|
|
Public Act 096-0804
|
| HB0366 Enrolled |
LRB096 04022 DRJ 14060 b |
|
|
AN ACT concerning aging.
|
Be it enacted by the People of the State of Illinois,
|
represented in the General Assembly:
|
Section 5. The Mobile Home Local Services Tax Act is |
amended by changing Section 7 as follows:
|
(35 ILCS 515/7) (from Ch. 120, par. 1207)
|
Sec. 7.
The local services tax for owners of mobile homes |
who (a) are
actually residing in such mobile homes, (b) hold |
title to such mobile
home as provided in the "Illinois Vehicle |
Code", approved September 29,
1969, as amended, and (c) are 65 |
years of age or older or are disabled
persons within the |
meaning of Section 3.14 of the "Senior Citizens and
Disabled |
Persons Property Tax Relief and Pharmaceutical Assistance Act"
|
on the annual billing date
shall be reduced to 80 percent of |
the tax provided for in Section 3 of
this Act. Proof that a |
claimant has been issued an Illinois Disabled
Person |
Identification Card stating that the claimant is under a Class |
2
disability, as provided in Section 4A of the The Illinois |
Identification Card
Act, shall constitute proof that the person |
thereon named is a disabled
person within the meaning of this |
Act. An application for reduction of
the tax shall be filed |
with
the county clerk by the individuals who are entitled to |
the reduction.
If the application is filed after May 1, the |
|
reduction in tax shall
begin with the next annual bill. |
Application for the reduction in tax
shall be done by |
submitting proof that the applicant has been issued an
Illinois |
Disabled Person Identification Card designating the |
applicant's
disability as a Class 2 disability, or by affidavit |
in substantially the
following form:
|
APPLICATION FOR REDUCTION OF MOBILE HOME LOCAL SERVICES TAX
|
I hereby make application for a reduction to 80% of the |
total tax
imposed under "An Act to provide for a local services
|
tax on mobile homes".
|
(1) Senior Citizens
|
(a) I actually reside in the mobile home ....
|
(b) I hold title to the mobile home as provided in the |
Illinois
Vehicle Code ....
|
(c) I reached the age of 65 on or before either January 1 |
(or July
1) of the year in which this statement is filed. My |
date of birth is: ...
|
(2) Disabled Persons
|
(a) I actually reside in the mobile home...
|
(b) I hold title to the mobile home as provided in the |
Illinois
Vehicle Code ....
|
(c) I was totally disabled on ... and have remained |
disabled until
the date of this application. My Social |
Security, Veterans, Railroad or
Civil Service Total Disability |
Claim Number is ... The undersigned
declares under the penalty |
of perjury that the above statements are true
and correct.
|
|
Dated (insert date).
|
...........................
|
Signature of owner
|
...........................
|
(Address)
|
...........................
|
(City) (State) (Zip)
|
Approved by:
|
.............................
|
(Assessor)
|
This application shall be accompanied by a copy of the |
applicant's
most recent application filed with the Illinois |
Department on Aging of Revenue
under the "Senior Citizens and |
Disabled Persons Property Tax Relief and
Pharmaceutical |
Assistance Act," approved July 17, 1972, as amended.
|
(Source: P.A. 91-357, eff. 7-29-99.)
|
Section 10. The Citizens Utility Board Act is amended by |
changing Section 9 as follows:
|
(220 ILCS 10/9) (from Ch. 111 2/3, par. 909)
|
Sec. 9. Mailing procedure.
|
(1) As used in this Section:
|
(a) "Enclosure" means a card, leaflet, envelope or |
combination thereof
furnished by the corporation under |
|
this Section.
|
(b) "Mailing" means any communication by a State |
agency, other than
a mailing made by the Department of |
Revenue under the Senior Citizens and
Disabled Persons |
Property Tax Relief and Pharmaceutical Assistance Act,
|
that is sent through the United States Postal Service to |
more than 50,000
persons within a 12-month period.
|
(c) "State agency" means any officer, department, |
board, commission,
institution or entity of the executive |
or legislative
branches of State government.
|
(2) To accomplish its powers and duties under Section 5 |
this Act, the
corporation, subject to the following |
limitations, may prepare and furnish
to any State agency an |
enclosure to be included with a mailing by that agency.
|
(a) A State agency furnished with an enclosure shall |
include the
enclosure within the mailing designated by the |
corporation.
|
(b) An enclosure furnished by the corporation under |
this Section shall
be provided to the State agency a |
reasonable period of time in advance of
the mailing.
|
(c) An enclosure furnished by the corporation under |
this Section shall be
limited to informing the reader of |
the purpose, nature and activities of the
corporation as |
set forth in this Act and informing the reader that it may
|
become a member in the corporation, maintain membership in |
the corporation
and contribute money to the corporation |
|
directly.
|
(d) Prior to furnishing an enclosure to the State |
agency, the
corporation shall seek and obtain approval of |
the content of the enclosure
from the Illinois Commerce |
Commission. The Commission shall approve the
enclosure if |
it determines that the enclosure (i) is not false or
|
misleading and (ii) satisfies the requirements of this Act. |
The Commission
shall be deemed to have approved the |
enclosure unless it disapproves the
enclosure within 14 |
days from the date of receipt.
|
(3) The corporation shall reimburse each State agency for |
all reasonable
incremental costs incurred by the State agency |
in complying with this
Section above the agency's normal |
mailing and handling costs, provided that:
|
(a) The State agency shall first furnish the |
corporation with an
itemized accounting of such additional |
cost; and
|
(b) The corporation shall not be required to reimburse |
the State agency
for postage costs if the weight of the |
corporation's enclosure does not
exceed .35 ounce |
avoirdupois. If the corporation's enclosure exceeds that
|
weight, then it shall only be required to reimburse the |
State agency for
postage cost over and above what the |
agency's postage cost would have been
had the enclosure |
weighed only .35 ounce avoirdupois.
|
(Source: P.A. 87-205.)
|
|
Section 15. The Senior Citizens and Disabled Persons |
Property Tax Relief and
Pharmaceutical Assistance Act is |
amended by changing Sections 1, 2, 3.01, 3.04, 3.05, 3.06, |
3.07, 3.08, 3.09, 3.10, 3.12, 4, 5, 7, 8, 8a, 9, 12, and 13 and |
by adding Sections 1.5, 3.01a, 3.03a, 3.05a, and 4.05 as |
follows:
|
(320 ILCS 25/1) (from Ch. 67 1/2, par. 401)
|
Sec. 1. Short title; common name. This Article shall be |
known and may be cited as the "Senior Citizens and
Disabled |
Persons Property Tax Relief and Pharmaceutical Assistance
|
Act". Common references to the "Circuit Breaker Act" mean this |
Article. As used in this Article, "this Act" means this |
Article.
|
(Source: P.A. 83-1531.)
|
(320 ILCS 25/1.5 new) |
Sec. 1.5. Implementation of Executive Order No. 3 of 2004. |
Executive Order No. 3 of 2004, in part, provided for the
|
transfer of the programs under this Act from the Department of
|
Revenue to the Department on Aging and the Department of
|
Healthcare and Family Services. It is the purpose of this
|
amendatory Act of the 96th General Assembly to conform this Act
|
and certain related provisions of other statutes to that
|
Executive Order. This amendatory Act of the 96th General
|
|
Assembly also makes other substantive changes
to this Act.
|
(320 ILCS 25/2) (from Ch. 67 1/2, par. 402)
|
Sec. 2. Purpose. The purpose of this Act is to provide |
incentives to the senior citizens
and disabled persons of this |
State to acquire and retain private housing of
their choice and |
at the same time to relieve those citizens from the
burdens of |
extraordinary property taxes and rising drug costs against |
their increasingly
restricted earning power, and thereby to |
reduce the requirements for public
housing in this State.
|
(Source: P.A. 77-2059.)
|
(320 ILCS 25/3.01) (from Ch. 67 1/2, par. 403.01)
|
Sec. 3.01. Claimant. "Claimant" means an individual who has |
filed a claim for a property tax relief grant under this Act. |
In appropriate contexts, "claimant" may also include a person |
who
has applied for pharmaceutical assistance under this Act or |
for
other benefits that are based on eligibility for benefits |
under
this Act.
|
(Source: P.A. 77-2059.)
|
(320 ILCS 25/3.01a new) |
Sec. 3.01a. Claim year. "Claim year" means the calendar
|
year prior to the period of time during which a claimant may
|
file an application for benefits under this Act.
|
|
(320 ILCS 25/3.03a new) |
Sec. 3.03a. Federal Poverty Level. "Federal Poverty Level"
|
means the federal poverty income guidelines as determined
|
annually by the United States Department of Health and Human
|
Services and updated periodically in the Federal Register by
|
that Department under the authority of 42 U.S.C. 9902(2).
|
(320 ILCS 25/3.04) (from Ch. 67 1/2, par. 403.04)
|
Sec. 3.04. Gross rent. "Gross rent Rent" means the total |
amount paid solely for the right to occupy
a residence.
|
If the residence is a nursing or sheltered care home, |
"gross rent" means
the amount paid in a taxable year that is |
attributable to the cost of
housing, but not of meals or care, |
for the claimant in that home,
determined in accordance with |
regulations of the Department on Aging.
|
(Source: P.A. 78-1249; 78-1297.)
|
(320 ILCS 25/3.05) (from Ch. 67 1/2, par. 403.05)
|
Sec. 3.05. Household. "Household" means a claimant or a |
claimant and his or her spouse, if any, living
together in the |
same residence. An additional resident may be counted in |
determining household size.
|
(Source: P.A. 77-2059.)
|
(320 ILCS 25/3.05a new) |
Sec. 3.05a. Additional resident. "Additional resident"
|
|
means a person who (i) is living in the same residence with a
|
claimant for the claim year and at the time of filing the
|
claim, (ii) is not the spouse of the claimant, (iii) does not
|
file a separate claim under this Act for the same period, and
|
(iv) receives more than half of his or her total financial
|
support for that claim year from the household. An additional |
resident who meets qualifications may receive pharmaceutical |
assistance based on a claimant's application.
|
(320 ILCS 25/3.06) (from Ch. 67 1/2, par. 403.06)
|
Sec. 3.06. Household income. "Household income" means the |
combined income of the members of a
household. The term does |
not include the income of any qualified additional resident who |
lives with the claimant.
|
(Source: P.A. 77-2059.)
|
(320 ILCS 25/3.07) (from Ch. 67 1/2, par. 403.07)
|
Sec. 3.07. Income. "Income" means adjusted gross income, |
properly reportable for
federal income tax purposes under the |
provisions of the Internal Revenue Code,
modified by adding |
thereto the sum of the following amounts to the extent
deducted |
or excluded from gross income in the computation of adjusted |
gross
income:
|
(A) An amount equal to all amounts paid or accrued as |
interest or
dividends during the taxable year;
|
(B) An amount equal to the amount of tax imposed by the |
|
Illinois Income
Tax Act paid for the taxable year;
|
(C) An amount equal to all amounts received during the |
taxable year as
an annuity under an annuity, endowment or |
life insurance contract or under
any other contract or |
agreement;
|
(D) An amount equal to the amount of benefits paid |
under the Federal
Social Security Act during the taxable |
year;
|
(E) An amount equal to the amount of benefits paid |
under the Railroad
Retirement Act during the taxable year;
|
(F) An amount equal to the total amount of cash public |
assistance
payments received from any governmental agency |
during the taxable year
other than benefits received |
pursuant to this Act;
|
(G) An amount equal to any net operating loss carryover |
deduction or
capital loss carryover deduction during the |
taxable year; and
|
(H) An For claim years beginning on or after January 1, |
2002, an amount
equal to any benefits received under the |
Workers' Compensation Act or the
Workers' Occupational |
Diseases Act during the
taxable year.
|
"Income" does not include any grant assistance received |
under the Nursing
Home Grant Assistance Act or any |
distributions or items of income described
under subparagraph |
(X) of paragraph (2) of subsection (a) of Section 203 of
the |
Illinois Income Tax Act or any payments under Section 2201 or |
|
Section 2202 of the American Recovery and Reinvestment Act of |
2009.
|
This amendatory Act of 1987 shall be effective for purposes |
of this
Section for tax years ending on or after December 31, |
1987.
|
(Source: P.A. 91-676, eff. 12-23-99; 92-131, eff. 7-23-01; |
92-519, eff.
1-1-02.)
|
(320 ILCS 25/3.08) (from Ch. 67 1/2, par. 403.08)
|
Sec. 3.08. Internal Revenue Code. "Internal Revenue Code" |
means the United States Internal Revenue Code of 1986
1954 or |
any successor law or laws relating to federal income taxes in
|
effect for the year.
|
(Source: P.A. 77-2059.)
|
(320 ILCS 25/3.09) (from Ch. 67 1/2, par. 403.09)
|
Sec. 3.09. Property taxes accrued. "Property taxes |
accrued" means the ad valorem property taxes
extended against a |
residence, but does not include special assessments,
interest |
or charges for service. In the case of real estate improved |
with a
multidwelling or multipurpose building, "property taxes |
accrued" extended
against a residence within such a building is |
an amount equal to the same
percentage of the total property |
taxes extended against that real estate as
improved as the |
value of the residence is to the total value of the
building. |
If the multidwelling building is owned and operated as a
|
|
cooperative, the value of an individual residence is the value |
of the
interest in the cooperative held by the owner of record |
of the legal or
equitable interest, other than a leasehold |
interest, in the cooperative
which confers the right to occupy |
that residence.
In determining the amount of grant under |
Section 4 for 1976
and thereafter, the applicable "property |
taxes accrued",
as determined under this Section, are those |
payable or paid
in the last preceding taxable year.
|
In addition, if the residence is a mobile home as defined |
in and subject
to the tax imposed by the Mobile Home Local |
Services Tax Act, "property taxes
accrued" includes the amount |
of privilege tax paid during the calendar year for
which |
benefits are claimed under that Act on that mobile home. If |
Beginning in
taxable year 1999, if (i) the residence is a |
mobile home, (ii) the resident is
the record owner of the |
property upon which the mobile home is
located, and (iii) the |
resident is liable for the taxes imposed under the
Property Tax |
Code for both the mobile home and the property, then "property
|
taxes accrued" includes the amount of property taxes paid on |
both the mobile
home and the property upon which the mobile |
home is located.
|
(Source: P.A. 91-357, eff. 7-29-99; 91-391, eff. 7-30-99.)
|
(320 ILCS 25/3.10) (from Ch. 67 1/2, par. 403.10)
|
Sec. 3.10. Regulations. "Regulations" includes both rules |
promulgated and forms prescribed by the applicable
Department. |
|
In this Act, references to the rules of the Department on Aging
|
or the Department of Healthcare and Family Services shall be
|
deemed to include, in appropriate cases, the corresponding
|
rules adopted by the Department of Revenue, to the extent that
|
those rules continue in force under Executive Order No. 3 of
|
2004.
|
(Source: P.A. 77-2059.)
|
(320 ILCS 25/3.12) (from Ch. 67 1/2, par. 403.12)
|
Sec. 3.12. Residence. "Residence" means the principal |
dwelling place occupied in this State by
a household and so |
much of the surrounding land as is reasonably necessary
for use |
of the dwelling as a home, and includes rental property, mobile
|
homes, single family dwellings, and units in multifamily, |
multidwelling or
multipurpose buildings. If the assessor has |
established a specific legal
description for a portion of |
property constituting the residence, then that
portion of |
property shall be deemed "residence" for the purposes of this
|
Act. "Residence" also includes that portion of a nursing or |
sheltered care
home occupied as a dwelling by a claimant, |
determined as prescribed in
regulations of the Department on |
Aging.
|
(Source: P.A. 78-1249.)
|
(320 ILCS 25/4) (from Ch. 67 1/2, par. 404)
|
Sec. 4. Amount of Grant.
|
|
(a) In general. Any individual 65 years or older or any |
individual who will
become 65 years old during the calendar |
year in which a claim is filed, and any
surviving spouse of |
such a claimant, who at the time of death received or was
|
entitled to receive a grant pursuant to this Section, which |
surviving spouse
will become 65 years of age within the 24 |
months immediately following the
death of such claimant and |
which surviving spouse but for his or her age is
otherwise |
qualified to receive a grant pursuant to this Section, and any
|
disabled person whose annual household income is less than the |
income eligibility limitation, as defined in subsection (a-5)
|
and whose household is liable for payment of property taxes |
accrued or has
paid rent constituting property taxes accrued |
and is domiciled in this State
at the time he or she files his |
or her claim is entitled to claim a
grant under this Act.
With |
respect to claims filed by individuals who will become 65 years |
old
during the calendar year in which a claim is filed, the |
amount of any grant
to which that household is entitled shall |
be an amount equal to 1/12 of the
amount to which the claimant |
would otherwise be entitled as provided in
this Section, |
multiplied by the number of months in which the claimant was
65 |
in the calendar year in which the claim is filed.
|
(a-5) Income eligibility limitation. For purposes of this |
Section, "income eligibility limitation" means an amount for |
grant years 2008 and thereafter: |
(i) for grant years before the 1998 grant year, less |
|
than $14,000; |
(ii) for the 1998 and 1999 grant year, less than |
$16,000; |
(iii) for grant years 2000 through 2007: |
(A) less than $21,218 for a household containing |
one person; |
(B) less than $28,480 for a household containing 2 |
persons; or |
(C) less than $35,740 for a
household containing 3 |
or more persons; or |
(iv) for grant years 2008 and thereafter:
|
(1) (A) less than $22,218 for a household containing |
one person; |
(2) (B) less than $29,480 for a household containing 2 |
persons; or |
(3) (C) less than $36,740 for a
household containing 3 |
or more persons. |
For 2009 claim year applications submitted during calendar |
year 2010, a household must have annual household income of |
less than $27,610 for a household containing one person; less |
than $36,635 for a household containing 2 persons; or less than |
$45,657 for a household containing 3 or more persons. |
The Department on Aging may adopt rules such that on |
January 1, 2011, and thereafter, the foregoing household income |
eligibility limits may be changed to reflect the annual cost of |
living adjustment in Social Security and Supplemental Security |
|
Income benefits that are applicable to the year for which those |
benefits are being reported as income on an application. |
If a person files as a surviving spouse, then only his or |
her income shall be counted in determining his or her household |
income. |
(b) Limitation. Except as otherwise provided in |
subsections (a) and (f)
of this Section, the maximum amount of |
grant which a claimant is
entitled to claim is the amount by |
which the property taxes accrued which
were paid or payable |
during the last preceding tax year or rent
constituting |
property taxes accrued upon the claimant's residence for the
|
last preceding taxable year exceeds 3 1/2% of the claimant's |
household
income for that year but in no event is the grant to |
exceed (i) $700 less
4.5% of household income for that year for |
those with a household income of
$14,000 or less or (ii) $70 if |
household income for that year is more than
$14,000.
|
(c) Public aid recipients. If household income in one or |
more
months during a year includes cash assistance in excess of |
$55 per month
from the Department of Healthcare and Family |
Services or the Department of Human Services (acting
as |
successor to the Department of Public Aid under the Department |
of Human
Services Act) which was determined under regulations |
of
that Department on a measure of need that included an |
allowance for actual
rent or property taxes paid by the |
recipient of that assistance, the amount
of grant to which that |
household is entitled, except as otherwise provided in
|
|
subsection (a), shall be the product of (1) the maximum amount |
computed as
specified in subsection (b) of this Section and (2) |
the ratio of the number of
months in which household income did |
not include such cash assistance over $55
to the number twelve. |
If household income did not include such cash assistance
over |
$55 for any months during the year, the amount of the grant to |
which the
household is entitled shall be the maximum amount |
computed as specified in
subsection (b) of this Section. For |
purposes of this paragraph (c), "cash
assistance" does not |
include any amount received under the federal Supplemental
|
Security Income (SSI) program.
|
(d) Joint ownership. If title to the residence is held |
jointly by
the claimant with a person who is not a member of |
his or her household,
the amount of property taxes accrued used |
in computing the amount of grant
to which he or she is entitled |
shall be the same percentage of property
taxes accrued as is |
the percentage of ownership held by the claimant in the
|
residence.
|
(e) More than one residence. If a claimant has occupied |
more than
one residence in the taxable year, he or she may |
claim only one residence
for any part of a month. In the case |
of property taxes accrued, he or she
shall prorate 1/12 of the |
total property taxes accrued on
his or her residence to each |
month that he or she owned and occupied
that residence; and, in |
the case of rent constituting property taxes accrued,
shall |
prorate each month's rent payments to the residence
actually |
|
occupied during that month.
|
(f) (Blank). There is hereby established a program of |
pharmaceutical assistance
to the aged and disabled which shall |
be administered by the Department in
accordance with this Act, |
to consist of payments to authorized pharmacies, on
behalf of |
beneficiaries of the program, for the reasonable costs of |
covered
prescription drugs. Each beneficiary who pays $5 for an |
identification card
shall pay no additional prescription |
costs. Each beneficiary who pays $25 for
an identification card |
shall pay $3 per prescription. In addition, after a
beneficiary |
receives $2,000 in benefits during a State fiscal year, that
|
beneficiary shall also be charged 20% of the cost of each |
prescription for
which payments are made by the program during |
the remainder of the fiscal
year. To become a beneficiary under |
this program a person must: (1)
be (i) 65 years of age or |
older, or (ii) the surviving spouse of such
a claimant, who at |
the time of death received or was entitled to receive
benefits |
pursuant to this subsection, which surviving spouse will become |
65
years of age within the 24 months immediately following the |
death of such
claimant and which surviving spouse but for his |
or her age is otherwise
qualified to receive benefits pursuant |
to this subsection, or (iii) disabled,
and (2) be domiciled in |
this State at the time he or she files
his or her claim, and (3) |
have a maximum household income of less
than the income |
eligibility limitation, as defined in subsection (a-5). In |
addition, each eligible person must (1) obtain an
|
|
identification card from the Department, (2) at the time the |
card is obtained,
sign a statement assigning to the State of |
Illinois benefits which may be
otherwise claimed under any |
private insurance plans, and (3) present the
identification |
card to the dispensing pharmacist.
|
The Department may adopt rules specifying
participation
|
requirements for the pharmaceutical assistance program, |
including copayment
amounts,
identification card fees, |
expenditure limits, and the benefit threshold after
which a 20% |
charge is imposed on the cost of each prescription, to be in
|
effect on and
after July 1, 2004.
Notwithstanding any other |
provision of this paragraph, however, the Department
may not
|
increase the identification card fee above the amount in effect |
on May 1, 2003
without
the express consent of the General |
Assembly.
To the extent practicable, those requirements shall |
be
commensurate
with the requirements provided in rules adopted |
by the Department of Healthcare and Family Services
to
|
implement the pharmacy assistance program under Section |
5-5.12a of the Illinois
Public
Aid Code.
|
Whenever a generic equivalent for a covered prescription |
drug is available,
the Department shall reimburse only for the |
reasonable costs of the generic
equivalent, less the co-pay |
established in this Section, unless (i) the covered
|
prescription drug contains one or more ingredients defined as a |
narrow
therapeutic index drug at 21 CFR 320.33, (ii) the |
prescriber indicates on the
face of the prescription "brand |
|
medically necessary", and (iii) the prescriber
specifies that a |
substitution is not permitted. When issuing an oral
|
prescription for covered prescription medication described in |
item (i) of this
paragraph, the prescriber shall stipulate |
"brand medically necessary" and
that a substitution is not |
permitted. If the covered prescription drug and its
authorizing |
prescription do not meet the criteria listed above, the |
beneficiary
may purchase the non-generic equivalent of the |
covered prescription drug by
paying the difference between the |
generic cost and the non-generic cost plus
the beneficiary |
co-pay.
|
Any person otherwise eligible for pharmaceutical |
assistance under this
Act whose covered drugs are covered by |
any public program for assistance in
purchasing any covered |
prescription drugs shall be ineligible for assistance
under |
this Act to the extent such costs are covered by such other |
plan.
|
The fee to be charged by the Department for the |
identification card shall
be equal to $5 per coverage year for |
persons below the official poverty line
as defined by the |
United States Department of Health and Human Services and
$25 |
per coverage year for all other persons.
|
In the event that 2 or more persons are eligible for any |
benefit under
this Act, and are members of the same household, |
(1) each such person shall
be entitled to participate in the |
pharmaceutical assistance program, provided
that he or she |
|
meets all other requirements imposed by this subsection
and (2) |
each participating household member contributes the fee |
required
for that person by the preceding paragraph for the |
purpose
of obtaining an identification card. |
The provisions of this subsection (f), other than this |
paragraph, are inoperative after December 31, 2005. |
Beneficiaries who received benefits under the program |
established by this subsection (f) are not entitled, at the |
termination of the program, to any refund of the identification |
card fee paid under this subsection. |
(g) Effective January 1, 2006, there is hereby established |
a program of pharmaceutical assistance to the aged and |
disabled, entitled the Illinois Seniors and Disabled Drug |
Coverage Program, which shall be administered by the Department |
of Healthcare and Family Services and the Department on Aging |
in accordance with this subsection, to consist of coverage of |
specified prescription drugs on behalf of beneficiaries of the |
program as set forth in this subsection. The program under this |
subsection replaces and supersedes the program established |
under subsection (f), which shall end at midnight on December |
31, 2005. |
To become a beneficiary under the program established under |
this subsection, a person must: |
(1) be (i) 65 years of age or older or (ii) disabled; |
and |
(2) be domiciled in this State; and |
|
(3) enroll with a qualified Medicare Part D |
Prescription Drug Plan if eligible and apply for all |
available subsidies under Medicare Part D; and |
(4) for the 2006 and 2007 claim years, have a maximum |
household income of (i) less than $21,218 for a household |
containing one person, (ii) less than $28,480 for a |
household containing 2 persons, or (iii) less than $35,740 |
for a household containing 3 or more persons; and . If any |
income eligibility limit set forth in items (i) through |
(iii) is less than 200% of the Federal Poverty Level for |
any year, the income eligibility limit for that year for |
households of that size shall be income equal to or less |
than 200% of the Federal Poverty Level. |
(5) for the 2008 claim year, have a maximum household |
income of (i) less than $22,218 for a household containing |
one person, (ii) $29,480 for a household containing 2 |
persons, or (iii) $36,740 for a household containing 3 or |
more persons; and |
(6) for 2009 claim year applications submitted during |
calendar year 2010, have annual household income of less |
than (i) $27,610 for a household containing one person; |
(ii) less than $36,635 for a household containing 2 |
persons; or (iii) less than $45,657 for a household |
containing 3 or more persons. |
The Department of Healthcare and Family Services may adopt |
rules such that on January 1, 2011, and thereafter, the |
|
foregoing household income eligibility limits may be changed to |
reflect the annual cost of living adjustment in Social Security |
and Supplemental Security Income benefits that are applicable |
to the year for which those benefits are being reported as |
income on an application. |
All individuals enrolled as of December 31, 2005, in the |
pharmaceutical assistance program operated pursuant to |
subsection (f) of this Section and all individuals enrolled as |
of December 31, 2005, in the SeniorCare Medicaid waiver program |
operated pursuant to Section 5-5.12a of the Illinois Public Aid |
Code shall be automatically enrolled in the program established |
by this subsection for the first year of operation without the |
need for further application, except that they must apply for |
Medicare Part D and the Low Income Subsidy under Medicare Part |
D. A person enrolled in the pharmaceutical assistance program |
operated pursuant to subsection (f) of this Section as of |
December 31, 2005, shall not lose eligibility in future years |
due only to the fact that they have not reached the age of 65. |
To the extent permitted by federal law, the Department may |
act as an authorized representative of a beneficiary in order |
to enroll the beneficiary in a Medicare Part D Prescription |
Drug Plan if the beneficiary has failed to choose a plan and, |
where possible, to enroll beneficiaries in the low-income |
subsidy program under Medicare Part D or assist them in |
enrolling in that program. |
Beneficiaries under the program established under this |
|
subsection shall be divided into the following 4 5 eligibility |
groups: |
(A) Eligibility Group 1 shall consist of beneficiaries |
who are not eligible for Medicare Part D coverage and who
|
are: |
(i) disabled and under age 65; or |
(ii) age 65 or older, with incomes over 200% of the |
Federal Poverty Level; or |
(iii) age 65 or older, with incomes at or below |
200% of the Federal Poverty Level and not eligible for |
federally funded means-tested benefits due to |
immigration status. |
(B) Eligibility Group 2 shall consist of beneficiaries |
otherwise described in Eligibility Group 1 but who are |
eligible for Medicare Part D coverage. |
(C) Eligibility Group 3 shall consist of beneficiaries |
age 65 or older, with incomes at or below 200% of the |
Federal Poverty Level, who are not barred from receiving |
federally funded means-tested benefits due to immigration |
status and are not eligible for Medicare Part D coverage. |
(D) Eligibility Group 4 shall consist of beneficiaries |
age 65 or older, with incomes at or below 200% of the |
Federal Poverty Level, who are not barred from receiving |
federally funded means-tested benefits due to immigration |
status and are not eligible for Medicare Part D coverage. |
If the State applies and receives federal approval for |
|
a waiver under Title XIX of the Social Security Act, |
persons in Eligibility Group 3 4 shall continue to receive |
benefits through the approved waiver, and Eligibility |
Group 3 4 may be expanded to include disabled persons under |
age 65 with incomes under 200% of the Federal Poverty Level |
who are not eligible for Medicare and who are not barred |
from receiving federally funded means-tested benefits due |
to immigration status. |
(D) (E) On and after January 1, 2007, Eligibility Group |
4 5 shall consist of beneficiaries who are otherwise |
described in Eligibility Group 2 Groups 2 and 3 who have a |
diagnosis of HIV or AIDS.
|
The program established under this subsection shall cover |
the cost of covered prescription drugs in excess of the |
beneficiary cost-sharing amounts set forth in this paragraph |
that are not covered by Medicare. In 2006, beneficiaries shall |
pay a co-payment of $2 for each prescription of a generic drug |
and $5 for each prescription of a brand-name drug. In future |
years, beneficiaries shall pay co-payments equal to the |
co-payments required under Medicare Part D for "other |
low-income subsidy eligible individuals" pursuant to 42 CFR |
423.782(b). For individuals in Eligibility Groups 1, 2, and 3, |
and 4, once the program established under this subsection and |
Medicare combined have paid $1,750 in a year for covered |
prescription drugs, the beneficiary shall pay 20% of the cost |
of each prescription in addition to the co-payments set forth |
|
in this paragraph. For individuals in Eligibility Group 4 5, |
once the program established under this subsection and Medicare |
combined have paid $1,750 in a year for covered prescription |
drugs, the beneficiary shall pay 20% of the cost of each |
prescription in addition to the co-payments set forth in this |
paragraph unless the drug is included in the formulary of the |
Illinois AIDS Drug Assistance Program operated by the Illinois |
Department of Public Health and covered by the Medicare Part D |
Prescription Drug Plan in which the beneficiary is enrolled. If |
the drug is included in the formulary of the Illinois AIDS Drug |
Assistance Program and covered by the Medicare Part D |
Prescription Drug Plan in which the beneficiary is enrolled, |
individuals in Eligibility Group 4 5 shall continue to pay the |
co-payments set forth in this paragraph after the program |
established under this subsection and Medicare combined have |
paid $1,750 in a year for covered prescription drugs.
|
For beneficiaries eligible for Medicare Part D coverage, |
the program established under this subsection shall pay 100% of |
the premiums charged by a qualified Medicare Part D |
Prescription Drug Plan for Medicare Part D basic prescription |
drug coverage, not including any late enrollment penalties. |
Qualified Medicare Part D Prescription Drug Plans may be |
limited by the Department of Healthcare and Family Services to |
those plans that sign a coordination agreement with the |
Department. |
Notwithstanding Section 3.15, for purposes of the program |
|
established under this subsection, the term "covered |
prescription drug" has the following meanings: |
For Eligibility Group 1, "covered prescription drug" |
means: (1) any cardiovascular agent or drug; (2) any |
insulin or other prescription drug used in the treatment of |
diabetes, including syringe and needles used to administer |
the insulin; (3) any prescription drug used in the |
treatment of arthritis; (4) any prescription drug used in |
the treatment of cancer; (5) any prescription drug used in |
the treatment of Alzheimer's disease; (6) any prescription |
drug used in the treatment of Parkinson's disease; (7) any |
prescription drug used in the treatment of glaucoma; (8) |
any prescription drug used in the treatment of lung disease |
and smoking-related illnesses; (9) any prescription drug |
used in the treatment of osteoporosis; and (10) any |
prescription drug used in the treatment of multiple |
sclerosis. The Department may add additional therapeutic |
classes by rule. The Department may adopt a preferred drug |
list within any of the classes of drugs described in items |
(1) through (10) of this paragraph. The specific drugs or |
therapeutic classes of covered prescription drugs shall be |
indicated by rule. |
For Eligibility Group 2, "covered prescription drug" |
means those drugs covered for Eligibility Group 1 that are |
also covered by the Medicare Part D Prescription Drug Plan |
in which the beneficiary is enrolled. |
|
For Eligibility Group 3, "covered prescription drug" |
means those drugs covered by the Medicare Part D |
Prescription Drug Plan in which the beneficiary is |
enrolled. |
For Eligibility Group 3 4, "covered prescription drug" |
means those drugs covered by the Medical Assistance Program |
under Article V of the Illinois Public Aid Code. |
For Eligibility Group 4 5, for individuals otherwise |
described in Eligibility Group 2, "covered prescription |
drug" means:
(1) those drugs covered for Eligibility Group |
2 that are also covered by the Medicare Part D Prescription |
Drug Plan in which the beneficiary is enrolled; and
(2) |
those drugs included in the formulary of the Illinois AIDS |
Drug Assistance Program operated by the Illinois |
Department of Public Health that are also covered by the |
Medicare Part D Prescription Drug Plan in which the |
beneficiary is enrolled.
For Eligibility Group 5, for |
individuals otherwise described in Eligibility Group 3, |
"covered prescription drug" means those drugs covered by |
the Medicare Part D Prescription Drug Plan in which the |
beneficiary is enrolled. |
An individual in Eligibility Group 1, 2, 3, or 4, or 5 may |
opt to receive a $25 monthly payment in lieu of the direct |
coverage described in this subsection. |
Any person otherwise eligible for pharmaceutical |
assistance under this subsection whose covered drugs are |
|
covered by any public program is ineligible for assistance |
under this subsection to the extent that the cost of those |
drugs is covered by the other program. |
The Department of Healthcare and Family Services shall |
establish by rule the methods by which it will provide for the |
coverage called for in this subsection. Those methods may |
include direct reimbursement to pharmacies or the payment of a |
capitated amount to Medicare Part D Prescription Drug Plans. |
For a pharmacy to be reimbursed under the program |
established under this subsection, it must comply with rules |
adopted by the Department of Healthcare and Family Services |
regarding coordination of benefits with Medicare Part D |
Prescription Drug Plans. A pharmacy may not charge a |
Medicare-enrolled beneficiary of the program established under |
this subsection more for a covered prescription drug than the |
appropriate Medicare cost-sharing less any payment from or on |
behalf of the Department of Healthcare and Family Services. |
The Department of Healthcare and Family Services or the |
Department on Aging, as appropriate, may adopt rules regarding |
applications, counting of income, proof of Medicare status, |
mandatory generic policies, and pharmacy reimbursement rates |
and any other rules necessary for the cost-efficient operation |
of the program established under this subsection. |
(h) A qualified individual is not entitled to duplicate
|
benefits in a coverage period as a result of the changes made
|
by this amendatory Act of the 96th General Assembly.
|
|
(Source: P.A. 94-86, eff. 1-1-06; 94-909, eff. 6-23-06; 95-208, |
eff. 8-16-07; 95-644, eff. 10-12-07; 95-876, eff. 8-21-08.)
|
(320 ILCS 25/4.05 new) |
Sec. 4.05. Application. |
(a) The Department on Aging shall establish the content,
|
required eligibility and identification information, use of
|
social security numbers, and manner of applying for benefits in |
a simplified format
under this Act, including claims filed for
|
new or renewed prescription drug benefits. |
(b) An application may be filed on paper or over the |
Internet to enable persons to apply separately
or for both a |
property tax relief grant and pharmaceutical
assistance on the |
same application. An application may also
enable persons to |
apply for other State or federal programs
that provide medical |
or pharmaceutical assistance or other
benefits, as determined |
by the Department on Aging in
conjunction with the Department |
of Healthcare and Family
Services. |
(c) Applications must be filed during the time period
|
prescribed by the Department.
|
(320 ILCS 25/5) (from Ch. 67 1/2, par. 405)
|
Sec. 5. Procedure.
|
(a) In general. Claims must be filed after January 1, on |
forms prescribed
by the Department. No claim may be filed more |
than one year after December 31
of the year for which the claim |
|
is filed except that claims for 1976 may be
filed until |
December 31, 1978. The pharmaceutical assistance |
identification
card provided for in subsection (f) of Section 4 |
shall be valid for a period determined by the Department of |
Healthcare and Family Services
not to exceed one year. On and |
after January 1, 2002, however, to enable the
Department to |
convert coverage for a pharmaceutical assistance program
|
participant to a State fiscal year basis, a card shall be valid |
for a longer or
shorter period than 12 months, depending on the |
date a timely claim is filed
and as determined by the |
Department. All applicants for benefits under this
program |
approved for benefits on or after July 1 but on or before |
December 31
of any State fiscal year are eligible for benefits |
through June 30 of that
State fiscal year. All applicants for |
benefits under this program approved for
benefits on or after |
January 1 but on or before June 30 of any State fiscal
year are |
eligible for benefits through June 30 of the following State |
fiscal
year.
|
(b) Claim is Personal. The right to file a claim under this |
Act
shall be personal to the claimant and shall not survive his |
death, but
such right may be exercised on behalf of a claimant |
by his legal
guardian or attorney-in-fact. If a claimant dies |
after having filed a
timely claim, the amount thereof shall be |
disbursed to his surviving spouse
or, if no spouse survives, to |
his surviving dependent minor children in
equal parts, provided |
the spouse or child, as the case may be, resided with
the |
|
claimant at the time he filed his claim. If at the time of |
disbursement
neither the claimant nor his spouse is surviving, |
and no dependent minor
children of the claimant are surviving |
the amount of the claim shall
escheat to the State.
|
(c) One claim per household. Only one member of a household |
may file
a claim under this Act in any calendar year; where |
both members of a
household are otherwise entitled to claim a |
grant under this Act, they
must agree as to which of them will |
file a claim for that year.
|
(d) (Blank). Content of application form. The form |
prescribed by the
Department for purposes of paragraph (a) |
shall include a table,
appropriately keyed to the parts of the |
form on which the claimant is
required to furnish information, |
which will enable the claimant to
determine readily the |
approximate amount of grant to which he is
entitled by relating |
levels of household income to property taxes
accrued or rent |
constituting property taxes accrued.
|
(e) Pharmaceutical Assistance Procedures. The Department |
shall establish
the form and manner for application, and |
establish by January 1, 1986 a
procedure to enable persons to |
apply for the additional grant or for the
pharmaceutical |
assistance identification card on the same application form.
|
The Department of Healthcare and Family Services shall |
determine eligibility for pharmaceutical assistance using
the |
applicant's current income. The Department shall determine a |
person's
current income in the manner provided by the |
|
Department by rule.
|
(Source: P.A. 91-533, eff. 8-13-99; 91-699, eff. 1-1-01; |
92-131, eff.
7-23-01; 92-519, eff. 1-1-02.)
|
(320 ILCS 25/7) (from Ch. 67 1/2, par. 407)
|
Sec. 7. Payment and denial of claims. |
(a) In general. The Director shall order the payment from |
appropriations
made for that purpose of grants to claimants |
under this Act in the amounts
to which the Department has |
determined they are entitled, respectively. If
a claim is |
denied, the Director shall cause written notice of that denial
|
and the reasons for that denial to be sent to the claimant.
|
(b) Payment of claims one dollar and under. Where the |
amount of the
grant computed under Section 4 is less than one |
dollar, the Department
shall pay to the claimant one dollar.
|
(c) Right to appeal. Any person aggrieved by an action or |
determination of
the Department on Aging arising under any of |
its powers or
duties under this Act may request in writing that |
the
Department on Aging reconsider its action or determination,
|
setting out the facts upon which the request is based. The
|
Department on Aging shall consider the request and either
|
modify or affirm its prior action or determination. The
|
Department on Aging may adopt, by rule, procedures for |
conducting
its review under this Section. |
Any person aggrieved by an action or determination of
the |
Department of Healthcare and Family Services arising under
any |
|
of its powers or duties under this Act may request in
writing |
that the Department of Healthcare and Family Services
|
reconsider its action or determination, setting out the facts
|
upon which the request is based. The Department of Healthcare
|
and Family Services shall consider the request and either
|
modify or affirm its prior action or determination. The
|
Department of Healthcare and Family Services may adopt, by |
rule,
procedures for conducting its review under this Section. |
Any claimant aggrieved by the action of the
Department under |
this Act, whether in the reduction of the amount of the
grant |
claimed or in the denial of the claim, may request in writing |
that
the Department reconsider its prior determination, |
setting out the facts on
which his request is based. The |
Department shall consider the request and
either modify or |
affirm its prior determination.
|
(d) (Blank). Administrative review. The decision of the |
Department to affirm its
prior determination, or the failure of |
the Department to act on a request
for reconsideration within |
60 days, is a final administrative decision
which is subject to |
judicial review under the Administrative Review Law,
and all |
amendments and modifications thereof and the rules adopted |
thereto.
The term "administrative decision" is defined as in |
Section 3-101 of the
Code of Civil Procedure.
|
(Source: P.A. 82-783.)
|
(320 ILCS 25/8) (from Ch. 67 1/2, par. 408)
|
|
Sec. 8. Records. Every claimant of a grant under this Act |
and every applicant for pharmaceutical assistance under this |
Act shall keep such records, render
such statements, file such |
forms and comply with such rules and regulations
as the |
Department on Aging may from time to time prescribe. The |
Department on Aging may by
regulations require landlords to |
furnish to tenants statements as to gross
rent or rent |
constituting property taxes accrued.
|
(Source: P.A. 77-2059.)
|
(320 ILCS 25/8a) (from Ch. 67 1/2, par. 408.1)
|
Sec. 8a. Confidentiality.
|
(a) Except as otherwise provided in this Act, all
|
information received by the Department of Revenue or its |
successors, the Department on Aging and the Department of |
Healthcare and Family Services, from claims filed under this |
Act, or
from any investigation conducted under the provisions
|
of this Act, shall be confidential, except for official |
purposes within those Departments
the Department or pursuant to |
official
procedures for collection of any State tax or |
enforcement of any civil or
criminal penalty or sanction |
imposed
by this Act or by any statute imposing a State tax, and |
any person who divulges
any such information in any
manner, |
except for such purposes and pursuant to order of the Director |
of one of those Departments or
in accordance with a proper |
judicial order, shall be guilty of a Class A
misdemeanor.
|
|
(b) Nothing contained in this Act shall prevent the |
Director of Aging from publishing
or making available |
reasonable statistics concerning the operation of the
grant |
programs contained in this Act wherein the contents
of claims |
are grouped into aggregates in such a way that information |
contained
in any individual claim shall not be disclosed.
|
(c) The Department on Aging shall furnish to the Secretary |
of State such
information as is reasonably necessary for the |
administration of reduced
vehicle registration fees pursuant |
to Section 3-806.3 of "The Illinois Vehicle
Code".
|
(Source: P.A. 89-399, eff. 8-20-95.)
|
(320 ILCS 25/9) (from Ch. 67 1/2, par. 409)
|
Sec. 9. Fraud; error. |
(a) Any person who files a fraudulent claim
for a grant |
under this Act, or who for compensation prepares a claim
for a |
grant and
knowingly enters false information on an application |
a claim form for any claimant under
this Act, or who |
fraudulently files multiple applications claim forms, or who
|
fraudulently states that a nondisabled person is disabled, or |
who
fraudulently procures a pharmaceutical assistance benefits |
identification card, or
who fraudulently uses such assistance |
card to procure covered prescription drugs, or
who, on behalf |
of an authorized pharmacy, files a fraudulent request claim for |
payment, is
guilty of a Class 4 felony for the first offense |
and is guilty of a Class 3
felony for each subsequent offense. |
|
(b) The Department on Aging and the Department of |
Healthcare and Family Services shall immediately
suspend the |
use of the pharmaceutical assistance benefits identification |
card of any
person suspected of fraudulent procurement or |
fraudulent use of such assistance card,
and shall revoke such |
assistance card upon a conviction. A person convicted of such
|
fraud under subsection (a) shall be permanently barred from all |
of the programs the program of pharmaceutical
assistance |
established under this Act. |
(c) The Department on Aging may recover from a
claimant, |
including an authorized pharmacy, any amount paid to that |
claimant under this
Act on account of an erroneous or
|
fraudulent claim, together with 6% interest per year. Amounts
|
recoverable from a claimant by the Department on Aging under
|
this Act may, but need not, be recovered by offsetting the
|
amount owed against any future grant payable to the person
|
under this Act. |
The Department of Healthcare and Family Services may
|
recover from an authorized pharmacy any amount paid to that
|
pharmacy under the pharmaceutical assistance program on
|
account of an erroneous or fraudulent request for payment under
|
that program, together with 6% interest per year. The
|
Department of Healthcare and Family Services may recover from a
|
person who erroneously or fraudulently obtains benefits under
|
the pharmaceutical assistance program the value of the benefits
|
so obtained, together with 6% interest per year. |
|
(d) A prosecution for
a violation of this Section may be |
commenced at any time within 3 years
of the commission of that |
violation.
|
(Source: P.A. 85-299.)
|
(320 ILCS 25/12) (from Ch. 67 1/2, par. 412)
|
Sec. 12. Regulations - Department on Aging.
|
(a) Regulations. Notwithstanding any other provision to |
the contrary,
the Department on Aging may adopt rules regarding |
applications,
proof of eligibility, required identification |
information, use
of social security numbers, counting of |
income, and a method of
computing "gross rent" in the case of a |
claimant living in a
nursing or sheltered care home, and any |
other rules necessary
for the cost-efficient operation of the |
program established
under Section 4. The Director shall |
promulgate such regulations as are
necessary or desirable to |
effectuate the purposes of this Act, including but
not limited |
to the method of computing "gross rent" in the case of a |
claimant
living in a nursing or sheltered care home.
|
(b) The Department on Aging shall, to the extent of |
appropriations made
for that purpose:
|
(1) attempt to secure the cooperation of appropriate |
federal, State and
local agencies in securing the names and |
addresses of persons to whom this
Act pertains;
|
(2) prepare a mailing list of persons eligible for |
grants under this Act;
|
|
(3) secure the cooperation of the Department of |
Revenue, the Department of Healthcare and Family Services, |
other State agencies, and of local
business establishments |
to facilitate distribution of applications application |
forms
under this Act to those eligible to file claims; and
|
(4) through use of direct mail, newspaper |
advertisements and radio and
television advertisements, |
and all other appropriate means of
communication, conduct |
an on-going public relations program to increase
awareness |
of eligible citizens of the benefits grants under this Act |
and the
procedures for applying for them.
|
(Source: P.A. 78-1249.)
|
(320 ILCS 25/13) (from Ch. 67 1/2, par. 413)
|
Sec. 13. List of persons who have qualified. The Department |
on Aging of Revenue shall maintain a list of all
persons who |
have qualified under this Act and shall make the list
available |
to the Department of Healthcare and Family Services, the |
Department of Public Health, the Secretary of State, |
municipalities, and public transit authorities upon request.
|
All information received by a State agency, municipality, |
or public transit authority under this Section
shall be |
confidential, except for official purposes, and any
person who |
divulges or uses that information in any manner,
except in |
accordance with a proper judicial order, shall be
guilty of a |
Class B misdemeanor.
|