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| Public Act 095-0200 |
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AN ACT concerning long-term care.
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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 | ||||
Illinois Long-Term Care Partnership Program Act. | ||||
Section 5. Findings. The General Assembly finds that our | ||||
nation's current financing structure relies too heavily on | ||||
individuals and families to bear the financial burden of | ||||
long-term supportive services. The financial burden can be so | ||||
large that, for many individuals, particularly those with | ||||
moderate income, the only alternative is Medicaid, which | ||||
requires spending down all assets in order to qualify to | ||||
receive long-term care benefits. | ||||
The General Assembly declares that Medicare is not intended | ||||
to cover the majority of long-term care expenses. Medicaid is | ||||
the largest source of funding for long-term care in the United | ||||
States, making the financing of long-term care costs a | ||||
significant issue for both State and federal budgets. The | ||||
growth in spending by the federal government and states for | ||||
long-term care services through Medicaid will continue to | ||||
increase as the American population ages. | ||||
The General Assembly finds that one solution to help | ||||
address the spiraling Medicaid growth and encourage | ||||
individuals to plan for their long-term care is the Long Term | ||
Care Partnership Program, a public-private partnership between | ||
states and private insurance companies. It is the intent of | ||
this program to reduce future Medicaid costs for long-term care | ||
by delaying or eliminating dependence on Medicaid by providing | ||
incentives for individuals to insure against the cost of | ||
providing for their long-term care needs. The program, | ||
including the treatment of assets for Medicaid eligibility and | ||
estate recovery, shall be structured and administered in | ||
accordance with federal law and applicable federal guidelines.
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Section 10. Definitions. As used in this Act: | ||
"Agency" means the Department of Healthcare and Family | ||
Services. | ||
"Asset disregard" means, with respect to qualification for | ||
State Medicaid benefits, the
disregard of any assets or | ||
resources in an amount equal to the insurance benefit payments | ||
that are made to or on the behalf of an individual who is a | ||
beneficiary under a qualified long-term care insurance | ||
partnership policy. | ||
"Department" means the Department of Financial and | ||
Professional Regulation. | ||
"Medicaid" means the federal medical assistance program | ||
established under Title XIX
of the Social Security Act.
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"Qualified long-term care insurance partnership policy" | ||
means a policy that meets all of the following requirements: | ||
(1) it covers an insured who was a resident of Illinois | ||
when coverage first became effective under the policy;
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(2) it is a qualified long-term care insurance policy | ||
as defined in Section 7702B(b) of the Internal Revenue Code | ||
of 1986 issued not earlier than the effective date of the | ||
State plan amendment;
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(3) it meets the model regulations and requirements of | ||
the National Association of Insurance Commissioners model | ||
specified in paragraph (5) of Title VI, Section 6021 of the | ||
federal Deficit Reduction Act of 2005, and the Director of | ||
the Division of Insurance of the Department certifies it as | ||
meeting these requirements; and | ||
(4) if the policy is sold to an individual who:
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(A) has not attained age 61 as of the date of | ||
purchase, the policy provides compound annual | ||
inflation protection;
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(B) has attained age 61 but has not attained age 76 | ||
as of such date, the policy provides some level of | ||
inflation protection; or | ||
(C) has attained age 76 as of such date, the policy | ||
may, but is not required to, provide some level of | ||
inflation protection.
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"State plan amendment" means a State Medicaid plan | ||
amendment made to the federal
Department of Health and Human | ||
Services that provides for the disregard of any assets or | ||
resources in an amount equal to the insurance benefit payments | ||
that are made to or on the behalf of an individual who is a | ||
beneficiary under a qualified long-term care insurance | ||
partnership policy.
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Section 15. Illinois Long-term Care Partnership Program. | ||
(a) In accordance with Title VI, Section 6021 of the | ||
federal Deficit Reduction Act of 2005, there shall be | ||
established the Illinois Long-Term Care Partnership Program, | ||
to be administered by the Agency with the assistance of the | ||
Department to do the following:
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(1) provide incentives for individuals to insure | ||
against the costs of providing for their long-term care | ||
needs;
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(2) provide a mechanism for individuals to qualify for | ||
coverage of the cost of their long-term care needs under | ||
Medicaid without first being required to substantially | ||
exhaust their resources;
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(3) provide counseling services to individuals | ||
planning for their long-term care needs; and
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(4) alleviate the financial burden on the State's | ||
medical assistance program by encouraging the pursuit of | ||
private initiatives.
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(b) The Agency shall:
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(1) Within 180 days of the effective date of this Act, | ||
or as soon thereafter as possible, make application to the | ||
federal Department of Health and Human Services for a State | ||
plan amendment to establish that, if an individual is a | ||
beneficiary of a long-term care partnership program | ||
certified policy, the total assets an individual owns and | ||
may retain under Medicaid and still qualify for benefits | ||
under Medicaid at the time the individual applies for | ||
long-term care benefits are increased by $1 for each $1 of | ||
benefit paid out under the individual's long-term care | ||
partnership program certified insurance policy.
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(2) Provide information and technical assistance to | ||
the Department on the Department's role in assuring that | ||
any individual who sells a qualified long-term care | ||
insurance partnership policy receives training and | ||
demonstrates evidence of an understanding of such policies | ||
and how they relate to other public and private coverage of | ||
long-term care. | ||
(c) The Department may not impose any requirement affecting | ||
the terms or benefits of qualified long-term care partnership | ||
policies unless the Department imposes the requirement on all | ||
long-term care policies sold in Illinois without regard to | ||
whether the policy is covered under the partnership or is | ||
offered in connection with the partnership.
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(d) The issuers of qualified long-term care partnership | ||
policies in Illinois shall provide regular reports to the | ||
Secretary of the federal Department of Health and Human | ||
Services, in accordance with federal regulation. Issuers of | ||
qualified long-term care partnership policies in Illinois | ||
shall provide appropriate reports to the Agency and to the | ||
Department as determined by those entities. | ||
Section 20. Administration. | ||
(a) The Agency and the Department are authorized to adopt | ||
regulations to implement the provisions of this Act and rules | ||
for its administration. | ||
(b) The Agency and Department must comply with all federal | ||
rules developed in accordance with Title VI, Section 6021 of | ||
the federal Deficit Reduction Act of 2005, regarding data | ||
reporting, reciprocity with other states that develop | ||
long-term care insurance partnership programs, and any other | ||
matters, and shall have the authority to adopt regulations | ||
relative to the provisions of any federal rules and their | ||
administration.
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(320 ILCS 35/Act rep.)
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Section 25. The Partnership for Long-Term Care Act is | ||
repealed.
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Section 99. Effective date. This Act takes effect upon | ||
becoming law.
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