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Public Act 094-0693 |
HB0806 Enrolled |
LRB094 03660 BDD 33665 b |
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AN ACT concerning State government.
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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 1. Short title. This Act may be cited as the |
Covering ALL KIDS Health Insurance Act. |
Section 5. Legislative intent. The General Assembly finds |
that, for the economic and social benefit of all residents of |
the State, it is important to enable all children of this State |
to access affordable health insurance that offers |
comprehensive coverage and emphasizes preventive healthcare. |
Many children in working families, including many families |
whose family income ranges between $40,000 and $80,000, are |
uninsured. Numerous studies, including the Institute of |
Medicine's report, "Health Insurance Matters", demonstrate |
that lack of insurance negatively affects health status. The |
General Assembly further finds that access to healthcare is a |
key component for children's healthy development and |
successful education. The effects of lack of insurance also |
negatively impact those who are insured because the cost of |
paying for care to the uninsured is often shifted to those who |
have insurance in the form of higher health insurance premiums. |
A Families USA 2005 report indicates that family premiums in |
Illinois are increased by $1,059 due to cost-shifting from the |
uninsured. It is, therefore, the intent of this legislation to |
provide access to affordable health insurance to all uninsured |
children in Illinois. |
Section 10. Definitions. In this Act: |
"Application agent" means an organization or individual, |
such as a licensed health care provider, school, youth service |
agency, employer, labor union, local chamber of commerce, |
community-based organization, or other organization, approved |
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by the Department to assist in enrolling children in the |
Program.
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"Child" means a person under the age of 19.
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"Department" means the Department of Healthcare and Family |
Services.
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"Medical assistance" means health care benefits provided |
under Article V of the Illinois Public Aid Code.
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"Program" means the Covering ALL KIDS Health Insurance |
Program.
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"Resident" means an individual (i) who is in the State for |
other than a temporary or transitory purpose during the taxable |
year or (ii) who is domiciled in this State but is absent from |
the State for a temporary or transitory purpose during the |
taxable year.
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Section 15. Operation of Program. The Covering ALL KIDS |
Health Insurance Program is created. The Program shall be |
administered by the Department of Healthcare and Family |
Services. The Department shall have the same powers and |
authority to administer the Program as are provided to the |
Department in connection with the Department's administration |
of the Illinois Public Aid Code and the Children's Health |
Insurance Program Act. The Department shall coordinate the |
Program with the existing children's health programs operated |
by the Department and other State agencies. |
Section 20. Eligibility. |
(a) To be eligible for the Program, a person must be a |
child:
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(1) who is a resident of the State of Illinois; and
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(2) who is ineligible for medical assistance under the |
Illinois Public Aid Code or benefits under the Children's |
Health Insurance Program Act; and
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(3) either (i) who has been without health insurance |
coverage for a period set forth by the Department in rules, |
but not less than 6 months during the first month of |
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operation of the Program, 7 months during the second month |
of operation, 8 months during the third month of operation, |
9 months during the fourth month of operation, 10 months |
during the fifth month of operation, 11 months during the |
sixth month of operation, and 12 months thereafter, (ii) |
whose parent has lost employment that made available |
affordable dependent health insurance coverage, until such |
time as affordable employer-sponsored dependent health |
insurance coverage is again available for the child as set |
forth by the Department in rules, (iii) who is a newborn |
whose responsible relative does not have available |
affordable private or employer-sponsored health insurance, |
or (iv) who, within one year of applying for coverage under |
this Act, lost medical benefits under the Illinois Public |
Aid Code or the Children's Health Insurance Program Act. |
An entity that provides health insurance coverage (as |
defined in Section 2 of the Comprehensive Health Insurance Plan |
Act) to Illinois residents shall provide health insurance data |
match to the Department of Healthcare and Family Services for |
the purpose of determining eligibility for the Program under |
this Act. |
The Department of Healthcare and Family Services, in |
collaboration with the Department of Financial and |
Professional Regulation, Division of Insurance, shall adopt |
rules governing the exchange of information under this Section. |
The rules shall be consistent with all laws relating to the |
confidentiality or privacy of personal information or medical |
records, including provisions under the Federal Health |
Insurance Portability and Accountability Act (HIPAA). |
(b) The Department shall monitor the availability and |
retention of employer-sponsored dependent health insurance |
coverage and shall modify the period described in subdivision |
(a)(3) if necessary to promote retention of private or |
employer-sponsored health insurance and timely access to |
healthcare services, but at no time shall the period described |
in subdivision (a)(3) be less than 6 months.
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(c) The Department, at its discretion, may take into |
account the affordability of dependent health insurance when |
determining whether employer-sponsored dependent health |
insurance coverage is available upon reemployment of a child's |
parent as provided in subdivision (a)(3). |
(d) A child who is determined to be eligible for the |
Program shall remain eligible for 12 months, provided that the |
child maintains his or her residence in this State, has not yet |
attained 19 years of age, and is not excluded under subsection |
(e). |
(e) A child is not eligible for coverage under the Program |
if: |
(1) the premium required under Section 40 has not been |
timely paid; if the required premiums are not paid, the |
liability of the Program shall be limited to benefits |
incurred under the Program for the time period for which |
premiums have been paid; if the required monthly premium is |
not paid, the child is ineligible for re-enrollment for a |
minimum period of 3 months; re-enrollment shall be |
completed before the next covered medical visit, and the |
first month's required premium shall be paid in advance of |
the next covered medical visit; or |
(2) the child is an inmate of a public institution or |
an institution for mental diseases.
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(f) The Department shall adopt eligibility rules, |
including, but not limited to: rules regarding annual renewals |
of eligibility for the Program; rules providing for |
re-enrollment, grace periods, notice requirements, and hearing |
procedures under subdivision (e)(1) of this Section; and rules |
regarding what constitutes availability and affordability of |
private or employer-sponsored health insurance, with |
consideration of such factors as the percentage of income |
needed to purchase children or family health insurance, the |
availability of employer subsidies, and other relevant |
factors. |
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Section 25. Enrollment in Program. The Department shall |
develop procedures to allow application agents to assist in |
enrolling children in the Program or other children's health |
programs operated by the Department. At the Department's |
discretion, technical assistance payments may be made |
available for approved applications facilitated by an |
application agent. |
Section 30. Program outreach and marketing. The Department |
may provide grants to application agents and other |
community-based organizations to educate the public about the |
availability of the Program. The Department shall adopt rules |
regarding performance standards and outcomes measures expected |
of organizations that are awarded grants under this Section, |
including penalties for nonperformance of contract standards. |
Section 35. Health care benefits for children. |
(a) The Department shall purchase or provide health care |
benefits for eligible children that are identical to the |
benefits provided for children under the Illinois Children's |
Health Insurance Program Act, except for non-emergency |
transportation.
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(b) As an alternative to the benefits set forth in |
subsection (a), and when cost-effective, the Department may |
offer families subsidies toward the cost of privately sponsored |
health insurance, including employer-sponsored health |
insurance.
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(c) Notwithstanding clause (i) of subdivision (a)(3) of |
Section 20, the Department may consider offering, as an |
alternative to the benefits set forth in subsection (a), |
partial coverage to children who are enrolled in a |
high-deductible private health insurance plan.
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(d) Notwithstanding clause (i) of subdivision (a)(3) of |
Section 20, the Department may consider offering, as an |
alternative to the benefits set forth in subsection (a), a |
limited package of benefits to children in families who have |
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private or employer-sponsored health insurance that does not |
cover certain benefits such as dental or vision benefits.
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(e) The content and availability of benefits described in |
subsections (b), (c), and (d), and the terms of eligibility for |
those benefits, shall be at the Department's discretion and the |
Department's determination of efficacy and cost-effectiveness |
as a means of promoting retention of private or |
employer-sponsored health insurance.
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Section 40. Cost-sharing. |
(a) Children enrolled in the Program under subsection (a) |
of Section 35 are subject to the following cost-sharing |
requirements:
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(1) The Department, by rule, shall set forth |
requirements concerning co-payments and coinsurance for |
health care services and monthly premiums. This |
cost-sharing shall be on a sliding scale based on family |
income. The Department may periodically modify such |
cost-sharing.
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(2) Notwithstanding paragraph (1), there shall be no |
co-payment required for well-baby or well-child health |
care, including, but not limited to, age-appropriate |
immunizations as required under State or federal law.
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(b) Children enrolled in a privately sponsored health |
insurance plan under subsection (b) of Section 35 are subject |
to the cost-sharing provisions stated in the privately |
sponsored health insurance plan.
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(c) Notwithstanding any other provision of law, rates paid |
by the Department shall not be used in any way to determine the |
usual and customary or reasonable charge, which is the charge |
for health care that is consistent with the average rate or |
charge for similar services furnished by similar providers in a |
certain geographic area. |
Section 45. Study. |
(a) The Department shall conduct a study that includes, but |
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is not limited to, the following: |
(1) Establishing estimates, broken down by regions of |
the State, of the number of children with and without |
health insurance coverage; the number of children who are |
eligible for Medicaid or the Children's Health Insurance |
Program, and, of that number, the number who are enrolled |
in Medicaid or the Children's Health Insurance Program; and |
the number of children with access to dependent coverage |
through an employer, and, of that number, the number who |
are enrolled in dependent coverage through an employer. |
(2) Surveying those families whose children have |
access to employer-sponsored dependent coverage but who |
decline such coverage as to the reasons for declining |
coverage. |
(3) Ascertaining, for the population of children |
accessing employer-sponsored dependent coverage or who |
have access to such coverage, the comprehensiveness of |
dependent coverage available, the amount of cost-sharing |
currently paid by the employees, and the cost-sharing |
associated with such coverage. |
(4) Measuring the health outcomes or other benefits for |
children utilizing the Covering ALL KIDS Health Insurance |
Program and analyzing the effects on utilization of |
healthcare services for children after enrollment in the |
Program compared to the preceding period of uninsured |
status. |
(b) The studies described in subsection (a) shall be |
conducted in a manner that compares a time period preceding or |
at the initiation of the program with a later period. |
(c) The Department shall submit the preliminary results of |
the study to the Governor and the General Assembly no later |
than July 1, 2008 and shall submit the final results to the |
Governor and the General Assembly no later than July 1, 2010. |
Section 50. Consultation with stakeholders. The Department |
shall present details regarding implementation of the Program |
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to the Medicaid Advisory Committee, and the Committee shall |
serve as the forum for healthcare providers, advocates, |
consumers, and other interested parties to advise the |
Department with respect to the Program. |
Section 55. Charge upon claims and causes of action; right |
of subrogation; recoveries. Sections 11-22, 11-22a, 11-22b, |
and 11-22c of the Illinois Public Aid Code apply to health care |
benefits provided to children under this Act, as provided in |
those Sections. |
Section 60. Federal financial participation. The |
Department shall request any necessary state plan amendments or |
waivers of federal requirements in order to allow receipt of |
federal funds for implementing any or all of the provisions of |
the Program. The failure of the responsible federal agency to |
approve a waiver or other State plan amendment shall not |
prevent the implementation of any provision of this Act. |
Section 65. Emergency rulemaking. The Department may adopt |
rules necessary to establish and implement this Act through the |
use of emergency rulemaking in accordance with Section 5-45 of |
the Illinois Administrative Procedure Act. For the purposes of |
that Act, the General Assembly finds that the adoption of rules |
to implement this Act is deemed an emergency and necessary for |
the public interest, safety, and welfare. This Section is |
repealed on July 1, 2008. |
Section 90. The Illinois Public Aid Code is amended by |
changing Sections 11-22, 11-22a, 11-22b, and 11-22c as follows:
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(305 ILCS 5/11-22) (from Ch. 23, par. 11-22)
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Sec. 11-22. Charge upon claims and causes of action for |
injuries. The Illinois Department shall have a charge upon all |
claims, demands and
causes of action for injuries to an |
applicant for or recipient of (i)
financial aid under Articles |
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III, IV, and V or (ii) health care benefits provided under the |
Covering ALL KIDS Health Insurance Act for the total
amount of
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medical assistance provided the recipient from the time of |
injury to the
date of recovery upon such claim, demand or cause |
of action. In addition, if
the applicant or recipient was |
employable, as defined by the Department, at
the time of the |
injury, the Department shall also have a charge upon any
such |
claims, demands and causes of action for the total amount of |
aid
provided to the recipient and his
dependents, including all |
cash assistance and medical assistance
only to the extent |
includable in the claimant's action, from the
time of injury to |
the date of recovery upon such
claim, demand or cause of |
action. Any definition of "employable"
adopted by the |
Department shall apply only to persons above the age of
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compulsory school attendance.
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If the injured person was employable at the time of the |
injury and is
provided aid under Articles III, IV, or V and any |
dependent or
member of his family is provided aid under Article |
VI, or vice versa,
both the Illinois Department and the local |
governmental unit shall have
a charge upon such claims, demands |
and causes of action for the aid
provided to the injured person |
and any
dependent member of his family, including all cash |
assistance, medical
assistance and food stamps, from the time |
of the injury to the date
of recovery.
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"Recipient", as used herein, means (i) in the case of |
financial aid provided under this Code, the grantee of record |
and any
persons whose needs are included in the financial aid |
provided to the
grantee of record or otherwise met by grants |
under the appropriate
Article of this Code for which such |
person is eligible and (ii) in the case of health care benefits |
provided under the Covering ALL KIDS Health Insurance Act, the |
child to whom those benefits are provided .
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In each case, the notice shall be served by certified mail |
or
registered mail, upon the party or parties against whom the |
applicant or
recipient has a claim, demand or cause of action. |
The notice shall
claim the charge and describe the interest the |
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Illinois Department, the
local governmental unit, or the |
county, has in the claim, demand, or
cause of action. The |
charge shall attach to any verdict or judgment
entered and to |
any money or property which may be recovered on account
of such |
claim, demand, cause of action or suit from and after the time
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of the service of the notice.
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On petition filed by the Illinois Department, or by the |
local
governmental unit or county if either is claiming a |
charge, or by the
recipient, or by the defendant, the court, on |
written notice to all
interested parties, may adjudicate the |
rights of the parties and enforce
the charge. The court may |
approve the settlement of any claim, demand
or cause of action |
either before or after a verdict, and nothing in this
Section |
shall be construed as requiring the actual trial or final
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adjudication of any claim, demand or cause of action upon which |
the
Illinois Department, the local governmental unit or county |
has charge.
The court may determine what portion of the |
recovery shall be paid to
the injured person and what portion |
shall be paid to the Illinois
Department, the local |
governmental unit or county having a charge
against the |
recovery.
In making this determination, the court shall conduct |
an evidentiary hearing
and shall consider competent evidence |
pertaining
to the following matters:
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(1) the amount of the charge sought to be enforced |
against the recovery
when expressed as a percentage of the |
gross amount of the recovery; the
amount of the charge |
sought to be enforced against the recovery when expressed
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as a percentage of the amount obtained by subtracting from |
the gross amount
of the recovery the total attorney's fees |
and other costs incurred by the
recipient incident to the |
recovery; and whether the Department, unit of
local |
government or county seeking to enforce the charge against |
the recovery
should as a matter of fairness and equity bear |
its proportionate share of
the fees and costs incurred to |
generate the recovery from which the charge
is sought to be |
satisfied;
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(2) the amount, if any, of the attorney's fees and |
other costs incurred
by the recipient incident to the |
recovery and paid by the recipient up to the
time of |
recovery, and the amount of such fees and costs remaining |
unpaid
at the time of recovery;
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(3) the total hospital, doctor and other medical |
expenses incurred for
care and treatment of the injury to |
the date of recovery therefor, the portion
of such expenses |
theretofore paid by the recipient, by insurance provided
by |
the recipient, and by the Department, unit of local |
government and county
seeking to enforce a charge against |
the recovery, and the amount of such
previously incurred |
expenses which remain unpaid at the time of recovery
and by |
whom such incurred, unpaid expenses are to be paid;
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(4) whether the recovery represents less than |
substantially full
recompense
for the injury and the |
hospital, doctor and other medical expenses incurred
to the |
date of recovery for the care and treatment of the injury, |
so that
reduction of the charge sought to be enforced |
against the recovery would
not likely result in a double |
recovery or unjust enrichment to the recipient;
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(5) the age of the recipient and of persons dependent |
for support upon
the recipient, the nature and permanency |
of the recipient's injuries as
they affect not only the |
future employability and education of the recipient
but |
also the reasonably necessary and foreseeable future |
material, maintenance,
medical, rehabilitative and |
training needs of the recipient, the cost of
such |
reasonably necessary and foreseeable future needs, and the |
resources
available to meet such needs and pay such costs;
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(6) the realistic ability of the recipient to repay in |
whole or in part
the charge sought to be enforced against |
the recovery when judged in light
of the factors enumerated |
above.
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The burden of producing evidence sufficient to support the |
exercise by
the court of its discretion to reduce the amount of |
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a proven charge sought
to be enforced against the recovery |
shall rest with the party seeking such reduction.
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The court may reduce and apportion the Illinois
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Department's lien proportionate to the recovery of the |
claimant. The court may
consider the nature and extent of the |
injury, economic and noneconomic
loss, settlement offers, |
comparative negligence as it applies to the case
at hand, |
hospital costs, physician costs, and all other appropriate |
costs.
The Illinois Department shall pay its pro rata share of |
the attorney fees
based on the Illinois Department's lien as it |
compares to the total
settlement agreed upon. This Section |
shall not affect the priority of an
attorney's lien under the |
Attorneys Lien Act. The charges of
the Illinois Department |
described in this Section, however, shall take
priority over |
all other liens and charges existing under the laws of the
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State of Illinois with the exception of the attorney's lien |
under said statute.
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Whenever the Department or any unit of local government
has |
a statutory charge under this Section against a recovery for |
damages
incurred by a recipient because of its advancement of |
any assistance, such
charge shall not be satisfied out of any |
recovery until the attorney's claim
for fees is satisfied, |
irrespective of whether or not an action based on
recipient's |
claim has been filed in court.
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This Section shall be inapplicable to any claim, demand or |
cause of
action arising under (a) the Workers' Compensation Act |
or the predecessor
Workers' Compensation Act
of
June 28, 1913, |
(b) the Workers' Occupational Diseases Act or the predecessor
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Workers' Occupational
Diseases Act of March 16, 1936; and (c) |
the Wrongful Death Act.
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(Source: P.A. 91-357, eff. 7-29-99; 92-111, eff. 1-1-02.)
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(305 ILCS 5/11-22a) (from Ch. 23, par. 11-22a)
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Sec. 11-22a. Right of Subrogation. To the extent of the |
amount of (i) medical
assistance provided by the Department to |
or on behalf of a recipient under
Article V or VI or (ii) |
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health care benefits provided for a child under the Covering |
ALL KIDS Health Insurance Act , the Department shall be
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subrogated
to any right of
recovery such recipient may have |
under the terms of any private or public
health care coverage |
or casualty coverage, including coverage under the
"Workers' |
Compensation Act", approved July 9, 1951, as amended, or the
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"Workers' Occupational Diseases Act", approved July 9, 1951, as |
amended,
without the necessity of assignment of claim or other |
authorization to secure
the right of recovery to the |
Department. To enforce its subrogation right, the
Department |
may (i) intervene or join in an action or proceeding brought by |
the
recipient, his or her guardian, personal representative, |
estate, dependents, or
survivors against any person or public |
or private entity that may be liable;
(ii) institute and |
prosecute legal proceedings against any person or public or
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private entity that may be liable for the cost of such |
services; or (iii)
institute and prosecute legal proceedings, |
to the extent necessary to reimburse
the Illinois Department |
for its costs, against any noncustodial parent who (A)
is |
required by court or administrative order to provide insurance |
or other
coverage of the cost of health care services for a |
child eligible for medical
assistance under this Code and (B) |
has received payment from a third party for
the costs of those |
services but has not used the payments to reimburse either
the |
other parent or the guardian of the child or the provider of |
the services.
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(Source: P.A. 92-111, eff. 1-1-02.)
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(305 ILCS 5/11-22b) (from Ch. 23, par. 11-22b)
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Sec. 11-22b. Recoveries.
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(a) As used in this Section:
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(1) "Carrier" means any insurer, including any private |
company,
corporation, mutual association, trust fund, |
reciprocal or interinsurance
exchange authorized under the |
laws of this State to insure persons against
liability or |
injuries caused to another and any insurer providing
benefits |
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under a policy of bodily injury liability insurance covering
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liability arising out of the ownership, maintenance or use of a |
motor
vehicle which provides uninsured motorist endorsement or |
coverage.
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(2) "Beneficiary" means any person or their dependents who |
has received
benefits or will be provided benefits under this |
Code or under the Covering ALL KIDS Health Insurance Act
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because of an injury for
which another person may be liable. It |
includes such beneficiary's guardian,
conservator or other |
personal representative, his estate or survivors.
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(b) (1) When benefits are provided or will be provided to a |
beneficiary
under this Code or under the Covering ALL KIDS |
Health Insurance Act because of an injury for which another |
person is liable, or
for which a carrier is liable in |
accordance with the provisions of any
policy of insurance |
issued pursuant to the Illinois Insurance Code, the
Illinois |
Department shall have a right to recover from such person or |
carrier
the reasonable value of benefits so provided. The |
Attorney General may, to
enforce such right, institute and |
prosecute legal proceedings against the
third person or carrier |
who may be liable for the injury in an appropriate
court, |
either in the name of the Illinois Department or in the name of |
the
injured person, his guardian, personal representative, |
estate, or survivors.
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(2) The Department may:
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(A) compromise or settle and release any such claim for |
benefits
provided under this Code, or
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(B) waive any such claims for benefits provided under |
this Code, in
whole or in part, for the convenience of the |
Department or if the Department
determines that collection |
would result in undue hardship upon the person who
suffered |
the injury or, in a wrongful death action, upon the heirs |
of the
deceased.
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(3) No action taken on behalf of the Department pursuant to |
this Section
or any judgment rendered in such action shall be a |
bar to any action upon
the claim or cause of action of the |
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beneficiary, his guardian, conservator,
personal |
representative, estate, dependents or survivors against the |
third
person who may be liable for the injury, or shall operate |
to deny to the
beneficiary the recovery for that portion of any |
damages not covered hereunder.
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(c) (1) When an action is brought by the Department |
pursuant to
subsection (b), it shall be commenced within the |
period prescribed by
Article XIII of the Code of Civil |
Procedure.
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However, the Department may not commence the action prior |
to 5 months
before the end of the applicable period prescribed |
by Article XIII of the
Code of Civil Procedure. Thirty days |
prior to commencing an action, the
Department shall notify the |
beneficiary of the Department's intent to
commence such an |
action.
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(2) The death of the beneficiary does not abate any right |
of action
established by subsection (b).
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(3) When an action or claim is brought by persons entitled |
to bring such
actions or assert such claims against a third |
person who may be liable for
causing the death of a |
beneficiary, any settlement, judgment or award
obtained is |
subject to the Department's claim for reimbursement of the
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benefits provided to the beneficiary under this Code or under |
the Covering ALL KIDS Health Insurance Act .
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(4) When the action or claim is brought by the beneficiary |
alone and
the beneficiary incurs a personal liability to pay |
attorney's fees and
costs of litigation, the Department's claim |
for reimbursement of the
benefits provided to the beneficiary |
shall be the full amount of benefits
paid on behalf of the |
beneficiary under this Code or under the Covering ALL KIDS |
Health Insurance Act less a pro rata
share which represents the |
Department's reasonable share of attorney's fees
paid by the |
beneficiary and that portion of the cost of litigation expenses
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determined by multiplying by the ratio of the full amount of |
the
expenditures of the full amount of the judgment, award or |
settlement.
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(d) (1) If either the beneficiary or the Department brings |
an action or
claim against such third party or carrier, the |
beneficiary or the
Department shall within 30 days of filing |
the action give to the other
written notice by personal service |
or registered mail of the action or
claim and of the name of |
the court in which the
action or claim is brought. Proof of |
such notice shall be filed in such
action or claim. If an |
action or claim is brought by either the Department
or the |
beneficiary, the other may, at any time before trial on the |
facts,
become a party to such action or claim or shall |
consolidate his action or
claim with the other if brought |
independently.
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(2) If an action or claim is brought by the Department |
pursuant to
subsection (b)(1), written notice to the |
beneficiary, guardian, personal
representative, estate or |
survivor given pursuant to this Section shall
advise him of his |
right to intervene in the proceeding, his right to obtain
a |
private attorney of his choice and the Department's right to |
recover the
reasonable value of the benefits provided.
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(e) In the event of judgment or award in a suit or claim |
against such
third person or carrier:
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(1) If the action or claim is prosecuted by the beneficiary |
alone, the
court shall first order paid from any judgment or |
award the
reasonable litigation expenses incurred in |
preparation and prosecution of
such action or claim, together |
with reasonable attorney's fees, when an
attorney has been |
retained. After payment of such expenses and attorney's
fees |
the court shall, on the application of the Department, allow
as |
a first lien against the amount of such judgment or award the |
amount of
the Department's expenditures for the benefit of the |
beneficiary under this
Code or under the Covering ALL KIDS |
Health Insurance Act , as provided in subsection (c)(4).
|
(2) If the action or claim is prosecuted both by the |
beneficiary and the
Department, the court shall first order |
paid from any judgment or
award the reasonable litigation |
expenses incurred in preparation and
prosecution of such action |
|
or claim, together with reasonable attorney's
fees for |
plaintiffs attorneys based solely on the services rendered for |
the
benefit of the beneficiary. After payment of such expenses |
and attorney's
fees, the court shall apply out of the balance |
of such judgment or award an
amount sufficient to reimburse the |
Department the full amount of benefits
paid on behalf of the |
beneficiary under this Code or under the Covering ALL KIDS |
Health Insurance Act .
|
(f) The court shall, upon further application at any time
|
before the judgment or award is satisfied, allow as a further |
lien the
amount of any expenditures of the Department in |
payment of additional
benefits arising out of the same cause of |
action or claim provided on
behalf of the beneficiary under |
this Code or under the Covering ALL KIDS Health Insurance Act , |
when such benefits were
provided or became payable subsequent |
to the original order.
|
(g) No judgment, award, or settlement in any action or |
claim by a
beneficiary to recover damages for injuries, when |
the Department has an
interest, shall be satisfied without |
first giving the Department notice and
a reasonable opportunity |
to perfect and satisfy its lien.
|
(h) When the Department has perfected a lien upon a |
judgment or award in
favor of a beneficiary against any third |
party for an injury for which the
beneficiary has received |
benefits under this Code or under the Covering ALL KIDS Health |
Insurance Act , the Department shall be
entitled to a writ of |
execution as lien claimant to enforce payment of said
lien |
against such third party with interest and other accruing costs |
as in
the case of other executions. In the event the amount of |
such judgment or
award so recovered has been paid to the |
beneficiary, the Department shall
be entitled to a writ of |
execution against such beneficiary to the extent of
the |
Department's lien, with interest and other accruing costs as in |
the case
of other executions.
|
(i) Except as otherwise provided in this Section, |
notwithstanding any
other provision of law, the entire amount |
|
of any settlement of the injured
beneficiary's action or claim, |
with or without suit, is subject to the
Department's claim for |
reimbursement of the benefits provided and any lien
filed |
pursuant thereto to the same extent and subject to the same
|
limitations as in Section 11-22 of this Code.
|
(Source: P.A. 92-651, eff. 7-11-02.)
|
(305 ILCS 5/11-22c) (from Ch. 23, par. 11-22c)
|
Sec. 11-22c. (a) As used in this Section, "recipient" means |
any person
receiving financial assistance under Article IV or |
Article VI of this Code or receiving health care benefits under |
the Covering ALL KIDS Health Insurance Act .
|
(b) If a recipient maintains any suit, charge or other |
court or
administrative action against an employer seeking back |
pay for a period
during which the recipient received financial |
assistance under Article IV
or Article VI of this Code or |
health care benefits under the Covering ALL KIDS Health |
Insurance Act , the recipient shall report such fact to the
|
Department. To the extent of the amount of assistance provided |
to or on
behalf of the recipient under Article IV or Article VI |
or health care benefits provided under the Covering ALL KIDS |
Health Insurance Act , the Department may
by intervention or |
otherwise without the necessity of assignment of claim,
attach |
a lien on the recovery of back wages equal to the amount of
|
assistance provided by the Department to the recipient under |
Article IV or
Article VI or under the Covering ALL KIDS Health |
Insurance Act .
|
(Source: P.A. 86-497.)
|
Section 97. Severability. If any provision of this Act or |
its application to any person or circumstance is held invalid, |
the invalidity of that provision or application does not affect |
other provisions or applications of this Act that can be given |
effect without the invalid provision or application, and to |
this end the provisions of this Act are severable. |