State of Illinois
92nd General Assembly
Legislation

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[ House Amendment 001 ]


92_HB0025ham002

 










                                           LRB9200896DJgcam05

 1                     AMENDMENT TO HOUSE BILL 25

 2        AMENDMENT NO.     .  Amend House Bill 25, AS AMENDED,  by
 3    replacing the title with the following:
 4        "AN ACT in relation to public aid."; and

 5    by  replacing  everything  after the enacting clause with the
 6    following:

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

 9        (305 ILCS 5/5-2) (from Ch. 23, par. 5-2)
10        Sec.   5-2.  Classes   of   Persons   Eligible.   Medical
11    assistance under this Article shall be available  to  any  of
12    the  following  classes  of persons in respect to whom a plan
13    for coverage has  been  submitted  to  the  Governor  by  the
14    Illinois Department and approved by him:
15        1.  Recipients of basic maintenance grants under Articles
16    III and IV.
17        2.  Persons  otherwise  eligible  for  basic  maintenance
18    under  Articles III and IV but who fail to qualify thereunder
19    on the basis of need, and who have  insufficient  income  and
20    resources  to  meet  the  costs  of  necessary  medical care,
21    including but not limited to the following:
 
                            -2-            LRB9200896DJgcam05
 1             (a)  All  persons  otherwise  eligible   for   basic
 2        maintenance  under  Article  III  but who fail to qualify
 3        under that Article on the basis  of  need  and  who  meet
 4        either of the following requirements:
 5                  (i)  their   income,   as   determined  by  the
 6             Illinois Department in accordance with  any  federal
 7             requirements, is equal to or less than 70% in fiscal
 8             year  2001, equal to or less than 85% in fiscal year
 9             2002, and equal to or less than 100% in fiscal  year
10             2003  and  thereafter of the nonfarm income official
11             poverty line, as defined by the  federal  Office  of
12             Management   and  Budget  and  revised  annually  in
13             accordance with Section 673(2) of the Omnibus Budget
14             Reconciliation Act of 1981, applicable  to  families
15             of the same size; or
16                  (ii)  their  income,  after  the  deduction  of
17             costs  incurred for medical care and for other types
18             of remedial care, is equal to or less  than  70%  in
19             fiscal  year  2001,  equal  to  or  less than 85% in
20             fiscal year 2002, and equal to or less than 100%  in
21             fiscal  year  2003  and  thereafter  of  the nonfarm
22             income official poverty line, as defined in item (i)
23             of this subparagraph (a).
24             (b)  All persons who would  be  determined  eligible
25        for   such   basic   maintenance   under  Article  IV  by
26        disregarding  the  maximum  earned  income  permitted  by
27        federal law.
28        3.  Persons who would otherwise qualify for  Aid  to  the
29    Medically Indigent under Article VII.
30        4.  Persons  not  eligible  under  any  of  the preceding
31    paragraphs who fall sick, are injured,  or  die,  not  having
32    sufficient  money,  property  or  other resources to meet the
33    costs  of  necessary  medical  care  or  funeral  and  burial
34    expenses.
 
                            -3-            LRB9200896DJgcam05
 1        5. (a)  Women  during  pregnancy,  after  the   fact   of
 2        pregnancy  has  been determined by medical diagnosis, and
 3        during the 60-day period beginning on the last day of the
 4        pregnancy, together with their infants and children  born
 5        after  September 30, 1983, whose income and resources are
 6        insufficient to meet the costs of necessary medical  care
 7        to  the  maximum  extent  possible under Title XIX of the
 8        Federal Social Security Act.
 9             (b)  The Illinois Department and the Governor  shall
10        provide a plan for coverage of the persons eligible under
11        paragraph 5(a) by April 1, 1990.  Such plan shall provide
12        ambulatory  prenatal  care  to  pregnant  women  during a
13        presumptive eligibility period and  establish  an  income
14        eligibility standard that is equal to 133% of the nonfarm
15        income  official  poverty line, as defined by the federal
16        Office of Management and Budget and revised  annually  in
17        accordance  with  Section  673(2)  of  the Omnibus Budget
18        Reconciliation Act of 1981, applicable to families of the
19        same size, provided that costs incurred for medical  care
20        are  not  taken  into  account in determining such income
21        eligibility.
22             (c)  The   Illinois   Department   may   conduct   a
23        demonstration in at least one county  that  will  provide
24        medical assistance to pregnant women, together with their
25        infants  and  children  up  to one year of age, where the
26        income eligibility standard is set  up  to  185%  of  the
27        nonfarm  income  official poverty line, as defined by the
28        federal Office of Management and Budget.    The  Illinois
29        Department  shall seek and obtain necessary authorization
30        provided  under  federal  law   to   implement   such   a
31        demonstration.  Such demonstration may establish resource
32        standards  that  are  not  more  restrictive  than  those
33        established under Article IV of this Code.
34        6.  Persons  under  the  age of 18 who fail to qualify as
 
                            -4-            LRB9200896DJgcam05
 1    dependent under Article IV and who have  insufficient  income
 2    and  resources to meet the costs of necessary medical care to
 3    the maximum extent permitted under Title XIX of  the  Federal
 4    Social Security Act.
 5        7.  Persons  who are 18 years of age or younger and would
 6    qualify as disabled as defined under the Federal Supplemental
 7    Security Income Program, provided medical  service  for  such
 8    persons    would    be   eligible   for   Federal   Financial
 9    Participation,   and   provided   the   Illinois   Department
10    determines that:
11             (a)  the person requires a level of care provided by
12        a hospital, skilled  nursing  facility,  or  intermediate
13        care  facility,  as determined by a physician licensed to
14        practice medicine in all its branches;
15             (b)  it is appropriate to provide such care  outside
16        of  an institution, as determined by a physician licensed
17        to practice medicine in all its branches;
18             (c)  the estimated amount which  would  be  expended
19        for  care outside the institution is not greater than the
20        estimated  amount  which  would   be   expended   in   an
21        institution.
22        8.  Persons  who  become ineligible for basic maintenance
23    assistance  under  Article  IV  of  this  Code  in   programs
24    administered  by  the  Illinois  Department due to employment
25    earnings and persons in assistance units comprised of  adults
26    and  children  who  become  ineligible  for basic maintenance
27    assistance under Article VI of this Code  due  to  employment
28    earnings.   The  plan  for coverage for this class of persons
29    shall:
30             (a)  extend the medical assistance coverage  for  up
31        to  12  months following termination of basic maintenance
32        assistance; and
33             (b)  offer persons who  have  initially  received  6
34        months  of  the coverage provided in paragraph (a) above,
 
                            -5-            LRB9200896DJgcam05
 1        the  option  of  receiving  an  additional  6  months  of
 2        coverage, subject to the following:
 3                  (i)  such  coverage  shall   be   pursuant   to
 4             provisions of the federal Social Security Act;
 5                  (ii)  such  coverage shall include all services
 6             covered while the  person  was  eligible  for  basic
 7             maintenance assistance;
 8                  (iii)  no  premium  shall  be  charged for such
 9             coverage; and
10                  (iv)  such coverage shall be suspended  in  the
11             event  of  a  person's failure without good cause to
12             file in a timely fashion reports required  for  this
13             coverage  under the Social Security Act and coverage
14             shall be reinstated upon the filing of such  reports
15             if the person remains otherwise eligible.
16        9.  Persons   with   acquired  immunodeficiency  syndrome
17    (AIDS) or with AIDS-related conditions with respect  to  whom
18    there   has  been  a  determination  that  but  for  home  or
19    community-based services such individuals would  require  the
20    level  of  care  provided  in  an inpatient hospital, skilled
21    nursing facility or intermediate care facility  the  cost  of
22    which  is reimbursed under this Article.  Assistance shall be
23    provided to such persons  to  the  maximum  extent  permitted
24    under Title XIX of the Federal Social Security Act.
25        10.  Participants   in   the   long-term  care  insurance
26    partnership program established  under  the  Partnership  for
27    Long-Term Care Act who meet the qualifications for protection
28    of resources described in Section 25 of that Act.
29        11.  Persons  with  disabilities  who  are  employed  and
30    eligible     for     Medicaid,     pursuant     to    Section
31    1902(a)(10)(A)(ii)(xv)  of  the  Social  Security   Act,   as
32    provided by the Illinois Department by rule.
33        12.  Subject   to   federal  approval,  persons  who  are
34    eligible for medical  assistance  coverage  under  applicable
 
                            -6-            LRB9200896DJgcam05
 1    provisions  of  the  federal  Social  Security   Act  and the
 2    federal Breast and Cervical Cancer Prevention  and  Treatment
 3    Act of 2000.   Those eligible persons are defined to include,
 4    but not be limited to, the following persons:
 5             (1)  persons  who  have  been screened for breast or
 6        cervical  cancer  under  the  U.S.  Centers  for  Disease
 7        Control and Prevention breast and cervical cancer program
 8        established under Title XV of the federal  Public  Health
 9        Services  Act  in  accordance  with  the  requirements of
10        Section 1504 of that Act as administered by the  Illinois
11        Department of Public Health; and
12             (2)  persons   whose   screenings  under  the  above
13        program  were  funded  in  whole  or  in  part  by  funds
14        appropriated to the Illinois Department of Public  Health
15        for breast or cervical cancer screening.
16    "Medical   assistance"  under  this  paragraph  12  shall  be
17    identical to the benefits provided under the State's approved
18    plan  under  Title  XIX  of  the  Social  Security  Act.  The
19    Department must request  federal  approval  of  the  coverage
20    under  this  paragraph  12 within 30 days after the effective
21    date of this amendatory Act of the 92nd General Assembly.
22        The Illinois Department and the Governor shall provide  a
23    plan  for  coverage of the persons eligible under paragraph 7
24    as soon as possible after July 1, 1984.
25        The eligibility of any such person for medical assistance
26    under this Article is not affected  by  the  payment  of  any
27    grant under the Senior Citizens and Disabled Persons Property
28    Tax   Relief   and   Pharmaceutical  Assistance  Act  or  any
29    distributions or items of income described under subparagraph
30    (X) of paragraph (2) of subsection (a) of Section 203 of  the
31    Illinois  Income  Tax  Act.   The  Department  shall  by rule
32    establish  the  amounts  of  assets  to  be  disregarded   in
33    determining  eligibility  for medical assistance, which shall
34    at a minimum equal the amounts to be  disregarded  under  the
 
                            -7-            LRB9200896DJgcam05
 1    Federal  Supplemental Security Income Program.  The amount of
 2    assets of a single person to be disregarded shall not be less
 3    than $2,000, and the amount of assets of a married couple  to
 4    be disregarded shall not be less than $3,000.
 5        To  the  extent  permitted  under federal law, any person
 6    found guilty of a second violation of Article VIIIA shall  be
 7    ineligible  for  medical  assistance  under  this Article, as
 8    provided in Section 8A-8.
 9        The eligibility of  any  person  for  medical  assistance
10    under  this  Article  shall not be affected by the receipt by
11    the person of donations or benefits from fundraisers held for
12    the person in cases of serious illness, as  long  as  neither
13    the  person  nor  members  of the person's family have actual
14    control over the donations or benefits or the disbursement of
15    the donations or benefits.
16    (Source: P.A. 91-676, eff.  12-23-99;  91-699,  eff.  7-1-00;
17    91-712, eff. 7-1-00; revised 6-26-00.)

18        Section  99.  Effective date.  This Act takes effect upon
19    becoming law.".

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