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