Full Text of HB4730 93rd General Assembly
HB4730ham002 93RD GENERAL ASSEMBLY
|
Labor Committee
Adopted in House Comm. on Mar 04, 2004
|
|
09300HB4730ham002 |
|
LRB093 19722 DRJ 48028 a |
|
| 1 |
| AMENDMENT TO HOUSE BILL 4730
| 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:
| 5 |
| "changing Sections 5-2, 6-1.7, and 12-4.4 and by adding Section | 6 |
| 9A-15 as follows:
| 7 |
| (305 ILCS 5/5-2) (from Ch. 23, par. 5-2)
| 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:
| 13 |
| 1. Recipients of basic maintenance grants under Articles | 14 |
| III and IV.
| 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:
| 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:
| 24 |
| (i) their income, as determined by the Illinois | 25 |
| Department in
accordance with any federal |
|
|
|
09300HB4730ham002 |
- 2 - |
LRB093 19722 DRJ 48028 a |
|
| 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
| 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).
| 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.
| 23 |
| 3. Persons who would otherwise qualify for Aid to the | 24 |
| Medically
Indigent under Article VII.
| 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.
| 29 |
| 5. (a) Women during pregnancy, after the fact
of pregnancy | 30 |
| has been determined by medical diagnosis, and during the
| 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
|
|
|
|
09300HB4730ham002 |
- 3 - |
LRB093 19722 DRJ 48028 a |
|
| 1 |
| the maximum extent possible under Title XIX of the
Federal | 2 |
| Social Security Act.
| 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
| 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
| 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
| 15 |
| eligibility.
| 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
| 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.
| 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.
| 33 |
| 7. Persons who are under 21 years of age and would
qualify | 34 |
| as
disabled as defined under the Federal Supplemental Security |
|
|
|
09300HB4730ham002 |
- 4 - |
LRB093 19722 DRJ 48028 a |
|
| 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:
| 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;
| 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;
| 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.
| 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:
| 22 |
| (a) extend the medical assistance coverage for up to 12 | 23 |
| months following
termination of basic maintenance | 24 |
| assistance; and
| 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:
| 29 |
| (i) such coverage shall be pursuant to provisions | 30 |
| of the federal
Social Security Act;
| 31 |
| (ii) such coverage shall include all services | 32 |
| covered while the person
was eligible for basic | 33 |
| maintenance assistance;
| 34 |
| (iii) no premium shall be charged for such |
|
|
|
09300HB4730ham002 |
- 5 - |
LRB093 19722 DRJ 48028 a |
|
| 1 |
| coverage; and
| 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.
| 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
| 15 |
| persons to the maximum extent permitted under Title
XIX of the | 16 |
| Federal Social Security Act.
| 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.
| 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.
| 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:
| 33 |
| (1) persons who have been screened for breast or | 34 |
| cervical cancer under
the U.S. Centers for Disease Control |
|
|
|
09300HB4730ham002 |
- 6 - |
LRB093 19722 DRJ 48028 a |
|
| 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
| 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.
| 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.
| 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.
| 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
| 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.
| 33 |
| To the extent permitted under federal law, any person found | 34 |
| guilty of a
second violation of Article VIIIA
shall be |
|
|
|
09300HB4730ham002 |
- 7 - |
LRB093 19722 DRJ 48028 a |
|
| 1 |
| ineligible for medical assistance under this Article, as | 2 |
| provided
in Section 8A-8.
| 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.
| 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
| 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.".
|
|