Illinois General Assembly - Full Text of Public Act 095-0458
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Public Act 095-0458




Public Act 095-0458
SB1349 Enrolled LRB095 09503 DRJ 29701 b

    AN ACT concerning public aid.
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
    Section 5. The Illinois Public Aid Code is amended by
changing Section 5-1.2 as follows:
    (305 ILCS 5/5-1.2)
    Sec. 5-1.2. Recipient eligibility verification.
    (a) The Illinois Department shall initiate a statewide
system by which providers and sites of medical care can
electronically verify recipient eligibility for aid under this
Article. High-volume providers and sites of medical care, as
defined by the Illinois Department by rule, shall be required
to participate in the eligibility verification system. Every
non-high-volume provider and site of medical care shall be
afforded the opportunity to participate in the eligibility
verification system. The Illinois Department shall provide by
rule for implementation of the system, which may be
accomplished in phases over time and by geographic region,
recipient classification, and provider type. The system shall
initially be implemented in, but not limited to, the following
zip codes in Cook County: 60601, 60602, 60603, 60604, 60605,
60606, 60607, 60608, 60609, 60612, and 60616. The system shall
be implemented within 6 months after approval by the federal
government. The Illinois Department shall report to the General
Assembly by December 31, 1994 on the status of the Illinois
Department's application to the federal government for
approval of this system. The recipient eligibility
verification system may be coordinated with the Electronic
Benefits Transfer system established by Section 11-3.1 of this
Code and compatible with any of the methods for the delivery of
medical care and services authorized by this Article. The
system shall make available to providers the history of claims
for medical services submitted to the Illinois Department for
those services provided to the recipient. The Illinois
Department shall develop safeguards to protect each
recipient's health information from misuse or unauthorized
    (b) The Illinois Department shall conduct a demonstration
project in at least 2 geographic locations for the purpose of
assessing the effectiveness of a recipient photo
identification card in reducing abuses in the provision of
services under this Article. In order to receive medical care,
recipients included in this demonstration project must present
a Medicaid card and photo identification card. The Illinois
Department shall apply for any federal waivers or approvals
necessary to conduct this demonstration project. The
demonstration project shall become operational (i) 12 months
after the effective date of this amendatory Act of 1994 or (ii)
after the Illinois Department's receipt of all necessary
federal waivers and approvals, whichever occurs later, and
shall operate for 12 months.
    (c) Effective October 1, 2007, all changes in status of
Medicaid recipients residing in Illinois nursing facilities
after initial eligibility for Medicaid has been established
shall be reported to the Department, using an Internet-based
electronic data interchange system, by the nursing facilities,
except for those changes made by personnel of the Department.
Changes reported using the Internet-based electronic data
interchange system shall be deemed valid and shall be used as
the basis for future Medicaid payments unless Department
approval of the transaction is required, or until such time as
any review or audit conducted by the State establishes that the
information is incorrect.
(Source: P.A. 88-554, eff. 7-26-94.)
    Section 99. Effective date. This Act takes effect upon
becoming law.

Effective Date: 8/27/2007