97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB6189

 

Introduced , by Rep. Robert Rita

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/11-22  from Ch. 23, par. 11-22
305 ILCS 5/12-4.18  from Ch. 23, par. 12-4.18

    Amends the Illinois Public Aid Code. Provides that within 180 days after the effective date of this amendatory Act, the Department of Healthcare and Family Services or the Department of Human Services shall issue a Request for Proposals to contract with a vendor or vendors to enforce, collect, and effectuate the recovery of the Department's liens involving claims, demands, and causes of action for injuries to an applicant for or recipient of financial aid under Articles III, IV, and V of the Code, under the Covering ALL KIDS Health Insurance Act, or under the Veterans' Health Insurance Program Act or the Veterans' Health Insurance Program Act of 2008. Provides that the scope of work shall include assuming the right and the authority to assume responsibility for the enforcement and collection of liens; notifying appropriate parties; negotiating settlement of the liens subject to pre-approval by the Department; coordinating payment of the liens and the terms of payment; and recovering the value of the liens and releasing the liens on behalf of the Department. Expands the Department's duties to include accepting, holding, and administering in behalf of the State any loans to the Department or to the State of Illinois for public aid or any related welfare purpose. Effective immediately.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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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 Sections 11-22 and 12-4.18 as follows:
 
6    (305 ILCS 5/11-22)  (from Ch. 23, par. 11-22)
7    Sec. 11-22. Charge upon claims and causes of action for
8injuries. The Illinois Department shall have a charge upon all
9claims, demands and causes of action for injuries to an
10applicant for or recipient of (i) financial aid under Articles
11III, IV, and V, (ii) health care benefits provided under the
12Covering ALL KIDS Health Insurance Act, or (iii) health care
13benefits provided under the Veterans' Health Insurance Program
14Act or the Veterans' Health Insurance Program Act of 2008 for
15the total amount of medical assistance provided the recipient
16from the time of injury to the date of recovery upon such
17claim, demand or cause of action. In addition, if the applicant
18or recipient was employable, as defined by the Department, at
19the time of the injury, the Department shall also have a charge
20upon any such claims, demands and causes of action for the
21total amount of aid provided to the recipient and his
22dependents, including all cash assistance and medical
23assistance only to the extent includable in the claimant's

 

 

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1action, from the time of injury to the date of recovery upon
2such claim, demand or cause of action. Any definition of
3"employable" adopted by the Department shall apply only to
4persons above the age of compulsory school attendance.
5    If the injured person was employable at the time of the
6injury and is provided aid under Articles III, IV, or V and any
7dependent or member of his family is provided aid under Article
8VI, or vice versa, both the Illinois Department and the local
9governmental unit shall have a charge upon such claims, demands
10and causes of action for the aid provided to the injured person
11and any dependent member of his family, including all cash
12assistance, medical assistance and food stamps, from the time
13of the injury to the date of recovery.
14    "Recipient", as used herein, means (i) in the case of
15financial aid provided under this Code, the grantee of record
16and any persons whose needs are included in the financial aid
17provided to the grantee of record or otherwise met by grants
18under the appropriate Article of this Code for which such
19person is eligible, (ii) in the case of health care benefits
20provided under the Covering ALL KIDS Health Insurance Act, the
21child to whom those benefits are provided, and (iii) in the
22case of health care benefits provided under the Veterans'
23Health Insurance Program Act or the Veterans' Health Insurance
24Program Act of 2008, the veteran to whom benefits are provided.
25    In each case, the notice shall be served by certified mail
26or registered mail, upon the party or parties against whom the

 

 

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1applicant or recipient has a claim, demand or cause of action.
2The notice shall claim the charge and describe the interest the
3Illinois Department, the local governmental unit, or the
4county, has in the claim, demand, or cause of action. The
5charge shall attach to any verdict or judgment entered and to
6any money or property which may be recovered on account of such
7claim, demand, cause of action or suit from and after the time
8of the service of the notice.
9    On petition filed by the Illinois Department, or by the
10local governmental unit or county if either is claiming a
11charge, or by the recipient, or by the defendant, the court, on
12written notice to all interested parties, may adjudicate the
13rights of the parties and enforce the charge. The court may
14approve the settlement of any claim, demand or cause of action
15either before or after a verdict, and nothing in this Section
16shall be construed as requiring the actual trial or final
17adjudication of any claim, demand or cause of action upon which
18the Illinois Department, the local governmental unit or county
19has charge. The court may determine what portion of the
20recovery shall be paid to the injured person and what portion
21shall be paid to the Illinois Department, the local
22governmental unit or county having a charge against the
23recovery. In making this determination, the court shall conduct
24an evidentiary hearing and shall consider competent evidence
25pertaining to the following matters:
26        (1) the amount of the charge sought to be enforced

 

 

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1    against the recovery when expressed as a percentage of the
2    gross amount of the recovery; the amount of the charge
3    sought to be enforced against the recovery when expressed
4    as a percentage of the amount obtained by subtracting from
5    the gross amount of the recovery the total attorney's fees
6    and other costs incurred by the recipient incident to the
7    recovery; and whether the Department, unit of local
8    government or county seeking to enforce the charge against
9    the recovery should as a matter of fairness and equity bear
10    its proportionate share of the fees and costs incurred to
11    generate the recovery from which the charge is sought to be
12    satisfied;
13        (2) the amount, if any, of the attorney's fees and
14    other costs incurred by the recipient incident to the
15    recovery and paid by the recipient up to the time of
16    recovery, and the amount of such fees and costs remaining
17    unpaid at the time of recovery;
18        (3) the total hospital, doctor and other medical
19    expenses incurred for care and treatment of the injury to
20    the date of recovery therefor, the portion of such expenses
21    theretofore paid by the recipient, by insurance provided by
22    the recipient, and by the Department, unit of local
23    government and county seeking to enforce a charge against
24    the recovery, and the amount of such previously incurred
25    expenses which remain unpaid at the time of recovery and by
26    whom such incurred, unpaid expenses are to be paid;

 

 

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1        (4) whether the recovery represents less than
2    substantially full recompense for the injury and the
3    hospital, doctor and other medical expenses incurred to the
4    date of recovery for the care and treatment of the injury,
5    so that reduction of the charge sought to be enforced
6    against the recovery would not likely result in a double
7    recovery or unjust enrichment to the recipient;
8        (5) the age of the recipient and of persons dependent
9    for support upon the recipient, the nature and permanency
10    of the recipient's injuries as they affect not only the
11    future employability and education of the recipient but
12    also the reasonably necessary and foreseeable future
13    material, maintenance, medical, rehabilitative and
14    training needs of the recipient, the cost of such
15    reasonably necessary and foreseeable future needs, and the
16    resources available to meet such needs and pay such costs;
17        (6) the realistic ability of the recipient to repay in
18    whole or in part the charge sought to be enforced against
19    the recovery when judged in light of the factors enumerated
20    above.
21    The burden of producing evidence sufficient to support the
22exercise by the court of its discretion to reduce the amount of
23a proven charge sought to be enforced against the recovery
24shall rest with the party seeking such reduction.
25    The court may reduce and apportion the Illinois
26Department's lien proportionate to the recovery of the

 

 

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1claimant. The court may consider the nature and extent of the
2injury, economic and noneconomic loss, settlement offers,
3comparative negligence as it applies to the case at hand,
4hospital costs, physician costs, and all other appropriate
5costs. The Illinois Department shall pay its pro rata share of
6the attorney fees based on the Illinois Department's lien as it
7compares to the total settlement agreed upon. This Section
8shall not affect the priority of an attorney's lien under the
9Attorneys Lien Act. The charges of the Illinois Department
10described in this Section, however, shall take priority over
11all other liens and charges existing under the laws of the
12State of Illinois with the exception of the attorney's lien
13under said statute.
14    Whenever the Department or any unit of local government has
15a statutory charge under this Section against a recovery for
16damages incurred by a recipient because of its advancement of
17any assistance, such charge shall not be satisfied out of any
18recovery until the attorney's claim for fees is satisfied,
19irrespective of whether or not an action based on recipient's
20claim has been filed in court.
21    Within 180 days after the effective date of this amendatory
22Act of the 97th General Assembly, the Illinois Department shall
23issue a Request for Proposals to contract with a vendor or
24vendors to enforce, collect, and effectuate the recovery of the
25Department's liens as provided by this Section 11-22 on behalf
26of the Illinois Department. The scope of work shall include, at

 

 

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1a minimum and to the extent permitted by federal and State law,
2assuming the right and the authority to assume responsibility
3for the enforcement and collection of liens; notifying
4appropriate parties; negotiating settlement of the liens
5subject to pre-approval by the Illinois Department;
6coordinating payment of the liens and the terms of payment; and
7recovering the value of the liens and releasing the liens on
8behalf of the Illinois Department. The vendor or vendors may be
9paid a percentage of actual cash recovered when practical and
10subject to federal law.
11    This Section shall be inapplicable to any claim, demand or
12cause of action arising under (a) the Workers' Compensation Act
13or the predecessor Workers' Compensation Act of June 28, 1913,
14(b) the Workers' Occupational Diseases Act or the predecessor
15Workers' Occupational Diseases Act of March 16, 1936; and (c)
16the Wrongful Death Act.
17(Source: P.A. 94-693, eff. 7-1-06; 94-816, eff. 5-30-06;
1895-755, eff. 7-25-08.)
 
19    (305 ILCS 5/12-4.18)  (from Ch. 23, par. 12-4.18)
20    Sec. 12-4.18. Grants, loans, and gifts for public aid and
21related welfare purposes. Accept, hold and administer in behalf
22of the State any grant, gift or legacy of money, securities,
23loans, or property to the Illinois Department or to the State
24of Illinois for public aid or any related welfare purpose.
25    From appropriations from the Assistance to the Homeless

 

 

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1Fund, a special fund in the State treasury, which is hereby
2created, provide grants to not-for-profit organizations for
3the purpose of providing assistance to homeless persons.
4    Grants, gifts, and legacies for employment and training
5programs for public assistance clients shall be deposited into
6the Employment and Training Fund.
7    Grants, gifts, donations, and legacies for functions
8connected with the administration of any medical program
9administered by the Illinois Department shall be deposited into
10the Medical Special Purposes Trust Fund created under Section
1112-10.5.
12(Source: P.A. 92-37, eff. 7-1-01.)
 
13    Section 99. Effective date. This Act takes effect upon
14becoming law.