State of Illinois
92nd General Assembly
Legislation

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92_HB0025

 
                                               LRB9200896DJgc

 1        AN ACT in relation to public aid.

 2        Be it enacted by the People of  the  State  of  Illinois,
 3    represented in the General Assembly:

 4        Section  5.  The  Illinois  Public Aid Code is amended by
 5    changing Section 5-2 as follows:

 6        (305 ILCS 5/5-2) (from Ch. 23, par. 5-2)
 7        Sec.  5-2.  Classes   of   Persons   Eligible.    Medical
 8    assistance  under  this  Article shall be available to any of
 9    the following classes of persons in respect to  whom  a  plan
10    for  coverage  has  been  submitted  to  the  Governor by the
11    Illinois Department and approved by him:
12        1.  Recipients of basic maintenance grants under Articles
13    III and IV.
14        2.  Persons  otherwise  eligible  for  basic  maintenance
15    under Articles III and IV but who fail to qualify  thereunder
16    on  the  basis  of need, and who have insufficient income and
17    resources to  meet  the  costs  of  necessary  medical  care,
18    including but not limited to the following:
19             (a)  All   persons   otherwise  eligible  for  basic
20        maintenance under Article III but  who  fail  to  qualify
21        under  that  Article  on  the  basis of need and who meet
22        either of the following requirements:
23                  (i)  their  income,  as   determined   by   the
24             Illinois  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 equal to or less than 100% in fiscal year
28             2003 and thereafter of the nonfarm  income  official
29             poverty  line,  as  defined by the federal Office of
30             Management  and  Budget  and  revised  annually   in
31             accordance with Section 673(2) of the Omnibus Budget
 
                            -2-                LRB9200896DJgc
 1             Reconciliation  Act  of 1981, applicable to families
 2             of the same size; or
 3                  (ii)  their  income,  after  the  deduction  of
 4             costs incurred for medical care and for other  types
 5             of  remedial  care,  is equal to or less than 70% in
 6             fiscal year 2001, equal  to  or  less  than  85%  in
 7             fiscal  year 2002, and equal to or less than 100% in
 8             fiscal year  2003  and  thereafter  of  the  nonfarm
 9             income official poverty line, as defined in item (i)
10             of this subparagraph (a).
11             (b)  All  persons  who  would be determined eligible
12        for  such  basic  maintenance   under   Article   IV   by
13        disregarding  the  maximum  earned  income  permitted  by
14        federal law.
15        3.  Persons  who  would  otherwise qualify for Aid to the
16    Medically Indigent under Article VII.
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
20    costs  of  necessary  medical  care  or  funeral  and  burial
21    expenses.
22        5. (a)  Women   during   pregnancy,  after  the  fact  of
23        pregnancy has been determined by medical  diagnosis,  and
24        during the 60-day period beginning on the last day of the
25        pregnancy,  together with their infants and children born
26        after September 30, 1983, whose income and resources  are
27        insufficient  to meet the costs of necessary medical care
28        to the maximum extent possible under  Title  XIX  of  the
29        Federal Social Security Act.
30             (b)  The  Illinois Department and the Governor shall
31        provide a plan for coverage of the persons eligible under
32        paragraph 5(a) by April 1, 1990.  Such plan shall provide
33        ambulatory prenatal  care  to  pregnant  women  during  a
34        presumptive  eligibility  period  and establish an income
 
                            -3-                LRB9200896DJgc
 1        eligibility standard that is equal to 133% of the nonfarm
 2        income official poverty line, as defined by  the  federal
 3        Office  of  Management and Budget and revised annually in
 4        accordance with Section  673(2)  of  the  Omnibus  Budget
 5        Reconciliation Act of 1981, applicable to families of the
 6        same  size, provided that costs incurred for medical care
 7        are not taken into account  in  determining  such  income
 8        eligibility.
 9             (c)  The   Illinois   Department   may   conduct   a
10        demonstration  in  at  least one county that will provide
11        medical assistance to pregnant women, together with their
12        infants and children up to one year  of  age,  where  the
13        income  eligibility  standard  is  set  up to 185% of the
14        nonfarm income official poverty line, as defined  by  the
15        federal  Office  of  Management and Budget.  The Illinois
16        Department shall seek and obtain necessary  authorization
17        provided   under   federal   law   to  implement  such  a
18        demonstration.  Such demonstration may establish resource
19        standards  that  are  not  more  restrictive  than  those
20        established under Article IV of this Code.
21        6.  Persons under the age of 18 who fail  to  qualify  as
22    dependent  under  Article IV and who have insufficient income
23    and resources to meet the costs of necessary medical care  to
24    the  maximum  extent permitted under Title XIX of the Federal
25    Social Security Act.
26        7.  Persons who are 18 years of age or younger and  would
27    qualify as disabled as defined under the Federal Supplemental
28    Security  Income  Program,  provided medical service for such
29    persons   would   be   eligible   for    Federal    Financial
30    Participation,   and   provided   the   Illinois   Department
31    determines that:
32             (a)  the person requires a level of care provided by
33        a  hospital,  skilled  nursing  facility, or intermediate
34        care facility, as determined by a physician  licensed  to
 
                            -4-                LRB9200896DJgc
 1        practice medicine in all its branches;
 2             (b)  it  is appropriate to provide such care outside
 3        of an institution, as determined by a physician  licensed
 4        to practice medicine in all its branches;
 5             (c)  the  estimated  amount  which would be expended
 6        for care outside the institution is not greater than  the
 7        estimated   amount   which   would   be  expended  in  an
 8        institution.
 9        8.  Persons who become ineligible for  basic  maintenance
10    assistance   under  Article  IV  of  this  Code  in  programs
11    administered by the Illinois  Department  due  to  employment
12    earnings  and persons in assistance units comprised of adults
13    and children who  become  ineligible  for  basic  maintenance
14    assistance  under  Article  VI of this Code due to employment
15    earnings.  The plan for coverage for this  class  of  persons
16    shall:
17             (a)  extend  the  medical assistance coverage for up
18        to 12 months following termination of  basic  maintenance
19        assistance; and
20             (b)  offer  persons  who  have  initially received 6
21        months of the coverage provided in paragraph  (a)  above,
22        the  option  of  receiving  an  additional  6  months  of
23        coverage, subject to the following:
24                  (i)  such   coverage   shall   be  pursuant  to
25             provisions of the federal Social Security Act;
26                  (ii)  such coverage shall include all  services
27             covered  while  the  person  was  eligible for basic
28             maintenance assistance;
29                  (iii)  no premium shall  be  charged  for  such
30             coverage; and
31                  (iv)  such  coverage  shall be suspended in the
32             event of a person's failure without  good  cause  to
33             file  in  a timely fashion reports required for this
34             coverage under the Social Security Act and  coverage
 
                            -5-                LRB9200896DJgc
 1             shall  be reinstated upon the filing of such reports
 2             if the person remains otherwise eligible.
 3        9.  Persons  with  acquired   immunodeficiency   syndrome
 4    (AIDS)  or  with AIDS-related conditions with respect to whom
 5    there  has  been  a  determination  that  but  for  home   or
 6    community-based  services  such individuals would require the
 7    level of care provided  in  an  inpatient  hospital,  skilled
 8    nursing  facility  or  intermediate care facility the cost of
 9    which is reimbursed under this Article.  Assistance shall  be
10    provided  to  such  persons  to  the maximum extent permitted
11    under Title XIX of the Federal Social Security Act.
12        10.  Participants  in  the   long-term   care   insurance
13    partnership  program  established  under  the Partnership for
14    Long-Term Care Act who meet the qualifications for protection
15    of resources described in Section 25 of that Act.
16        11.  Persons  with  disabilities  who  are  employed  and
17    eligible    for     Medicaid,     pursuant     to     Section
18    1902(a)(10)(A)(ii)(xv)   of   the  Social  Security  Act,  as
19    provided by  the  Illinois  Department  by  rule.  LRB9114972
20    inserts
21        12.  Persons  who are (i) enrolled and participating in a
22    breast cancer screening and treatment  program  funded  under
23    the  National  Breast  and  Cervical  Cancer  Early Detection
24    Program and administered by the Department of  Public  Health
25    and  (ii)  eligible for medical assistance coverage of breast
26    cancer screening and treatment under the federal  Breast  and
27    Cervical   Cancer  Prevention  and  Treatment  Act  of  2000.
28    Medical  assistance  coverage  under  this  paragraph   shall
29    include  coverage  of  breast  cancer screening and treatment
30    during the time that the person is enrolled and participating
31    in the Department of Public Health program.
32        The Illinois Department and the Governor shall provide  a
33    plan  for  coverage of the persons eligible under paragraph 7
34    as soon as possible after July 1, 1984.
 
                            -6-                LRB9200896DJgc
 1        The eligibility of any such person for medical assistance
 2    under this Article is not affected  by  the  payment  of  any
 3    grant under the Senior Citizens and Disabled Persons Property
 4    Tax   Relief   and   Pharmaceutical  Assistance  Act  or  any
 5    distributions or items of income described under subparagraph
 6    (X) of paragraph (2) of subsection (a) of Section 203 of  the
 7    Illinois  Income  Tax  Act.   The  Department  shall  by rule
 8    establish  the  amounts  of  assets  to  be  disregarded   in
 9    determining  eligibility  for medical assistance, which shall
10    at a minimum equal the amounts to be  disregarded  under  the
11    Federal  Supplemental Security Income Program.  The amount of
12    assets of a single person to be disregarded shall not be less
13    than $2,000, and the amount of assets of a married couple  to
14    be disregarded shall not be less than $3,000.
15        To  the  extent  permitted  under federal law, any person
16    found 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.
19        The eligibility of  any  person  for  medical  assistance
20    under  this  Article  shall not be affected by the receipt by
21    the person of donations or benefits from fundraisers held for
22    the person in cases of serious illness, as  long  as  neither
23    the  person  nor  members  of the person's family have actual
24    control over the donations or benefits or the disbursement of
25    the donations or benefits.
26    (Source: P.A. 91-676, eff.  12-23-99;  91-699,  eff.  7-1-00;
27    91-712, eff. 7-1-00; revised 6-26-00.)

28        Section  99.  Effective date.  This Act takes effect upon
29    becoming law.

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