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