98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014
HB4489

 

Introduced , by Rep. Patricia R. Bellock

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/11-5.2

    Amends the Illinois Public Aid Code. In a provision concerning the Department of Healthcare and Family Services' Medicaid integrated eligibility system, provides that until the system is operational the Department shall (rather than may) enter into a contract with the vendor selected as necessary to obtain certain electronic data matching. 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 Section 11-5.2 as follows:
 
6    (305 ILCS 5/11-5.2)
7    Sec. 11-5.2. Income, Residency, and Identity Verification
8System.
9    (a) The Department shall ensure that its proposed
10integrated eligibility system shall include the computerized
11functions of income, residency, and identity eligibility
12verification to verify eligibility, eliminate duplication of
13medical assistance, and deter fraud. Until the integrated
14eligibility system is operational, the Department shall may
15enter into a contract with the vendor selected pursuant to
16Section 11-5.3 as necessary to obtain the electronic data
17matching described in this Section. This contract shall be
18exempt from the Illinois Procurement Code pursuant to
19subsection (h) of Section 1-10 of that Code.
20    (b) Prior to awarding medical assistance at application
21under Article V of this Code, the Department shall, to the
22extent such databases are available to the Department, conduct
23data matches using the name, date of birth, address, and Social

 

 

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1Security Number of each applicant or recipient or responsible
2relative of an applicant or recipient against the following:
3        (1) Income tax information.
4        (2) Employer reports of income and unemployment
5    insurance payment information maintained by the Department
6    of Employment Security.
7        (3) Earned and unearned income, citizenship and death,
8    and other relevant information maintained by the Social
9    Security Administration.
10        (4) Immigration status information maintained by the
11    United States Citizenship and Immigration Services.
12        (5) Wage reporting and similar information maintained
13    by states contiguous to this State.
14        (6) Employment information maintained by the
15    Department of Employment Security in its New Hire Directory
16    database.
17        (7) Employment information maintained by the United
18    States Department of Health and Human Services in its
19    National Directory of New Hires database.
20        (8) Veterans' benefits information maintained by the
21    United States Department of Health and Human Services, in
22    coordination with the Department of Health and Human
23    Services and the Department of Veterans' Affairs, in the
24    federal Public Assistance Reporting Information System
25    (PARIS) database.
26        (9) Residency information maintained by the Illinois

 

 

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1    Secretary of State.
2        (10) A database which is substantially similar to or a
3    successor of a database described in this Section that
4    contains information relevant for verifying eligibility
5    for medical assistance.
6    (c) (Blank).
7    (d) If a discrepancy results between information provided
8by an applicant, recipient, or responsible relative and
9information contained in one or more of the databases or
10information tools listed under subsection (b) or (c) of this
11Section or subsection (c) of Section 11-5.3 and that
12discrepancy calls into question the accuracy of information
13relevant to a condition of eligibility provided by the
14applicant, recipient, or responsible relative, the Department
15or its contractor shall review the applicant's or recipient's
16case using the following procedures:
17        (1) If the information discovered under subsection (b)
18    (c) of this Section or subsection (c) of Section 11-5.3
19    does not result in the Department finding the applicant or
20    recipient ineligible for assistance under Article V of this
21    Code, the Department shall finalize the determination or
22    redetermination of eligibility.
23        (2) If the information discovered results in the
24    Department finding the applicant or recipient ineligible
25    for assistance, the Department shall provide notice as set
26    forth in Section 11-7 of this Article.

 

 

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1        (3) If the information discovered is insufficient to
2    determine that the applicant or recipient is eligible or
3    ineligible, the Department shall provide written notice to
4    the applicant or recipient which shall describe in
5    sufficient detail the circumstances of the discrepancy,
6    the information or documentation required, the manner in
7    which the applicant or recipient may respond, and the
8    consequences of failing to take action. The applicant or
9    recipient shall have 10 business days to respond.
10        (4) If the applicant or recipient does not respond to
11    the notice, the Department shall deny assistance for
12    failure to cooperate, in which case the Department shall
13    provide notice as set forth in Section 11-7. Eligibility
14    for assistance shall not be established until the
15    discrepancy has been resolved.
16        (5) If an applicant or recipient responds to the
17    notice, the Department shall determine the effect of the
18    information or documentation provided on the applicant's
19    or recipient's case and shall take appropriate action.
20    Written notice of the Department's action shall be provided
21    as set forth in Section 11-7 of this Article.
22        (6) Suspected cases of fraud shall be referred to the
23    Department's Inspector General.
24    (e) The Department shall adopt any rules necessary to
25implement this Section.
26(Source: P.A. 97-689, eff. 6-14-12; revised 11-12-13.)
 

 

 

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1    Section 99. Effective date. This Act takes effect upon
2becoming law.