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1 | AN ACT concerning public aid.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Illinois Public Aid Code is amended by | ||||||||||||||||||||||||||||||||||
5 | changing Sections 8A-2.5, 8A-6, 8A-7, 8A-11, 8A-16, and 8A-17 | ||||||||||||||||||||||||||||||||||
6 | as follows:
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7 | (305 ILCS 5/8A-2.5)
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8 | Sec. 8A-2.5. Unauthorized use of medical assistance.
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9 | (a) Any person who knowingly uses, acquires, possesses, or | ||||||||||||||||||||||||||||||||||
10 | transfers a
medical card in any manner not authorized by law or | ||||||||||||||||||||||||||||||||||
11 | by rules and regulations of
the Illinois Department, or who | ||||||||||||||||||||||||||||||||||
12 | knowingly alters a medical card, or who
knowingly uses, | ||||||||||||||||||||||||||||||||||
13 | acquires, possesses, or transfers an altered medical card, is
| ||||||||||||||||||||||||||||||||||
14 | guilty of a violation of this Article and shall be punished as | ||||||||||||||||||||||||||||||||||
15 | provided in
Section 8A-6.
| ||||||||||||||||||||||||||||||||||
16 | (b) Any person who knowingly obtains unauthorized medical | ||||||||||||||||||||||||||||||||||
17 | benefits or causes to be obtained unauthorized medical benefits | ||||||||||||||||||||||||||||||||||
18 | with or
without use of a medical card is guilty of a violation | ||||||||||||||||||||||||||||||||||
19 | of this Article and
shall be punished as provided in Section | ||||||||||||||||||||||||||||||||||
20 | 8A-6.
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21 | (b-5) Any vendor that knowingly assists a person in | ||||||||||||||||||||||||||||||||||
22 | committing a violation under subsection (a) or (b) of this | ||||||||||||||||||||||||||||||||||
23 | Section is guilty of a violation of this Article and shall be |
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| |||||||
1 | punished as provided in Section 8A-6. | ||||||
2 | (b-6) Any person (including a vendor, organization, | ||||||
3 | agency, or other entity) that, in any matter related to the | ||||||
4 | medical assistance program, knowingly or willfully falsifies, | ||||||
5 | conceals, or omits by any trick, scheme, artifice, or device a | ||||||
6 | material fact, or makes any false, fictitious, or fraudulent | ||||||
7 | statement or representation, or makes or uses any false writing | ||||||
8 | or document, knowing the same to contain any false, fictitious, | ||||||
9 | or fraudulent statement or entry in connection with the | ||||||
10 | provision of health care or related services, is guilty of a | ||||||
11 | violation of this Article and shall be punished as provided in | ||||||
12 | Section 8A-6. | ||||||
13 | (c) The Department may seek to recover any and all State | ||||||
14 | and federal monies for which it has improperly and erroneously | ||||||
15 | paid benefits as a result of a fraudulent action and any civil | ||||||
16 | penalties authorized in this Section. Pursuant to Section | ||||||
17 | 11-14.5 of this Code, the Department may determine the monetary | ||||||
18 | value of benefits improperly and erroneously received. The | ||||||
19 | Department may recover the monies paid for such benefits and | ||||||
20 | interest on that amount at the rate of 5% per annum for the | ||||||
21 | period from which payment was made to the date upon which | ||||||
22 | repayment is made to the State. Prior to the recovery of any | ||||||
23 | amount paid for benefits allegedly obtained by fraudulent | ||||||
24 | means, the recipient or payee of such benefits shall be | ||||||
25 | afforded an opportunity for a hearing after reasonable notice. | ||||||
26 | The notice shall be served personally or by certified or |
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1 | registered mail or as otherwise provided by law upon the | ||||||
2 | parties or their agents appointed to receive service of process | ||||||
3 | and shall include the following: | ||||||
4 | (1) A statement of the time, place and nature of the | ||||||
5 | hearing. | ||||||
6 | (2) A statement of the legal authority and jurisdiction | ||||||
7 | under which the hearing is to be held. | ||||||
8 | (3) A reference to the particular Sections of the | ||||||
9 | substantive and procedural statutes and rules involved. | ||||||
10 | (4) Except where a more detailed statement is otherwise | ||||||
11 | provided for by law, a short and plain statement of the | ||||||
12 | matters asserted, the consequences of a failure to respond, | ||||||
13 | and the official file or other reference number. | ||||||
14 | (5) A statement of the monetary value of the benefits | ||||||
15 | fraudulently received by the person accused. | ||||||
16 | (6) A statement that, in addition to any other | ||||||
17 | penalties provided by law, a civil penalty in an amount not | ||||||
18 | to exceed $4,000 $2,000 may be imposed for each fraudulent | ||||||
19 | claim for benefits or payments. | ||||||
20 | (7) A statement providing that the determination of the | ||||||
21 | monetary value may be contested by petitioning the | ||||||
22 | Department for an administrative hearing within 30 days | ||||||
23 | from the date of mailing the notice. | ||||||
24 | (8) The names and mailing addresses of the | ||||||
25 | administrative law judge, all parties, and all other | ||||||
26 | persons to whom the agency gives notice of the hearing |
| |||||||
| |||||||
1 | unless otherwise confidential by law. | ||||||
2 | An opportunity shall be afforded all parties to be | ||||||
3 | represented by legal counsel and to respond and present | ||||||
4 | evidence and argument. | ||||||
5 | Unless precluded by law, disposition may be made of any | ||||||
6 | contested case by stipulation, agreed settlement, consent | ||||||
7 | order, or default. | ||||||
8 | Any final order, decision, or other determination made, | ||||||
9 | issued or executed by the Director under the provisions of this | ||||||
10 | Article whereby any person is aggrieved shall be subject to | ||||||
11 | review in accordance with the provisions of the Administrative | ||||||
12 | Review Law, and the rules adopted pursuant thereto, which shall | ||||||
13 | apply to and govern all proceedings for the judicial review of | ||||||
14 | final administrative decisions of the Director. | ||||||
15 | Upon entry of a final administrative decision for repayment | ||||||
16 | of any benefits obtained by fraudulent means, or for any civil | ||||||
17 | penalties assessed, a lien shall attach to all property and | ||||||
18 | assets of such person, firm, corporation, association, agency, | ||||||
19 | institution, vendor, or other legal entity until the judgment | ||||||
20 | is satisfied. | ||||||
21 | Within 18 months of the effective date of this amendatory | ||||||
22 | Act of the 96th General Assembly, the Department of Healthcare | ||||||
23 | and Family Services will report to the General Assembly on the | ||||||
24 | number of fraud cases identified and pursued, and the fines | ||||||
25 | assessed and collected. The report will also include the | ||||||
26 | Department's analysis as to the use of private sector resources |
| |||||||
| |||||||
1 | to bring action, investigate, and collect monies owed. | ||||||
2 | (d) In subsections (a), (b), (b-5) and (b-6), "knowledge" | ||||||
3 | has the meaning ascribed to that term in Section 4-5 of the | ||||||
4 | Criminal Code of 2012. For any administrative action brought | ||||||
5 | under subsection (c) pursuant to a violation of this Section, | ||||||
6 | the Department shall define "knowing" by rule. | ||||||
7 | (Source: P.A. 97-23, eff. 1-1-12; 98-354, eff. 8-16-13.)
| ||||||
8 | (305 ILCS 5/8A-6) (from Ch. 23, par. 8A-6)
| ||||||
9 | Sec. 8A-6. Classification of violations.
| ||||||
10 | (a) Any person, firm, corporation,
association, agency, | ||||||
11 | institution or other legal entity that has been found
by a | ||||||
12 | court to have engaged in an act, practice or course of conduct | ||||||
13 | declared
unlawful under Sections 8A-2 through 8A-5 or Section | ||||||
14 | 8A-13 or 8A-14 where:
| ||||||
15 | (1) the total amount of money involved in the | ||||||
16 | violation, including the
monetary value of federal food | ||||||
17 | stamps and the value of commodities, is less
than $150, | ||||||
18 | shall be guilty of a Class 4 felony Class A misdemeanor ;
| ||||||
19 | (2) the total amount of money involved in the | ||||||
20 | violation, including the
monetary value of federal food | ||||||
21 | stamps and the value of commodities, is $150
or more but | ||||||
22 | less than $1,000, shall be guilty of a Class 3 Class 4 | ||||||
23 | felony;
| ||||||
24 | (3) the total amount of money involved in the | ||||||
25 | violation, including the
monetary value of federal food |
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| |||||||
1 | stamps and the value of commodities, is
$1,000 or more but | ||||||
2 | less than $5,000, shall be guilty of a Class 2 Class 3 | ||||||
3 | felony;
| ||||||
4 | (4) the total amount of money involved in the | ||||||
5 | violation, including the
monetary value of federal food | ||||||
6 | stamps and the value of commodities, is
$5,000 or more but | ||||||
7 | less than $10,000, shall be guilty of a Class 1 Class 2 | ||||||
8 | felony; or
| ||||||
9 | (5) the total amount of money involved in the | ||||||
10 | violation, including the
monetary value of federal food | ||||||
11 | stamps and the value of commodities, is
$10,000 or more, | ||||||
12 | shall be guilty of a Class X Class 1 felony and, | ||||||
13 | notwithstanding
the provisions of Section 8A-8 except for | ||||||
14 | Subsection (c) of Section 8A-8,
shall be ineligible for | ||||||
15 | financial aid under this Article for a period of
two years | ||||||
16 | following conviction or until the total amount of money,
| ||||||
17 | including the value of federal food stamps, is repaid, | ||||||
18 | whichever first occurs.
| ||||||
19 | (b) Any person, firm, corporation, association, agency, | ||||||
20 | institution
or other legal entity that commits a subsequent | ||||||
21 | violation of any of the
provisions of Sections 8A-2 through | ||||||
22 | 8A-5 and:
| ||||||
23 | (1) the total amount of money involved in the | ||||||
24 | subsequent violation,
including the monetary value of | ||||||
25 | federal food stamps and the value of
commodities, is less | ||||||
26 | than $150,
shall be guilty of a Class 3 Class 4 felony;
|
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| |||||||
1 | (2) the total amount of money involved in the | ||||||
2 | subsequent violation,
including the monetary value of | ||||||
3 | federal food stamps and the value of
commodities, is $150 | ||||||
4 | or more but
less than $1,000, shall be guilty of a Class 2 | ||||||
5 | Class 3 felony;
| ||||||
6 | (3) the total amount of money involved in the | ||||||
7 | subsequent violation,
including the monetary value of | ||||||
8 | federal food stamps and the value of
commodities, is $1,000 | ||||||
9 | or more
but less than $5,000, shall be guilty of a Class 1 | ||||||
10 | Class 2 felony;
| ||||||
11 | (4) the total amount of money involved in the | ||||||
12 | subsequent violation,
including the monetary value of | ||||||
13 | federal food stamps and the value of
commodities, is $5,000 | ||||||
14 | or more but
less than $10,000, shall be guilty of a Class X | ||||||
15 | Class 1 felony.
| ||||||
16 | (c) For purposes of determining the classification of | ||||||
17 | offense under
this Section, all of the money received as a | ||||||
18 | result of the unlawful act,
practice or course of conduct can | ||||||
19 | be accumulated.
| ||||||
20 | (Source: P.A. 90-538, eff. 12-1-97.)
| ||||||
21 | (305 ILCS 5/8A-7) (from Ch. 23, par. 8A-7)
| ||||||
22 | Sec. 8A-7. Civil Remedies. (a) A person who receives | ||||||
23 | financial aid by
means of a false statement, willful | ||||||
24 | misrepresentation or by his failure
to notify the county | ||||||
25 | department or local governmental unit, as the case
may be, of a |
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| |||||||
1 | change in his status as required by Sections 11-18 and 11-19,
| ||||||
2 | for the purpose of preventing the denial, cancellation or | ||||||
3 | suspension of
his grant, or a variation in the amount thereof, | ||||||
4 | or by other fraudulent
device, or a person who knowingly aids | ||||||
5 | or abets any person in obtaining
financial aid for which he is | ||||||
6 | not eligible, shall be answerable to the county
department or | ||||||
7 | the local governmental unit, as the case may be, for refunding
| ||||||
8 | the entire amount of aid received. If the refund is not made, | ||||||
9 | it shall be
recoverable in a civil action from the person who | ||||||
10 | received the aid, or from
anyone who willfully aided such | ||||||
11 | person to obtain the aid. If an act which
would be unlawful | ||||||
12 | under Section 8A-2 is proven, the court may as a penalty
assess | ||||||
13 | an additional sum of money, not to exceed the entire amount of | ||||||
14 | aid
provided, against the recipient or against any person who | ||||||
15 | willfully aided
the recipient. If assessed, the penalty shall | ||||||
16 | be included in any judgment
entered for the aid received, and | ||||||
17 | paid to the county department or the
local governmental unit, | ||||||
18 | as the case may be. Upon entry of the judgment a
lien shall | ||||||
19 | attach to all property and assets of such person until the
| ||||||
20 | judgment is satisfied.
| ||||||
21 | (b) Any person, firm, corporation, association, agency, | ||||||
22 | institution or
other legal entity, other than an individual | ||||||
23 | recipient, that willfully,
by means of a false statement or | ||||||
24 | representation, or by concealment of any
material fact or by | ||||||
25 | other fraudulent scheme or device on behalf of himself
or | ||||||
26 | others, obtains or attempts to obtain benefits or payments |
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| |||||||
1 | under this
Code to which he or it is not entitled, or in a | ||||||
2 | greater amount than that
to which he or it is entitled, shall | ||||||
3 | be liable for repayment of any excess
benefits or payments | ||||||
4 | received and, in addition to any other penalties provided
by | ||||||
5 | law, civil penalties consisting of (1) the interest on the | ||||||
6 | amount of
excess benefits or payments at the maximum legal rate | ||||||
7 | in effect on the date
the payment was made to such person, | ||||||
8 | firm, corporation, association, agency,
institution or other | ||||||
9 | legal entity for the period from the date upon which
payment | ||||||
10 | was made to the date upon which repayment is made to the State,
| ||||||
11 | (2) an amount not to exceed 3 times the amount of such excess | ||||||
12 | benefits or
payments, and (3) the sum of $4,000 $2,000 for each | ||||||
13 | excessive claim for benefits
or payments. Upon entry of a | ||||||
14 | judgment for repayment of any excess benefits
or payments, or | ||||||
15 | for any civil penalties assessed by the court, a lien shall
| ||||||
16 | attach to all property and assets of such person, firm, | ||||||
17 | corporation,
association, agency, institution or other legal | ||||||
18 | entity until the judgment is satisfied.
| ||||||
19 | (c) Civil recoveries provided for in this Section may be | ||||||
20 | recoverable in
court proceedings initiated by the Attorney | ||||||
21 | General or, in actions
involving a local governmental unit, by | ||||||
22 | the State's Attorney.
| ||||||
23 | (d) Any person who commits the offense of vendor fraud or | ||||||
24 | recipient
fraud as defined in Section 8A-2 and Section 8A-3 of | ||||||
25 | this Article shall
forfeit, according to the provisions
of this | ||||||
26 | subsection, any monies, profits or proceeds, and any interest |
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| |||||||
1 | or
property which the sentencing court determines he has | ||||||
2 | acquired or maintained,
directly or indirectly, in whole or in | ||||||
3 | part as a result of such offense.
Such person shall also | ||||||
4 | forfeit any interest in, securities of, claim against,
or | ||||||
5 | contractual right of any kind which affords him a source of | ||||||
6 | influence
over, any enterprise which he has established, | ||||||
7 | operated, controlled, conducted,
or participated in | ||||||
8 | conducting, where his relationship to or connection with
any | ||||||
9 | such thing or activity directly or indirectly, in whole or in | ||||||
10 | part,
is traceable to any thing or benefit which he has | ||||||
11 | obtained or acquired through
vendor fraud or recipient fraud.
| ||||||
12 | Proceedings instituted pursuant to this subsection shall | ||||||
13 | be subject to
and conducted in accordance with the following | ||||||
14 | procedures:
| ||||||
15 | (1) The sentencing court shall, upon petition by the | ||||||
16 | Attorney General
or State's Attorney at any time following | ||||||
17 | sentencing, conduct a hearing
to determine whether any property | ||||||
18 | or property interest is subject to forfeiture
under this | ||||||
19 | subsection. At the forfeiture hearing the People shall have
the | ||||||
20 | burden of establishing, by a preponderance of the evidence, | ||||||
21 | that the
property or property interests are subject to such | ||||||
22 | forfeiture.
| ||||||
23 | (2) In any action brought by the People of the State of | ||||||
24 | Illinois under
this Section, in which any restraining order, | ||||||
25 | injunction or prohibition or
any other action in connection | ||||||
26 | with any property or interest subject to
forfeiture under this |
| |||||||
| |||||||
1 | subsection is sought, the circuit court presiding
over the | ||||||
2 | trial of the person charged with recipient fraud or
vendor | ||||||
3 | fraud as defined in Sections 8A-2 or 8A-3 of this Article shall
| ||||||
4 | first determine whether there is probable cause to believe that | ||||||
5 | the person
so charged has committed the offense of recipient | ||||||
6 | fraud or
vendor fraud and whether the property or interest is | ||||||
7 | subject to forfeiture
under this subsection. To make such a | ||||||
8 | determination, prior to
entering any such order, the court | ||||||
9 | shall conduct a hearing without a jury,
at which the People | ||||||
10 | shall establish that there is (i) probable cause that
the | ||||||
11 | person so charged has committed the offense of recipient
fraud | ||||||
12 | or vendor fraud and (ii) probable cause that any property or | ||||||
13 | interest
may be subject to forfeiture pursuant to this | ||||||
14 | subsection. Such hearing may
be conducted simultaneously with a | ||||||
15 | preliminary hearing, if the prosecution
is commenced by | ||||||
16 | information or complaint, or by motion of the People at any
| ||||||
17 | stage in the proceedings. The court may accept a finding of | ||||||
18 | probable cause
at a preliminary hearing following the filing of | ||||||
19 | an information charging
the offense of recipient fraud or | ||||||
20 | vendor fraud as defined in Sections 8A-2
or 8A-3 or the return | ||||||
21 | of an indictment by a grand jury charging the offense
of | ||||||
22 | recipient fraud or vendor fraud as defined in Sections 8A-2 or | ||||||
23 | 8A-3 of
this Article as sufficient evidence of probable cause | ||||||
24 | as provided in item
(i) above. Upon such a finding, the circuit | ||||||
25 | court shall enter such
restraining order, injunction or | ||||||
26 | prohibition, or shall take such other
action in connection with |
| |||||||
| |||||||
1 | any such property or other interest subject to
forfeiture under | ||||||
2 | this Act as is necessary to insure that such property is
not | ||||||
3 | removed from the jurisdiction of the court, concealed, | ||||||
4 | destroyed or
otherwise disposed of by the owner of that | ||||||
5 | property or interest prior to a
forfeiture hearing under this | ||||||
6 | subsection. The Attorney General or State's
Attorney shall file | ||||||
7 | a certified copy of such restraining order, injunction
or other | ||||||
8 | prohibition with the recorder of deeds or registrar of titles | ||||||
9 | of
each county where any such property of the defendant may be | ||||||
10 | located. No
such injunction, restraining order or other | ||||||
11 | prohibition shall affect the
rights of any bonafide purchaser, | ||||||
12 | mortgagee, judgement creditor or other
lien holder arising | ||||||
13 | prior to the date of such filing. The court may, at
any time, | ||||||
14 | upon verified petition by the defendant, conduct a hearing to
| ||||||
15 | determine whether all or portions of any such property or | ||||||
16 | interest which
the court previously determined to be subject to | ||||||
17 | forfeiture
or subject to any restraining order, injunction, or | ||||||
18 | prohibition or other
action, should be released. The court may | ||||||
19 | in its discretion release such
property to the defendant for | ||||||
20 | good cause shown.
| ||||||
21 | (3) Upon conviction of a person under this Article, the | ||||||
22 | court shall
authorize the Director of the Illinois Department | ||||||
23 | of State Police to seize
all property or other interest | ||||||
24 | declared forfeited under this subsection upon
such terms and | ||||||
25 | conditions as the court shall deem proper.
| ||||||
26 | (4) The Director of the Illinois Department of State Police |
| |||||||
| |||||||
1 | is
authorized to sell all property forfeited and seized | ||||||
2 | pursuant to this
subsection, unless such property is
required | ||||||
3 | by law to be destroyed or is harmful to the public.
After the | ||||||
4 | deduction of all requisite expenses of administration and
sale, | ||||||
5 | the court shall order the Director to distribute to the | ||||||
6 | Illinois
Department an amount from the proceeds of the | ||||||
7 | forfeited property, or monies
forfeited or seized, which will | ||||||
8 | satisfy any unsatisfied court order of
restitution entered | ||||||
9 | pursuant to a conviction under this Article. If the
proceeds | ||||||
10 | are less than the amount necessary to satisfy the order of
| ||||||
11 | restitution, the Director shall distribute to the Illinois | ||||||
12 | Department the
entire amount of the remaining proceeds. The | ||||||
13 | Director shall distribute any
remaining proceeds of such sale, | ||||||
14 | along with any monies forfeited or seized,
in accordance with | ||||||
15 | the following schedules:
| ||||||
16 | (a) 25% shall be distributed to the unit of local | ||||||
17 | government whose
officers or employees conducted the | ||||||
18 | investigation into recipient fraud or
vendor fraud and caused | ||||||
19 | the arrest or arrests and prosecution leading to
the | ||||||
20 | forfeiture. Amounts distributed to units of local government | ||||||
21 | shall be
used solely for enforcement matters relating to | ||||||
22 | detection, investigation or
prosecution of recipient fraud or | ||||||
23 | vendor fraud as defined in Section 8A-2
or 8A-3 of this | ||||||
24 | Article. Where the investigation, arrest or arrests leading to
| ||||||
25 | the prosecution and forfeiture is undertaken solely by the | ||||||
26 | Illinois
Department of State Police, the portion provided |
| |||||||
| |||||||
1 | hereunder shall be paid
into the Medicaid Fraud and Abuse | ||||||
2 | Prevention Fund, which is hereby created
in the State treasury. | ||||||
3 | Monies from this fund shall be used by the
Department of State | ||||||
4 | Police for the furtherance of enforcement matters
relating to | ||||||
5 | detection, investigation or prosecution of recipient fraud or
| ||||||
6 | vendor fraud. Monies directed to this fund shall be used in | ||||||
7 | addition to,
and not as a substitute for, funds annually | ||||||
8 | appropriated to the Department
of State Police for medicaid | ||||||
9 | fraud enforcement.
| ||||||
10 | (b) 25% shall be distributed to the county in which the | ||||||
11 | prosecution and
petition for forfeiture resulting in the | ||||||
12 | forfeiture was instituted,
and deposited in a special fund in | ||||||
13 | the county treasury
and appropriated to the State's Attorney | ||||||
14 | for use solely in enforcement
matters relating to detection, | ||||||
15 | investigation or prosecution of recipient
fraud or vendor | ||||||
16 | fraud; however, if the Attorney General brought the
prosecution | ||||||
17 | resulting in the forfeiture, the portion provided hereunder
| ||||||
18 | shall be paid into the Medicaid Fraud and Abuse Prevention | ||||||
19 | Fund, to be used
by the Medicaid Fraud Control Unit of the | ||||||
20 | Illinois Department of State Police
for enforcement matters | ||||||
21 | relating to detection, investigation or prosecution
of | ||||||
22 | recipient fraud or vendor fraud. Where the Attorney General and | ||||||
23 | a
State's Attorney have jointly participated in any portion of | ||||||
24 | the
proceedings, 12.5% shall be distributed to the county in | ||||||
25 | which the
prosecution resulting in the forfeiture was | ||||||
26 | instituted, and used as
specified herein, and 12.5% shall be |
| |||||||
| |||||||
1 | paid into the Medicaid Fraud and Abuse
Prevention Fund, and | ||||||
2 | used as specified herein.
| ||||||
3 | (c) 50% shall be transmitted to the State Treasurer for | ||||||
4 | deposit in the
General Revenue Fund.
| ||||||
5 | (Source: P.A. 85-707.)
| ||||||
6 | (305 ILCS 5/8A-11) (from Ch. 23, par. 8A-11)
| ||||||
7 | Sec. 8A-11. (a) No person shall:
| ||||||
8 | (1) Knowingly charge a resident of a nursing home for | ||||||
9 | any services
provided pursuant to Article V of the Illinois | ||||||
10 | Public Aid Code, money or
other consideration at a rate in | ||||||
11 | excess of the rates established for covered
services by the | ||||||
12 | Illinois Department pursuant to Article V of the Illinois
| ||||||
13 | Public Aid Code; or
| ||||||
14 | (2) Knowingly charge, solicit, accept or receive, in | ||||||
15 | addition to any
amount otherwise authorized or required to | ||||||
16 | be paid pursuant to Article V of
the Illinois Public Aid | ||||||
17 | Code, any gift, money, donation or other consideration:
| ||||||
18 | (i) As a precondition to admitting or expediting | ||||||
19 | the admission of a
recipient or applicant, pursuant to | ||||||
20 | Article V of the Illinois Public Aid Code,
to a | ||||||
21 | long-term care facility as defined in Section 1-113 of | ||||||
22 | the Nursing
Home Care Act or a facility as defined in | ||||||
23 | Section 1-113 of the ID/DD Community Care Act, Section | ||||||
24 | 1-113 of the MC/DD Act, or Section 1-102 of the | ||||||
25 | Specialized Mental Health Rehabilitation Act of 2013; |
| |||||||
| |||||||
1 | and
| ||||||
2 | (ii) As a requirement for the recipient's or | ||||||
3 | applicant's continued stay
in such facility when the | ||||||
4 | cost of the services provided therein to the
recipient | ||||||
5 | is paid for, in whole or in part, pursuant to Article V | ||||||
6 | of the
Illinois Public Aid Code.
| ||||||
7 | (b) Nothing herein shall prohibit a person from making a | ||||||
8 | voluntary
contribution, gift or donation to a long-term care | ||||||
9 | facility.
| ||||||
10 | (c) This paragraph shall not apply to agreements to provide | ||||||
11 | continuing
care or life care between a life care facility as | ||||||
12 | defined by the Life
Care Facilities Act, and a person | ||||||
13 | financially eligible for benefits pursuant to
Article V of the | ||||||
14 | Illinois Public Aid Code.
| ||||||
15 | (d) Any person who violates this Section shall be guilty of | ||||||
16 | a business
offense and fined not less than $10,000 $5,000 nor | ||||||
17 | more than $50,000 $25,000 .
| ||||||
18 | (e) "Person", as used in this Section, means an individual, | ||||||
19 | corporation,
partnership, or unincorporated association.
| ||||||
20 | (f) The State's Attorney of the county in which the | ||||||
21 | facility is located
and the Attorney General shall be notified | ||||||
22 | by the Illinois Department of
any alleged violations of this | ||||||
23 | Section known to the Department.
| ||||||
24 | (g) The Illinois Department shall adopt rules and | ||||||
25 | regulations to carry
out the provisions of this Section.
| ||||||
26 | (Source: P.A. 98-104, eff. 7-22-13; 99-180, eff. 7-29-15.)
|
| |||||||
| |||||||
1 | (305 ILCS 5/8A-16)
| ||||||
2 | Sec. 8A-16. Unfair or deceptive marketing practices.
| ||||||
3 | (a) As used in this Section, "health plan" has the meaning | ||||||
4 | attributed to
that term in Section 8A-13.
| ||||||
5 | (b) It is unlawful to knowingly and willfully engage in any | ||||||
6 | unfair or
deceptive marketing practice
in connection with | ||||||
7 | proposing, offering, selling, soliciting, or providing any
| ||||||
8 | health care service or any health plan. Unfair or deceptive | ||||||
9 | marketing
practices include the following:
| ||||||
10 | (1) Making a false and misleading oral or written | ||||||
11 | statement, visual
description, advertisement, or other | ||||||
12 | representation of any kind that has the
capacity, tendency, | ||||||
13 | or effect of deceiving or misleading health care consumers
| ||||||
14 | with respect to any health care service, health plan, or | ||||||
15 | health care provider.
| ||||||
16 | (2) Making a representation that a health care plan or | ||||||
17 | a health care
provider offers any service, benefit, access | ||||||
18 | to care, or choice that it does
not in fact offer.
| ||||||
19 | (3) Making a representation that a health plan or | ||||||
20 | health care provider has
any status, certification, | ||||||
21 | qualification, sponsorship, affiliation, or
licensure that | ||||||
22 | it does not have.
| ||||||
23 | (4) A failure to state a material fact if the failure | ||||||
24 | deceives or tends to
deceive.
| ||||||
25 | (5) Offering any kickback, bribe, reward, or benefit to |
| |||||||
| |||||||
1 | any person as an
inducement to select or to refrain from | ||||||
2 | selecting any health care service,
health plan, or health | ||||||
3 | care provider, unless the benefit offered is medically
| ||||||
4 | necessary health care or is permitted by the Illinois | ||||||
5 | Department.
| ||||||
6 | (6) The use of health care consumer or other | ||||||
7 | information that is
confidential or privileged or that | ||||||
8 | cannot be disclosed to or obtained by the
user without | ||||||
9 | violating a State or federal confidentiality law, | ||||||
10 | including:
| ||||||
11 | (A) medical records information; and
| ||||||
12 | (B) information that identifies the health care | ||||||
13 | consumer or any member
of his or her group as a | ||||||
14 | recipient of any government sponsored or mandated
| ||||||
15 | welfare program.
| ||||||
16 | (7) The use of any device or artifice in advertising a | ||||||
17 | health plan or
soliciting a health care consumer that | ||||||
18 | misrepresents the solicitor's
profession, status, | ||||||
19 | affiliation, or mission.
| ||||||
20 | (c) Any person who commits a first violation of this | ||||||
21 | Section is guilty of a
Class
4
felony A misdemeanor and is | ||||||
22 | subject to a fine of not more than $10,000 $5,000 . Any person | ||||||
23 | who
commits a second or subsequent violation of this Section is | ||||||
24 | guilty of a Class 3 4
felony and is subject to a fine of not | ||||||
25 | more than $50,000 $25,000 .
| ||||||
26 | (Source: P.A. 90-538, eff. 12-1-97.)
|
| |||||||
| |||||||
1 | (305 ILCS 5/8A-17)
| ||||||
2 | Sec. 8A-17. Penalties enhanced for persons other than | ||||||
3 | individuals. If a
person who violates Section 8A-13, 8A-14, | ||||||
4 | 8A-15, or 8A-16 is any person other
than an individual, then | ||||||
5 | that person is subject to a fine of not more than
$100,000 | ||||||
6 | $50,000 if the violation is a Class 1, 2, 3, or 4 felony | ||||||
7 | misdemeanor and a fine of not more than $500,000 $250,000
if | ||||||
8 | the violation is a Class X felony a felony .
| ||||||
9 | (Source: P.A. 90-538, eff. 12-1-97.)
|