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| Public Act 103-0997 | ||||
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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 | ||||
adding Section 12-4.59 as follows: | ||||
(305 ILCS 5/12-4.59 new) | ||||
Sec. 12-4.59. Informational guide on Medicaid 5-year | ||||
look-back period. | ||||
(a) Informational guide. On and after July 1, 2025, the | ||||
Department of Healthcare and Family Services shall develop, | ||||
post, and maintain on its official website a comprehensive | ||||
informational guide that explains the Medicaid 5-year | ||||
look-back period as it applies to eligibility for long-term | ||||
care coverage under the medical assistance program established | ||||
under Article V of this Code. The contents of the | ||||
informational guide must include the following: | ||||
(1) Overview of the Medicaid 5-year look-back period: | ||||
A detailed explanation of the 5-year look-back period, | ||||
including its purpose and relevance to eligibility for | ||||
medical assistance. | ||||
(2) Eligibility criteria affected by the Medicaid | ||||
5-year look-back period: Clear information on how the | ||||
5-year look-back period affects eligibility criteria, | ||||
including income and asset requirements. | ||
(3) Calculation of the Medicaid 5-year look-back | ||
period: Step-by-step guidance on how the 5-year look-back | ||
period is calculated, including the start date and end | ||
date considerations. | ||
(4) Examples and scenarios: Real-life examples and | ||
scenarios illustrating how the 5-year look-back period | ||
applies in different situations, providing practical | ||
insights for the public. The guide must include a | ||
calculator that allows a user to enter the transfer dates | ||
and monetary value of any assets the user transferred | ||
during the 5-year look back period in order to estimate | ||
the earliest date upon which the user may qualify for | ||
medical assistance for long-term care services. | ||
(5) Transfers or gifts during the Medicaid 5-year | ||
look-back period: Explanation of the consequences and | ||
implications of transfers or gifts made during the 5-year | ||
look-back period, emphasizing the impact on eligibility | ||
and potential penalties. | ||
(6) Exceptions and exemptions: Information on | ||
exceptions and exemptions to the 5-year look-back period, | ||
clarifying circumstances where certain transfers or assets | ||
may not be subject to scrutiny. | ||
(7) Documentation requirements: Guidance on the | ||
documentation individuals may need to provide or maintain | ||
to demonstrate compliance with the 5-year look-back | ||
period. | ||
(8) Planning for eligibility: Tips and considerations | ||
for individuals and families on how to plan for | ||
eligibility for medical assistance under Article V of this | ||
Code, taking into account the 5-year look-back period. | ||
(9) Appeals and dispute resolution: Information on the | ||
process for appeals and dispute resolution related to | ||
decisions made based on the 5-year look-back period. | ||
(10) Contact information and resources: Clear and | ||
accessible contact information for the Department of | ||
Healthcare and Family Services, as well as a listing of | ||
additional resources or agencies that individuals can | ||
reach out to for assistance or further clarification. | ||
(11) Frequently asked questions: A "Frequently Asked | ||
Questions" section that lists common questions and | ||
concerns related to the 5-year look-back period and | ||
provides a quick reference for users. | ||
(b) Accessibility of the guide. To ensure user-friendly | ||
navigation and visibility, the Department of Healthcare and | ||
Family Services shall post on its official website detailed | ||
information on how users can easily access the comprehensive | ||
guide on the website and a hyperlink that directs users to the | ||
comprehensive guide. | ||