102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB5597

 

Introduced 1/31/2022, by Rep. Mary E. Flowers

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-2.03
305 ILCS 5/5-45 new

    Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services, in collaboration with the Department of Human Services, to update its eligibility verification and enrollment processing system to allow for the automatic enrollment of all eligible uninsured childless adults into the medical assistance program. Provides that under the updated processing system, hospitals, community-based organizations, and other entities approved by the Departments shall be authorized to screen and identify for medical assistance uninsured childless adults aged 19 or older, but younger than 65, who otherwise meet the eligibility requirements for medical assistance. Provides that a hospital, community-based organization, or other approved entity shall inform a Medicaid-eligible uninsured childless adult that the adult is presumptively eligible for medical assistance and offer to submit an electronic application for medical assistance on the adult's behalf. Requires the electronic application to be no longer than 2 pages in length as prescribed by the Department of Human Services. Requires the Department of Human Services to designate staff to receive and review completed electronic applications for medical assistance from hospitals, community-based organizations, or other approved entities. Requires the designated staff to verify, as soon as practical, the uninsured childless adult's eligibility for medical assistance based on the information provided in the adult's completed electronic application and without requesting additional information or attestations from the uninsured childless adult. Provides that the uninsured childless adult shall be enrolled in the medical assistance program upon verification of eligibility. Grants the Departments rulemaking authority. Requires the Department of Healthcare and Family Services to apply for any federal waivers or approvals necessary to implement the amendatory Act. Provides that implementation is subject to federal approval.


LRB102 21968 KTG 31095 b

 

 

A BILL FOR

 

HB5597LRB102 21968 KTG 31095 b

1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Public Aid Code is amended by
5changing Section 5-2.03 and by adding Section 5-45 as follows:
 
6    (305 ILCS 5/5-2.03)
7    Sec. 5-2.03. Presumptive eligibility. Beginning on the
8effective date of this amendatory Act of the 96th General
9Assembly and except where federal law requires presumptive
10eligibility, no adult may be presumed eligible for medical
11assistance under this Code and the Department may not cover
12any service rendered to an adult unless the adult has
13completed an application for benefits, all required
14verifications have been received, and the Department or its
15designee has found the adult eligible for the date on which
16that service was provided. Nothing in this Section shall apply
17to pregnant women, to childless adults as provided in Section
185-45, or to persons enrolled under the medical assistance
19program due to expansions approved by the federal government
20that are financed entirely by units of local government and
21federal matching funds.
22(Source: P.A. 96-1501, eff. 1-25-11; 97-687, eff. 6-14-12.)
 

 

 

HB5597- 2 -LRB102 21968 KTG 31095 b

1    (305 ILCS 5/5-45 new)
2    Sec. 5-45. Automatic enrollment; uninsured childless
3adults. The Department of Healthcare and Family Services, in
4collaboration with the Department of Human Services, shall
5update its eligibility verification and enrollment processing
6system to allow for the automatic enrollment of all eligible
7uninsured childless adults into the medical assistance
8program. Under the updated processing system, hospitals,
9community-based organizations, and other entities approved by
10the Departments shall be authorized to screen and identify for
11medical assistance uninsured childless adults aged 19 or
12older, but younger than 65, who otherwise meet the eligibility
13requirements for medical assistance under paragraph 18 of
14Section 5-2. Once a hospital, community-based organization, or
15other approved entity identifies a client as an eligible
16uninsured childless adult, the hospital, community-based
17organization, or other approved entity shall inform the adult
18that the adult is presumptively eligible for medical
19assistance and offer to submit an electronic application for
20medical assistance on the adult's behalf. The electronic
21application must be no longer than 2 pages in length as
22prescribed by the Department of Human Services. The Department
23of Human Services shall designate staff to receive and review
24completed electronic applications for medical assistance from
25hospitals, community-based organizations, or other approved
26entities. As soon as practical, the designated staff shall

 

 

HB5597- 3 -LRB102 21968 KTG 31095 b

1verify an uninsured childless adult's eligibility for medical
2assistance with the information provided in the adult's
3completed electronic application and without requesting
4additional information or attestations from the uninsured
5childless adult. Upon verification of an uninsured childless
6adult's eligibility for medical assistance, the adult shall be
7fully enrolled in the medical assistance program and receive
8coverage for the Health Benefits Service Package as that term
9is defined in subsection (m) of Section 5-1.1 of this Code.
10    The Department of Healthcare and Family Services and the
11Department of Human Services may adopt any rules necessary to
12implement the provisions of this Section. The Department of
13Healthcare and Family Services shall apply for any federal
14waivers or approvals necessary to implement this Section.
15Implementation of this Section is subject to federal approval.