Public Act 100-0990
 
HB4736 EnrolledLRB100 17508 KTG 32677 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 5-2b and by adding Section 5-30a as follows:
 
    (305 ILCS 5/5-2b)
    Sec. 5-2b. Medically fragile and technology dependent 
children eligibility and program. Notwithstanding any other 
provision of law except as provided in Section 5-30a, on and 
after September 1, 2012, subject to federal approval, medical 
assistance under this Article shall be available to children 
who qualify as persons with a disability, as defined under the 
federal Supplemental Security Income program and who are 
medically fragile and technology dependent. The program shall 
allow eligible children to receive the medical assistance 
provided under this Article in the community and must maximize, 
to the fullest extent permissible under federal law, federal 
reimbursement and family cost-sharing, including co-pays, 
premiums, or any other family contributions, except that the 
Department shall be permitted to incentivize the utilization of 
selected services through the use of cost-sharing adjustments. 
The Department shall establish the policies, procedures, 
standards, services, and criteria for this program by rule.

(Source: P.A. 97-689, eff. 6-14-12; 98-104, eff. 7-22-13.)
 
    (305 ILCS 5/5-30a new)
    Sec. 5-30a. Exemptions from managed care enrollment; 
children. Notwithstanding any other provision of law, the 
Department shall not require any of the following children to 
enroll in or transition to the State's managed care medical 
assistance program:
        (1) Children who are authorized by the Department to 
    receive in-home shift nursing services as required by the 
    federal Early and Periodic Screening, Diagnostic and 
    Treatment (EPSDT) provisions under 42 CFR 441.50 et seq.
        (2) Children made eligible for medical assistance 
    through any home and community-based services waiver 
    program for medically fragile and technology dependent 
    children authorized under Section 1915(c) of the Social 
    Security Act.
    Any children who meet the criteria under paragraph (1) or 
(2) and who are enrolled in the State's managed care medical 
assistance program on or before the effective date of this 
amendatory Act of the 100th General Assembly shall be given the 
option to disenroll from the State's managed care medical 
assistance program and receive medical assistance coverage 
under the State's traditional fee-for-service program.