103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB3430

 

Introduced 2/8/2024, by Sen. Chapin Rose

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/12-4.59 new

    Amends the Administration Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to develop, post, and maintain on its official website a comprehensive informational guide that explains the Medicaid 5-year look-back period as it applies to eligibility for long-term care coverage under the medical assistance program. Provides that the informational guide must be posted within 6 months after the effective date of the amendatory Act. Provides that the contents of the informational guide must include a detailed explanation of the 5-year look-back period, including its purpose and relevance to eligibility for medical assistance; clear information on how the 5-year look-back period affects eligibility criteria, including income and asset requirements; step-by-step guidance on how the 5-year look-back period is calculated, including the start date and end date considerations; explanation of the consequences and implications of transfers or gifts made during the 5-year look-back period; information on exceptions and exemptions to the 5-year look-back period, clarifying circumstances where certain transfers or assets may not be subject to scrutiny; guidance on the documentation individuals may need to provide or maintain to demonstrate compliance with the 5-year look-back period; tips and considerations for individuals and families on how to plan for eligibility for medical assistance, taking into account the 5-year look-back period; information on the process for appeals and dispute resolution related to decisions made based on the 5-year look-back period; and other matters. Provides that to ensure user-friendly navigation and visibility, the Department shall post on the main page of its official website detailed information on how users can easily access the comprehensive guide on the website and a hyperlink that directs users to the comprehensive guide. Requires the Department to develop and implement strategies and initiatives to promote awareness and utilization of the guide, including outreach efforts through community organizations, healthcare providers, and other relevant channels.


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A BILL FOR

 

SB3430LRB103 37615 KTG 67741 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
5adding Section 12-4.59 as follows:
 
6    (305 ILCS 5/12-4.59 new)
7    Sec. 12-4.59. Informational guide on Medicaid 5-year
8look-back period.
9    (a) Informational guide. Within 6 months after the
10effective date of this amendatory Act of the 103rd General
11Assembly, the Department of Healthcare and Family Services
12shall develop, post, and maintain on its official website a
13comprehensive informational guide that explains the Medicaid
145-year look-back period as it applies to eligibility for
15long-term care coverage under the medical assistance program
16established under Article V of this Code. The contents of the
17informational guide must include the following:
18        (1) Overview of the Medicaid 5-year look-back period:
19    A detailed explanation of the 5-year look-back period,
20    including its purpose and relevance to eligibility for
21    medical assistance.
22        (2) Eligibility criteria affected by the Medicaid
23    5-year look-back period: Clear information on how the

 

 

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1    5-year look-back period affects eligibility criteria,
2    including income and asset requirements.
3        (3) Calculation of the Medicaid 5-year look-back
4    period: Step-by-step guidance on how the 5-year look-back
5    period is calculated, including the start date and end
6    date considerations.
7        (4) Examples and scenarios: Real-life examples and
8    scenarios illustrating how the 5-year look-back period
9    applies in different situations, providing practical
10    insights for the public. The guide must include a
11    calculator that allows a user to enter the transfer dates
12    and monetary value of any assets the user transferred
13    during the 5-year look back period in order to estimate
14    the earliest date upon which the user may qualify for
15    medical assistance for long-term care services.
16        (5) Transfers or gifts during the Medicaid 5-year
17    look-back period: Explanation of the consequences and
18    implications of transfers or gifts made during the 5-year
19    look-back period, emphasizing the impact on eligibility
20    and potential penalties.
21        (6) Exceptions and exemptions: Information on
22    exceptions and exemptions to the 5-year look-back period,
23    clarifying circumstances where certain transfers or assets
24    may not be subject to scrutiny.
25        (7) Documentation requirements: Guidance on the
26    documentation individuals may need to provide or maintain

 

 

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1    to demonstrate compliance with the 5-year look-back
2    period.
3        (8) Planning for eligibility: Tips and considerations
4    for individuals and families on how to plan for
5    eligibility for medical assistance under Article V of this
6    Code, taking into account the 5-year look-back period.
7        (9) Appeals and dispute resolution: Information on the
8    process for appeals and dispute resolution related to
9    decisions made based on the 5-year look-back period.
10        (10) Contact information and resources: Clear and
11    accessible contact information for the Department of
12    Healthcare and Family Services, as well as a listing of
13    additional resources or agencies that individuals can
14    reach out to for assistance or further clarification.
15        (11) Frequently asked questions: A "Frequently Asked
16    Questions" section that lists common questions and
17    concerns related to the 5-year look-back period and
18    provides a quick reference for users.
19    (b) Accessibility of the guide. To ensure user-friendly
20navigation and visibility, the Department of Healthcare and
21Family Services shall post on the main page of its official
22website detailed information on how users can easily access
23the comprehensive guide on the website and a hyperlink that
24directs users to the comprehensive guide.
25    (c) Public outreach. The Department of Healthcare and
26Family Services shall develop and implement strategies and

 

 

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1initiatives to promote awareness and utilization of the guide,
2including outreach efforts through community organizations,
3healthcare providers, and other relevant channels.
4