104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
SB3294

 

Introduced 2/3/2026, by Sen. Julie A. Morrison

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-2.03
305 ILCS 5/5-2.03a new

    Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that any person who was initially determined to be eligible for medical assistance and is receiving institutional services or home and community-based services as authorized under the Article shall be presumed eligible for a continuation of coverage for such services during any redetermination process. Requires the Department of Healthcare and Family Services to continue to make payments for such services unless the person experiences a material change in financial circumstances that results in the loss of eligibility. Provides that if the person experiences a material change in financial circumstances that results in the loss of eligibility, the person, or the person's designated caregiver or responsible party, shall notify the Department. Provides that if the Department subsequently conducts a redetermination of eligibility, the Department must provide written notice to the person (i) before the commencement of the redetermination; and (ii) upon conclusion of the redetermination. Requires the Department to develop a process to facilitate the written notifications. Provides that no later than October 1, 2026, the Department shall seek federal authorization to exempt persons with disabilities who are eligible for medical assistance from annual redeterminations of eligibility, except that a full redetermination shall be conducted at least once every 5 years, regardless of whether a material change in financial circumstances has occurred. Effective immediately.


LRB104 18099 KTG 31538 b

 

 

A BILL FOR

 

SB3294LRB104 18099 KTG 31538 b

1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Public Aid Code is amended by
5changing Section 5-2.03 and by adding Section 5-2.03a as
6follows:
 
7    (305 ILCS 5/5-2.03)
8    Sec. 5-2.03. Presumptive eligibility. Except as provided
9in Section 5-2.03a Beginning on the effective date of this
10amendatory Act of the 96th General Assembly and except where
11federal law requires presumptive eligibility, no adult may be
12presumed eligible for medical assistance under this Code and
13the Department may not cover any service rendered to an adult
14unless the adult has completed an application for benefits,
15all required verifications have been received, and the
16Department or its designee has found the adult eligible for
17the date on which that service was provided. Nothing in this
18Section shall apply to pregnant women or to persons enrolled
19under the medical assistance program due to expansions
20approved by the federal government that are financed entirely
21by units of local government and federal matching funds.
22(Source: P.A. 96-1501, eff. 1-25-11; 97-687, eff. 6-14-12.)
 

 

 

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1    (305 ILCS 5/5-2.03a new)
2    Sec. 5-2.03a. Redeterminations of eligibility for certain
3persons.
4    (a) Any person who was initially determined to be eligible
5for medical assistance and is receiving institutional services
6or home and community-based services as authorized under this
7Article shall be presumed eligible for a continuation of
8coverage for such services during any redetermination process.
9The Department shall continue to make payments for such
10services unless the person experiences a material change in
11financial circumstances that results in the loss of
12eligibility.
13    (b) If the person experiences a material change in
14financial circumstances that results in the loss of
15eligibility, the person, or the person's designated caregiver
16or responsible party, shall notify the Department. The
17Department may conduct a redetermination of eligibility. If a
18redetermination is conducted, the Department must provide
19written notice to the person or to the person's designated
20caregiver or responsible party:
21        (1) before the commencement of the redetermination;
22    and
23        (2) upon conclusion of the redetermination, including
24    the results and the effective date of any eligibility
25    change.
26    (c) No later than October 1, 2026, the Department shall

 

 

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1seek federal authorization to exempt persons with disabilities
2who are eligible for medical assistance from annual
3redeterminations of eligibility, except that a full
4redetermination shall be conducted at least once every 5
5years, regardless of whether a material change in financial
6circumstances has occurred.
7    (d) The Department shall develop a process to facilitate
8the notifications required under subsection (b).
 
9    Section 99. Effective date. This Act takes effect upon
10becoming law.