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| Public Act 095-0458 |
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AN ACT concerning public aid.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Illinois Public Aid Code is amended by | ||||
changing Section 5-1.2 as follows:
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(305 ILCS 5/5-1.2)
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Sec. 5-1.2. Recipient eligibility verification.
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(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
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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
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disclosure.
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(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
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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
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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
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shall operate for 12 months.
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(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,
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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
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any review or audit conducted by the State establishes that the
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information is incorrect.
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(Source: P.A. 88-554, eff. 7-26-94.)
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Section 99. Effective date. This Act takes effect upon | ||
becoming law.
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