Sen. Heather Steans
Filed: 1/5/2011
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1 | AMENDMENT TO HOUSE BILL 5420
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2 | AMENDMENT NO. ______. Amend House Bill 5420, AS AMENDED, by | ||||||
3 | replacing everything after the enacting clause with the | ||||||
4 | following:
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5 | "Section 5. The State Budget Law of the Civil | ||||||
6 | Administrative Code of Illinois is amended by adding Section | ||||||
7 | 50-30 as follows: | ||||||
8 | (15 ILCS 20/50-30 new) | ||||||
9 | Sec. 50-30. Long-term care rebalancing. In light of the | ||||||
10 | increasing demands confronting the State in meeting the needs | ||||||
11 | of individuals utilizing long-term care services under the | ||||||
12 | medical assistance program and any other long-term care related | ||||||
13 | benefit program administered by the State, it is the intent of | ||||||
14 | the General Assembly to address the needs of both the State and | ||||||
15 | the individuals eligible for such services by cost effective | ||||||
16 | and efficient means through the advancement of a long-term care |
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1 | rebalancing initiative. Notwithstanding any State law to the | ||||||
2 | contrary, and subject to federal laws, regulations, and court | ||||||
3 | decrees, the following shall apply to the long-term care | ||||||
4 | rebalancing initiative: | ||||||
5 | (1) "Long-term care rebalancing", as used in this | ||||||
6 | Section, means removing barriers to community living for | ||||||
7 | people of all ages with disabilities and long-term | ||||||
8 | illnesses by offering individuals utilizing long-term care | ||||||
9 | services a reasonable array of options, in particular | ||||||
10 | adequate choices of community and institutional options, | ||||||
11 | to achieve a balance between the proportion of total | ||||||
12 | Medicaid long-term support expenditures used for | ||||||
13 | institutional services and those used for community-based | ||||||
14 | supports. | ||||||
15 | (2) Subject to the provisions of this Section, the | ||||||
16 | Governor shall create a unified budget report identifying | ||||||
17 | the budgets of all State agencies offering long-term care | ||||||
18 | services to persons in either institutional or community | ||||||
19 | settings, including the budgets of State-operated | ||||||
20 | facilities for persons with developmental disabilities | ||||||
21 | that shall include, but not be limited to, the following | ||||||
22 | service and financial data: | ||||||
23 | (A) A breakdown of long-term care services, | ||||||
24 | defined as institutional or community care, by the | ||||||
25 | State agency primarily responsible for administration | ||||||
26 | of the program. |
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1 | (B) Actual and estimated enrollment, caseload, | ||||||
2 | service hours, or service days provided for long-term | ||||||
3 | care services described in a consistent format for | ||||||
4 | those services, for each of the following age groups: | ||||||
5 | older adults 65 years of age and older, younger adults | ||||||
6 | 21 years of age through 64 years of age, and children | ||||||
7 | under 21 years of age. | ||||||
8 | (C) Funding sources for long-term care services. | ||||||
9 | (D) Comparison of service and expenditure data, by | ||||||
10 | services, both in aggregate and per person enrolled. | ||||||
11 | (3) For each fiscal year, the unified budget report | ||||||
12 | described in subdivision (2) shall be prepared with | ||||||
13 | reference to the prioritized outcomes for that fiscal year | ||||||
14 | contemplated by Sections 50-5 and 50-25 of this Code. | ||||||
15 | (4) Each State agency responsible for the | ||||||
16 | administration of long-term care services shall provide an | ||||||
17 | analysis of the progress being made by the agency to | ||||||
18 | transition persons from institutional to community | ||||||
19 | settings, where appropriate, as part of the State's | ||||||
20 | long-term care rebalancing initiative. | ||||||
21 | (5) The Governor may designate amounts set aside for | ||||||
22 | institutional services appropriated from the General | ||||||
23 | Revenue Fund or any other State fund that receives monies | ||||||
24 | for long-term care services to be transferred to all State | ||||||
25 | agencies responsible for the administration of | ||||||
26 | community-based long-term care programs, including, but |
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1 | not limited to, community-based long-term care programs | ||||||
2 | administered by the Department of Healthcare and Family | ||||||
3 | Services, the Department of Human Services, and the | ||||||
4 | Department on Aging, provided that the Director of | ||||||
5 | Healthcare and Family Services first certifies that the | ||||||
6 | amounts being transferred are necessary for the purpose of | ||||||
7 | assisting persons in or at risk of being in institutional | ||||||
8 | care to transition to community-based settings, including | ||||||
9 | the financial data needed to prove the need for the | ||||||
10 | transfer of funds. The total amounts transferred shall not | ||||||
11 | exceed 4% in total of the amounts appropriated from the | ||||||
12 | General Revenue Fund or any other State fund that receives | ||||||
13 | monies for long-term care services for each fiscal year. A | ||||||
14 | notice of the fund transfer must be made to the General | ||||||
15 | Assembly and posted at a minimum on the Department of | ||||||
16 | Healthcare and Family Services website, the Governor's | ||||||
17 | Office of Management and Budget website, and any other | ||||||
18 | website the Governor sees fit. These postings shall serve | ||||||
19 | as notice to the General Assembly of the amounts to be | ||||||
20 | transferred. Notice shall be given at least 30 days prior | ||||||
21 | to transfer. | ||||||
22 | (6) This Section shall be liberally construed and | ||||||
23 | interpreted in a manner that allows the State to advance | ||||||
24 | its long-term care rebalancing initiatives. | ||||||
25 | Section 10. The State Finance Act is amended by changing |
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1 | Sections 13.2 and 25 as follows:
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2 | (30 ILCS 105/13.2) (from Ch. 127, par. 149.2)
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3 | Sec. 13.2. Transfers among line item appropriations. | ||||||
4 | (a) Transfers among line item appropriations from the same
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5 | treasury fund for the objects specified in this Section may be | ||||||
6 | made in
the manner provided in this Section when the balance | ||||||
7 | remaining in one or
more such line item appropriations is | ||||||
8 | insufficient for the purpose for
which the appropriation was | ||||||
9 | made. | ||||||
10 | (a-1) No transfers may be made from one
agency to another | ||||||
11 | agency, nor may transfers be made from one institution
of | ||||||
12 | higher education to another institution of higher education | ||||||
13 | except as provided by subsection (a-4) .
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14 | (a-2) Except as otherwise provided in this Section, | ||||||
15 | transfers may be made only among the objects of expenditure | ||||||
16 | enumerated
in this Section, except that no funds may be | ||||||
17 | transferred from any
appropriation for personal services, from | ||||||
18 | any appropriation for State
contributions to the State | ||||||
19 | Employees' Retirement System, from any
separate appropriation | ||||||
20 | for employee retirement contributions paid by the
employer, nor | ||||||
21 | from any appropriation for State contribution for
employee | ||||||
22 | group insurance. During State fiscal year 2005, an agency may | ||||||
23 | transfer amounts among its appropriations within the same | ||||||
24 | treasury fund for personal services, employee retirement | ||||||
25 | contributions paid by employer, and State Contributions to |
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1 | retirement systems; notwithstanding and in addition to the | ||||||
2 | transfers authorized in subsection (c) of this Section, the | ||||||
3 | fiscal year 2005 transfers authorized in this sentence may be | ||||||
4 | made in an amount not to exceed 2% of the aggregate amount | ||||||
5 | appropriated to an agency within the same treasury fund. During | ||||||
6 | State fiscal year 2007, the Departments of Children and Family | ||||||
7 | Services, Corrections, Human Services, and Juvenile Justice | ||||||
8 | may transfer amounts among their respective appropriations | ||||||
9 | within the same treasury fund for personal services, employee | ||||||
10 | retirement contributions paid by employer, and State | ||||||
11 | contributions to retirement systems. During State fiscal year | ||||||
12 | 2010, the Department of Transportation may transfer amounts | ||||||
13 | among their respective appropriations within the same treasury | ||||||
14 | fund for personal services, employee retirement contributions | ||||||
15 | paid by employer, and State contributions to retirement | ||||||
16 | systems. During State fiscal year 2010 only, an agency may | ||||||
17 | transfer amounts among its respective appropriations within | ||||||
18 | the same treasury fund for personal services, employee | ||||||
19 | retirement contributions paid by employer, and State | ||||||
20 | contributions to retirement systems. Notwithstanding, and in | ||||||
21 | addition to, the transfers authorized in subsection (c) of this | ||||||
22 | Section, these transfers may be made in an amount not to exceed | ||||||
23 | 2% of the aggregate amount appropriated to an agency within the | ||||||
24 | same treasury fund.
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25 | (a-3) Further, if an agency receives a separate
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26 | appropriation for employee retirement contributions paid by |
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1 | the employer,
any transfer by that agency into an appropriation | ||||||
2 | for personal services
must be accompanied by a corresponding | ||||||
3 | transfer into the appropriation for
employee retirement | ||||||
4 | contributions paid by the employer, in an amount
sufficient to | ||||||
5 | meet the employer share of the employee contributions
required | ||||||
6 | to be remitted to the retirement system. | ||||||
7 | (a-4) Long-Term Care Rebalancing. The Governor may | ||||||
8 | designate amounts set aside for institutional services | ||||||
9 | appropriated from the General Revenue Fund or any other State | ||||||
10 | fund that receives monies for long-term care services to be | ||||||
11 | transferred to all State agencies responsible for the | ||||||
12 | administration of community-based long-term care programs, | ||||||
13 | including, but not limited to, community-based long-term care | ||||||
14 | programs administered by the Department of Healthcare and | ||||||
15 | Family Services, the Department of Human Services, and the | ||||||
16 | Department on Aging, provided that the Director of Healthcare | ||||||
17 | and Family Services first certifies that the amounts being | ||||||
18 | transferred are necessary for the purpose of assisting persons | ||||||
19 | in or at risk of being in institutional care to transition to | ||||||
20 | community-based settings, including the financial data needed | ||||||
21 | to prove the need for the transfer of funds. The total amounts | ||||||
22 | transferred shall not exceed 4% in total of the amounts | ||||||
23 | appropriated from the General Revenue Fund or any other State | ||||||
24 | fund that receives monies for long-term care services for each | ||||||
25 | fiscal year. A notice of the fund transfer must be made to the | ||||||
26 | General Assembly and posted at a minimum on the Department of |
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1 | Healthcare and Family Services website, the Governor's Office | ||||||
2 | of Management and Budget website, and any other website the | ||||||
3 | Governor sees fit. These postings shall serve as notice to the | ||||||
4 | General Assembly of the amounts to be transferred. Notice shall | ||||||
5 | be given at least 30 days prior to transfer. | ||||||
6 | (b) In addition to the general transfer authority provided | ||||||
7 | under
subsection (c), the following agencies have the specific | ||||||
8 | transfer authority
granted in this subsection: | ||||||
9 | The Department of Healthcare and Family Services is | ||||||
10 | authorized to make transfers
representing savings attributable | ||||||
11 | to not increasing grants due to the
births of additional | ||||||
12 | children from line items for payments of cash grants to
line | ||||||
13 | items for payments for employment and social services for the | ||||||
14 | purposes
outlined in subsection (f) of Section 4-2 of the | ||||||
15 | Illinois Public Aid Code. | ||||||
16 | The Department of Children and Family Services is | ||||||
17 | authorized to make
transfers not exceeding 2% of the aggregate | ||||||
18 | amount appropriated to it within
the same treasury fund for the | ||||||
19 | following line items among these same line
items: Foster Home | ||||||
20 | and Specialized Foster Care and Prevention, Institutions
and | ||||||
21 | Group Homes and Prevention, and Purchase of Adoption and | ||||||
22 | Guardianship
Services. | ||||||
23 | The Department on Aging is authorized to make transfers not
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24 | exceeding 2% of the aggregate amount appropriated to it within | ||||||
25 | the same
treasury fund for the following Community Care Program | ||||||
26 | line items among these
same line items: Homemaker and Senior |
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1 | Companion Services, Alternative Senior Services, Case | ||||||
2 | Coordination
Units, and Adult Day Care Services. | ||||||
3 | The State Treasurer is authorized to make transfers among | ||||||
4 | line item
appropriations
from the Capital Litigation Trust | ||||||
5 | Fund, with respect to costs incurred in
fiscal years 2002 and | ||||||
6 | 2003 only, when the balance remaining in one or
more such
line | ||||||
7 | item appropriations is insufficient for the purpose for which | ||||||
8 | the
appropriation was
made, provided that no such transfer may | ||||||
9 | be made unless the amount transferred
is no
longer required for | ||||||
10 | the purpose for which that appropriation was made. | ||||||
11 | The State Board of Education is authorized to make | ||||||
12 | transfers from line item appropriations within the same | ||||||
13 | treasury fund for General State Aid and General State Aid - | ||||||
14 | Hold Harmless, provided that no such transfer may be made | ||||||
15 | unless the amount transferred is no longer required for the | ||||||
16 | purpose for which that appropriation was made, to the line item | ||||||
17 | appropriation for Transitional Assistance when the balance | ||||||
18 | remaining in such line item appropriation is insufficient for | ||||||
19 | the purpose for which the appropriation was made. | ||||||
20 | The State Board of Education is authorized to make | ||||||
21 | transfers between the following line item appropriations | ||||||
22 | within the same treasury fund: Disabled Student | ||||||
23 | Services/Materials (Section 14-13.01 of the School Code), | ||||||
24 | Disabled Student Transportation Reimbursement (Section | ||||||
25 | 14-13.01 of the School Code), Disabled Student Tuition - | ||||||
26 | Private Tuition (Section 14-7.02 of the School Code), |
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1 | Extraordinary Special Education (Section 14-7.02b of the | ||||||
2 | School Code), Reimbursement for Free Lunch/Breakfast Program, | ||||||
3 | Summer School Payments (Section 18-4.3 of the School Code), and | ||||||
4 | Transportation - Regular/Vocational Reimbursement (Section | ||||||
5 | 29-5 of the School Code). Such transfers shall be made only | ||||||
6 | when the balance remaining in one or more such line item | ||||||
7 | appropriations is insufficient for the purpose for which the | ||||||
8 | appropriation was made and provided that no such transfer may | ||||||
9 | be made unless the amount transferred is no longer required for | ||||||
10 | the purpose for which that appropriation was made. | ||||||
11 | During State fiscal years 2010 and 2011 only, the | ||||||
12 | Department of Healthcare and Family Services is authorized to | ||||||
13 | make transfers not exceeding 4% of the aggregate amount | ||||||
14 | appropriated to it, within the same treasury fund, among the | ||||||
15 | various line items appropriated for Medical Assistance. | ||||||
16 | (c) The sum of such transfers for an agency in a fiscal | ||||||
17 | year shall not
exceed 2% of the aggregate amount appropriated | ||||||
18 | to it within the same treasury
fund for the following objects: | ||||||
19 | Personal Services; Extra Help; Student and
Inmate | ||||||
20 | Compensation; State Contributions to Retirement Systems; State
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21 | Contributions to Social Security; State Contribution for | ||||||
22 | Employee Group
Insurance; Contractual Services; Travel; | ||||||
23 | Commodities; Printing; Equipment;
Electronic Data Processing; | ||||||
24 | Operation of Automotive Equipment;
Telecommunications | ||||||
25 | Services; Travel and Allowance for Committed, Paroled
and | ||||||
26 | Discharged Prisoners; Library Books; Federal Matching Grants |
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1 | for
Student Loans; Refunds; Workers' Compensation, | ||||||
2 | Occupational Disease, and
Tort Claims; and, in appropriations | ||||||
3 | to institutions of higher education,
Awards and Grants. | ||||||
4 | Notwithstanding the above, any amounts appropriated for
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5 | payment of workers' compensation claims to an agency to which | ||||||
6 | the authority
to evaluate, administer and pay such claims has | ||||||
7 | been delegated by the
Department of Central Management Services | ||||||
8 | may be transferred to any other
expenditure object where such | ||||||
9 | amounts exceed the amount necessary for the
payment of such | ||||||
10 | claims. | ||||||
11 | (c-1) Special provisions for State fiscal year 2003. | ||||||
12 | Notwithstanding any
other provision of this Section to the | ||||||
13 | contrary, for State fiscal year 2003
only, transfers among line | ||||||
14 | item appropriations to an agency from the same
treasury fund | ||||||
15 | may be made provided that the sum of such transfers for an | ||||||
16 | agency
in State fiscal year 2003 shall not exceed 3% of the | ||||||
17 | aggregate amount
appropriated to that State agency for State | ||||||
18 | fiscal year 2003 for the following
objects: personal services, | ||||||
19 | except that no transfer may be approved which
reduces the | ||||||
20 | aggregate appropriations for personal services within an | ||||||
21 | agency;
extra help; student and inmate compensation; State
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22 | contributions to retirement systems; State contributions to | ||||||
23 | social security;
State contributions for employee group | ||||||
24 | insurance; contractual services; travel;
commodities; | ||||||
25 | printing; equipment; electronic data processing; operation of
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26 | automotive equipment; telecommunications services; travel and |
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1 | allowance for
committed, paroled, and discharged prisoners; | ||||||
2 | library books; federal matching
grants for student loans; | ||||||
3 | refunds; workers' compensation, occupational disease,
and tort | ||||||
4 | claims; and, in appropriations to institutions of higher | ||||||
5 | education,
awards and grants. | ||||||
6 | (c-2) Special provisions for State fiscal year 2005. | ||||||
7 | Notwithstanding subsections (a), (a-2), and (c), for State | ||||||
8 | fiscal year 2005 only, transfers may be made among any line | ||||||
9 | item appropriations from the same or any other treasury fund | ||||||
10 | for any objects or purposes, without limitation, when the | ||||||
11 | balance remaining in one or more such line item appropriations | ||||||
12 | is insufficient for the purpose for which the appropriation was | ||||||
13 | made, provided that the sum of those transfers by a State | ||||||
14 | agency shall not exceed 4% of the aggregate amount appropriated | ||||||
15 | to that State agency for fiscal year 2005.
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16 | (d) Transfers among appropriations made to agencies of the | ||||||
17 | Legislative
and Judicial departments and to the | ||||||
18 | constitutionally elected officers in the
Executive branch | ||||||
19 | require the approval of the officer authorized in Section 10
of | ||||||
20 | this Act to approve and certify vouchers. Transfers among | ||||||
21 | appropriations
made to the University of Illinois, Southern | ||||||
22 | Illinois University, Chicago State
University, Eastern | ||||||
23 | Illinois University, Governors State University, Illinois
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24 | State University, Northeastern Illinois University, Northern | ||||||
25 | Illinois
University, Western Illinois University, the Illinois | ||||||
26 | Mathematics and Science
Academy and the Board of Higher |
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1 | Education require the approval of the Board of
Higher Education | ||||||
2 | and the Governor. Transfers among appropriations to all other
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3 | agencies require the approval of the Governor. | ||||||
4 | The officer responsible for approval shall certify that the
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5 | transfer is necessary to carry out the programs and purposes | ||||||
6 | for which
the appropriations were made by the General Assembly | ||||||
7 | and shall transmit
to the State Comptroller a certified copy of | ||||||
8 | the approval which shall
set forth the specific amounts | ||||||
9 | transferred so that the Comptroller may
change his records | ||||||
10 | accordingly. The Comptroller shall furnish the
Governor with | ||||||
11 | information copies of all transfers approved for agencies
of | ||||||
12 | the Legislative and Judicial departments and transfers | ||||||
13 | approved by
the constitutionally elected officials of the | ||||||
14 | Executive branch other
than the Governor, showing the amounts | ||||||
15 | transferred and indicating the
dates such changes were entered | ||||||
16 | on the Comptroller's records. | ||||||
17 | (e) The State Board of Education, in consultation with the | ||||||
18 | State Comptroller, may transfer line item appropriations for | ||||||
19 | General State Aid between the Common School Fund and the | ||||||
20 | Education Assistance Fund. With the advice and consent of the | ||||||
21 | Governor's Office of Management and Budget, the State Board of | ||||||
22 | Education, in consultation with the State Comptroller, may | ||||||
23 | transfer line item appropriations between the General Revenue | ||||||
24 | Fund and the Education Assistance Fund for the following | ||||||
25 | programs: | ||||||
26 | (1) Disabled Student Personnel Reimbursement (Section |
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1 | 14-13.01 of the School Code); | ||||||
2 | (2) Disabled Student Transportation Reimbursement | ||||||
3 | (subsection (b) of Section 14-13.01 of the School Code); | ||||||
4 | (3) Disabled Student Tuition - Private Tuition | ||||||
5 | (Section 14-7.02 of the School Code); | ||||||
6 | (4) Extraordinary Special Education (Section 14-7.02b | ||||||
7 | of the School Code); | ||||||
8 | (5) Reimbursement for Free Lunch/Breakfast Programs; | ||||||
9 | (6) Summer School Payments (Section 18-4.3 of the | ||||||
10 | School Code); | ||||||
11 | (7) Transportation - Regular/Vocational Reimbursement | ||||||
12 | (Section 29-5 of the School Code); | ||||||
13 | (8) Regular Education Reimbursement (Section 18-3 of | ||||||
14 | the School Code); and | ||||||
15 | (9) Special Education Reimbursement (Section 14-7.03 | ||||||
16 | of the School Code). | ||||||
17 | (Source: P.A. 95-707, eff. 1-11-08; 96-37, eff. 7-13-09; | ||||||
18 | 96-820, eff. 11-18-09; 96-959, eff. 7-1-10; 96-1086, eff. | ||||||
19 | 7-16-10.)
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20 | (30 ILCS 105/25) (from Ch. 127, par. 161)
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21 | Sec. 25. Fiscal year limitations.
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22 | (a) All appropriations shall be
available for expenditure | ||||||
23 | for the fiscal year or for a lesser period if the
Act making | ||||||
24 | that appropriation so specifies. A deficiency or emergency
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25 | appropriation shall be available for expenditure only through |
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1 | June 30 of
the year when the Act making that appropriation is | ||||||
2 | enacted unless that Act
otherwise provides.
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3 | (b) Outstanding liabilities as of June 30, payable from | ||||||
4 | appropriations
which have otherwise expired, may be paid out of | ||||||
5 | the expiring
appropriations during the 2-month period ending at | ||||||
6 | the
close of business on August 31. Any service involving
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7 | professional or artistic skills or any personal services by an | ||||||
8 | employee whose
compensation is subject to income tax | ||||||
9 | withholding must be performed as of June
30 of the fiscal year | ||||||
10 | in order to be considered an "outstanding liability as of
June | ||||||
11 | 30" that is thereby eligible for payment out of the expiring
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12 | appropriation.
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13 | (b-1) However, payment of tuition reimbursement claims | ||||||
14 | under Section 14-7.03 or
18-3 of the School Code may be made by | ||||||
15 | the State Board of Education from its
appropriations for those | ||||||
16 | respective purposes for any fiscal year, even though
the claims | ||||||
17 | reimbursed by the payment may be claims attributable to a prior
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18 | fiscal year, and payments may be made at the direction of the | ||||||
19 | State
Superintendent of Education from the fund from which the | ||||||
20 | appropriation is made
without regard to any fiscal year | ||||||
21 | limitations , except as required by subsection (j) of this | ||||||
22 | Section. Beginning on June 30, 2021, payment of tuition | ||||||
23 | reimbursement claims under Section 14-7.03 or 18-3 of the | ||||||
24 | School Code as of June 30, payable from appropriations that | ||||||
25 | have otherwise expired, may be paid out of the expiring | ||||||
26 | appropriation during the 4-month period ending at the close of |
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1 | business on October 31 .
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2 | (b-2) All outstanding liabilities as of June 30, 2010, | ||||||
3 | payable from appropriations that would otherwise expire at the | ||||||
4 | conclusion of the lapse period for fiscal year 2010, and | ||||||
5 | interest penalties payable on those liabilities under the State | ||||||
6 | Prompt Payment Act, may be paid out of the expiring | ||||||
7 | appropriations until December 31, 2010, without regard to the | ||||||
8 | fiscal year in which the payment is made, as long as vouchers | ||||||
9 | for the liabilities are received by the Comptroller no later | ||||||
10 | than August 31, 2010. | ||||||
11 | (b-3) Medical payments may be made by the Department of | ||||||
12 | Veterans' Affairs from
its
appropriations for those purposes | ||||||
13 | for any fiscal year, without regard to the
fact that the | ||||||
14 | medical services being compensated for by such payment may have
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15 | been rendered in a prior fiscal year , except as required by | ||||||
16 | subsection (j) of this Section. Beginning on June 30, 2021, | ||||||
17 | medical payments payable from appropriations that have | ||||||
18 | otherwise expired may be paid out of the expiring appropriation | ||||||
19 | during the 4-month period ending at the close of business on | ||||||
20 | October 31 .
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21 | (b-4) Medical payments may be made by the Department of | ||||||
22 | Healthcare and Family Services and medical payments and child | ||||||
23 | care
payments may be made by the Department of
Human Services | ||||||
24 | (as successor to the Department of Public Aid) from
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25 | appropriations for those purposes for any fiscal year,
without | ||||||
26 | regard to the fact that the medical or child care services |
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1 | being
compensated for by such payment may have been rendered in | ||||||
2 | a prior fiscal
year; and payments may be made at the direction | ||||||
3 | of the Department of
Healthcare and Family Services Central | ||||||
4 | Management Services from the Health Insurance Reserve Fund and | ||||||
5 | the
Local Government Health Insurance Reserve Fund without | ||||||
6 | regard to any fiscal
year limitations , except as required by | ||||||
7 | subsection (j) of this Section. Beginning on June 30, 2021, | ||||||
8 | medical payments made by the Department of Healthcare and | ||||||
9 | Family Services, child care payments made by the Department of | ||||||
10 | Human Services, and payments made at the discretion of the | ||||||
11 | Department of Healthcare and Family Services from the Health | ||||||
12 | Insurance Reserve Fund and the Local Government Health | ||||||
13 | Insurance Reserve Fund payable from appropriations that have | ||||||
14 | otherwise expired may be paid out of the expiring appropriation | ||||||
15 | during the 4-month period ending at the close of business on | ||||||
16 | October 31 .
| ||||||
17 | (b-5) Medical payments may be made by the Department of | ||||||
18 | Human Services from its appropriations relating to substance | ||||||
19 | abuse treatment services for any fiscal year, without regard to | ||||||
20 | the fact that the medical services being compensated for by | ||||||
21 | such payment may have been rendered in a prior fiscal year, | ||||||
22 | provided the payments are made on a fee-for-service basis | ||||||
23 | consistent with requirements established for Medicaid | ||||||
24 | reimbursement by the Department of Healthcare and Family | ||||||
25 | Services , except as required by subsection (j) of this Section. | ||||||
26 | Beginning on June 30, 2021, medical payments made by the |
| |||||||
| |||||||
1 | Department of Human Services relating to substance abuse | ||||||
2 | treatment services payable from appropriations that have | ||||||
3 | otherwise expired may be paid out of the expiring appropriation | ||||||
4 | during the 4-month period ending at the close of business on | ||||||
5 | October 31 . | ||||||
6 | (b-6) Additionally, payments may be made by the Department | ||||||
7 | of Human Services from
its appropriations, or any other State | ||||||
8 | agency from its appropriations with
the approval of the | ||||||
9 | Department of Human Services, from the Immigration Reform
and | ||||||
10 | Control Fund for purposes authorized pursuant to the | ||||||
11 | Immigration Reform
and Control Act of 1986, without regard to | ||||||
12 | any fiscal year limitations , except as required by subsection | ||||||
13 | (j) of this Section. Beginning on June 30, 2021, payments made | ||||||
14 | by the Department of Human Services from the Immigration Reform | ||||||
15 | and Control Fund for purposes authorized pursuant to the | ||||||
16 | Immigration Reform and Control Act of 1986 payable from | ||||||
17 | appropriations that have otherwise expired may be paid out of | ||||||
18 | the expiring appropriation during the 4-month period ending at | ||||||
19 | the close of business on October 31 .
| ||||||
20 | Further, with respect to costs incurred in fiscal years | ||||||
21 | 2002 and 2003 only,
payments may be made by the State Treasurer | ||||||
22 | from its
appropriations
from the Capital Litigation Trust Fund | ||||||
23 | without regard to any fiscal year
limitations.
| ||||||
24 | Lease payments may be made by the Department of Central | ||||||
25 | Management
Services under the sale and leaseback provisions of
| ||||||
26 | Section 7.4 of
the State Property Control Act with respect to |
| |||||||
| |||||||
1 | the James R. Thompson Center and
the
Elgin Mental Health Center | ||||||
2 | and surrounding land from appropriations for that
purpose | ||||||
3 | without regard to any fiscal year
limitations.
| ||||||
4 | Lease payments may be made under the sale and leaseback | ||||||
5 | provisions of
Section 7.5 of the State Property Control Act | ||||||
6 | with
respect to the
Illinois State Toll Highway Authority | ||||||
7 | headquarters building and surrounding
land
without regard to | ||||||
8 | any fiscal year
limitations.
| ||||||
9 | (b-7) Payments may be made in accordance with a plan | ||||||
10 | authorized by paragraph (11) or (12) of Section 405-105 of the | ||||||
11 | Department of Central Management Services Law from | ||||||
12 | appropriations for those payments without regard to fiscal year | ||||||
13 | limitations. | ||||||
14 | (c) Further, payments may be made by the Department of | ||||||
15 | Public Health , and the
Department of Human Services (acting as | ||||||
16 | successor to the Department of Public
Health under the | ||||||
17 | Department of Human Services Act) , and the Department of | ||||||
18 | Healthcare and Family Services
from their respective | ||||||
19 | appropriations for grants for medical care to or on
behalf of | ||||||
20 | persons
suffering from chronic renal disease, persons | ||||||
21 | suffering from hemophilia, rape
victims, and premature and | ||||||
22 | high-mortality risk infants and their mothers and
for grants | ||||||
23 | for supplemental food supplies provided under the United States
| ||||||
24 | Department of Agriculture Women, Infants and Children | ||||||
25 | Nutrition Program,
for any fiscal year without regard to the | ||||||
26 | fact that the services being
compensated for by such payment |
| |||||||
| |||||||
1 | may have been rendered in a prior fiscal year , except as | ||||||
2 | required by subsection (j) of this Section. Beginning on June | ||||||
3 | 30, 2021, payments made by the Department of Public Health, the | ||||||
4 | Department of Human Services, and the Department of Healthcare | ||||||
5 | and Family Services from their respective appropriations for | ||||||
6 | grants for medical care to or on behalf of persons suffering | ||||||
7 | from chronic renal disease, persons suffering from hemophilia, | ||||||
8 | rape victims, and premature and high-mortality risk infants and | ||||||
9 | their mothers and for grants for supplemental food supplies | ||||||
10 | provided under the United States Department of Agriculture | ||||||
11 | Women, Infants and Children Nutrition Program payable from | ||||||
12 | appropriations that have otherwise expired may be paid out of | ||||||
13 | the expiring appropriations during the 4-month period ending at | ||||||
14 | the close of business on October 31 .
| ||||||
15 | (d) The Department of Public Health and the Department of | ||||||
16 | Human Services
(acting as successor to the Department of Public | ||||||
17 | Health under the Department of
Human Services Act) shall each | ||||||
18 | annually submit to the State Comptroller, Senate
President, | ||||||
19 | Senate
Minority Leader, Speaker of the House, House Minority | ||||||
20 | Leader, and the
respective Chairmen and Minority Spokesmen of | ||||||
21 | the
Appropriations Committees of the Senate and the House, on | ||||||
22 | or before
December 31, a report of fiscal year funds used to | ||||||
23 | pay for services
provided in any prior fiscal year. This report | ||||||
24 | shall document by program or
service category those | ||||||
25 | expenditures from the most recently completed fiscal
year used | ||||||
26 | to pay for services provided in prior fiscal years.
|
| |||||||
| |||||||
1 | (e) The Department of Healthcare and Family Services, the | ||||||
2 | Department of Human Services
(acting as successor to the | ||||||
3 | Department of Public Aid), and the Department of Human Services | ||||||
4 | making fee-for-service payments relating to substance abuse | ||||||
5 | treatment services provided during a previous fiscal year shall | ||||||
6 | each annually
submit to the State
Comptroller, Senate | ||||||
7 | President, Senate Minority Leader, Speaker of the House,
House | ||||||
8 | Minority Leader, the respective Chairmen and Minority | ||||||
9 | Spokesmen of the
Appropriations Committees of the Senate and | ||||||
10 | the House, on or before November
30, a report that shall | ||||||
11 | document by program or service category those
expenditures from | ||||||
12 | the most recently completed fiscal year used to pay for (i)
| ||||||
13 | services provided in prior fiscal years and (ii) services for | ||||||
14 | which claims were
received in prior fiscal years.
| ||||||
15 | (f) The Department of Human Services (as successor to the | ||||||
16 | Department of
Public Aid) shall annually submit to the State
| ||||||
17 | Comptroller, Senate President, Senate Minority Leader, Speaker | ||||||
18 | of the House,
House Minority Leader, and the respective | ||||||
19 | Chairmen and Minority Spokesmen of
the Appropriations | ||||||
20 | Committees of the Senate and the House, on or before
December | ||||||
21 | 31, a report
of fiscal year funds used to pay for services | ||||||
22 | (other than medical care)
provided in any prior fiscal year. | ||||||
23 | This report shall document by program or
service category those | ||||||
24 | expenditures from the most recently completed fiscal
year used | ||||||
25 | to pay for services provided in prior fiscal years.
| ||||||
26 | (g) In addition, each annual report required to be |
| |||||||
| |||||||
1 | submitted by the
Department of Healthcare and Family Services | ||||||
2 | under subsection (e) shall include the following
information | ||||||
3 | with respect to the State's Medicaid program:
| ||||||
4 | (1) Explanations of the exact causes of the variance | ||||||
5 | between the previous
year's estimated and actual | ||||||
6 | liabilities.
| ||||||
7 | (2) Factors affecting the Department of Healthcare and | ||||||
8 | Family Services' liabilities,
including but not limited to | ||||||
9 | numbers of aid recipients, levels of medical
service | ||||||
10 | utilization by aid recipients, and inflation in the cost of | ||||||
11 | medical
services.
| ||||||
12 | (3) The results of the Department's efforts to combat | ||||||
13 | fraud and abuse.
| ||||||
14 | (h) As provided in Section 4 of the General Assembly | ||||||
15 | Compensation Act,
any utility bill for service provided to a | ||||||
16 | General Assembly
member's district office for a period | ||||||
17 | including portions of 2 consecutive
fiscal years may be paid | ||||||
18 | from funds appropriated for such expenditure in
either fiscal | ||||||
19 | year.
| ||||||
20 | (i) An agency which administers a fund classified by the | ||||||
21 | Comptroller as an
internal service fund may issue rules for:
| ||||||
22 | (1) billing user agencies in advance for payments or | ||||||
23 | authorized inter-fund transfers
based on estimated charges | ||||||
24 | for goods or services;
| ||||||
25 | (2) issuing credits, refunding through inter-fund | ||||||
26 | transfers, or reducing future inter-fund transfers
during
|
| |||||||
| |||||||
1 | the subsequent fiscal year for all user agency payments or | ||||||
2 | authorized inter-fund transfers received during the
prior | ||||||
3 | fiscal year which were in excess of the final amounts owed | ||||||
4 | by the user
agency for that period; and
| ||||||
5 | (3) issuing catch-up billings to user agencies
during | ||||||
6 | the subsequent fiscal year for amounts remaining due when | ||||||
7 | payments or authorized inter-fund transfers
received from | ||||||
8 | the user agency during the prior fiscal year were less than | ||||||
9 | the
total amount owed for that period.
| ||||||
10 | User agencies are authorized to reimburse internal service | ||||||
11 | funds for catch-up
billings by vouchers drawn against their | ||||||
12 | respective appropriations for the
fiscal year in which the | ||||||
13 | catch-up billing was issued or by increasing an authorized | ||||||
14 | inter-fund transfer during the current fiscal year. For the | ||||||
15 | purposes of this Act, "inter-fund transfers" means transfers | ||||||
16 | without the use of the voucher-warrant process, as authorized | ||||||
17 | by Section 9.01 of the State Comptroller Act.
| ||||||
18 | (i-1) Beginning on July 1, 2021, all outstanding | ||||||
19 | liabilities, not payable during the 4-month lapse period as | ||||||
20 | described in subsections (b-1), (b-3), (b-4), (b-5), (b-6), and | ||||||
21 | (c) of this Section, that are made from appropriations for that | ||||||
22 | purpose for any fiscal year, without regard to the fact that | ||||||
23 | the services being compensated for by those payments may have | ||||||
24 | been rendered in a prior fiscal year, are limited to only those | ||||||
25 | claims that have been incurred but for which a proper bill or | ||||||
26 | invoice as defined by the State Prompt Payment Act has not been |
| |||||||
| |||||||
1 | received by September 30th following the end of the fiscal year | ||||||
2 | in which the service was rendered. | ||||||
3 | (j) Notwithstanding any other provision of this Act, the | ||||||
4 | aggregate amount of payments to be made without regard for | ||||||
5 | fiscal year limitations as contained in subsections (b-1), | ||||||
6 | (b-3), (b-4), (b-5), (b-6), and (c) of this Section, and | ||||||
7 | determined by using Generally Accepted Accounting Principles, | ||||||
8 | shall not exceed the following amounts: | ||||||
9 | (1) $6,000,000,000 for outstanding liabilities related | ||||||
10 | to fiscal year 2012; | ||||||
11 | (2) $5,300,000,000 for outstanding liabilities related | ||||||
12 | to fiscal year 2013; | ||||||
13 | (3) $4,600,000,000 for outstanding liabilities related | ||||||
14 | to fiscal year 2014; | ||||||
15 | (4) $4,000,000,000 for outstanding liabilities related | ||||||
16 | to fiscal year 2015; | ||||||
17 | (5) $3,300,000,000 for outstanding liabilities related | ||||||
18 | to fiscal year 2016; | ||||||
19 | (6) $2,600,000,000 for outstanding liabilities related | ||||||
20 | to fiscal year 2017; | ||||||
21 | (7) $2,000,000,000 for outstanding liabilities related | ||||||
22 | to fiscal year 2018; | ||||||
23 | (8) $1,300,000,000 for outstanding liabilities related | ||||||
24 | to fiscal year 2019; | ||||||
25 | (9) $600,000,000 for outstanding liabilities related | ||||||
26 | to fiscal year 2020; and |
| |||||||
| |||||||
1 | (10) $0 for outstanding liabilities related to fiscal | ||||||
2 | year 2021 and fiscal years thereafter. | ||||||
3 | (Source: P.A. 95-331, eff. 8-21-07; 96-928, eff. 6-15-10; | ||||||
4 | 96-958, eff. 7-1-10; revised 7-22-10.)
| ||||||
5 | Section 15. The State Prompt Payment Act is amended by | ||||||
6 | changing Section 3-2 as follows:
| ||||||
7 | (30 ILCS 540/3-2)
| ||||||
8 | Sec. 3-2. Beginning July 1, 1993, in any instance where a | ||||||
9 | State official or
agency is late in payment of a vendor's bill | ||||||
10 | or invoice for goods or services
furnished to the State, as | ||||||
11 | defined in Section 1, properly approved in
accordance with | ||||||
12 | rules promulgated under Section 3-3, the State official or
| ||||||
13 | agency shall pay interest to the vendor in accordance with the | ||||||
14 | following:
| ||||||
15 | (1) Any bill, except a bill submitted under Article V | ||||||
16 | of the Illinois Public Aid Code, approved for payment under | ||||||
17 | this Section must be paid
or the payment issued to the | ||||||
18 | payee within 60 days of receipt
of a proper bill or | ||||||
19 | invoice.
If payment is not issued to the payee within this | ||||||
20 | 60 day
period, an
interest penalty of 1.0% of any amount | ||||||
21 | approved and unpaid shall be added
for each month or | ||||||
22 | fraction thereof after the end of this 60 day period,
until | ||||||
23 | final payment is made. Any bill , except a bill for pharmacy | ||||||
24 | services or goods, submitted under Article V of the |
| |||||||
| |||||||
1 | Illinois Public Aid Code approved for payment under this | ||||||
2 | Section must be paid
or the payment issued to the payee | ||||||
3 | within 60 days after receipt
of a proper bill or invoice, | ||||||
4 | and,
if payment is not issued to the payee within this | ||||||
5 | 60-day
period, an
interest penalty of 2.0% of any amount | ||||||
6 | approved and unpaid shall be added
for each month or | ||||||
7 | fraction thereof after the end of this 60-day period,
until | ||||||
8 | final payment is made. Any bill for pharmacy services or | ||||||
9 | goods submitted under Article V of the Illinois Public Aid | ||||||
10 | Code, approved for payment under this Section must be paid | ||||||
11 | or the payment issued to the payee within 60 days of | ||||||
12 | receipt of a proper bill or invoice. If payment is not | ||||||
13 | issued to the payee within this 60 day period, an interest | ||||||
14 | penalty of 1.0% of any amount approved and unpaid shall be | ||||||
15 | added for each month or fraction thereof after the end of | ||||||
16 | this 60 day period, until final payment is made.
| ||||||
17 | (1.1) A State agency shall review in a timely manner | ||||||
18 | each bill or
invoice after its receipt. If the
State agency | ||||||
19 | determines that the bill or invoice contains a defect | ||||||
20 | making it
unable to process the payment request, the agency
| ||||||
21 | shall notify the vendor requesting payment as soon as | ||||||
22 | possible after
discovering the
defect pursuant to rules | ||||||
23 | promulgated under Section 3-3; provided, however, that the | ||||||
24 | notice for construction related bills or invoices must be | ||||||
25 | given not later than 30 days after the bill or invoice was | ||||||
26 | first submitted. The notice shall
identify the defect and |
| |||||||
| |||||||
1 | any additional information
necessary to correct the | ||||||
2 | defect. If one or more items on a construction related bill | ||||||
3 | or invoice are disapproved, but not the entire bill or | ||||||
4 | invoice, then the portion that is not disapproved shall be | ||||||
5 | paid.
| ||||||
6 | (2) Where a State official or agency is late in payment | ||||||
7 | of a
vendor's bill or invoice properly approved in | ||||||
8 | accordance with this Act, and
different late payment terms | ||||||
9 | are not reduced to writing as a contractual
agreement, the | ||||||
10 | State official or agency shall automatically pay interest
| ||||||
11 | penalties required by this Section amounting to $50 or more | ||||||
12 | to the appropriate
vendor. Each agency shall be responsible | ||||||
13 | for determining whether an interest
penalty
is
owed and
for | ||||||
14 | paying the interest to the vendor.
Interest due to a vendor | ||||||
15 | that amounts to less than $50 shall not be paid but shall | ||||||
16 | be accrued until all interest due the vendor for all | ||||||
17 | similar warrants exceeds $50, at which time the accrued | ||||||
18 | interest shall be payable and interest will begin accruing | ||||||
19 | again, except that interest accrued as of the end of the | ||||||
20 | fiscal year that does not exceed $50 shall be payable at | ||||||
21 | that time. In the event an
individual has paid a vendor for | ||||||
22 | services in advance, the provisions of this
Section shall | ||||||
23 | apply until payment is made to that individual.
| ||||||
24 | (3) The provisions of this amendatory Act of the 96th | ||||||
25 | General Assembly reducing the interest rate on pharmacy | ||||||
26 | claims under Article V of the Illinois Public Aid Code to |
| |||||||
| |||||||
1 | 1.0% per month shall apply to any pharmacy bills for | ||||||
2 | services and goods under Article V of the Illinois Public | ||||||
3 | Aid Code received on or after the date 60 days before the | ||||||
4 | effective date of this amendatory Act of the 96th General | ||||||
5 | Assembly. | ||||||
6 | (Source: P.A. 96-555, eff. 8-18-09; 96-802, eff. 1-1-10; | ||||||
7 | 96-959, eff. 7-1-10; 96-1000, eff. 7-2-10.)
| ||||||
8 | Section 20. The Illinois Income Tax Act is amended by | ||||||
9 | changing Section 917 as follows:
| ||||||
10 | (35 ILCS 5/917) (from Ch. 120, par. 9-917)
| ||||||
11 | Sec. 917. Confidentiality and information sharing.
| ||||||
12 | (a) Confidentiality.
Except as provided in this Section, | ||||||
13 | all information received by the Department
from returns filed | ||||||
14 | under this Act, or from any investigation conducted under
the | ||||||
15 | provisions of this Act, shall be confidential, except for | ||||||
16 | official purposes
within the Department or pursuant to official | ||||||
17 | procedures for collection
of any State tax or pursuant to an | ||||||
18 | investigation or audit by the Illinois
State Scholarship | ||||||
19 | Commission of a delinquent student loan or monetary award
or | ||||||
20 | enforcement of any civil or criminal penalty or sanction
| ||||||
21 | imposed by this Act or by another statute imposing a State tax, | ||||||
22 | and any
person who divulges any such information in any manner, | ||||||
23 | except for such
purposes and pursuant to order of the Director | ||||||
24 | or in accordance with a proper
judicial order, shall be guilty |
| |||||||
| |||||||
1 | of a Class A misdemeanor. However, the
provisions of this | ||||||
2 | paragraph are not applicable to information furnished
to (i) | ||||||
3 | the Department of Healthcare and Family Services (formerly
| ||||||
4 | Department of Public Aid), State's Attorneys, and the Attorney | ||||||
5 | General for child support enforcement purposes and (ii) a | ||||||
6 | licensed attorney representing the taxpayer where an appeal or | ||||||
7 | a protest
has been filed on behalf of the taxpayer. If it is | ||||||
8 | necessary to file information obtained pursuant to this Act in | ||||||
9 | a child support enforcement proceeding, the information shall | ||||||
10 | be filed under seal.
| ||||||
11 | (b) Public information. Nothing contained in this Act shall | ||||||
12 | prevent
the Director from publishing or making available to the | ||||||
13 | public the names
and addresses of persons filing returns under | ||||||
14 | this Act, or from publishing
or making available reasonable | ||||||
15 | statistics concerning the operation of the
tax wherein the | ||||||
16 | contents of returns are grouped into aggregates in such a
way | ||||||
17 | that the information contained in any individual return shall | ||||||
18 | not be
disclosed.
| ||||||
19 | (c) Governmental agencies. The Director may make available | ||||||
20 | to the
Secretary of the Treasury of the United States or his | ||||||
21 | delegate, or the
proper officer or his delegate of any other | ||||||
22 | state imposing a tax upon or
measured by income, for | ||||||
23 | exclusively official purposes, information received
by the | ||||||
24 | Department in the administration of this Act, but such | ||||||
25 | permission
shall be granted only if the United States or such | ||||||
26 | other state, as the case
may be, grants the Department |
| |||||||
| |||||||
1 | substantially similar privileges. The Director
may exchange | ||||||
2 | information with the Department of Healthcare and Family | ||||||
3 | Services and the
Department of Human Services (acting as | ||||||
4 | successor to the Department of Public
Aid under the Department | ||||||
5 | of Human Services Act) for
the purpose of verifying sources and | ||||||
6 | amounts of income and for other purposes
directly connected | ||||||
7 | with the administration of this Act , the Illinois Public Aid | ||||||
8 | Code, and any other health benefit program administered by the | ||||||
9 | State and the Illinois
Public Aid Code . The Director may | ||||||
10 | exchange information with the Director of
the Department of | ||||||
11 | Employment Security for the purpose of verifying sources
and | ||||||
12 | amounts of income and for other purposes directly connected | ||||||
13 | with the
administration of this Act and Acts administered by | ||||||
14 | the Department of
Employment
Security.
The Director may make | ||||||
15 | available to the Illinois Workers' Compensation Commission
| ||||||
16 | information regarding employers for the purpose of verifying | ||||||
17 | the insurance
coverage required under the Workers' | ||||||
18 | Compensation Act and Workers'
Occupational Diseases Act. The | ||||||
19 | Director may exchange information with the Illinois Department | ||||||
20 | on Aging for the purpose of verifying sources and amounts of | ||||||
21 | income for purposes directly related to confirming eligibility | ||||||
22 | for participation in the programs of benefits authorized by the | ||||||
23 | Senior Citizens and Disabled Persons Property Tax Relief and | ||||||
24 | Pharmaceutical Assistance Act.
| ||||||
25 | The Director may make available to any State agency, | ||||||
26 | including the
Illinois Supreme Court, which licenses persons to |
| |||||||
| |||||||
1 | engage in any occupation,
information that a person licensed by | ||||||
2 | such agency has failed to file
returns under this Act or pay | ||||||
3 | the tax, penalty and interest shown therein,
or has failed to | ||||||
4 | pay any final assessment of tax, penalty or interest due
under | ||||||
5 | this Act.
The Director may make available to any State agency, | ||||||
6 | including the Illinois
Supreme
Court, information regarding | ||||||
7 | whether a bidder, contractor, or an affiliate of a
bidder or
| ||||||
8 | contractor has failed to file returns under this Act or pay the | ||||||
9 | tax, penalty,
and interest
shown therein, or has failed to pay | ||||||
10 | any final assessment of tax, penalty, or
interest due
under | ||||||
11 | this Act, for the limited purpose of enforcing bidder and | ||||||
12 | contractor
certifications.
For purposes of this Section, the | ||||||
13 | term "affiliate" means any entity that (1)
directly,
| ||||||
14 | indirectly, or constructively controls another entity, (2) is | ||||||
15 | directly,
indirectly, or
constructively controlled by another | ||||||
16 | entity, or (3) is subject to the control
of
a common
entity. | ||||||
17 | For purposes of this subsection (a), an entity controls another | ||||||
18 | entity
if
it owns,
directly or individually, more than 10% of | ||||||
19 | the voting securities of that
entity.
As used in
this | ||||||
20 | subsection (a), the term "voting security" means a security | ||||||
21 | that (1)
confers upon the
holder the right to vote for the | ||||||
22 | election of members of the board of directors
or similar
| ||||||
23 | governing body of the business or (2) is convertible into, or | ||||||
24 | entitles the
holder to receive
upon its exercise, a security | ||||||
25 | that confers such a right to vote. A general
partnership
| ||||||
26 | interest is a voting security.
|
| |||||||
| |||||||
1 | The Director may make available to any State agency, | ||||||
2 | including the
Illinois
Supreme Court, units of local | ||||||
3 | government, and school districts, information
regarding
| ||||||
4 | whether a bidder or contractor is an affiliate of a person who | ||||||
5 | is not
collecting
and
remitting Illinois Use taxes, for the | ||||||
6 | limited purpose of enforcing bidder and
contractor
| ||||||
7 | certifications.
| ||||||
8 | The Director may also make available to the Secretary of | ||||||
9 | State
information that a corporation which has been issued a | ||||||
10 | certificate of
incorporation by the Secretary of State has | ||||||
11 | failed to file returns under
this Act or pay the tax, penalty | ||||||
12 | and interest shown therein, or has failed
to pay any final | ||||||
13 | assessment of tax, penalty or interest due under this Act.
An | ||||||
14 | assessment is final when all proceedings in court for
review of | ||||||
15 | such assessment have terminated or the time for the taking
| ||||||
16 | thereof has expired without such proceedings being instituted. | ||||||
17 | For
taxable years ending on or after December 31, 1987, the | ||||||
18 | Director may make
available to the Director or principal | ||||||
19 | officer of any Department of the
State of Illinois, information | ||||||
20 | that a person employed by such Department
has failed to file | ||||||
21 | returns under this Act or pay the tax, penalty and
interest | ||||||
22 | shown therein. For purposes of this paragraph, the word
| ||||||
23 | "Department" shall have the same meaning as provided in Section | ||||||
24 | 3 of the
State Employees Group Insurance Act of 1971.
| ||||||
25 | (d) The Director shall make available for public
inspection | ||||||
26 | in the Department's principal office and for publication, at |
| |||||||
| |||||||
1 | cost,
administrative decisions issued on or after January
1, | ||||||
2 | 1995. These decisions are to be made available in a manner so | ||||||
3 | that the
following
taxpayer information is not disclosed:
| ||||||
4 | (1) The names, addresses, and identification numbers | ||||||
5 | of the taxpayer,
related entities, and employees.
| ||||||
6 | (2) At the sole discretion of the Director, trade | ||||||
7 | secrets
or other confidential information identified as | ||||||
8 | such by the taxpayer, no later
than 30 days after receipt | ||||||
9 | of an administrative decision, by such means as the
| ||||||
10 | Department shall provide by rule.
| ||||||
11 | The Director shall determine the
appropriate extent of the
| ||||||
12 | deletions allowed in paragraph (2). In the event the taxpayer | ||||||
13 | does not submit
deletions,
the Director shall make only the | ||||||
14 | deletions specified in paragraph (1).
| ||||||
15 | The Director shall make available for public inspection and | ||||||
16 | publication an
administrative decision within 180 days after | ||||||
17 | the issuance of the
administrative
decision. The term | ||||||
18 | "administrative decision" has the same meaning as defined in
| ||||||
19 | Section 3-101 of Article III of the Code of Civil Procedure. | ||||||
20 | Costs collected
under this Section shall be paid into the Tax | ||||||
21 | Compliance and Administration
Fund.
| ||||||
22 | (e) Nothing contained in this Act shall prevent the | ||||||
23 | Director from
divulging
information to any person pursuant to a | ||||||
24 | request or authorization made by the
taxpayer, by an authorized | ||||||
25 | representative of the taxpayer, or, in the case of
information | ||||||
26 | related to a joint return, by the spouse filing the joint |
| |||||||
| |||||||
1 | return
with the taxpayer.
| ||||||
2 | (Source: P.A. 94-1074, eff. 12-26-06; 95-331, eff. 8-21-07.)
| ||||||
3 | Section 25. The Illinois Insurance Code is amended by | ||||||
4 | changing Section 5.5 as follows: | ||||||
5 | (215 ILCS 5/5.5) | ||||||
6 | Sec. 5.5. Compliance with the Department of Healthcare and | ||||||
7 | Family Services. A company authorized to do business in this | ||||||
8 | State or accredited by the State to issue policies of health | ||||||
9 | insurance, including but not limited to, self-insured plans, | ||||||
10 | group health plans (as defined in Section 607(1) of the | ||||||
11 | Employee Retirement Income Security Act of 1974), service | ||||||
12 | benefit plans, managed care organizations, pharmacy benefit | ||||||
13 | managers, or other parties that are by statute, contract, or | ||||||
14 | agreement legally responsible for payment of a claim for a | ||||||
15 | health care item or service as a condition of doing business in | ||||||
16 | the State must: | ||||||
17 | (1) provide to the Department of Healthcare and Family | ||||||
18 | Services, or any successor agency, on at least a quarterly | ||||||
19 | basis if so requested by the Department, information upon | ||||||
20 | request information to determine during what period any | ||||||
21 | individual may be, or may have been, covered by a health | ||||||
22 | insurer and the nature of the coverage that is or was | ||||||
23 | provided by the health insurer, including the name, | ||||||
24 | address, and identifying number of the plan; |
| |||||||
| |||||||
1 | (2) accept the State's right of recovery and the | ||||||
2 | assignment to the State of any right of an individual or | ||||||
3 | other entity to payment from the party for an item or | ||||||
4 | service for which payment has been made under the medical | ||||||
5 | programs of the Department of Healthcare and Family | ||||||
6 | Services, or any successor agency, under this Code or the | ||||||
7 | Illinois Public Aid Code; | ||||||
8 | (3) respond to any inquiry by the Department of | ||||||
9 | Healthcare and Family Services regarding a claim for | ||||||
10 | payment for any health care item or service that is | ||||||
11 | submitted not later than 3 years after the date of the | ||||||
12 | provision of such health care item or service; and | ||||||
13 | (4) agree not to deny a claim submitted by the | ||||||
14 | Department of Healthcare and Family Services solely on the | ||||||
15 | basis of the date of submission of the claim, the type or | ||||||
16 | format of the claim form, or a failure to present proper | ||||||
17 | documentation at the point-of-sale that is the basis of the | ||||||
18 | claim if (i) the claim is submitted by the Department of | ||||||
19 | Healthcare and Family Services within the 3-year period | ||||||
20 | beginning on the date on which the item or service was | ||||||
21 | furnished and (ii) any action by the Department of | ||||||
22 | Healthcare and Family Services to enforce its rights with | ||||||
23 | respect to such claim is commenced within 6 years of its | ||||||
24 | submission of such claim.
| ||||||
25 | In cases in which the Department of Healthcare and Family | ||||||
26 | Services has determined that an entity that provides health |
| |||||||
| |||||||
1 | insurance coverage has established a pattern of failure to | ||||||
2 | provide the information required under this Section, and has | ||||||
3 | subsequently certified that determination, along with | ||||||
4 | supporting documentation, to the Director of the Department of | ||||||
5 | Insurance, the Director of the Department of Insurance, based | ||||||
6 | upon the certification of determination made by the Department | ||||||
7 | of Healthcare and Family Services, may commence regulatory | ||||||
8 | proceedings in accordance with all applicable provisions of the | ||||||
9 | Illinois Insurance Code. | ||||||
10 | (Source: P.A. 95-632, eff. 9-25-07.) | ||||||
11 | Section 30. The Children's Health Insurance Program Act is | ||||||
12 | amended by changing Section 15 and by adding Sections 7, 21, | ||||||
13 | 23, and 26 as follows: | ||||||
14 | (215 ILCS 106/7 new) | ||||||
15 | Sec. 7. Eligibility verification. Notwithstanding any | ||||||
16 | other provision of this Act, with respect to applications for | ||||||
17 | benefits provided under the Program, eligibility shall be | ||||||
18 | determined in a manner that ensures program integrity and that | ||||||
19 | complies with federal law and regulations while minimizing | ||||||
20 | unnecessary barriers to enrollment. To this end, as soon as | ||||||
21 | practicable, and unless the Department receives written denial | ||||||
22 | from the federal government, this Section shall be implemented: | ||||||
23 | (a) The Department of Healthcare and Family Services or its | ||||||
24 | designees shall: |
| |||||||
| |||||||
1 | (1) By no later than July 1, 2011, require verification | ||||||
2 | of, at a minimum, one month's income from all sources | ||||||
3 | required for determining the eligibility of applicants to | ||||||
4 | the Program. Such verification shall take the form of pay | ||||||
5 | stubs, business or income and expense records for | ||||||
6 | self-employed persons, letters from employers, and any | ||||||
7 | other valid documentation of income including data | ||||||
8 | obtained electronically by the Department or its designees | ||||||
9 | from other sources as described in subsection (b) of this | ||||||
10 | Section. | ||||||
11 | (2) By no later than October 1, 2011, require | ||||||
12 | verification of, at a minimum, one month's income from all | ||||||
13 | sources required for determining the continued eligibility | ||||||
14 | of recipients at their annual review of eligibility under | ||||||
15 | the Program. Such verification shall take the form of pay | ||||||
16 | stubs, business or income and expense records for | ||||||
17 | self-employed persons, letters from employers, and any | ||||||
18 | other valid documentation of income including data | ||||||
19 | obtained electronically by the Department or its designees | ||||||
20 | from other sources as described in subsection (b) of this | ||||||
21 | Section. The Department shall send a notice to the | ||||||
22 | recipient at least 60 days prior to the end of the period | ||||||
23 | of eligibility that informs them of the requirements for | ||||||
24 | continued eligibility. If a recipient does not fulfill the | ||||||
25 | requirements for continued eligibility by the deadline | ||||||
26 | established in the notice, a notice of cancellation shall |
| |||||||
| |||||||
1 | be issued to the recipient and coverage shall end on the | ||||||
2 | last day of the eligibility period. A recipient's | ||||||
3 | eligibility may be reinstated without requiring a new | ||||||
4 | application if the recipient fulfills the requirements for | ||||||
5 | continued eligibility prior to the end of the month | ||||||
6 | following the last date of coverage. Nothing in this | ||||||
7 | Section shall prevent an individual whose coverage has been | ||||||
8 | cancelled from reapplying for health benefits at any time. | ||||||
9 | (3) By no later than July 1, 2011, require verification | ||||||
10 | of Illinois residency. | ||||||
11 | (b) The Department shall establish or continue cooperative
| ||||||
12 | arrangements with the Social Security Administration, the
| ||||||
13 | Illinois Secretary of State, the Department of Human Services,
| ||||||
14 | the Department of Revenue, the Department of Employment | ||||||
15 | Security, and any other appropriate entity to gain electronic
| ||||||
16 | access, to the extent allowed by law, to information available | ||||||
17 | to those entities that may be appropriate for electronically
| ||||||
18 | verifying any factor of eligibility for benefits under the
| ||||||
19 | Program. Data relevant to eligibility shall be provided for no
| ||||||
20 | other purpose than to verify the eligibility of new applicants | ||||||
21 | or current recipients of health benefits under the Program. | ||||||
22 | Data will be requested or provided for any new applicant or | ||||||
23 | current recipient only insofar as that individual's | ||||||
24 | circumstances are relevant to that individual's or another | ||||||
25 | individual's eligibility. | ||||||
26 | (c) Within 90 days of the effective date of this amendatory |
| |||||||
| |||||||
1 | Act of the 96th General Assembly, the Department of Healthcare | ||||||
2 | and Family Services shall send notice to current recipients | ||||||
3 | informing them of the changes regarding their eligibility | ||||||
4 | verification.
| ||||||
5 | (215 ILCS 106/15)
| ||||||
6 | Sec. 15. Operation of the Program. There is hereby created | ||||||
7 | a
Children's Health Insurance Program. The Program shall | ||||||
8 | operate subject
to appropriation and shall be administered by | ||||||
9 | the Department of Healthcare and Family Services. The | ||||||
10 | Department shall have the powers and authority granted to the
| ||||||
11 | Department under the Illinois Public Aid Code , including, but | ||||||
12 | not limited to, Section 11-5.1 of the Code . The Department may | ||||||
13 | contract
with a Third Party Administrator or other entities to | ||||||
14 | administer and oversee
any portion of this Program.
| ||||||
15 | (Source: P.A. 95-331, eff. 8-21-07.)
| ||||||
16 | (215 ILCS 106/21 new) | ||||||
17 | Sec. 21. Presumptive eligibility. Beginning on the | ||||||
18 | effective date of this amendatory Act of the 96th General | ||||||
19 | Assembly and except where federal law requires presumptive | ||||||
20 | eligibility, no adult may be presumed eligible for health care | ||||||
21 | coverage under the Program, and the Department may not cover | ||||||
22 | any service rendered to an adult unless the adult has completed | ||||||
23 | an application for benefits, all required verifications have | ||||||
24 | been received and the Department or its designee has found the |
| |||||||
| |||||||
1 | adult eligible for the date on which that service was provided. | ||||||
2 | Nothing in this Section shall apply to pregnant women. | ||||||
3 | (215 ILCS 106/23 new) | ||||||
4 | Sec. 23. Care coordination. | ||||||
5 | (a) At least 50% of recipients eligible for comprehensive | ||||||
6 | medical benefits in all medical assistance programs or other | ||||||
7 | health benefit programs administered by the Department, | ||||||
8 | including the Children's Health Insurance Program Act and the | ||||||
9 | Covering ALL KIDS Health Insurance Act, shall be enrolled in a | ||||||
10 | care coordination program by no later than January 1, 2015. For | ||||||
11 | purposes of this Section, "coordinated care" or "care | ||||||
12 | coordination" means delivery systems where recipients will | ||||||
13 | receive their care from providers who participate under | ||||||
14 | contract in integrated delivery systems that are responsible | ||||||
15 | for providing or arranging the majority of care, including | ||||||
16 | primary care physician services, referrals from primary care | ||||||
17 | physicians, diagnostic and treatment services, behavioral | ||||||
18 | health services, in-patient and outpatient hospital services, | ||||||
19 | dental services, and rehabilitation and long-term care | ||||||
20 | services. The Department shall designate or contract for such | ||||||
21 | integrated delivery systems (i) to ensure enrollees have a | ||||||
22 | choice of systems and of primary care providers within such | ||||||
23 | systems; (ii) to ensure that enrollees receive quality care in | ||||||
24 | a culturally and linguistically appropriate manner; and (iii) | ||||||
25 | to ensure that coordinated care programs meet the diverse needs |
| |||||||
| |||||||
1 | of enrollees with developmental, mental health, physical, and | ||||||
2 | age-related disabilities. | ||||||
3 | (b) Payment for such coordinated care shall be based on | ||||||
4 | arrangements where the State pays for performance related to | ||||||
5 | health care outcomes, the use of evidence-based practices, the | ||||||
6 | use of primary care delivered through comprehensive medical | ||||||
7 | homes, the use of electronic medical records, and the | ||||||
8 | appropriate exchange of health information electronically made | ||||||
9 | either on a capitated basis in which a fixed monthly premium | ||||||
10 | per recipient is paid and full financial risk is assumed for | ||||||
11 | the delivery of services, or through other risk-based payment | ||||||
12 | arrangements. | ||||||
13 | (c) To qualify for compliance with this Section, the 50% | ||||||
14 | goal shall be achieved by enrolling medical assistance | ||||||
15 | enrollees from each medical assistance enrollment category, | ||||||
16 | including parents, children, seniors, and people with | ||||||
17 | disabilities to the extent that current State Medicaid payment | ||||||
18 | laws would not limit federal matching funds for recipients in | ||||||
19 | care coordination programs. In addition, services must be more | ||||||
20 | comprehensively defined and more risk shall be assumed than in | ||||||
21 | the Department's primary care case management program as of the | ||||||
22 | effective date of this amendatory Act of the 96th General | ||||||
23 | Assembly. | ||||||
24 | (d) The Department shall report to the General Assembly in | ||||||
25 | a separate part of its annual medical assistance program | ||||||
26 | report, beginning April, 2012 until April, 2016, on the |
| |||||||
| |||||||
1 | progress and implementation of the care coordination program | ||||||
2 | initiatives established by the provisions of this amendatory | ||||||
3 | Act of the 96th General Assembly. The Department shall include | ||||||
4 | in its April 2011 report a full analysis of federal laws or | ||||||
5 | regulations regarding upper payment limitations to providers | ||||||
6 | and the necessary revisions or adjustments in rate | ||||||
7 | methodologies and payments to providers under this Code that | ||||||
8 | would be necessary to implement coordinated care with full | ||||||
9 | financial risk by a party other than the Department. | ||||||
10 | (215 ILCS 106/26 new) | ||||||
11 | Sec. 26. Moratorium on eligibility expansions. Beginning | ||||||
12 | on the effective date of this amendatory Act of the 96th | ||||||
13 | General Assembly, there shall be a 2-year moratorium on the | ||||||
14 | expansion of eligibility through increasing financial | ||||||
15 | eligibility standards, or through increasing income | ||||||
16 | disregards, or through the creation of new programs that would | ||||||
17 | add new categories of eligible individuals under the medical | ||||||
18 | assistance program under the Illinois Public Aid Code in | ||||||
19 | addition to those categories covered on January 1, 2011. This | ||||||
20 | moratorium shall not apply to expansions required as a federal | ||||||
21 | condition of State participation in the medical assistance | ||||||
22 | program. | ||||||
23 | Section 35. The Covering ALL KIDS Health Insurance Act is | ||||||
24 | amended by changing Sections 15, 20, and 98 and by adding |
| |||||||
| |||||||
1 | Sections 7, 21, 26, 36, and 56 as follows: | ||||||
2 | (215 ILCS 170/7 new) | ||||||
3 | Sec. 7. Eligibility verification. Notwithstanding any | ||||||
4 | other provision of this Act, with respect to applications for | ||||||
5 | benefits provided under the Program, eligibility shall be | ||||||
6 | determined in a manner that ensures program integrity and that | ||||||
7 | complies with federal law and regulations while minimizing | ||||||
8 | unnecessary barriers to enrollment. To this end, as soon as | ||||||
9 | practicable, and unless the Department receives written denial | ||||||
10 | from the federal government, this Section shall be implemented: | ||||||
11 | (a) The Department of Healthcare and Family Services or its | ||||||
12 | designees shall: | ||||||
13 | (1) By July 1, 2011, require verification of, at a | ||||||
14 | minimum, one month's income from all sources required for | ||||||
15 | determining the eligibility of applicants to the Program.
| ||||||
16 | Such verification shall take the form of pay stubs, | ||||||
17 | business or income and expense records for self-employed | ||||||
18 | persons, letters from employers, and any other valid | ||||||
19 | documentation of income including data obtained | ||||||
20 | electronically by the Department or its designees from | ||||||
21 | other sources as described in subsection (b) of this | ||||||
22 | Section. | ||||||
23 | (2) By October 1, 2011, require verification of, at a | ||||||
24 | minimum, one month's income from all sources required for | ||||||
25 | determining the continued eligibility of recipients at |
| |||||||
| |||||||
1 | their annual review of eligibility under the Program. Such | ||||||
2 | verification shall take the form of pay stubs, business or | ||||||
3 | income and expense records for self-employed persons, | ||||||
4 | letters from employers, and any other valid documentation | ||||||
5 | of income including data obtained electronically by the | ||||||
6 | Department or its designees from other sources as described | ||||||
7 | in subsection (b) of this Section. The Department shall | ||||||
8 | send a notice to
recipients at least 60 days prior to the | ||||||
9 | end of their period
of eligibility that informs them of the
| ||||||
10 | requirements for continued eligibility. If a recipient
| ||||||
11 | does not fulfill the requirements for continued | ||||||
12 | eligibility by the
deadline established in the notice, a | ||||||
13 | notice of cancellation shall be issued to the recipient and | ||||||
14 | coverage shall end on the last day of the eligibility | ||||||
15 | period. A recipient's eligibility may be reinstated | ||||||
16 | without requiring a new application if the recipient | ||||||
17 | fulfills the requirements for continued eligibility prior | ||||||
18 | to the end of the month following the last date of | ||||||
19 | coverage. Nothing in this Section shall prevent an | ||||||
20 | individual whose coverage has been cancelled from | ||||||
21 | reapplying for health benefits at any time. | ||||||
22 | (3) By July 1, 2011, require verification of Illinois | ||||||
23 | residency. | ||||||
24 | (b) The Department shall establish or continue cooperative
| ||||||
25 | arrangements with the Social Security Administration, the
| ||||||
26 | Illinois Secretary of State, the Department of Human Services,
|
| |||||||
| |||||||
1 | the Department of Revenue, the Department of Employment
| ||||||
2 | Security, and any other appropriate entity to gain electronic
| ||||||
3 | access, to the extent allowed by law, to information available
| ||||||
4 | to those entities that may be appropriate for electronically
| ||||||
5 | verifying any factor of eligibility for benefits under the
| ||||||
6 | Program. Data relevant to eligibility shall be provided for no
| ||||||
7 | other purpose than to verify the eligibility of new applicants | ||||||
8 | or current recipients of health benefits under the Program. | ||||||
9 | Data will be requested or provided for any new applicant or | ||||||
10 | current recipient only insofar as that individual's | ||||||
11 | circumstances are relevant to that individual's or another | ||||||
12 | individual's eligibility. | ||||||
13 | (c) Within 90 days of the effective date of this amendatory | ||||||
14 | Act of the 96th General Assembly, the Department of Healthcare | ||||||
15 | and Family Services shall send notice to current recipients | ||||||
16 | informing them of the changes regarding their eligibility | ||||||
17 | verification. | ||||||
18 | (215 ILCS 170/15) | ||||||
19 | (Section scheduled to be repealed on July 1, 2011)
| ||||||
20 | Sec. 15. Operation of Program. The Covering ALL KIDS Health | ||||||
21 | Insurance Program is created. The Program shall be administered | ||||||
22 | by the Department of Healthcare and Family Services. The | ||||||
23 | Department shall have the same powers and authority to | ||||||
24 | administer the Program as are provided to the Department in | ||||||
25 | connection with the Department's administration of the |
| |||||||
| |||||||
1 | Illinois Public Aid Code , including, but not limited to, the | ||||||
2 | provisions under Section 11-5.1 of the Code, and the Children's | ||||||
3 | Health Insurance Program Act. The Department shall coordinate | ||||||
4 | the Program with the existing children's health programs | ||||||
5 | operated by the Department and other State agencies.
| ||||||
6 | (Source: P.A. 94-693, eff. 7-1-06 .) | ||||||
7 | (215 ILCS 170/20) | ||||||
8 | (Section scheduled to be repealed on July 1, 2011)
| ||||||
9 | Sec. 20. Eligibility. | ||||||
10 | (a) To be eligible for the Program, a person must be a | ||||||
11 | child:
| ||||||
12 | (1) who is a resident of the State of Illinois; and | ||||||
13 | (2) who is ineligible for medical assistance under the | ||||||
14 | Illinois Public Aid Code or benefits under the Children's | ||||||
15 | Health Insurance Program Act; and
| ||||||
16 | (3) either (i) who has been without health insurance | ||||||
17 | coverage for a period set forth by the Department in rules, | ||||||
18 | but not less than 6 months during the first month of | ||||||
19 | operation of the Program, 7 months during the second month | ||||||
20 | of operation, 8 months during the third month of operation, | ||||||
21 | 9 months during the fourth month of operation, 10 months | ||||||
22 | during the fifth month of operation, 11 months during the | ||||||
23 | sixth month of operation, and 12 months thereafter , (ii) | ||||||
24 | whose parent has lost employment that made available | ||||||
25 | affordable dependent health insurance coverage, until such |
| |||||||
| |||||||
1 | time as affordable employer-sponsored dependent health | ||||||
2 | insurance coverage is again available for the child as set | ||||||
3 | forth by the Department in rules, (iii) who is a newborn | ||||||
4 | whose responsible relative does not have available | ||||||
5 | affordable private or employer-sponsored health insurance, | ||||||
6 | or (iv) who, within one year of applying for coverage under | ||||||
7 | this Act, lost medical benefits under the Illinois Public | ||||||
8 | Aid Code or the Children's Health Insurance Program Act ; | ||||||
9 | and . | ||||||
10 | (3.5) whose household income, as determined by the | ||||||
11 | Department, is at or below 300% of the federal poverty | ||||||
12 | level. This item (3.5) is effective July 1, 2011. | ||||||
13 | An entity that provides health insurance coverage (as | ||||||
14 | defined in Section 2 of the Comprehensive Health Insurance Plan | ||||||
15 | Act) to Illinois residents shall provide health insurance data | ||||||
16 | match to the Department of Healthcare and Family Services as | ||||||
17 | provided by and subject to Section 5.5 of the Illinois | ||||||
18 | Insurance Code for the purpose of determining eligibility for | ||||||
19 | the Program under this Act . | ||||||
20 | The Department of Healthcare and Family Services, in | ||||||
21 | collaboration with the Department of Financial and | ||||||
22 | Professional Regulation, Division of Insurance, shall adopt | ||||||
23 | rules governing the exchange of information under this Section. | ||||||
24 | The rules shall be consistent with all laws relating to the | ||||||
25 | confidentiality or privacy of personal information or medical | ||||||
26 | records, including provisions under the Federal Health |
| |||||||
| |||||||
1 | Insurance Portability and Accountability Act (HIPAA). | ||||||
2 | (b) The Department shall monitor the availability and | ||||||
3 | retention of employer-sponsored dependent health insurance | ||||||
4 | coverage and shall modify the period described in subdivision | ||||||
5 | (a)(3) if necessary to promote retention of private or | ||||||
6 | employer-sponsored health insurance and timely access to | ||||||
7 | healthcare services, but at no time shall the period described | ||||||
8 | in subdivision (a)(3) be less than 6 months.
| ||||||
9 | (c) The Department, at its discretion, may take into | ||||||
10 | account the affordability of dependent health insurance when | ||||||
11 | determining whether employer-sponsored dependent health | ||||||
12 | insurance coverage is available upon reemployment of a child's | ||||||
13 | parent as provided in subdivision (a)(3). | ||||||
14 | (d) A child who is determined to be eligible for the | ||||||
15 | Program shall remain eligible for 12 months, provided that the | ||||||
16 | child maintains his or her residence in this State, has not yet | ||||||
17 | attained 19 years of age, and is not excluded under subsection | ||||||
18 | (e). | ||||||
19 | (e) A child is not eligible for coverage under the Program | ||||||
20 | if: | ||||||
21 | (1) the premium required under Section 40 has not been | ||||||
22 | timely paid; if the required premiums are not paid, the | ||||||
23 | liability of the Program shall be limited to benefits | ||||||
24 | incurred under the Program for the time period for which | ||||||
25 | premiums have been paid; re-enrollment shall be completed | ||||||
26 | before the next covered medical visit, and the first |
| |||||||
| |||||||
1 | month's required premium shall be paid in advance of the | ||||||
2 | next covered medical visit; or | ||||||
3 | (2) the child is an inmate of a public institution or | ||||||
4 | an institution for mental diseases.
| ||||||
5 | (f) The Department may shall adopt eligibility rules, | ||||||
6 | including, but not limited to: rules regarding annual renewals | ||||||
7 | of eligibility for the Program in conformance with Section 7 of | ||||||
8 | this Act; rules regarding annual renewals of eligibility for | ||||||
9 | the Program; rules providing for re-enrollment, grace periods, | ||||||
10 | notice requirements, and hearing procedures under subdivision | ||||||
11 | (e)(1) of this Section; and rules regarding what constitutes | ||||||
12 | availability and affordability of private or | ||||||
13 | employer-sponsored health insurance, with consideration of | ||||||
14 | such factors as the percentage of income needed to purchase | ||||||
15 | children or family health insurance, the availability of | ||||||
16 | employer subsidies, and other relevant factors.
| ||||||
17 | (g) Each child enrolled in the Program as of July 1, 2011 | ||||||
18 | whose family income, as established by the Department, exceeds | ||||||
19 | 300% of the federal poverty level may remain enrolled in the | ||||||
20 | Program for 12 additional months commencing July 1, 2011. | ||||||
21 | Continued enrollment pursuant to this subsection shall be | ||||||
22 | available only if the child continues to meet all eligibility | ||||||
23 | criteria established under the Program as of the effective date | ||||||
24 | of this amendatory Act of the 96th General Assembly without a | ||||||
25 | break in coverage. Nothing contained in this subsection shall | ||||||
26 | prevent a child from qualifying for any other health benefits |
| |||||||
| |||||||
1 | program operated by the Department. | ||||||
2 | (Source: P.A. 96-1272, eff. 1-1-11.) | ||||||
3 | (215 ILCS 170/21 new) | ||||||
4 | Sec. 21. Presumptive eligibility. Beginning on the | ||||||
5 | effective date of this amendatory Act of the 96th General | ||||||
6 | Assembly and except where federal law or regulation requires | ||||||
7 | presumptive eligibility, no adult may be presumed eligible for | ||||||
8 | health care coverage under the Program and the Department may | ||||||
9 | not cover any service rendered to an adult unless the adult has | ||||||
10 | completed an application for benefits, all required | ||||||
11 | verifications have been received, and the Department or its | ||||||
12 | designee has found the adult eligible for the date on which | ||||||
13 | that service was provided. Nothing in this Section shall apply | ||||||
14 | to pregnant women. | ||||||
15 | (215 ILCS 170/36 new) | ||||||
16 | Sec. 36. Moratorium on eligibility expansions. Beginning | ||||||
17 | on the effective date of this amendatory Act of the 96th | ||||||
18 | General Assembly, there shall be a 2-year moratorium on the | ||||||
19 | expansion of eligibility through increasing financial | ||||||
20 | eligibility standards, or through increasing income | ||||||
21 | disregards, or through the creation of new programs that would | ||||||
22 | add new categories of eligible individuals under the medical | ||||||
23 | assistance program under the Illinois Public Aid Code in | ||||||
24 | addition to those categories covered on January 1, 2011. This |
| |||||||
| |||||||
1 | moratorium shall not apply to expansions required as a federal | ||||||
2 | condition of State participation in the medical assistance | ||||||
3 | program. | ||||||
4 | (215 ILCS 170/56 new) | ||||||
5 | Sec. 56. Care coordination. | ||||||
6 | (a) At least 50% of recipients eligible for comprehensive | ||||||
7 | medical benefits in all medical assistance programs or other | ||||||
8 | health benefit programs administered by the Department, | ||||||
9 | including the Children's Health Insurance Program Act and the | ||||||
10 | Covering ALL KIDS Health Insurance Act, shall be enrolled in a | ||||||
11 | care coordination program by no later than January 1, 2015. For | ||||||
12 | purposes of this Section, "coordinated care" or "care | ||||||
13 | coordination" means delivery systems where recipients will | ||||||
14 | receive their care from providers who participate under | ||||||
15 | contract in integrated delivery systems that are responsible | ||||||
16 | for providing or arranging the majority of care, including | ||||||
17 | primary care physician services, referrals from primary care | ||||||
18 | physicians, diagnostic and treatment services, behavioral | ||||||
19 | health services, in-patient and outpatient hospital services, | ||||||
20 | dental services, and rehabilitation and long-term care | ||||||
21 | services. The Department shall designate or contract for such | ||||||
22 | integrated delivery systems (i) to ensure enrollees have a | ||||||
23 | choice of systems and of primary care providers within such | ||||||
24 | systems; (ii) to ensure that enrollees receive quality care in | ||||||
25 | a culturally and linguistically appropriate manner; and (iii) |
| |||||||
| |||||||
1 | to ensure that coordinated care programs meet the diverse needs | ||||||
2 | of enrollees with developmental, mental health, physical, and | ||||||
3 | age-related disabilities. | ||||||
4 | (b) Payment for such coordinated care shall be based on | ||||||
5 | arrangements where the State pays for performance related to | ||||||
6 | health care outcomes, the use of evidence-based practices, the | ||||||
7 | use of primary care delivered through comprehensive medical | ||||||
8 | homes, the use of electronic medical records, and the | ||||||
9 | appropriate exchange of health information electronically made | ||||||
10 | either on a capitated basis in which a fixed monthly premium | ||||||
11 | per recipient is paid and full financial risk is assumed for | ||||||
12 | the delivery of services, or through other risk-based payment | ||||||
13 | arrangements. | ||||||
14 | (c) To qualify for compliance with this Section, the 50% | ||||||
15 | goal shall be achieved by enrolling medical assistance | ||||||
16 | enrollees from each medical assistance enrollment category, | ||||||
17 | including parents, children, seniors, and people with | ||||||
18 | disabilities to the extent that current State Medicaid payment | ||||||
19 | laws would not limit federal matching funds for recipients in | ||||||
20 | care coordination programs. In addition, services must be more | ||||||
21 | comprehensively defined and more risk shall be assumed than in | ||||||
22 | the Department's primary care case management program as of the | ||||||
23 | effective date of this amendatory Act of the 96th General | ||||||
24 | Assembly. | ||||||
25 | (d) The Department shall report to the General Assembly in | ||||||
26 | a separate part of its annual medical assistance program |
| |||||||
| |||||||
1 | report, beginning April, 2012 until April, 2016, on the | ||||||
2 | progress and implementation of the care coordination program | ||||||
3 | initiatives established by the provisions of this amendatory | ||||||
4 | Act of the 96th General Assembly. The Department shall include | ||||||
5 | in its April 2011 report a full analysis of federal laws or | ||||||
6 | regulations regarding upper payment limitations to providers | ||||||
7 | and the necessary revisions or adjustments in rate | ||||||
8 | methodologies and payments to providers under this Code that | ||||||
9 | would be necessary to implement coordinated care with full | ||||||
10 | financial risk by a party other than the Department. | ||||||
11 | (215 ILCS 170/98) | ||||||
12 | (Section scheduled to be repealed on July 1, 2011)
| ||||||
13 | Sec. 98. Repealer. This Act is repealed on July 1, 2016 | ||||||
14 | July 1, 2011 .
| ||||||
15 | (Source: P.A. 94-693, eff. 7-1-06 .) | ||||||
16 | Section 40. The Illinois Public Aid Code is amended by | ||||||
17 | changing Sections 5-4.1, 5-5.12, 5-11, 8A-2.5, and 11-26 and by | ||||||
18 | adding Sections 5-1.3, 5-1.4, 5-2.03, 5-11a, 5-29, 5-30, and | ||||||
19 | 11-5.1 as follows: | ||||||
20 | (305 ILCS 5/5-1.3 new) | ||||||
21 | Sec. 5-1.3. Payer of last resort. To the extent permissible | ||||||
22 | under federal law, the State may pay for medical services only | ||||||
23 | after payment from all other sources of payment have been |
| |||||||
| |||||||
1 | exhausted, or after the Department has determined that pursuit | ||||||
2 | of such payment is economically unfeasible. Applicants for, and | ||||||
3 | recipients of, medical assistance under this Code shall | ||||||
4 | disclose to the State all insurance coverage they have. To the | ||||||
5 | extent permissible under federal law, the State shall require | ||||||
6 | vendors of medical services to bill third-party payers for | ||||||
7 | services that may be covered by those third-party payers prior | ||||||
8 | to submission of a request for payment to the State. The | ||||||
9 | Department shall, to the extent permissible under federal law, | ||||||
10 | reject a request for payment of a medical service that should | ||||||
11 | first have been submitted to a third-party payer. | ||||||
12 | (305 ILCS 5/5-1.4 new) | ||||||
13 | Sec. 5-1.4. Moratorium on eligibility expansions. | ||||||
14 | Beginning on the effective date of this amendatory Act of the | ||||||
15 | 96th General Assembly, there shall be a 2-year moratorium on | ||||||
16 | the expansion of eligibility through increasing financial | ||||||
17 | eligibility standards, or through increasing income | ||||||
18 | disregards, or through the creation of new programs which would | ||||||
19 | add new categories of eligible individuals under the medical | ||||||
20 | assistance program in addition to those categories covered on | ||||||
21 | January 1, 2011. This moratorium shall not apply to expansions | ||||||
22 | required as a federal condition of State participation in the | ||||||
23 | medical assistance program. | ||||||
24 | (305 ILCS 5/5-2.03 new) |
| |||||||
| |||||||
1 | Sec. 5-2.03. Presumptive eligibility. Beginning on the | ||||||
2 | effective date of this amendatory Act of the 96th General | ||||||
3 | Assembly and except where federal law requires presumptive | ||||||
4 | eligibility, no adult may be presumed eligible for medical | ||||||
5 | assistance under this Code and the Department may not cover any | ||||||
6 | service rendered to an adult unless the adult has completed an | ||||||
7 | application for benefits, all required verifications have been | ||||||
8 | received, and the Department or its designee has found the | ||||||
9 | adult eligible for the date on which that service was provided. | ||||||
10 | Nothing in this Section shall apply to pregnant women.
| ||||||
11 | (305 ILCS 5/5-4.1) (from Ch. 23, par. 5-4.1)
| ||||||
12 | Sec. 5-4.1. Co-payments. The Department may by rule provide | ||||||
13 | that recipients
under any Article of this Code shall pay a fee | ||||||
14 | as a co-payment for services.
Co-payments shall be maximized to | ||||||
15 | the extent permitted by federal law may not exceed $3 for brand | ||||||
16 | name drugs, $1 for other pharmacy
services other than for | ||||||
17 | generic drugs, and $2 for physicians services, dental
services, | ||||||
18 | optical services and supplies, chiropractic services, podiatry
| ||||||
19 | services, and encounter rate clinic services. There shall be no | ||||||
20 | co-payment for
generic drugs. Co-payments may not exceed $3 for | ||||||
21 | hospital outpatient and clinic
services . Provided, however, | ||||||
22 | that any such rule must provide that no
co-payment requirement | ||||||
23 | can exist
for renal dialysis, radiation therapy, cancer | ||||||
24 | chemotherapy, or insulin, and
other products necessary on a | ||||||
25 | recurring basis, the absence of which would
be life |
| |||||||
| |||||||
1 | threatening, or where co-payment expenditures for required | ||||||
2 | services
and/or medications for chronic diseases that the | ||||||
3 | Illinois Department shall
by rule designate shall cause an | ||||||
4 | extensive financial burden on the
recipient, and provided no | ||||||
5 | co-payment shall exist for emergency room
encounters which are | ||||||
6 | for medical emergencies. The Department shall seek approval of | ||||||
7 | a State plan amendment that allows pharmacies to refuse to | ||||||
8 | dispense drugs in circumstances where the recipient does not | ||||||
9 | pay the required co-payment. In the event the State plan | ||||||
10 | amendment is rejected, co-payments may not exceed $3 for brand | ||||||
11 | name drugs, $1 for other pharmacy
services other than for | ||||||
12 | generic drugs, and $2 for physician services, dental
services, | ||||||
13 | optical services and supplies, chiropractic services, podiatry
| ||||||
14 | services, and encounter rate clinic services. There shall be no | ||||||
15 | co-payment for
generic drugs. Co-payments may not exceed $3 for | ||||||
16 | hospital outpatient and clinic
services.
| ||||||
17 | (Source: P.A. 92-597, eff. 6-28-02; 93-593, eff. 8-25-03 .)
| ||||||
18 | (305 ILCS 5/5-5.12) (from Ch. 23, par. 5-5.12)
| ||||||
19 | Sec. 5-5.12. Pharmacy payments.
| ||||||
20 | (a) Every request submitted by a pharmacy for reimbursement | ||||||
21 | under this
Article for prescription drugs provided to a | ||||||
22 | recipient of aid under this
Article shall include the name of | ||||||
23 | the prescriber or an acceptable
identification number as | ||||||
24 | established by the Department.
| ||||||
25 | (b) Pharmacies providing prescription drugs under
this |
| |||||||
| |||||||
1 | Article shall be reimbursed at a rate which shall include
a | ||||||
2 | professional dispensing fee as determined by the Illinois
| ||||||
3 | Department, plus the current acquisition cost of the | ||||||
4 | prescription
drug dispensed. The Illinois Department shall | ||||||
5 | update its
information on the acquisition costs of all | ||||||
6 | prescription drugs
no less frequently than every 30 days. | ||||||
7 | However, the Illinois
Department may set the rate of | ||||||
8 | reimbursement for the acquisition
cost, by rule, at a | ||||||
9 | percentage of the current average wholesale
acquisition cost.
| ||||||
10 | (c) (Blank).
| ||||||
11 | (d) The Department shall not impose requirements for prior | ||||||
12 | approval
based on a preferred drug list for anti-retroviral, | ||||||
13 | anti-hemophilic factor
concentrates,
or
any atypical | ||||||
14 | antipsychotics, conventional antipsychotics,
or | ||||||
15 | anticonvulsants used for the treatment of serious mental
| ||||||
16 | illnesses
until 30 days after it has conducted a study of the | ||||||
17 | impact of such
requirements on patient care and submitted a | ||||||
18 | report to the Speaker of the
House of Representatives and the | ||||||
19 | President of the Senate. The Department shall review | ||||||
20 | utilization of narcotic medications in the medical assistance | ||||||
21 | program and impose utilization controls that protect against | ||||||
22 | abuse.
| ||||||
23 | (e) When making determinations as to which drugs shall be | ||||||
24 | on a prior approval list, the Department shall include as part | ||||||
25 | of the analysis for this determination, the degree to which a | ||||||
26 | drug may affect individuals in different ways based on factors |
| |||||||
| |||||||
1 | including the gender of the person taking the medication. | ||||||
2 | (f) (e) The Department shall cooperate with the Department | ||||||
3 | of Public Health and the Department of Human Services Division | ||||||
4 | of Mental Health in identifying psychotropic medications that, | ||||||
5 | when given in a particular form, manner, duration, or frequency | ||||||
6 | (including "as needed") in a dosage, or in conjunction with | ||||||
7 | other psychotropic medications to a nursing home resident, may | ||||||
8 | constitute a chemical restraint or an "unnecessary drug" as | ||||||
9 | defined by the Nursing Home Care Act or Titles XVIII and XIX of | ||||||
10 | the Social Security Act and the implementing rules and | ||||||
11 | regulations. The Department shall require prior approval for | ||||||
12 | any such medication prescribed for a nursing home resident that | ||||||
13 | appears to be a chemical restraint or an unnecessary drug. The | ||||||
14 | Department shall consult with the Department of Human Services | ||||||
15 | Division of Mental Health in developing a protocol and criteria | ||||||
16 | for deciding whether to grant such prior approval. | ||||||
17 | (g) The Department may by rule provide for reimbursement of | ||||||
18 | the dispensing of a 90-day supply of a generic, non-narcotic | ||||||
19 | maintenance medication in circumstances where it is cost | ||||||
20 | effective. | ||||||
21 | (Source: P.A. 96-1269, eff. 7-26-10; 96-1372, eff. 7-29-10; | ||||||
22 | revised 9-2-10.)
| ||||||
23 | (305 ILCS 5/5-11) (from Ch. 23, par. 5-11)
| ||||||
24 | Sec. 5-11. Co-operative arrangements; contracts with other | ||||||
25 | State
agencies, health care and rehabilitation organizations, |
| |||||||
| |||||||
1 | and fiscal
intermediaries.
| ||||||
2 | (a) The Illinois Department may enter into co-operative | ||||||
3 | arrangements
with
State agencies responsible for administering | ||||||
4 | or supervising the
administration of health services and | ||||||
5 | vocational rehabilitation services to
the end that there may be | ||||||
6 | maximum utilization of such services in the
provision of | ||||||
7 | medical assistance.
| ||||||
8 | The Illinois Department shall, not later than June 30, | ||||||
9 | 1993, enter into
one or more co-operative arrangements with the | ||||||
10 | Department of Mental Health
and Developmental Disabilities | ||||||
11 | providing that the Department of Mental
Health and | ||||||
12 | Developmental Disabilities will be responsible for | ||||||
13 | administering
or supervising all programs for services to | ||||||
14 | persons in community care
facilities for persons with | ||||||
15 | developmental disabilities, including but not
limited to | ||||||
16 | intermediate care facilities, that are supported by State funds | ||||||
17 | or
by funding under Title XIX of the federal Social Security | ||||||
18 | Act. The
responsibilities of the Department of Mental Health | ||||||
19 | and Developmental
Disabilities under these agreements are | ||||||
20 | transferred to the Department of
Human Services as provided in | ||||||
21 | the Department of Human Services Act.
| ||||||
22 | The Department may also contract with such State health and
| ||||||
23 | rehabilitation agencies and other public or private health care | ||||||
24 | and
rehabilitation organizations to act for it in supplying | ||||||
25 | designated medical
services to persons eligible therefor under | ||||||
26 | this Article. Any contracts
with health services or health |
| |||||||
| |||||||
1 | maintenance organizations shall be
restricted to organizations | ||||||
2 | which have been certified as being in
compliance with standards | ||||||
3 | promulgated pursuant to the laws of this State
governing the | ||||||
4 | establishment and operation of health services or health
| ||||||
5 | maintenance organizations. The Department shall renegotiate | ||||||
6 | the contracts with health maintenance organizations and | ||||||
7 | managed care community
networks that took effect August 1, | ||||||
8 | 2003, so as to produce $70,000,000 savings to the Department | ||||||
9 | net of resulting increases to the fee-for-service program for | ||||||
10 | State fiscal year 2006. The Department may also contract with | ||||||
11 | insurance
companies or other corporate entities serving as | ||||||
12 | fiscal intermediaries in
this State for the Federal Government | ||||||
13 | in respect to Medicare payments under
Title XVIII of the | ||||||
14 | Federal Social Security Act to act for the Department in
paying | ||||||
15 | medical care suppliers. The provisions of Section 9 of "An Act | ||||||
16 | in
relation to State finance", approved June 10, 1919, as | ||||||
17 | amended,
notwithstanding, such contracts with State agencies, | ||||||
18 | other health care and
rehabilitation organizations, or fiscal | ||||||
19 | intermediaries may provide for
advance payments.
| ||||||
20 | (b) For purposes of this subsection (b), "managed care | ||||||
21 | community
network" means an entity, other than a health | ||||||
22 | maintenance organization, that
is owned, operated, or governed | ||||||
23 | by providers of health care services within
this State and that | ||||||
24 | provides or arranges primary, secondary, and tertiary
managed | ||||||
25 | health care services under contract with the Illinois | ||||||
26 | Department
exclusively to persons participating in programs |
| |||||||
| |||||||
1 | administered by the Illinois
Department.
| ||||||
2 | The Illinois Department may certify managed care community
| ||||||
3 | networks, including managed care community networks owned, | ||||||
4 | operated, managed,
or
governed by State-funded medical | ||||||
5 | schools, as risk-bearing entities eligible to
contract with the | ||||||
6 | Illinois Department as Medicaid managed care
organizations. | ||||||
7 | The Illinois Department may contract with those managed
care | ||||||
8 | community networks to furnish health care services to or | ||||||
9 | arrange those
services for individuals participating in | ||||||
10 | programs administered by the Illinois
Department. The rates for | ||||||
11 | those provider-sponsored organizations may be
determined on a | ||||||
12 | prepaid, capitated basis. A managed care community
network may | ||||||
13 | choose to contract with the Illinois Department to provide only
| ||||||
14 | pediatric
health care services.
The
Illinois Department shall | ||||||
15 | by rule adopt the criteria, standards, and procedures
by
which | ||||||
16 | a managed care community network may be permitted to contract | ||||||
17 | with
the Illinois Department and shall consult with the | ||||||
18 | Department of Insurance in
adopting these rules.
| ||||||
19 | A county provider as defined in Section 15-1 of this Code | ||||||
20 | may
contract with the Illinois Department to provide primary, | ||||||
21 | secondary, or
tertiary managed health care services as a | ||||||
22 | managed care
community network without the need to establish a | ||||||
23 | separate entity and shall
be deemed a managed care community | ||||||
24 | network for purposes of this Code
only to the extent it | ||||||
25 | provides services to participating individuals. A county
| ||||||
26 | provider is entitled to contract with the Illinois Department |
| |||||||
| |||||||
1 | with respect to
any contracting region located in whole or in | ||||||
2 | part within the county. A
county provider is not required to | ||||||
3 | accept enrollees who do not reside within
the county.
| ||||||
4 | In order
to (i) accelerate and facilitate the development | ||||||
5 | of integrated health care in
contracting areas outside counties | ||||||
6 | with populations in excess of 3,000,000 and
counties adjacent | ||||||
7 | to those counties and (ii) maintain and sustain the high
| ||||||
8 | quality of education and residency programs coordinated and | ||||||
9 | associated with
local area hospitals, the Illinois Department | ||||||
10 | may develop and implement a
demonstration program from managed | ||||||
11 | care community networks owned, operated,
managed, or
governed | ||||||
12 | by State-funded medical schools. The Illinois Department shall
| ||||||
13 | prescribe by rule the criteria, standards, and procedures for | ||||||
14 | effecting this
demonstration program.
| ||||||
15 | A managed care community network that
contracts with the | ||||||
16 | Illinois Department to furnish health care services to or
| ||||||
17 | arrange those services for enrollees participating in programs | ||||||
18 | administered by
the Illinois Department shall do all of the | ||||||
19 | following:
| ||||||
20 | (1) Provide that any provider affiliated with the | ||||||
21 | managed care community
network may also provide services on | ||||||
22 | a
fee-for-service basis to Illinois Department clients not | ||||||
23 | enrolled in such
managed care entities.
| ||||||
24 | (2) Provide client education services as determined | ||||||
25 | and approved by the
Illinois Department, including but not | ||||||
26 | limited to (i) education regarding
appropriate utilization |
| |||||||
| |||||||
1 | of health care services in a managed care system, (ii)
| ||||||
2 | written disclosure of treatment policies and restrictions | ||||||
3 | or limitations on
health services, including, but not | ||||||
4 | limited to, physical services, clinical
laboratory tests, | ||||||
5 | hospital and surgical procedures, prescription drugs and
| ||||||
6 | biologics, and radiological examinations, and (iii) | ||||||
7 | written notice that the
enrollee may receive from another | ||||||
8 | provider those covered services that are not
provided by | ||||||
9 | the managed care community network.
| ||||||
10 | (3) Provide that enrollees within the system may choose | ||||||
11 | the site for
provision of services and the panel of health | ||||||
12 | care providers.
| ||||||
13 | (4) Not discriminate in enrollment or disenrollment | ||||||
14 | practices among
recipients of medical services or | ||||||
15 | enrollees based on health status.
| ||||||
16 | (5) Provide a quality assurance and utilization review | ||||||
17 | program that
meets
the requirements established by the | ||||||
18 | Illinois Department in rules that
incorporate those | ||||||
19 | standards set forth in the Health Maintenance Organization
| ||||||
20 | Act.
| ||||||
21 | (6) Issue a managed care community network
| ||||||
22 | identification card to each enrollee upon enrollment. The | ||||||
23 | card
must contain all of the following:
| ||||||
24 | (A) The enrollee's health plan.
| ||||||
25 | (B) The name and telephone number of the enrollee's | ||||||
26 | primary care
physician or the site for receiving |
| |||||||
| |||||||
1 | primary care services.
| ||||||
2 | (C) A telephone number to be used to confirm | ||||||
3 | eligibility for benefits
and authorization for | ||||||
4 | services that is available 24 hours per day, 7 days per
| ||||||
5 | week.
| ||||||
6 | (7) Ensure that every primary care physician and | ||||||
7 | pharmacy in the managed
care community network meets the | ||||||
8 | standards
established by the Illinois Department for | ||||||
9 | accessibility and quality of care.
The Illinois Department | ||||||
10 | shall arrange for and oversee an evaluation of the
| ||||||
11 | standards established under this paragraph (7) and may | ||||||
12 | recommend any necessary
changes to these standards.
| ||||||
13 | (8) Provide a procedure for handling complaints that
| ||||||
14 | meets the
requirements established by the Illinois | ||||||
15 | Department in rules that incorporate
those standards set | ||||||
16 | forth in the Health Maintenance Organization Act.
| ||||||
17 | (9) Maintain, retain, and make available to the | ||||||
18 | Illinois Department
records, data, and information, in a | ||||||
19 | uniform manner determined by the Illinois
Department, | ||||||
20 | sufficient for the Illinois Department to monitor | ||||||
21 | utilization,
accessibility, and quality of care.
| ||||||
22 | (10) (Blank) Provide that the pharmacy formulary used | ||||||
23 | by the managed care
community
network and its contract | ||||||
24 | providers be no
more restrictive than the Illinois | ||||||
25 | Department's pharmaceutical program on the
effective date | ||||||
26 | of this amendatory Act of 1998 and as amended after that |
| |||||||
| |||||||
1 | date .
| ||||||
2 | The Illinois Department shall contract with an entity or | ||||||
3 | entities to provide
external peer-based quality assurance | ||||||
4 | review for the managed health care
programs administered by the | ||||||
5 | Illinois Department. The entity shall meet all federal | ||||||
6 | requirements for an external quality review organization be
| ||||||
7 | representative of Illinois physicians licensed to practice | ||||||
8 | medicine in all its
branches and have statewide geographic | ||||||
9 | representation in all specialities of
medical care that are | ||||||
10 | provided in managed health care programs administered by
the | ||||||
11 | Illinois Department. The entity may not be a third party payer | ||||||
12 | and shall
maintain offices in locations around the State in | ||||||
13 | order to provide service and
continuing medical education to | ||||||
14 | physician participants within those managed
health care | ||||||
15 | programs administered by the Illinois Department. The review
| ||||||
16 | process shall be developed and conducted by Illinois physicians | ||||||
17 | licensed to
practice medicine in all its branches. In | ||||||
18 | consultation with the entity, the
Illinois Department may | ||||||
19 | contract with other entities for professional
peer-based | ||||||
20 | quality assurance review of individual
categories of services | ||||||
21 | other than services provided, supervised, or coordinated
by | ||||||
22 | physicians licensed to practice medicine in all its branches. | ||||||
23 | The Illinois
Department shall establish, by rule, criteria to | ||||||
24 | avoid conflicts of interest in
the conduct of quality assurance | ||||||
25 | activities consistent with professional
peer-review standards. | ||||||
26 | All quality assurance activities shall be coordinated
by the |
| |||||||
| |||||||
1 | Illinois Department .
| ||||||
2 | Each managed care community network must demonstrate its | ||||||
3 | ability to
bear the financial risk of serving individuals under | ||||||
4 | this program.
The Illinois Department shall by rule adopt | ||||||
5 | standards for assessing the
solvency and financial soundness of | ||||||
6 | each managed care community network.
Any solvency and financial | ||||||
7 | standards adopted for managed care community
networks
shall be | ||||||
8 | no more restrictive than the solvency and financial standards | ||||||
9 | adopted
under
Section 1856(a) of the Social Security Act for | ||||||
10 | provider-sponsored
organizations under Part C of Title XVIII of | ||||||
11 | the Social Security Act.
| ||||||
12 | The Illinois
Department may implement the amendatory | ||||||
13 | changes to this
Code made by this amendatory Act of 1998 | ||||||
14 | through the use of emergency
rules in accordance with Section | ||||||
15 | 5-45 of the Illinois Administrative Procedure
Act. For purposes | ||||||
16 | of that Act, the adoption of rules to implement these
changes | ||||||
17 | is deemed an emergency and necessary for the public interest,
| ||||||
18 | safety, and welfare.
| ||||||
19 | (c) Not later than June 30, 1996, the Illinois Department | ||||||
20 | shall
enter into one or more cooperative arrangements with the | ||||||
21 | Department of Public
Health for the purpose of developing a | ||||||
22 | single survey for
nursing facilities, including but not limited | ||||||
23 | to facilities funded under Title
XVIII or Title XIX of the | ||||||
24 | federal Social Security Act or both, which shall be
| ||||||
25 | administered and conducted solely by the Department of Public | ||||||
26 | Health.
The Departments shall test the single survey process on |
| |||||||
| |||||||
1 | a pilot basis, with
both the Departments of Public Aid and | ||||||
2 | Public Health represented on the
consolidated survey team. The | ||||||
3 | pilot will sunset June 30, 1997. After June 30,
1997, unless | ||||||
4 | otherwise determined by the Governor, a single survey shall be
| ||||||
5 | implemented by the Department of Public Health which would not | ||||||
6 | preclude staff
from the Department of Healthcare and Family | ||||||
7 | Services (formerly Department of Public Aid) from going on-site | ||||||
8 | to nursing facilities to
perform necessary audits and reviews | ||||||
9 | which shall not replicate the single State
agency survey | ||||||
10 | required by this Act. This Section shall not apply to community
| ||||||
11 | or intermediate care facilities for persons with developmental | ||||||
12 | disabilities.
| ||||||
13 | (d) Nothing in this Code in any way limits or otherwise | ||||||
14 | impairs the
authority or power of the Illinois Department to | ||||||
15 | enter into a negotiated
contract pursuant to this Section with | ||||||
16 | a managed care community network or
a health maintenance | ||||||
17 | organization, as defined in the Health Maintenance
| ||||||
18 | Organization Act, that provides for
termination or nonrenewal | ||||||
19 | of the contract without cause, upon notice as
provided in the | ||||||
20 | contract, and without a hearing.
| ||||||
21 | (Source: P.A. 94-48, eff. 7-1-05; 95-331, eff. 8-21-07.)
| ||||||
22 | (305 ILCS 5/5-11a new) | ||||||
23 | Sec. 5-11a. Health Benefit Information Systems. | ||||||
24 | (a) It is the intent of the General Assembly to support | ||||||
25 | unified electronic systems initiatives that will improve |
| |||||||
| |||||||
1 | management of information related to medical assistance | ||||||
2 | programs. This will include improved management capabilities | ||||||
3 | and new systems for Eligibility, Verification, and Enrollment | ||||||
4 | (EVE) that will simplify and increase efficiencies in and | ||||||
5 | access to the medical assistance programs and ensure program | ||||||
6 | integrity. The Department of Healthcare and Family Services, in | ||||||
7 | coordination with the Department of Human Services and other | ||||||
8 | appropriate state agencies, shall develop a plan by July 1, | ||||||
9 | 2011, that will: | ||||||
10 | (1) Subject to federal and State privacy and | ||||||
11 | confidentiality laws and regulations, meet standards for | ||||||
12 | timely eligibility verification and enrollment, and annual | ||||||
13 | redetermination of eligibility, of applicants for and | ||||||
14 | recipients of means-tested health benefits sponsored by | ||||||
15 | the State, including medical assistance under this Code. | ||||||
16 | (2) Receive and update data electronically from the | ||||||
17 | Social Security Administration, the U.S. Postal Service, | ||||||
18 | the Illinois Secretary of State, the Department of Revenue, | ||||||
19 | the Department of Employment Security, and other | ||||||
20 | governmental entities, as appropriate and to the extent | ||||||
21 | allowed by law, for verification of any factor of | ||||||
22 | eligibility for medical assistance and for updating | ||||||
23 | addresses of applicants and recipients of medical | ||||||
24 | assistance and other health benefit programs administered | ||||||
25 | by the Department. Data relevant to eligibility shall be | ||||||
26 | provided for no other purpose than to verify the |
| |||||||
| |||||||
1 | eligibility of new applicants or current recipients of | ||||||
2 | health benefits provided by the State. Data shall be | ||||||
3 | requested or provided for any individual only insofar as | ||||||
4 | that new applicant or current recipient's circumstances | ||||||
5 | are relevant to that individual's or another individual's | ||||||
6 | eligibility for State-sponsored health benefits. | ||||||
7 | (3) Meet federal requirements for timely installation | ||||||
8 | by January 1, 2014 to provide integration with a Health | ||||||
9 | Benefits Exchange pursuant to the requirements of the | ||||||
10 | federal Affordable Care Act and the Reconciliation Act and | ||||||
11 | any subsequent amendments thereto and to ensure capture of | ||||||
12 | the maximum available federal financial
participation | ||||||
13 | (FFP). | ||||||
14 | (4) Meet federal requirements for compliance with | ||||||
15 | architectural standards, including, but not limited to, | ||||||
16 | (i) the use of a module development as outlined by the | ||||||
17 | Medicaid Information Technology Architecture standards, | ||||||
18 | (ii) the use of federally approved open-interfaces where | ||||||
19 | they exist, (iii) the use or the creation of | ||||||
20 | open-interfaces where necessary, and (iv) the use of rules | ||||||
21 | technology that can dynamically accept and modify rules in | ||||||
22 | standard formats. | ||||||
23 | (5) Include plans to ensure coordination with the State | ||||||
24 | of Illinois Framework Project that will (i) expedite and | ||||||
25 | simplify access to services provided by Illinois human | ||||||
26 | services programs; (ii) streamline administration and data |
| |||||||
| |||||||
1 | sharing; (iii) enhance planning capacity, program | ||||||
2 | evaluation, and fraud detection or prevention with access | ||||||
3 | to cross-agency data; and (iv) simplify service reporting | ||||||
4 | for contracted providers. | ||||||
5 | (b) The Department of Healthcare and Family Services shall | ||||||
6 | continue to plan for and implement a new Medicaid Management | ||||||
7 | Information System (MMIS) and upgrade the capabilities of the | ||||||
8 | MMIS data warehouse. Upgrades shall include, among other | ||||||
9 | things, enhanced capabilities in data analysis including the | ||||||
10 | ability to identify risk factors that could impact the | ||||||
11 | treatment and resulting quality of care, and tools that perform | ||||||
12 | predictive analytics on data applying to newborns, women with | ||||||
13 | high risk pregnancies, and other populations served by the | ||||||
14 | Department. | ||||||
15 | (c) The Department of Healthcare and Family Services shall | ||||||
16 | report in its annual Medical Assistance program report each | ||||||
17 | April through April, 2015 on the progress and implementation of | ||||||
18 | this plan. | ||||||
19 | (305 ILCS 5/5-29 new) | ||||||
20 | Sec. 5-29. Income Limits and Parental Responsibility. In | ||||||
21 | light of the unprecedented fiscal crisis confronting the State, | ||||||
22 | it is the intent of the General Assembly to explore whether the | ||||||
23 | income limits and income counting methods established for | ||||||
24 | children under the Covering ALL KIDS Health Insurance Act, | ||||||
25 | pursuant to this amendatory Act of the 96th General Assembly, |
| |||||||
| |||||||
1 | should apply to medical assistance programs available to | ||||||
2 | children made eligible under the Illinois Public Aid Code, | ||||||
3 | including through home and community based services waiver | ||||||
4 | programs authorized under Section 1915(c) of the Social | ||||||
5 | Security Act, where parental income is currently not considered | ||||||
6 | in determining a child's eligibility for medical assistance. | ||||||
7 | The Department of Healthcare and Family Services is hereby | ||||||
8 | directed, with the participation of the Department of Human | ||||||
9 | Services and stakeholders, to conduct an analysis of these | ||||||
10 | programs to determine parental cost sharing opportunities, how | ||||||
11 | these opportunities may impact the children currently in the | ||||||
12 | programs, waivers and on the waiting list, and any other | ||||||
13 | factors which may increase efficiencies and decrease State | ||||||
14 | costs. The Department is further directed to review how | ||||||
15 | services under these programs and waivers may be provided by | ||||||
16 | the use of a combination of skilled, unskilled, and | ||||||
17 | uncompensated care and to advise as to what revisions to the | ||||||
18 | Nurse Practice Act, and Acts regulating other relevant | ||||||
19 | professions, are necessary to accomplish this combination of | ||||||
20 | care. The Department shall submit a written analysis on the | ||||||
21 | children's programs and waivers as part of the Department's | ||||||
22 | annual Medicaid reports due to the General Assembly in 2011 and | ||||||
23 | 2012. | ||||||
24 | (305 ILCS 5/5-30 new) | ||||||
25 | Sec. 5-30. Care coordination. |
| |||||||
| |||||||
1 | (a) At least 50% of recipients eligible for comprehensive | ||||||
2 | medical benefits in all medical assistance programs or other | ||||||
3 | health benefit programs administered by the Department, | ||||||
4 | including the Children's Health Insurance Program Act and the | ||||||
5 | Covering ALL KIDS Health Insurance Act, shall be enrolled in a | ||||||
6 | care coordination program by no later than January 1, 2015. For | ||||||
7 | purposes of this Section, "coordinated care" or "care | ||||||
8 | coordination" means delivery systems where recipients will | ||||||
9 | receive their care from providers who participate under | ||||||
10 | contract in integrated delivery systems that are responsible | ||||||
11 | for providing or arranging the majority of care, including | ||||||
12 | primary care physician services, referrals from primary care | ||||||
13 | physicians, diagnostic and treatment services, behavioral | ||||||
14 | health services, in-patient and outpatient hospital services, | ||||||
15 | dental services, and rehabilitation and long-term care | ||||||
16 | services. The Department shall designate or contract for such | ||||||
17 | integrated delivery systems (i) to ensure enrollees have a | ||||||
18 | choice of systems and of primary care providers within such | ||||||
19 | systems; (ii) to ensure that enrollees receive quality care in | ||||||
20 | a culturally and linguistically appropriate manner; and (iii) | ||||||
21 | to ensure that coordinated care programs meet the diverse needs | ||||||
22 | of enrollees with developmental, mental health, physical, and | ||||||
23 | age-related disabilities. | ||||||
24 | (b) Payment for such coordinated care shall be based on | ||||||
25 | arrangements where the State pays for performance related to | ||||||
26 | health care outcomes, the use of evidence-based practices, the |
| |||||||
| |||||||
1 | use of primary care delivered through comprehensive medical | ||||||
2 | homes, the use of electronic medical records, and the | ||||||
3 | appropriate exchange of health information electronically made | ||||||
4 | either on a capitated basis in which a fixed monthly premium | ||||||
5 | per recipient is paid and full financial risk is assumed for | ||||||
6 | the delivery of services, or through other risk-based payment | ||||||
7 | arrangements. | ||||||
8 | (c) To qualify for compliance with this Section, the 50% | ||||||
9 | goal shall be achieved by enrolling medical assistance | ||||||
10 | enrollees from each medical assistance enrollment category, | ||||||
11 | including parents, children, seniors, and people with | ||||||
12 | disabilities to the extent that current State Medicaid payment | ||||||
13 | laws would not limit federal matching funds for recipients in | ||||||
14 | care coordination programs. In addition, services must be more | ||||||
15 | comprehensively defined and more risk shall be assumed than in | ||||||
16 | the Department's primary care case management program as of the | ||||||
17 | effective date of this amendatory Act of the 96th General | ||||||
18 | Assembly. | ||||||
19 | (d) The Department shall report to the General Assembly in | ||||||
20 | a separate part of its annual medical assistance program | ||||||
21 | report, beginning April, 2012 until April, 2016, on the | ||||||
22 | progress and implementation of the care coordination program | ||||||
23 | initiatives established by the provisions of this amendatory | ||||||
24 | Act of the 96th General Assembly. The Department shall include | ||||||
25 | in its April 2011 report a full analysis of federal laws or | ||||||
26 | regulations regarding upper payment limitations to providers |
| |||||||
| |||||||
1 | and the necessary revisions or adjustments in rate | ||||||
2 | methodologies and payments to providers under this Code that | ||||||
3 | would be necessary to implement coordinated care with full | ||||||
4 | financial risk by a party other than the Department.
| ||||||
5 | (305 ILCS 5/8A-2.5)
| ||||||
6 | Sec. 8A-2.5. Unauthorized use of medical assistance.
| ||||||
7 | (a) Any person who knowingly uses, acquires, possesses, or | ||||||
8 | transfers a
medical card in any manner not authorized by law or | ||||||
9 | by rules and regulations of
the Illinois Department, or who | ||||||
10 | knowingly alters a medical card, or who
knowingly uses, | ||||||
11 | acquires, possesses, or transfers an altered medical card, is
| ||||||
12 | guilty of a violation of this Article and shall be punished as | ||||||
13 | provided in
Section 8A-6.
| ||||||
14 | (b) Any person who knowingly obtains unauthorized medical | ||||||
15 | benefits with or
without use of a medical card is guilty of a | ||||||
16 | violation of this Article and
shall be punished as provided in | ||||||
17 | Section 8A-6.
| ||||||
18 | (c) The Department may seek to recover any and all State | ||||||
19 | and federal monies for which it has improperly and erroneously | ||||||
20 | paid benefits as a result of a fraudulent action and any civil | ||||||
21 | penalties authorized in this Section. Pursuant to Section | ||||||
22 | 11-14.5 of this Code, the Department may determine the monetary | ||||||
23 | value of benefits improperly and erroneously received. The | ||||||
24 | Department may recover the monies paid for such benefits and | ||||||
25 | interest on that amount at the rate of 5% per annum for the |
| |||||||
| |||||||
1 | period from which payment was made to the date upon which | ||||||
2 | repayment is made to the State. Prior to the recovery of any | ||||||
3 | amount paid for benefits allegedly obtained by fraudulent | ||||||
4 | means, the recipient of such benefits shall be afforded an | ||||||
5 | opportunity for a hearing after reasonable notice. The notice | ||||||
6 | shall be served personally or by certified or registered mail | ||||||
7 | or as otherwise provided by law upon the parties or their | ||||||
8 | agents appointed to receive service of process and shall | ||||||
9 | include the following: | ||||||
10 | (1) A statement of the time, place and nature of the | ||||||
11 | hearing. | ||||||
12 | (2) A statement of the legal authority and jurisdiction | ||||||
13 | under which the hearing is to be held. | ||||||
14 | (3) A reference to the particular Sections of the | ||||||
15 | substantive and procedural statutes and rules involved. | ||||||
16 | (4) Except where a more detailed statement is otherwise | ||||||
17 | provided for by law, a short and plain statement of the | ||||||
18 | matters asserted, the consequences of a failure to respond, | ||||||
19 | and the official file or other reference number. | ||||||
20 | (5) A statement of the monetary value of the benefits | ||||||
21 | fraudulently received by the person accused. | ||||||
22 | (6) A statement that, in addition to any other | ||||||
23 | penalties provided by law, a civil penalty in an amount not | ||||||
24 | to exceed $2,000 may be imposed for each fraudulent claim | ||||||
25 | for benefits or payments. | ||||||
26 | (7) A statement providing that the determination of the |
| |||||||
| |||||||
1 | monetary value may be contested by petitioning the | ||||||
2 | Department for an administrative hearing within 30 days | ||||||
3 | from the date of mailing the notice. | ||||||
4 | (8) The names and mailing addresses of the | ||||||
5 | administrative law judge, all parties, and all other | ||||||
6 | persons to whom the agency gives notice of the hearing | ||||||
7 | unless otherwise confidential by law. | ||||||
8 | An opportunity shall be afforded all parties to be | ||||||
9 | represented by legal counsel and to respond and present | ||||||
10 | evidence and argument. | ||||||
11 | Unless precluded by law, disposition may be made of any | ||||||
12 | contested case by stipulation, agreed settlement, consent | ||||||
13 | order, or default. | ||||||
14 | Any final order, decision, or other determination made, | ||||||
15 | issued or executed by the Director under the provisions of this | ||||||
16 | Article whereby any person is aggrieved shall be subject to | ||||||
17 | review in accordance with the provisions of the Administrative | ||||||
18 | Review Law, and the rules adopted pursuant thereto, which shall | ||||||
19 | apply to and govern all proceeding for the judicial review of | ||||||
20 | final administrative decisions of the Director. | ||||||
21 | Upon entry of a final administrative decision for repayment | ||||||
22 | of any benefits obtained by fraudulent means, or for any civil | ||||||
23 | penalties assessed, a lien shall attach to all property and | ||||||
24 | assets of such person, firm, corporation, association, agency, | ||||||
25 | institution, or other legal entity until the judgment is | ||||||
26 | satisfied. |
| |||||||
| |||||||
1 | Within 12 months of the effective date of this amendatory | ||||||
2 | Act of the 96th General Assembly, the Department of Healthcare | ||||||
3 | and Family Services will report to the General Assembly on the | ||||||
4 | number of fraud cases identified and pursued, and the fines | ||||||
5 | assessed and collected. The report will also include the | ||||||
6 | Department's analysis as to the use of private sector resources | ||||||
7 | to bring action, investigate, and collect monies owed. | ||||||
8 | (Source: P.A. 89-289, eff. 1-1-96.)
| ||||||
9 | (305 ILCS 5/11-5.1 new) | ||||||
10 | Sec. 11-5.1. Eligibility verification. Notwithstanding any | ||||||
11 | other provision of this Code, with respect to applications for | ||||||
12 | medical assistance provided under Article V of this Code, | ||||||
13 | eligibility shall be determined in a manner that ensures | ||||||
14 | program integrity and complies with federal laws and | ||||||
15 | regulations while minimizing unnecessary barriers to | ||||||
16 | enrollment. To this end, as soon as practicable, and unless the | ||||||
17 | Department receives written denial from the federal | ||||||
18 | government, this Section shall be implemented: | ||||||
19 | (a) The Department of Healthcare and Family Services or its | ||||||
20 | designees shall: | ||||||
21 | (1) By no later than July 1, 2011, require verification | ||||||
22 | of, at a minimum, one month's income from all sources | ||||||
23 | required for determining the eligibility of applicants for | ||||||
24 | medical assistance under this Code. Such verification | ||||||
25 | shall take the form of pay stubs, business or income and |
| |||||||
| |||||||
1 | expense records for self-employed persons, letters from | ||||||
2 | employers, and any other valid documentation of income | ||||||
3 | including data obtained electronically by the Department | ||||||
4 | or its designees from other sources as described in | ||||||
5 | subsection (b) of this Section. | ||||||
6 | (2) By no later than October 1, 2011, require | ||||||
7 | verification of, at a minimum, one month's income from all | ||||||
8 | sources required for determining the continued eligibility | ||||||
9 | of recipients at their annual review of eligibility for | ||||||
10 | medical assistance under this Code. Such verification | ||||||
11 | shall take the form of pay stubs, business or income and | ||||||
12 | expense records for self-employed persons, letters from | ||||||
13 | employers, and any other valid documentation of income | ||||||
14 | including data obtained electronically by the Department | ||||||
15 | or its designees from other sources as described in | ||||||
16 | subsection (b) of this Section. The
Department shall send a | ||||||
17 | notice to
recipients at least 60 days prior to the end of | ||||||
18 | their period
of eligibility that informs them of the
| ||||||
19 | requirements for continued eligibility. If a recipient
| ||||||
20 | does not fulfill the requirements for continued | ||||||
21 | eligibility by the
deadline established in the notice a | ||||||
22 | notice of cancellation shall be issued to the recipient and | ||||||
23 | coverage shall end on the last day of the eligibility | ||||||
24 | period. A recipient's eligibility may be reinstated | ||||||
25 | without requiring a new application if the recipient | ||||||
26 | fulfills the requirements for continued eligibility prior |
| |||||||
| |||||||
1 | to the end of the month following the last date of | ||||||
2 | coverage. Nothing in this Section shall prevent an | ||||||
3 | individual whose coverage has been cancelled from | ||||||
4 | reapplying for health benefits at any time. | ||||||
5 | (3) By no later than July 1, 2011, require verification | ||||||
6 | of Illinois residency. | ||||||
7 | (b) The Department shall establish or continue cooperative
| ||||||
8 | arrangements with the Social Security Administration, the
| ||||||
9 | Illinois Secretary of State, the Department of Human Services,
| ||||||
10 | the Department of Revenue, the Department of Employment
| ||||||
11 | Security, and any other appropriate entity to gain electronic
| ||||||
12 | access, to the extent allowed by law, to information available
| ||||||
13 | to those entities that may be appropriate for electronically
| ||||||
14 | verifying any factor of eligibility for benefits under the
| ||||||
15 | Program. Data relevant to eligibility shall be provided for no
| ||||||
16 | other purpose than to verify the eligibility of new applicants | ||||||
17 | or current recipients of health benefits under the Program. | ||||||
18 | Data shall be requested or provided for any new applicant or | ||||||
19 | current recipient only insofar as that individual's | ||||||
20 | circumstances are relevant to that individual's or another | ||||||
21 | individual's eligibility. | ||||||
22 | (c) Within 90 days of the effective date of this amendatory | ||||||
23 | Act of the 96th General Assembly, the Department of Healthcare | ||||||
24 | and Family Services shall send notice to current recipients | ||||||
25 | informing them of the changes regarding their eligibility | ||||||
26 | verification.
|
| |||||||
| |||||||
1 | (305 ILCS 5/11-26) (from Ch. 23, par. 11-26)
| ||||||
2 | Sec. 11-26.
Recipient's abuse of medical care; | ||||||
3 | restrictions on access to
medical care.
| ||||||
4 | (a) When the Department determines, on the basis of | ||||||
5 | statistical norms and
medical judgment, that a medical care | ||||||
6 | recipient has received medical services
in excess of need and | ||||||
7 | with such frequency or in such a manner as to constitute
an | ||||||
8 | abuse of the recipient's medical care privileges, the | ||||||
9 | recipient's access to
medical care may be restricted.
| ||||||
10 | (b) When the Department has determined that a recipient is | ||||||
11 | abusing his or
her medical care privileges as described in this | ||||||
12 | Section, it may require that
the recipient designate a primary | ||||||
13 | provider type primary care provider, primary care pharmacy, or
| ||||||
14 | health maintenance organization of the recipient's own | ||||||
15 | choosing to assume
responsibility for the recipient's care. For | ||||||
16 | the purposes of this subsection, "primary provider type" means | ||||||
17 | a primary care provider, primary care pharmacy, primary | ||||||
18 | dentist, primary podiatrist, or primary durable medical | ||||||
19 | equipment provider. Instead of requiring a recipient to
make a | ||||||
20 | designation as provided in this subsection, the Department, | ||||||
21 | pursuant to
rules adopted by the Department and without regard | ||||||
22 | to any choice of an entity
that the recipient might otherwise | ||||||
23 | make, may initially designate a primary provider type provided | ||||||
24 | that the primary provider type is willing to provide that care | ||||||
25 | primary care
provider, primary care pharmacy, or health |
| |||||||
| |||||||
1 | maintenance organization to assume
responsibility for the | ||||||
2 | recipient's care, provided that the primary care
provider, | ||||||
3 | primary care pharmacy, or health maintenance organization is | ||||||
4 | willing
to provide that care .
| ||||||
5 | (c) When the Department has requested that a recipient | ||||||
6 | designate a
primary provider type primary care provider, | ||||||
7 | primary care pharmacy or health maintenance
organization and | ||||||
8 | the recipient fails or refuses to do so, the Department
may, | ||||||
9 | after a reasonable period of time, assign the recipient to a | ||||||
10 | primary provider type of its own choice and determination, | ||||||
11 | provided such primary provider type is willing to provide such | ||||||
12 | care primary care
provider, primary care pharmacy or health | ||||||
13 | maintenance organization of its own
choice and determination, | ||||||
14 | provided such primary care provider, primary care
pharmacy or | ||||||
15 | health maintenance organization is willing to provide such | ||||||
16 | care .
| ||||||
17 | (d) When a recipient has been restricted to a designated | ||||||
18 | primary provider type primary care
provider, primary care | ||||||
19 | pharmacy or health maintenance organization , the
recipient may | ||||||
20 | change the primary provider type primary care provider, primary | ||||||
21 | care pharmacy or
health maintenance organization :
| ||||||
22 | (1) when the designated source becomes unavailable, as | ||||||
23 | the Department
shall determine by rule; or
| ||||||
24 | (2) when the designated primary provider type primary | ||||||
25 | care provider, primary care pharmacy or
health maintenance | ||||||
26 | organization notifies the Department that it wishes to
|
| |||||||
| |||||||
1 | withdraw from any obligation as primary provider type | ||||||
2 | primary care provider, primary care pharmacy or health | ||||||
3 | maintenance organization ; or
| ||||||
4 | (3) in other situations, as the Department shall | ||||||
5 | provide by rule.
| ||||||
6 | The Department shall, by rule, establish procedures for | ||||||
7 | providing medical or
pharmaceutical services when the | ||||||
8 | designated source becomes unavailable or
wishes to withdraw | ||||||
9 | from any obligation as primary provider type primary care | ||||||
10 | provider, primary care
pharmacy or health maintenance | ||||||
11 | organization , shall, by rule, take into
consideration the need | ||||||
12 | for emergency or temporary medical assistance and shall
ensure | ||||||
13 | that the recipient has continuous and unrestricted access to | ||||||
14 | medical
care from the date on which such unavailability or | ||||||
15 | withdrawal becomes effective
until such time as the recipient | ||||||
16 | designates a primary provider type or a primary provider type | ||||||
17 | care source or a primary
care source willing to provide such | ||||||
18 | care is designated by the Department
consistent with | ||||||
19 | subsections (b) and (c) and such restriction becomes effective.
| ||||||
20 | (e) Prior to initiating any action to restrict a | ||||||
21 | recipient's access to
medical or pharmaceutical care, the | ||||||
22 | Department shall notify the recipient
of its intended action. | ||||||
23 | Such notification shall be in writing and shall set
forth the | ||||||
24 | reasons for and nature of the proposed action. In addition, the
| ||||||
25 | notification shall:
| ||||||
26 | (1) inform the recipient that (i) the recipient has a |
| |||||||
| |||||||
1 | right to
designate a primary provider type primary care | ||||||
2 | provider, primary care pharmacy, or health maintenance
| ||||||
3 | organization of the recipient's own choosing willing to | ||||||
4 | accept such designation
and that the recipient's failure to | ||||||
5 | do so within a reasonable time may result
in such | ||||||
6 | designation being made by the Department or (ii) the | ||||||
7 | Department has
designated a primary provider type primary | ||||||
8 | care provider, primary care pharmacy, or health
| ||||||
9 | maintenance organization to assume responsibility for the | ||||||
10 | recipient's care; and
| ||||||
11 | (2) inform the recipient that the recipient has a right | ||||||
12 | to appeal the
Department's determination to restrict the | ||||||
13 | recipient's access to medical care
and provide the | ||||||
14 | recipient with an explanation of how such appeal is to be
| ||||||
15 | made. The notification shall also inform the recipient of | ||||||
16 | the circumstances
under which unrestricted medical | ||||||
17 | eligibility shall continue until a decision is
made on | ||||||
18 | appeal and that if the recipient chooses to appeal, the | ||||||
19 | recipient will
be able to review the medical payment data | ||||||
20 | that was utilized by the Department
to decide that the | ||||||
21 | recipient's access to medical care should be restricted.
| ||||||
22 | (f) The Department shall, by rule or regulation, establish | ||||||
23 | procedures for
appealing a determination to restrict a | ||||||
24 | recipient's access to medical care,
which procedures shall, at | ||||||
25 | a minimum, provide for a reasonable opportunity
to be heard | ||||||
26 | and, where the appeal is denied, for a written statement
of the |
| |||||||
| |||||||
1 | reason or reasons for such denial.
| ||||||
2 | (g) Except as otherwise provided in this subsection, when a | ||||||
3 | recipient
has had his or her medical card restricted for 4 full | ||||||
4 | quarters (without regard
to any period of ineligibility for | ||||||
5 | medical assistance under this Code, or any
period for which the | ||||||
6 | recipient voluntarily terminates his or her receipt of
medical | ||||||
7 | assistance, that may occur before the expiration of those 4 | ||||||
8 | full
quarters), the Department shall reevaluate the | ||||||
9 | recipient's medical usage to
determine whether it is still in | ||||||
10 | excess of need and with such frequency or in
such a manner as | ||||||
11 | to constitute an abuse of the receipt of medical assistance.
If | ||||||
12 | it is still in excess of need, the restriction shall be | ||||||
13 | continued for
another 4 full quarters. If it is no longer in | ||||||
14 | excess of need, the restriction
shall be discontinued. If a | ||||||
15 | recipient's access to medical care has been
restricted under | ||||||
16 | this Section and the Department then determines, either at
| ||||||
17 | reevaluation or after the restriction has been discontinued, to | ||||||
18 | restrict the
recipient's access to medical care a second or | ||||||
19 | subsequent time, the second or
subsequent restriction may be | ||||||
20 | imposed for a period of more than 4 full
quarters. If the | ||||||
21 | Department restricts a recipient's access to medical care for
a | ||||||
22 | period of more than 4 full quarters, as determined by rule, the | ||||||
23 | Department
shall reevaluate the recipient's medical usage | ||||||
24 | after the end of the restriction
period rather than after the | ||||||
25 | end of 4 full quarters. The Department shall
notify the | ||||||
26 | recipient, in writing, of any decision to continue the |
| |||||||
| |||||||
1 | restriction
and the reason or reasons therefor. A "quarter", | ||||||
2 | for purposes of this Section,
shall be defined as one of the | ||||||
3 | following 3-month periods of time:
January-March, April-June, | ||||||
4 | July-September or October-December.
| ||||||
5 | (h) In addition to any other recipient whose acquisition of | ||||||
6 | medical care
is determined to be in excess of need, the | ||||||
7 | Department may restrict the medical
care privileges of the | ||||||
8 | following persons:
| ||||||
9 | (1) recipients found to have loaned or altered their | ||||||
10 | cards or misused or
falsely represented medical coverage;
| ||||||
11 | (2) recipients found in possession of blank or forged | ||||||
12 | prescription pads;
| ||||||
13 | (3) recipients who knowingly assist providers in | ||||||
14 | rendering excessive
services or defrauding the medical | ||||||
15 | assistance program.
| ||||||
16 | The procedural safeguards in this Section shall apply to | ||||||
17 | the above
individuals.
| ||||||
18 | (i) Restrictions under this Section shall be in addition to | ||||||
19 | and shall
not in any way be limited by or limit any actions | ||||||
20 | taken under Article
VIII-A of this Code.
| ||||||
21 | (Source: P.A. 88-554, eff. 7-26-94 .)
| ||||||
22 | (305 ILCS 5/5-5.15 rep.)
| ||||||
23 | Section 45. The Illinois Public Aid Code is amended by | ||||||
24 | repealing Section 5-5.15. |
| |||||||
| |||||||
1 | Section 50. The Illinois Vehicle Code is amended by | ||||||
2 | changing Section 2-123 as follows:
| ||||||
3 | (625 ILCS 5/2-123) (from Ch. 95 1/2, par. 2-123)
| ||||||
4 | Sec. 2-123. Sale and Distribution of Information.
| ||||||
5 | (a) Except as otherwise provided in this Section, the | ||||||
6 | Secretary may make the
driver's license, vehicle and title | ||||||
7 | registration lists, in part or in whole,
and any statistical | ||||||
8 | information derived from these lists available to local
| ||||||
9 | governments, elected state officials, state educational | ||||||
10 | institutions, and all
other governmental units of the State and | ||||||
11 | Federal
Government
requesting them for governmental purposes. | ||||||
12 | The Secretary shall require any such
applicant for services to | ||||||
13 | pay for the costs of furnishing such services and the
use of | ||||||
14 | the equipment involved, and in addition is empowered to | ||||||
15 | establish prices
and charges for the services so furnished and | ||||||
16 | for the use of the electronic
equipment utilized.
| ||||||
17 | (b) The Secretary is further empowered to and he may, in | ||||||
18 | his discretion,
furnish to any applicant, other than listed in | ||||||
19 | subsection (a) of this Section,
vehicle or driver data on a | ||||||
20 | computer tape, disk, other electronic format or
computer | ||||||
21 | processable medium, or printout at a fixed fee of
$250 for | ||||||
22 | orders received before October 1, 2003 and $500 for orders | ||||||
23 | received
on or after October 1, 2003, in advance, and require | ||||||
24 | in addition a
further sufficient
deposit based upon the | ||||||
25 | Secretary of State's estimate of the total cost of the
|
| |||||||
| |||||||
1 | information requested and a charge of $25 for orders received | ||||||
2 | before October
1, 2003 and $50 for orders received on or after | ||||||
3 | October 1, 2003, per 1,000
units or part
thereof identified or | ||||||
4 | the actual cost, whichever is greater. The Secretary is
| ||||||
5 | authorized to refund any difference between the additional | ||||||
6 | deposit and the
actual cost of the request. This service shall | ||||||
7 | not be in lieu of an abstract
of a driver's record nor of a | ||||||
8 | title or registration search. This service may
be limited to | ||||||
9 | entities purchasing a minimum number of records as required by
| ||||||
10 | administrative rule. The information
sold pursuant to this | ||||||
11 | subsection shall be the entire vehicle or driver data
list, or | ||||||
12 | part thereof. The information sold pursuant to this subsection
| ||||||
13 | shall not contain personally identifying information unless | ||||||
14 | the information is
to be used for one of the purposes | ||||||
15 | identified in subsection (f-5) of this
Section. Commercial | ||||||
16 | purchasers of driver and vehicle record databases shall
enter | ||||||
17 | into a written agreement with the Secretary of State that | ||||||
18 | includes
disclosure of the commercial use of the information to | ||||||
19 | be purchased. | ||||||
20 | (b-1) The Secretary is further empowered to and may, in his | ||||||
21 | or her discretion, furnish vehicle or driver data on a computer | ||||||
22 | tape, disk, or other electronic format or computer processible | ||||||
23 | medium, at no fee, to any State or local governmental agency | ||||||
24 | that uses the information provided by the Secretary to transmit | ||||||
25 | data back to the Secretary that enables the Secretary to | ||||||
26 | maintain accurate driving records, including dispositions of |
| |||||||
| |||||||
1 | traffic cases. This information may be provided without fee not | ||||||
2 | more often than once every 6 months.
| ||||||
3 | (c) Secretary of State may issue registration lists. The | ||||||
4 | Secretary
of State may compile a list of all registered
| ||||||
5 | vehicles. Each list of registered vehicles shall be arranged | ||||||
6 | serially
according to the registration numbers assigned to | ||||||
7 | registered vehicles and
may contain in addition the names and | ||||||
8 | addresses of registered owners and
a brief description of each | ||||||
9 | vehicle including the serial or other
identifying number | ||||||
10 | thereof. Such compilation may be in such form as in the
| ||||||
11 | discretion of the Secretary of State may seem best for the | ||||||
12 | purposes intended.
| ||||||
13 | (d) The Secretary of State shall furnish no more than 2 | ||||||
14 | current available
lists of such registrations to the sheriffs | ||||||
15 | of all counties and to the chiefs
of police of all cities and | ||||||
16 | villages and towns of 2,000 population and over
in this State | ||||||
17 | at no cost. Additional copies may be purchased by the sheriffs
| ||||||
18 | or chiefs of police at the fee
of $500 each or at the cost of | ||||||
19 | producing the list as determined
by the Secretary of State. | ||||||
20 | Such lists are to be used for governmental
purposes only.
| ||||||
21 | (e) (Blank).
| ||||||
22 | (e-1) (Blank).
| ||||||
23 | (f) The Secretary of State shall make a title or | ||||||
24 | registration search of the
records of his office and a written | ||||||
25 | report on the same for any person, upon
written application of | ||||||
26 | such person, accompanied by a fee of $5 for
each registration |
| |||||||
| |||||||
1 | or title search. The written application shall set forth
the | ||||||
2 | intended use of the requested information. No fee shall be | ||||||
3 | charged for a
title or
registration search, or for the | ||||||
4 | certification thereof requested by a government
agency. The | ||||||
5 | report of the title or registration search shall not contain
| ||||||
6 | personally identifying information unless the request for a | ||||||
7 | search was made for
one of the purposes identified in | ||||||
8 | subsection (f-5) of this Section. The report of the title or | ||||||
9 | registration search shall not contain highly
restricted | ||||||
10 | personal
information unless specifically authorized by this | ||||||
11 | Code.
| ||||||
12 | The Secretary of State shall certify a title or | ||||||
13 | registration record upon
written request. The fee for | ||||||
14 | certification shall be $5 in addition
to the fee required for a | ||||||
15 | title or registration search. Certification shall
be made under | ||||||
16 | the signature of the Secretary of State and shall be
| ||||||
17 | authenticated by Seal of the Secretary of State.
| ||||||
18 | The Secretary of State may notify the vehicle owner or | ||||||
19 | registrant of
the request for purchase of his title or | ||||||
20 | registration information as the
Secretary deems appropriate.
| ||||||
21 | No information shall be released to the requestor until | ||||||
22 | expiration of a
10 day period. This 10 day period shall not | ||||||
23 | apply to requests for
information made by law enforcement | ||||||
24 | officials, government agencies,
financial institutions, | ||||||
25 | attorneys, insurers, employers, automobile
associated | ||||||
26 | businesses, persons licensed as a private detective or firms
|
| |||||||
| |||||||
1 | licensed as a private detective agency under the Private | ||||||
2 | Detective, Private
Alarm, Private Security, Fingerprint | ||||||
3 | Vendor, and Locksmith Act of 2004, who are employed by or are
| ||||||
4 | acting on
behalf of law enforcement officials, government | ||||||
5 | agencies, financial
institutions, attorneys, insurers, | ||||||
6 | employers, automobile associated businesses,
and other | ||||||
7 | business entities for purposes consistent with the Illinois | ||||||
8 | Vehicle
Code, the vehicle owner or registrant or other entities | ||||||
9 | as the Secretary may
exempt by rule and regulation.
| ||||||
10 | Any misrepresentation made by a requestor of title or | ||||||
11 | vehicle information
shall be punishable as a petty offense, | ||||||
12 | except in the case of persons
licensed as a private detective | ||||||
13 | or firms licensed as a private detective agency
which shall be | ||||||
14 | subject to disciplinary sanctions under Section 40-10 of the
| ||||||
15 | Private Detective, Private Alarm, Private Security, | ||||||
16 | Fingerprint Vendor, and Locksmith Act of 2004.
| ||||||
17 | (f-5) The Secretary of State shall not disclose or | ||||||
18 | otherwise make
available to
any person or entity any personally | ||||||
19 | identifying information obtained by the
Secretary
of State in | ||||||
20 | connection with a driver's license, vehicle, or title | ||||||
21 | registration
record
unless the information is disclosed for one | ||||||
22 | of the following purposes:
| ||||||
23 | (1) For use by any government agency, including any | ||||||
24 | court or law
enforcement agency, in carrying out its | ||||||
25 | functions, or any private person or
entity acting on behalf | ||||||
26 | of a federal, State, or local agency in carrying out
its
|
| |||||||
| |||||||
1 | functions.
| ||||||
2 | (2) For use in connection with matters of motor vehicle | ||||||
3 | or driver safety
and theft; motor vehicle emissions; motor | ||||||
4 | vehicle product alterations, recalls,
or advisories; | ||||||
5 | performance monitoring of motor vehicles, motor vehicle | ||||||
6 | parts,
and dealers; and removal of non-owner records from | ||||||
7 | the original owner
records of motor vehicle manufacturers.
| ||||||
8 | (3) For use in the normal course of business by a | ||||||
9 | legitimate business or
its agents, employees, or | ||||||
10 | contractors, but only:
| ||||||
11 | (A) to verify the accuracy of personal information | ||||||
12 | submitted by
an individual to the business or its | ||||||
13 | agents, employees, or contractors;
and
| ||||||
14 | (B) if such information as so submitted is not | ||||||
15 | correct or is no
longer correct, to obtain the correct | ||||||
16 | information, but only for the
purposes of preventing | ||||||
17 | fraud by, pursuing legal remedies against, or
| ||||||
18 | recovering on a debt or security interest against, the | ||||||
19 | individual.
| ||||||
20 | (4) For use in research activities and for use in | ||||||
21 | producing statistical
reports, if the personally | ||||||
22 | identifying information is not published,
redisclosed, or | ||||||
23 | used to
contact individuals.
| ||||||
24 | (5) For use in connection with any civil, criminal, | ||||||
25 | administrative, or
arbitral proceeding in any federal, | ||||||
26 | State, or local court or agency or before
any
|
| |||||||
| |||||||
1 | self-regulatory body, including the service of process, | ||||||
2 | investigation in
anticipation of litigation, and the | ||||||
3 | execution or enforcement of judgments and
orders, or | ||||||
4 | pursuant to an order of a federal, State, or local court.
| ||||||
5 | (6) For use by any insurer or insurance support | ||||||
6 | organization or by a
self-insured entity or its agents, | ||||||
7 | employees, or contractors in connection with
claims | ||||||
8 | investigation activities, antifraud activities, rating, or | ||||||
9 | underwriting.
| ||||||
10 | (7) For use in providing notice to the owners of towed | ||||||
11 | or
impounded vehicles.
| ||||||
12 | (8) For use by any person licensed as a private | ||||||
13 | detective or firm licensed as a private
detective agency | ||||||
14 | under
the Private Detective, Private Alarm, Private | ||||||
15 | Security, Fingerprint Vendor, and Locksmith Act of
2004, | ||||||
16 | private investigative agency or security service
licensed | ||||||
17 | in Illinois for any purpose permitted under this | ||||||
18 | subsection.
| ||||||
19 | (9) For use by an employer or its agent or insurer to | ||||||
20 | obtain or verify
information relating to a holder of a | ||||||
21 | commercial driver's license that is
required under chapter | ||||||
22 | 313 of title 49 of the United States Code.
| ||||||
23 | (10) For use in connection with the operation of | ||||||
24 | private toll
transportation facilities.
| ||||||
25 | (11) For use by any requester, if the requester | ||||||
26 | demonstrates it has
obtained the written consent of the |
| |||||||
| |||||||
1 | individual to whom the information
pertains.
| ||||||
2 | (12) For use by members of the news media, as defined | ||||||
3 | in
Section 1-148.5, for the purpose of newsgathering when | ||||||
4 | the request relates to
the
operation of a motor vehicle or | ||||||
5 | public safety.
| ||||||
6 | (13) For any other use specifically authorized by law, | ||||||
7 | if that use is
related to the operation of a motor vehicle | ||||||
8 | or public safety. | ||||||
9 | (f-6) The Secretary of State shall not disclose or | ||||||
10 | otherwise make
available to any
person or entity any highly | ||||||
11 | restricted personal information obtained by the
Secretary of
| ||||||
12 | State in connection with a driver's license, vehicle, or
title | ||||||
13 | registration
record unless
specifically authorized by this | ||||||
14 | Code.
| ||||||
15 | (g) 1. The Secretary of State may, upon receipt of a | ||||||
16 | written request
and a fee of $6 before October 1, 2003 and | ||||||
17 | a fee of $12 on and after October
1, 2003, furnish to the | ||||||
18 | person or agency so requesting a
driver's record. Such | ||||||
19 | document may include a record of: current driver's
license | ||||||
20 | issuance information, except that the information on | ||||||
21 | judicial driving
permits shall be available only as | ||||||
22 | otherwise provided by this Code;
convictions; orders | ||||||
23 | entered revoking, suspending or cancelling a
driver's
| ||||||
24 | license or privilege; and notations of accident | ||||||
25 | involvement. All other
information, unless otherwise | ||||||
26 | permitted by
this Code, shall remain confidential. |
| |||||||
| |||||||
1 | Information released pursuant to a
request for a driver's | ||||||
2 | record shall not contain personally identifying
| ||||||
3 | information, unless the request for the driver's record was | ||||||
4 | made for one of the
purposes set forth in subsection (f-5) | ||||||
5 | of this Section. The Secretary of State may, without fee, | ||||||
6 | allow a parent or guardian of a person under the age of 18 | ||||||
7 | years, who holds an instruction permit or graduated | ||||||
8 | driver's license, to view that person's driving record | ||||||
9 | online, through a computer connection.
The parent or | ||||||
10 | guardian's online access to the driving record will | ||||||
11 | terminate when the instruction permit or graduated | ||||||
12 | driver's license holder reaches the age of 18.
| ||||||
13 | 2. The Secretary of State shall not disclose or | ||||||
14 | otherwise make available
to any
person or
entity any highly | ||||||
15 | restricted personal information obtained by the Secretary | ||||||
16 | of
State in
connection with a driver's license, vehicle, or | ||||||
17 | title
registration record
unless specifically
authorized | ||||||
18 | by this Code. The Secretary of State may certify an | ||||||
19 | abstract of a driver's record
upon written request | ||||||
20 | therefor. Such certification
shall be made under the | ||||||
21 | signature of the Secretary of State and shall be
| ||||||
22 | authenticated by the Seal of his office.
| ||||||
23 | 3. All requests for driving record information shall be | ||||||
24 | made in a manner
prescribed by the Secretary and shall set | ||||||
25 | forth the intended use of the
requested information.
| ||||||
26 | The Secretary of State may notify the affected driver |
| |||||||
| |||||||
1 | of the request
for purchase of his driver's record as the | ||||||
2 | Secretary deems appropriate.
| ||||||
3 | No information shall be released to the requester until | ||||||
4 | expiration of a
10 day period. This 10 day period shall not | ||||||
5 | apply to requests for information
made by law enforcement | ||||||
6 | officials, government agencies, financial institutions,
| ||||||
7 | attorneys, insurers, employers, automobile associated | ||||||
8 | businesses, persons
licensed as a private detective or | ||||||
9 | firms licensed as a private detective agency
under the | ||||||
10 | Private Detective, Private Alarm, Private Security, | ||||||
11 | Fingerprint Vendor, and Locksmith Act
of 2004,
who are | ||||||
12 | employed by or are acting on behalf of law enforcement | ||||||
13 | officials,
government agencies, financial institutions, | ||||||
14 | attorneys, insurers, employers,
automobile associated | ||||||
15 | businesses, and other business entities for purposes
| ||||||
16 | consistent with the Illinois Vehicle Code, the affected | ||||||
17 | driver or other
entities as the Secretary may exempt by | ||||||
18 | rule and regulation.
| ||||||
19 | Any misrepresentation made by a requestor of driver | ||||||
20 | information shall
be punishable as a petty offense, except | ||||||
21 | in the case of persons licensed as
a private detective or | ||||||
22 | firms licensed as a private detective agency which shall
be | ||||||
23 | subject to disciplinary sanctions under Section 40-10 of | ||||||
24 | the Private
Detective, Private Alarm, Private Security, | ||||||
25 | Fingerprint Vendor, and Locksmith Act of 2004.
| ||||||
26 | 4. The Secretary of State may furnish without fee, upon |
| |||||||
| |||||||
1 | the written
request of a law enforcement agency, any | ||||||
2 | information from a driver's
record on file with the | ||||||
3 | Secretary of State when such information is required
in the | ||||||
4 | enforcement of this Code or any other law relating to the | ||||||
5 | operation
of motor vehicles, including records of | ||||||
6 | dispositions; documented
information involving the use of | ||||||
7 | a motor vehicle; whether such individual
has, or previously | ||||||
8 | had, a driver's license; and the address and personal
| ||||||
9 | description as reflected on said driver's record.
| ||||||
10 | 5. Except as otherwise provided in this Section, the | ||||||
11 | Secretary of
State may furnish, without fee, information | ||||||
12 | from an individual driver's
record on file, if a written | ||||||
13 | request therefor is submitted
by any public transit system | ||||||
14 | or authority, public defender, law enforcement
agency, a | ||||||
15 | state or federal agency, or an Illinois local | ||||||
16 | intergovernmental
association, if the request is for the | ||||||
17 | purpose of a background check of
applicants for employment | ||||||
18 | with the requesting agency, or for the purpose of
an | ||||||
19 | official investigation conducted by the agency, or to | ||||||
20 | determine a
current address for the driver so public funds | ||||||
21 | can be recovered or paid to
the driver, or for any other | ||||||
22 | purpose set forth in subsection (f-5)
of this Section.
| ||||||
23 | The Secretary may also furnish the courts a copy of an | ||||||
24 | abstract of a
driver's record, without fee, subsequent to | ||||||
25 | an arrest for a violation of
Section 11-501 or a similar | ||||||
26 | provision of a local ordinance. Such abstract
may include |
| |||||||
| |||||||
1 | records of dispositions; documented information involving
| ||||||
2 | the use of a motor vehicle as contained in the current | ||||||
3 | file; whether such
individual has, or previously had, a | ||||||
4 | driver's license; and the address and
personal description | ||||||
5 | as reflected on said driver's record.
| ||||||
6 | 6. Any certified abstract issued by the Secretary of | ||||||
7 | State or
transmitted electronically by the Secretary of | ||||||
8 | State pursuant to this
Section,
to a court or on request of | ||||||
9 | a law enforcement agency, for the record of a
named person | ||||||
10 | as to the status of the person's driver's license shall be
| ||||||
11 | prima facie evidence of the facts therein stated and if the | ||||||
12 | name appearing
in such abstract is the same as that of a | ||||||
13 | person named in an information or
warrant, such abstract | ||||||
14 | shall be prima facie evidence that the person named
in such | ||||||
15 | information or warrant is the same person as the person | ||||||
16 | named in
such abstract and shall be admissible for any | ||||||
17 | prosecution under this Code and
be admitted as proof of any | ||||||
18 | prior conviction or proof of records, notices, or
orders | ||||||
19 | recorded on individual driving records maintained by the | ||||||
20 | Secretary of
State.
| ||||||
21 | 7. Subject to any restrictions contained in the | ||||||
22 | Juvenile Court Act of
1987, and upon receipt of a proper | ||||||
23 | request and a fee of $6 before October 1,
2003 and a fee of | ||||||
24 | $12 on or after October 1, 2003, the
Secretary of
State | ||||||
25 | shall provide a driver's record to the affected driver, or | ||||||
26 | the affected
driver's attorney, upon verification. Such |
| |||||||
| |||||||
1 | record shall contain all the
information referred to in | ||||||
2 | paragraph 1 of this subsection (g) plus: any
recorded | ||||||
3 | accident involvement as a driver; information recorded | ||||||
4 | pursuant to
subsection (e) of Section 6-117 and paragraph | ||||||
5 | (4) of subsection (a) of
Section 6-204 of this Code. All | ||||||
6 | other information, unless otherwise permitted
by this | ||||||
7 | Code, shall remain confidential.
| ||||||
8 | (h) The Secretary shall not disclose social security | ||||||
9 | numbers or any associated information obtained from the Social | ||||||
10 | Security Administration except pursuant
to a written request | ||||||
11 | by, or with the prior written consent of, the
individual | ||||||
12 | except: (1) to officers and employees of the Secretary
who
have | ||||||
13 | a need to know the social security numbers in performance of | ||||||
14 | their
official duties, (2) to law enforcement officials for a | ||||||
15 | lawful, civil or
criminal law enforcement investigation, and if | ||||||
16 | the head of the law enforcement
agency has made a written | ||||||
17 | request to the Secretary specifying the law
enforcement | ||||||
18 | investigation for which the social security numbers are being
| ||||||
19 | sought, (3) to the United States Department of Transportation, | ||||||
20 | or any other
State, pursuant to the administration and | ||||||
21 | enforcement of the Commercial
Motor Vehicle Safety Act of 1986, | ||||||
22 | (4) pursuant to the order of a court
of competent jurisdiction, | ||||||
23 | (5) to the Department of Healthcare and Family Services | ||||||
24 | (formerly Department of Public Aid) for
utilization
in the | ||||||
25 | child support enforcement duties assigned to that Department | ||||||
26 | under
provisions of the Illinois Public Aid Code after the |
| |||||||
| |||||||
1 | individual has received advanced
meaningful notification of | ||||||
2 | what redisclosure is sought by the Secretary in
accordance with | ||||||
3 | the federal Privacy Act, (5.5) to the Department of Healthcare | ||||||
4 | and Family Services and the Department of Human Services solely | ||||||
5 | for the purpose of verifying Illinois residency where such | ||||||
6 | residency is an eligibility requirement for benefits under the | ||||||
7 | Illinois Public Aid Code or any other health benefit program | ||||||
8 | administered by the Department of Healthcare and Family | ||||||
9 | Services or the Department of Human Services, or (6) to the | ||||||
10 | Illinois Department of Revenue solely for use by the Department | ||||||
11 | in the collection of any tax or debt that the Department of | ||||||
12 | Revenue is authorized or required by law to collect, provided | ||||||
13 | that the Department shall not disclose the social security | ||||||
14 | number to any person or entity outside of the Department.
| ||||||
15 | (i) (Blank).
| ||||||
16 | (j) Medical statements or medical reports received in the | ||||||
17 | Secretary of
State's Office shall be confidential. No | ||||||
18 | confidential information may be
open to public inspection or | ||||||
19 | the contents disclosed to anyone, except
officers and employees | ||||||
20 | of the Secretary who have a need to know the information
| ||||||
21 | contained in the medical reports and the Driver License Medical | ||||||
22 | Advisory
Board, unless so directed by an order of a court of | ||||||
23 | competent jurisdiction.
| ||||||
24 | (k) All fees collected under this Section shall be paid | ||||||
25 | into the Road
Fund of the State Treasury, except that (i) for | ||||||
26 | fees collected before October
1, 2003, $3 of the $6 fee for a
|
| |||||||
| |||||||
1 | driver's record shall be paid into the Secretary of State | ||||||
2 | Special Services
Fund, (ii) for fees collected on and after | ||||||
3 | October 1, 2003, of the $12 fee
for a driver's record, $3 shall | ||||||
4 | be paid into the Secretary of State Special
Services Fund and | ||||||
5 | $6 shall be paid into the General Revenue Fund, and (iii) for
| ||||||
6 | fees collected on and after October 1, 2003, 50% of the amounts | ||||||
7 | collected
pursuant to subsection (b) shall be paid into the | ||||||
8 | General Revenue Fund.
| ||||||
9 | (l) (Blank).
| ||||||
10 | (m) Notations of accident involvement that may be disclosed | ||||||
11 | under this
Section shall not include notations relating to | ||||||
12 | damage to a vehicle or other
property being transported by a | ||||||
13 | tow truck. This information shall remain
confidential, | ||||||
14 | provided that nothing in this subsection (m) shall limit
| ||||||
15 | disclosure of any notification of accident involvement to any | ||||||
16 | law enforcement
agency or official.
| ||||||
17 | (n) Requests made by the news media for driver's license, | ||||||
18 | vehicle, or
title registration information may be furnished | ||||||
19 | without charge or at a reduced
charge, as determined by the | ||||||
20 | Secretary, when the specific purpose for
requesting the | ||||||
21 | documents is deemed to be in the public interest. Waiver or
| ||||||
22 | reduction of the fee is in the public interest if the principal | ||||||
23 | purpose of the
request is to access and disseminate information | ||||||
24 | regarding the health, safety,
and welfare or the legal rights | ||||||
25 | of the general public and is not for the
principal purpose of | ||||||
26 | gaining a personal or commercial benefit.
The information |
| |||||||
| |||||||
1 | provided pursuant to this subsection shall not contain
| ||||||
2 | personally identifying information unless the information is | ||||||
3 | to be used for one
of the
purposes identified in subsection | ||||||
4 | (f-5) of this Section.
| ||||||
5 | (o) The redisclosure of personally identifying information
| ||||||
6 | obtained
pursuant
to this Section is prohibited, except to the | ||||||
7 | extent necessary to effectuate the
purpose
for which the | ||||||
8 | original disclosure of the information was permitted.
| ||||||
9 | (p) The Secretary of State is empowered to adopt rules
to
| ||||||
10 | effectuate this Section.
| ||||||
11 | (Source: P.A. 95-201, eff. 1-1-08; 95-287, eff. 1-1-08; 95-331, | ||||||
12 | eff. 8-21-07; 95-613, eff. 9-11-07; 95-876, eff. 8-21-08; | ||||||
13 | 96-1383, eff. 1-1-11.)
| ||||||
14 | Section 95. Severability. If any provision of this Act or | ||||||
15 | application thereof to any person or circumstance is held | ||||||
16 | invalid, such invalidity does not affect other provisions or | ||||||
17 | applications of this Act which can be given effect without the | ||||||
18 | invalid application or provision, and to this end the | ||||||
19 | provisions of this Act are declared to be severable.
| ||||||
20 | Section 99. Effective date. This Act takes effect upon | ||||||
21 | becoming law.".
|