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Public Act 92-0047
HB0025 Enrolled LRB9200896DJgc
AN ACT in relation to 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 5-2 as follows:
(305 ILCS 5/5-2) (from Ch. 23, par. 5-2)
Sec. 5-2. Classes of Persons Eligible. Medical
assistance under this Article shall be available to any of
the following classes of persons in respect to whom a plan
for coverage has been submitted to the Governor by the
Illinois Department and approved by him:
1. Recipients of basic maintenance grants under Articles
III and IV.
2. Persons otherwise eligible for basic maintenance
under Articles III and IV but who fail to qualify thereunder
on the basis of need, and who have insufficient income and
resources to meet the costs of necessary medical care,
including but not limited to the following:
(a) All persons otherwise eligible for basic
maintenance under Article III but who fail to qualify
under that Article on the basis of need and who meet
either of the following requirements:
(i) their income, as determined by the
Illinois Department in accordance with any federal
requirements, is equal to or less than 70% in fiscal
year 2001, equal to or less than 85% in fiscal year
2002, and equal to or less than 100% in fiscal year
2003 and thereafter of the nonfarm income official
poverty line, as defined by the federal Office of
Management and Budget and revised annually in
accordance with Section 673(2) of the Omnibus Budget
Reconciliation Act of 1981, applicable to families
of the same size; or
(ii) their income, after the deduction of
costs incurred for medical care and for other types
of remedial care, is equal to or less than 70% in
fiscal year 2001, equal to or less than 85% in
fiscal year 2002, and equal to or less than 100% in
fiscal year 2003 and thereafter of the nonfarm
income official poverty line, as defined in item (i)
of this subparagraph (a).
(b) All persons who would be determined eligible
for such basic maintenance under Article IV by
disregarding the maximum earned income permitted by
federal law.
3. Persons who would otherwise qualify for Aid to the
Medically Indigent under Article VII.
4. Persons not eligible under any of the preceding
paragraphs who fall sick, are injured, or die, not having
sufficient money, property or other resources to meet the
costs of necessary medical care or funeral and burial
expenses.
5. (a) Women during pregnancy, after the fact of
pregnancy has been determined by medical diagnosis, and
during the 60-day period beginning on the last day of the
pregnancy, together with their infants and children born
after September 30, 1983, whose income and resources are
insufficient to meet the costs of necessary medical care
to the maximum extent possible under Title XIX of the
Federal Social Security Act.
(b) The Illinois Department and the Governor shall
provide a plan for coverage of the persons eligible under
paragraph 5(a) by April 1, 1990. Such plan shall provide
ambulatory prenatal care to pregnant women during a
presumptive eligibility period and establish an income
eligibility standard that is equal to 133% of the nonfarm
income official poverty line, as defined by the federal
Office of Management and Budget and revised annually in
accordance with Section 673(2) of the Omnibus Budget
Reconciliation Act of 1981, applicable to families of the
same size, provided that costs incurred for medical care
are not taken into account in determining such income
eligibility.
(c) The Illinois Department may conduct a
demonstration in at least one county that will provide
medical assistance to pregnant women, together with their
infants and children up to one year of age, where the
income eligibility standard is set up to 185% of the
nonfarm income official poverty line, as defined by the
federal Office of Management and Budget. The Illinois
Department shall seek and obtain necessary authorization
provided under federal law to implement such a
demonstration. Such demonstration may establish resource
standards that are not more restrictive than those
established under Article IV of this Code.
6. Persons under the age of 18 who fail to qualify as
dependent under Article IV and who have insufficient income
and resources to meet the costs of necessary medical care to
the maximum extent permitted under Title XIX of the Federal
Social Security Act.
7. Persons who are 18 years of age or younger and would
qualify as disabled as defined under the Federal Supplemental
Security Income Program, provided medical service for such
persons would be eligible for Federal Financial
Participation, and provided the Illinois Department
determines that:
(a) the person requires a level of care provided by
a hospital, skilled nursing facility, or intermediate
care facility, as determined by a physician licensed to
practice medicine in all its branches;
(b) it is appropriate to provide such care outside
of an institution, as determined by a physician licensed
to practice medicine in all its branches;
(c) the estimated amount which would be expended
for care outside the institution is not greater than the
estimated amount which would be expended in an
institution.
8. Persons who become ineligible for basic maintenance
assistance under Article IV of this Code in programs
administered by the Illinois Department due to employment
earnings and persons in assistance units comprised of adults
and children who become ineligible for basic maintenance
assistance under Article VI of this Code due to employment
earnings. The plan for coverage for this class of persons
shall:
(a) extend the medical assistance coverage for up
to 12 months following termination of basic maintenance
assistance; and
(b) offer persons who have initially received 6
months of the coverage provided in paragraph (a) above,
the option of receiving an additional 6 months of
coverage, subject to the following:
(i) such coverage shall be pursuant to
provisions of the federal Social Security Act;
(ii) such coverage shall include all services
covered while the person was eligible for basic
maintenance assistance;
(iii) no premium shall be charged for such
coverage; and
(iv) such coverage shall be suspended in the
event of a person's failure without good cause to
file in a timely fashion reports required for this
coverage under the Social Security Act and coverage
shall be reinstated upon the filing of such reports
if the person remains otherwise eligible.
9. Persons with acquired immunodeficiency syndrome
(AIDS) or with AIDS-related conditions with respect to whom
there has been a determination that but for home or
community-based services such individuals would require the
level of care provided in an inpatient hospital, skilled
nursing facility or intermediate care facility the cost of
which is reimbursed under this Article. Assistance shall be
provided to such persons to the maximum extent permitted
under Title XIX of the Federal Social Security Act.
10. Participants in the long-term care insurance
partnership program established under the Partnership for
Long-Term Care Act who meet the qualifications for protection
of resources described in Section 25 of that Act.
11. Persons with disabilities who are employed and
eligible for Medicaid, pursuant to Section
1902(a)(10)(A)(ii)(xv) of the Social Security Act, as
provided by the Illinois Department by rule.
12. Subject to federal approval, persons who are
eligible for medical assistance coverage under applicable
provisions of the federal Social Security Act and the
federal Breast and Cervical Cancer Prevention and Treatment
Act of 2000. Those eligible persons are defined to include,
but not be limited to, the following persons:
(1) persons who have been screened for breast or
cervical cancer under the U.S. Centers for Disease
Control and Prevention Breast and Cervical Cancer Program
established under Title XV of the federal Public Health
Services Act in accordance with the requirements of
Section 1504 of that Act as administered by the Illinois
Department of Public Health; and
(2) persons whose screenings under the above
program were funded in whole or in part by funds
appropriated to the Illinois Department of Public Health
for breast or cervical cancer screening.
"Medical assistance" under this paragraph 12 shall be
identical to the benefits provided under the State's approved
plan under Title XIX of the Social Security Act. The
Department must request federal approval of the coverage
under this paragraph 12 within 30 days after the effective
date of this amendatory Act of the 92nd General Assembly.
The Illinois Department and the Governor shall provide a
plan for coverage of the persons eligible under paragraph 7
as soon as possible after July 1, 1984.
The eligibility of any such person for medical assistance
under this Article is not affected by the payment of any
grant under the Senior Citizens and Disabled Persons Property
Tax Relief and Pharmaceutical 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. The Department shall by rule
establish the amounts of assets to be disregarded in
determining eligibility for medical assistance, which shall
at a minimum equal the amounts to be disregarded under the
Federal Supplemental Security Income Program. The amount of
assets of a single person to be disregarded shall not be less
than $2,000, and the amount of assets of a married couple to
be disregarded shall not be less than $3,000.
To the extent permitted under federal law, any person
found guilty of a second violation of Article VIIIA shall be
ineligible for medical assistance under this Article, as
provided in Section 8A-8.
The eligibility of any person for medical assistance
under this Article shall not be affected by the receipt by
the person of donations or benefits from fundraisers held for
the person in cases of serious illness, as long as neither
the person nor members of the person's family have actual
control over the donations or benefits or the disbursement of
the donations or benefits.
(Source: P.A. 91-676, eff. 12-23-99; 91-699, eff. 7-1-00;
91-712, eff. 7-1-00; revised 6-26-00.)
Section 99. Effective date. This Act takes effect upon
becoming law.
Passed in the General Assembly May 01, 2001.
Approved July 03, 2001.
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