ||||||
9 | or with
AIDS-related conditions with respect to whom there has | ||||||
10 | been a determination
that but for home or community-based | ||||||
11 | services such individuals would
require the level of care | ||||||
12 | provided in an inpatient hospital, skilled
nursing facility or | ||||||
13 | intermediate care facility the cost of which is
reimbursed | ||||||
14 | under this Article. Assistance shall be provided to such
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15 | persons to the maximum extent permitted under Title
XIX of the | ||||||
16 | Federal Social Security Act.
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17 | 10. Participants in the long-term care insurance | ||||||
18 | partnership program
established under the Partnership for | ||||||
19 | Long-Term Care Act who meet the
qualifications for protection | ||||||
20 | of resources described in Section 25 of that
Act.
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21 | 11. Persons with disabilities who are employed and eligible | ||||||
22 | for Medicaid,
pursuant to Section 1902(a)(10)(A)(ii)(xv) of | ||||||
23 | the Social Security Act, as
provided by the Illinois Department | ||||||
24 | by rule.
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25 | 12. Subject to federal approval, persons who are eligible | ||||||
26 | for medical
assistance coverage under applicable provisions of | ||||||
27 | the federal Social Security
Act and the federal Breast and | ||||||
28 | Cervical Cancer Prevention and Treatment Act of
2000 or who | ||||||
29 | would have been eligible for such coverage except that they are | ||||||
30 | found to need treatment for a cancer other than breast or | ||||||
31 | cervical cancer . Those eligible persons are defined to include, | ||||||
32 | but not be limited to,
the following persons:
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33 | (1) persons who have been screened for breast or | ||||||
34 | cervical cancer under
the U.S. Centers for Disease Control |
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1 | and Prevention Breast and Cervical Cancer
Program | ||||||
2 | established under Title XV of the federal Public Health | ||||||
3 | Services Act in
accordance with the requirements of Section | ||||||
4 | 1504 of that Act as administered by
the Illinois Department | ||||||
5 | of Public Health; and
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6 | (2) persons whose screenings under the above program | ||||||
7 | were funded in whole
or in part by funds appropriated to | ||||||
8 | the Illinois Department of Public Health
for breast or | ||||||
9 | cervical cancer screening.
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10 | "Medical assistance" under this paragraph 12 shall be identical | ||||||
11 | to the benefits
provided under the State's approved plan under | ||||||
12 | Title XIX of the Social Security
Act. The Department must | ||||||
13 | request federal approval of the coverage under this
paragraph | ||||||
14 | 12 within 30 days after the effective date of this amendatory | ||||||
15 | Act of
the 92nd General Assembly.
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16 | The Illinois Department and the Governor shall provide a | ||||||
17 | plan for
coverage of the persons eligible under paragraph 7 as | ||||||
18 | soon as possible after
July 1, 1984.
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19 | The eligibility of any such person for medical assistance | ||||||
20 | under this
Article is not affected by the payment of any grant | ||||||
21 | under the Senior
Citizens and Disabled Persons Property Tax | ||||||
22 | Relief and Pharmaceutical
Assistance Act or any distributions | ||||||
23 | or items of income described under
subparagraph (X) of
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24 | paragraph (2) of subsection (a) of Section 203 of the Illinois | ||||||
25 | Income Tax
Act. The Department shall by rule establish the | ||||||
26 | amounts of
assets to be disregarded in determining eligibility | ||||||
27 | for medical assistance,
which shall at a minimum equal the | ||||||
28 | amounts to be disregarded under the
Federal Supplemental | ||||||
29 | Security Income Program. The amount of assets of a
single | ||||||
30 | person to be disregarded
shall not be less than $2,000, and the | ||||||
31 | amount of assets of a married couple
to be disregarded shall | ||||||
32 | not be less than $3,000.
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33 | To the extent permitted under federal law, any person found | ||||||
34 | guilty of a
second violation of Article VIIIA
shall be |
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1 | ineligible for medical assistance under this Article, as | ||||||
2 | provided
in Section 8A-8.
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3 | The eligibility of any person for medical assistance under | ||||||
4 | this Article
shall not be affected by the receipt by the person | ||||||
5 | of donations or benefits
from fundraisers held for the person | ||||||
6 | in cases of serious illness,
as long as neither the person nor | ||||||
7 | members of the person's family
have actual control over the | ||||||
8 | donations or benefits or the disbursement
of the donations or | ||||||
9 | benefits.
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10 | (Source: P.A. 92-16, eff. 6-28-01; 92-47, eff. 7-3-01; 92-597, | ||||||
11 | eff. 6-28-02;
93-20, eff. 6-20-03.)"; and
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12 | on page 6, line 22, before the period, by inserting ", except | ||||||
13 | that the changes to Sec. 5-2 in Section 5 take effect on | ||||||
14 | January 1, 2005.".
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