103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB1395

 

Introduced 2/6/2023, by Sen. Adriane Johnson

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/12-4.35

    Amends the Administration Article of the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services may provide coverage for organ transplants for noncitizens who (i) are not eligible for medical assistance under Article V of the Code due to their not meeting the citizenship requirements under the Code and (ii) have income at or below 133% of the federal poverty level plus 5% for the applicable family size as determined under applicable federal law and regulations. Provides that persons eligible for medical services under the amendatory Act shall receive benefits identical to the benefits provided under the Health Benefits Service Package as that term is defined under the Code.


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A BILL FOR

 

SB1395LRB103 26140 KTG 52497 b

1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Public Aid Code is amended by
5changing Section 12-4.35 as follows:
 
6    (305 ILCS 5/12-4.35)
7    Sec. 12-4.35. Medical services for certain noncitizens.
8    (a) Notwithstanding Section 1-11 of this Code or Section
920(a) of the Children's Health Insurance Program Act, the
10Department of Healthcare and Family Services may provide
11medical services to noncitizens who have not yet attained 19
12years of age and who are not eligible for medical assistance
13under Article V of this Code or under the Children's Health
14Insurance Program created by the Children's Health Insurance
15Program Act due to their not meeting the otherwise applicable
16provisions of Section 1-11 of this Code or Section 20(a) of the
17Children's Health Insurance Program Act. The medical services
18available, standards for eligibility, and other conditions of
19participation under this Section shall be established by rule
20by the Department; however, any such rule shall be at least as
21restrictive as the rules for medical assistance under Article
22V of this Code or the Children's Health Insurance Program
23created by the Children's Health Insurance Program Act.

 

 

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1    (a-5) Notwithstanding Section 1-11 of this Code, the
2Department of Healthcare and Family Services may provide
3medical assistance in accordance with Article V of this Code
4to noncitizens over the age of 65 years of age who are not
5eligible for medical assistance under Article V of this Code
6due to their not meeting the otherwise applicable provisions
7of Section 1-11 of this Code, whose income is at or below 100%
8of the federal poverty level after deducting the costs of
9medical or other remedial care, and who would otherwise meet
10the eligibility requirements in Section 5-2 of this Code. The
11medical services available, standards for eligibility, and
12other conditions of participation under this Section shall be
13established by rule by the Department; however, any such rule
14shall be at least as restrictive as the rules for medical
15assistance under Article V of this Code.
16    (a-6) By May 30, 2022, notwithstanding Section 1-11 of
17this Code, the Department of Healthcare and Family Services
18may provide medical services to noncitizens 55 years of age
19through 64 years of age who (i) are not eligible for medical
20assistance under Article V of this Code due to their not
21meeting the otherwise applicable provisions of Section 1-11 of
22this Code and (ii) have income at or below 133% of the federal
23poverty level plus 5% for the applicable family size as
24determined under applicable federal law and regulations.
25Persons eligible for medical services under Public Act 102-16
26shall receive benefits identical to the benefits provided

 

 

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1under the Health Benefits Service Package as that term is
2defined in subsection (m) of Section 5-1.1 of this Code.
3    (a-7) By July 1, 2022, notwithstanding Section 1-11 of
4this Code, the Department of Healthcare and Family Services
5may provide medical services to noncitizens 42 years of age
6through 54 years of age who (i) are not eligible for medical
7assistance under Article V of this Code due to their not
8meeting the otherwise applicable provisions of Section 1-11 of
9this Code and (ii) have income at or below 133% of the federal
10poverty level plus 5% for the applicable family size as
11determined under applicable federal law and regulations. The
12medical services available, standards for eligibility, and
13other conditions of participation under this Section shall be
14established by rule by the Department; however, any such rule
15shall be at least as restrictive as the rules for medical
16assistance under Article V of this Code. In order to provide
17for the timely and expeditious implementation of this
18subsection, the Department may adopt rules necessary to
19establish and implement this subsection through the use of
20emergency rulemaking in accordance with Section 5-45 of the
21Illinois Administrative Procedure Act. For purposes of the
22Illinois Administrative Procedure Act, the General Assembly
23finds that the adoption of rules to implement this subsection
24is deemed necessary for the public interest, safety, and
25welfare.
26    (a-8) Notwithstanding Section 1-11 of this Code, the

 

 

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1Department of Healthcare and Family Services may provide
2coverage for organ transplants for noncitizens who (i) are not
3eligible for medical assistance under Article V of this Code
4due to their not meeting the otherwise applicable provisions
5of Section 1-11 of this Code and (ii) have income at or below
6133% of the federal poverty level plus 5% for the applicable
7family size as determined under applicable federal law and
8regulations. Persons eligible for medical services under this
9amendatory Act of the 103rd General Assembly shall receive
10benefits identical to the benefits provided under the Health
11Benefits Service Package as that term is defined in subsection
12(m) of Section 5-1.1 of this Code.
13    (a-10) Notwithstanding the provisions of Section 1-11, the
14Department shall cover immunosuppressive drugs and related
15services associated with post-kidney transplant management,
16excluding long-term care costs, for noncitizens who: (i) are
17not eligible for comprehensive medical benefits; (ii) meet the
18residency requirements of Section 5-3; and (iii) would meet
19the financial eligibility requirements of Section 5-2.
20    (b) The Department is authorized to take any action that
21would not otherwise be prohibited by applicable law,
22including, without limitation, cessation or limitation of
23enrollment, reduction of available medical services, and
24changing standards for eligibility, that is deemed necessary
25by the Department during a State fiscal year to assure that
26payments under this Section do not exceed available funds.

 

 

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1    (c) (Blank).
2    (d) (Blank).
3(Source: P.A. 101-636, eff. 6-10-20; 102-16, eff. 6-17-21;
4102-43, Article 25, Section 25-15, eff. 7-6-21; 102-43,
5Article 45, Section 45-5, eff. 7-6-21; 102-813, eff. 5-13-22;
6102-1037, eff. 6-2-22.)