Illinois General Assembly - Full Text of HB4736
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Full Text of HB4736  100th General Assembly




HB4736 EnrolledLRB100 17508 KTG 32677 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 5-2b and by adding Section 5-30a as follows:
6    (305 ILCS 5/5-2b)
7    Sec. 5-2b. Medically fragile and technology dependent
8children eligibility and program. Notwithstanding any other
9provision of law except as provided in Section 5-30a, on and
10after September 1, 2012, subject to federal approval, medical
11assistance under this Article shall be available to children
12who qualify as persons with a disability, as defined under the
13federal Supplemental Security Income program and who are
14medically fragile and technology dependent. The program shall
15allow eligible children to receive the medical assistance
16provided under this Article in the community and must maximize,
17to the fullest extent permissible under federal law, federal
18reimbursement and family cost-sharing, including co-pays,
19premiums, or any other family contributions, except that the
20Department shall be permitted to incentivize the utilization of
21selected services through the use of cost-sharing adjustments.
22The Department shall establish the policies, procedures,
23standards, services, and criteria for this program by rule.



HB4736 Enrolled- 2 -LRB100 17508 KTG 32677 b

1(Source: P.A. 97-689, eff. 6-14-12; 98-104, eff. 7-22-13.)
2    (305 ILCS 5/5-30a new)
3    Sec. 5-30a. Exemptions from managed care enrollment;
4children. Notwithstanding any other provision of law, the
5Department shall not require any of the following children to
6enroll in or transition to the State's managed care medical
7assistance program:
8        (1) Children who are authorized by the Department to
9    receive in-home shift nursing services as required by the
10    federal Early and Periodic Screening, Diagnostic and
11    Treatment (EPSDT) provisions under 42 CFR 441.50 et seq.
12        (2) Children made eligible for medical assistance
13    through any home and community-based services waiver
14    program for medically fragile and technology dependent
15    children authorized under Section 1915(c) of the Social
16    Security Act.
17    Any children who meet the criteria under paragraph (1) or
18(2) and who are enrolled in the State's managed care medical
19assistance program on or before the effective date of this
20amendatory Act of the 100th General Assembly shall be given the
21option to disenroll from the State's managed care medical
22assistance program and receive medical assistance coverage
23under the State's traditional fee-for-service program.