Full Text of SB0627 94th General Assembly
SB0627sam001 94TH GENERAL ASSEMBLY
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Sen. Debbie DeFrancesco Halvorson
Filed: 4/5/2006
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| AMENDMENT TO SENATE BILL 627
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| AMENDMENT NO. ______. Amend Senate Bill 627 by replacing | 3 |
| everything after the enacting clause with the following:
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| "Section 1. Short title. This Act may be cited as the | 5 |
| Veterans' Health Insurance Program Act. | 6 |
| Section 3. Legislative intent. The General Assembly finds | 7 |
| that those who have served their country honorably in military | 8 |
| service and who are residing in this State deserve access to | 9 |
| affordable, comprehensive health insurance. Many veterans are | 10 |
| uninsured, unable to afford healthcare, and reside far from a | 11 |
| medical facility of the United States Veterans' Health | 12 |
| Administration (VHA), leaving them without access to health | 13 |
| care. This lack of healthcare, including preventative care, | 14 |
| often exacerbates health conditions. The effects of lack of | 15 |
| insurance negatively impact those residents of the State who | 16 |
| are insured because the cost of paying for care to the | 17 |
| uninsured is often shifted to those who have insurance in the | 18 |
| form of higher health insurance premiums. It is, therefore, the | 19 |
| intent of this legislation to provide access to affordable | 20 |
| health insurance for veterans residing in Illinois who are | 21 |
| unable to afford such coverage. | 22 |
| Section 5. Definitions. The following words have the | 23 |
| following meanings: |
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| "Department" means the Department of Healthcare and Family | 2 |
| Services, or any successor agency. | 3 |
| "Director" means the Director of Healthcare and Family | 4 |
| Services, or any successor agency. | 5 |
| "Medical assistance" means health care benefits provided | 6 |
| under Article V of the Illinois Public Aid Code. | 7 |
| "Program" means the Veterans' Health Insurance Program. | 8 |
| "Resident" means an individual who has an Illinois | 9 |
| residence, as provided in Section 5-3 of the Illinois Public | 10 |
| Aid Code. | 11 |
| "Veteran" means any person who has served in a branch of | 12 |
| the United States military for greater than 180 consecutive | 13 |
| days after initial training. | 14 |
| "Veterans' Affairs" or "VA" means the United States | 15 |
| Department of Veterans' Affairs. | 16 |
| Section 10. Operation of the Program. The Veterans' Health | 17 |
| Insurance Program is created. As soon as practical after the | 18 |
| effective date of this Act, coverage for this Program shall | 19 |
| begin. The Program shall be administered by the Department of | 20 |
| Healthcare and Family Services in collaboration with the | 21 |
| Department of Veterans' Affairs. The Department shall have the | 22 |
| same powers and authority to administer the Program as are | 23 |
| provided to the Department in connection with the Department's | 24 |
| administration of the Illinois Public Aid Code. The Department | 25 |
| shall coordinate the Program with other health programs | 26 |
| operated by the Department and other State and federal | 27 |
| agencies. | 28 |
| Section 15. Eligibility. | 29 |
| (a) To be eligible for the Program, a person must: | 30 |
| (1) be a veteran who is not on active duty and who has | 31 |
| not been dishonorably discharged from service; | 32 |
| (2) be a resident of the State of Illinois; |
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| (3) be at least 19 years of age and no older than 64 | 2 |
| years of age; | 3 |
| (4) be uninsured, as defined by the Department by rule, | 4 |
| for a period of time established by the Department by rule, | 5 |
| which shall be no less than 6 months; | 6 |
| (5) not be eligible for medical assistance under the | 7 |
| Illinois Public Aid Code; | 8 |
| (6) reside too far from a medical facility of the VHA | 9 |
| to have reasonable access, as defined by the Department by | 10 |
| rule, to VHA healthcare; and | 11 |
| (7) have an income no greater than 100% of the federal | 12 |
| poverty level, unless the Department establishes a higher | 13 |
| or lower income threshold by rule, depending on available | 14 |
| funding for the Program. | 15 |
| (b) A veteran who is determined to be eligible for the | 16 |
| Program shall remain eligible for 12 months, provided the | 17 |
| veteran remains a resident of the State and is not excluded | 18 |
| under subsection (c) of this Section. | 19 |
| (c) A veteran is not eligible for coverage under the | 20 |
| Program if: | 21 |
| (1) the premium required under Section 35 of this Act | 22 |
| has not been timely paid; if the required premiums are not | 23 |
| paid, the liability of the Program shall be limited to | 24 |
| benefits incurred under the Program for the time period for | 25 |
| which premiums have been paid and for grace periods as | 26 |
| established under subsection (d) below; if the required | 27 |
| monthly premium is not paid, the veteran is ineligible for | 28 |
| re-enrollment for a minimum period of 3 months; or | 29 |
| (2) the veteran is a resident of a nursing facility or | 30 |
| an inmate of a public institution, as defined by 42 CFR | 31 |
| 435.1009. | 32 |
| (d) The Department shall adopt rules for the Program, | 33 |
| including, but not limited to, rules relating to eligibility, | 34 |
| re-enrollment, grace periods, notice requirements, hearing |
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| procedures, what constitutes reasonable access to healthcare, | 2 |
| cost-sharing, covered services, provider requirements, and | 3 |
| rates of payment.
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| Section 20. Notice of decisions to terminate eligibility. | 5 |
| Whenever the Department decides to either deny or terminate | 6 |
| eligibility under this Act, the veteran shall have a right to | 7 |
| notice and a hearing, as provided by the Department by rule. | 8 |
| Section 25. Illinois Department of Veterans' Affairs. The | 9 |
| Department shall coordinate with the Illinois Department of | 10 |
| Veterans' Affairs to allow State Veterans' Affairs service | 11 |
| officers to assist veterans to apply for the Program. | 12 |
| Section 30. Health care benefits. | 13 |
| (a) The Department shall purchase or provide health care | 14 |
| benefits for eligible veterans that are identical to the | 15 |
| benefits provided to adults under the State's approved plan | 16 |
| under Title XIX of the Social Security Act, except for nursing | 17 |
| facility services and non-emergency transportation. | 18 |
| (b) Providers shall be subject to approval by the | 19 |
| Department to provide health care under the Illinois Public Aid | 20 |
| Code and shall be reimbursed at the same rates as providers | 21 |
| reimbursed under the State's approved plan under Title XIX of | 22 |
| the Social Security Act. | 23 |
| (c) As an alternative to the benefits set forth in | 24 |
| subsection (a) of this Section, and when cost-effective, the | 25 |
| Department may offer veterans subsidies toward the cost of | 26 |
| privately sponsored health insurance, including | 27 |
| employer-sponsored health insurance.
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| Section 35. Cost-sharing. The Department, by rule, shall | 29 |
| set forth requirements concerning co-payments and monthly | 30 |
| premiums for health care services. This cost-sharing shall be |
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| based on income, as defined by the Department by rule, and | 2 |
| excluding federal veterans cash benefits. | 3 |
| Section 40. Charge upon claims and causes of action; right | 4 |
| of subrogation; recoveries. Sections 11-22, 11-22a, 11-22b, | 5 |
| and 11-22c of the Illinois Public Aid Code apply to health | 6 |
| benefits provided to veterans under this Act, as provided in | 7 |
| those Sections. | 8 |
| Section 45. Emergency rulemaking. The Department may adopt | 9 |
| rules necessary to establish and implement this Act through the | 10 |
| use of emergency rulemaking in accordance with Section 5-45 of | 11 |
| the Illinois Administrative Procedures Act. For the purposes of | 12 |
| that Act, the General Assembly finds that the adoption of rules | 13 |
| to implement this Act is deemed an emergency and necessary for | 14 |
| the public interest, safety, and welfare. | 15 |
| Section 50. The Illinois Public Aid Code is amended by | 16 |
| changing Sections 11-22, 11-22a, 11-22b, and 11-22c as follows:
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| (305 ILCS 5/11-22) (from Ch. 23, par. 11-22)
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| (Text of Section after amendment by P.A. 94-693 )
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| Sec. 11-22. Charge upon claims and causes of action for | 20 |
| injuries. The Illinois Department shall have a charge upon all | 21 |
| claims, demands and
causes of action for injuries to an | 22 |
| applicant for or recipient of (i)
financial aid under Articles | 23 |
| III, IV, and V ,
or (ii) health care benefits provided under the | 24 |
| Covering ALL KIDS Health Insurance Act , or (iii) health care | 25 |
| benefits provided under the Veterans' Health Insurance Program | 26 |
| Act for the total
amount of
medical assistance provided the | 27 |
| recipient from the time of injury to the
date of recovery upon | 28 |
| such claim, demand or cause of action. In addition, if
the | 29 |
| applicant or recipient was employable, as defined by the | 30 |
| Department, at
the time of the injury, the Department shall |
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| also have a charge upon any
such claims, demands and causes of | 2 |
| action for the total amount of aid
provided to the recipient | 3 |
| and his
dependents, including all cash assistance and medical | 4 |
| assistance
only to the extent includable in the claimant's | 5 |
| action, from the
time of injury to the date of recovery upon | 6 |
| such
claim, demand or cause of action. Any definition of | 7 |
| "employable"
adopted by the Department shall apply only to | 8 |
| persons above the age of
compulsory school attendance.
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| If the injured person was employable at the time of the | 10 |
| injury and is
provided aid under Articles III, IV, or V and any | 11 |
| dependent or
member of his family is provided aid under Article | 12 |
| VI, or vice versa,
both the Illinois Department and the local | 13 |
| governmental unit shall have
a charge upon such claims, demands | 14 |
| and causes of action for the aid
provided to the injured person | 15 |
| and any
dependent member of his family, including all cash | 16 |
| assistance, medical
assistance and food stamps, from the time | 17 |
| of the injury to the date
of recovery.
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| "Recipient", as used herein, means (i) in the case of | 19 |
| financial aid provided under this Code, the grantee of record | 20 |
| and any
persons whose needs are included in the financial aid | 21 |
| provided to the
grantee of record or otherwise met by grants | 22 |
| under the appropriate
Article of this Code for which such | 23 |
| person is eligible ,
and (ii) in the case of health care | 24 |
| benefits provided under the Covering ALL KIDS Health Insurance | 25 |
| Act, the child to whom those benefits are provided , and (iii) | 26 |
| in the case of health care benefits provided under the | 27 |
| Veterans' Health Insurance Program Act, the veteran to whom | 28 |
| benefits are provided .
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| In each case, the notice shall be served by certified mail | 30 |
| or
registered mail, upon the party or parties against whom the | 31 |
| applicant or
recipient has a claim, demand or cause of action. | 32 |
| The notice shall
claim the charge and describe the interest the | 33 |
| Illinois Department, the
local governmental unit, or the | 34 |
| county, has in the claim, demand, or
cause of action. The |
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| charge shall attach to any verdict or judgment
entered and to | 2 |
| any money or property which may be recovered on account
of such | 3 |
| claim, demand, cause of action or suit from and after the time
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| of the service of the notice.
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| On petition filed by the Illinois Department, or by the | 6 |
| local
governmental unit or county if either is claiming a | 7 |
| charge, or by the
recipient, or by the defendant, the court, on | 8 |
| written notice to all
interested parties, may adjudicate the | 9 |
| rights of the parties and enforce
the charge. The court may | 10 |
| approve the settlement of any claim, demand
or cause of action | 11 |
| either before or after a verdict, and nothing in this
Section | 12 |
| shall be construed as requiring the actual trial or final
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| adjudication of any claim, demand or cause of action upon which | 14 |
| the
Illinois Department, the local governmental unit or county | 15 |
| has charge.
The court may determine what portion of the | 16 |
| recovery shall be paid to
the injured person and what portion | 17 |
| shall be paid to the Illinois
Department, the local | 18 |
| governmental unit or county having a charge
against the | 19 |
| recovery.
In making this determination, the court shall conduct | 20 |
| an evidentiary hearing
and shall consider competent evidence | 21 |
| pertaining
to the following matters:
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| (1) the amount of the charge sought to be enforced | 23 |
| against the recovery
when expressed as a percentage of the | 24 |
| gross amount of the recovery; the
amount of the charge | 25 |
| sought to be enforced against the recovery when expressed
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| as a percentage of the amount obtained by subtracting from | 27 |
| the gross amount
of the recovery the total attorney's fees | 28 |
| and other costs incurred by the
recipient incident to the | 29 |
| recovery; and whether the Department, unit of
local | 30 |
| government or county seeking to enforce the charge against | 31 |
| the recovery
should as a matter of fairness and equity bear | 32 |
| its proportionate share of
the fees and costs incurred to | 33 |
| generate the recovery from which the charge
is sought to be | 34 |
| satisfied;
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| (2) the amount, if any, of the attorney's fees and | 2 |
| other costs incurred
by the recipient incident to the | 3 |
| recovery and paid by the recipient up to the
time of | 4 |
| recovery, and the amount of such fees and costs remaining | 5 |
| unpaid
at the time of recovery;
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| (3) the total hospital, doctor and other medical | 7 |
| expenses incurred for
care and treatment of the injury to | 8 |
| the date of recovery therefor, the portion
of such expenses | 9 |
| theretofore paid by the recipient, by insurance provided
by | 10 |
| the recipient, and by the Department, unit of local | 11 |
| government and county
seeking to enforce a charge against | 12 |
| the recovery, and the amount of such
previously incurred | 13 |
| expenses which remain unpaid at the time of recovery
and by | 14 |
| whom such incurred, unpaid expenses are to be paid;
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| (4) whether the recovery represents less than | 16 |
| substantially full
recompense
for the injury and the | 17 |
| hospital, doctor and other medical expenses incurred
to the | 18 |
| date of recovery for the care and treatment of the injury, | 19 |
| so that
reduction of the charge sought to be enforced | 20 |
| against the recovery would
not likely result in a double | 21 |
| recovery or unjust enrichment to the recipient;
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| (5) the age of the recipient and of persons dependent | 23 |
| for support upon
the recipient, the nature and permanency | 24 |
| of the recipient's injuries as
they affect not only the | 25 |
| future employability and education of the recipient
but | 26 |
| also the reasonably necessary and foreseeable future | 27 |
| material, maintenance,
medical, rehabilitative and | 28 |
| training needs of the recipient, the cost of
such | 29 |
| reasonably necessary and foreseeable future needs, and the | 30 |
| resources
available to meet such needs and pay such costs;
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| (6) the realistic ability of the recipient to repay in | 32 |
| whole or in part
the charge sought to be enforced against | 33 |
| the recovery when judged in light
of the factors enumerated | 34 |
| above.
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| The burden of producing evidence sufficient to support the | 2 |
| exercise by
the court of its discretion to reduce the amount of | 3 |
| a proven charge sought
to be enforced against the recovery | 4 |
| shall rest with the party seeking such reduction.
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| The court may reduce and apportion the Illinois
| 6 |
| Department's lien proportionate to the recovery of the | 7 |
| claimant. The court may
consider the nature and extent of the | 8 |
| injury, economic and noneconomic
loss, settlement offers, | 9 |
| comparative negligence as it applies to the case
at hand, | 10 |
| hospital costs, physician costs, and all other appropriate | 11 |
| costs.
The Illinois Department shall pay its pro rata share of | 12 |
| the attorney fees
based on the Illinois Department's lien as it | 13 |
| compares to the total
settlement agreed upon. This Section | 14 |
| shall not affect the priority of an
attorney's lien under the | 15 |
| Attorneys Lien Act. The charges of
the Illinois Department | 16 |
| described in this Section, however, shall take
priority over | 17 |
| all other liens and charges existing under the laws of the
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| State of Illinois with the exception of the attorney's lien | 19 |
| under said statute.
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| Whenever the Department or any unit of local government
has | 21 |
| a statutory charge under this Section against a recovery for | 22 |
| damages
incurred by a recipient because of its advancement of | 23 |
| any assistance, such
charge shall not be satisfied out of any | 24 |
| recovery until the attorney's claim
for fees is satisfied, | 25 |
| irrespective of whether or not an action based on
recipient's | 26 |
| claim has been filed in court.
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| This Section shall be inapplicable to any claim, demand or | 28 |
| cause of
action arising under (a) the Workers' Compensation Act | 29 |
| or the predecessor
Workers' Compensation Act
of
June 28, 1913, | 30 |
| (b) the Workers' Occupational Diseases Act or the predecessor
| 31 |
| Workers' Occupational
Diseases Act of March 16, 1936; and (c) | 32 |
| the Wrongful Death Act.
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| (Source: P.A. 94-693, eff. 7-1-06.)
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| (305 ILCS 5/11-22a) (from Ch. 23, par. 11-22a)
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| (Text of Section after amendment by P.A. 94-693 )
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| Sec. 11-22a. Right of Subrogation. To the extent of the | 4 |
| amount of (i) medical
assistance provided by the Department to | 5 |
| or on behalf of a recipient under
Article V or VI ,
or (ii) | 6 |
| health care benefits provided for a child under the Covering | 7 |
| ALL KIDS Health Insurance Act, or (iii) health care benefits | 8 |
| provided to a veteran under the Veterans' Health Insurance | 9 |
| Program Act, the Department shall be
subrogated
to any right of
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| recovery such recipient may have under the terms of any private | 11 |
| or public
health care coverage or casualty coverage, including | 12 |
| coverage under the
"Workers' Compensation Act", approved July | 13 |
| 9, 1951, as amended, or the
"Workers' Occupational Diseases | 14 |
| Act", approved July 9, 1951, as amended,
without the necessity | 15 |
| of assignment of claim or other authorization to secure
the | 16 |
| right of recovery to the Department. To enforce its subrogation | 17 |
| right, the
Department may (i) intervene or join in an action or | 18 |
| proceeding brought by the
recipient, his or her guardian, | 19 |
| personal representative, estate, dependents, or
survivors | 20 |
| against any person or public or private entity that may be | 21 |
| liable;
(ii) institute and prosecute legal proceedings against | 22 |
| any person or public or
private entity that may be liable for | 23 |
| the cost of such services; or (iii)
institute and prosecute | 24 |
| legal proceedings, to the extent necessary to reimburse
the | 25 |
| Illinois Department for its costs, against any noncustodial | 26 |
| parent who (A)
is required by court or administrative order to | 27 |
| provide insurance or other
coverage of the cost of health care | 28 |
| services for a child eligible for medical
assistance under this | 29 |
| Code and (B) has received payment from a third party for
the | 30 |
| costs of those services but has not used the payments to | 31 |
| reimburse either
the other parent or the guardian of the child | 32 |
| or the provider of the services.
| 33 |
| (Source: P.A. 94-693, eff. 7-1-06.)
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| (305 ILCS 5/11-22b) (from Ch. 23, par. 11-22b)
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| (Text of Section after amendment by P.A. 94-693 )
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| Sec. 11-22b. Recoveries.
| 4 |
| (a) As used in this Section:
| 5 |
| (1) "Carrier" means any insurer, including any private | 6 |
| company,
corporation, mutual association, trust fund, | 7 |
| reciprocal or interinsurance
exchange authorized under the | 8 |
| laws of this State to insure persons against
liability or | 9 |
| injuries caused to another and any insurer providing
benefits | 10 |
| under a policy of bodily injury liability insurance covering
| 11 |
| liability arising out of the ownership, maintenance or use of a | 12 |
| motor
vehicle which provides uninsured motorist endorsement or | 13 |
| coverage.
| 14 |
| (2) "Beneficiary" means any person or their dependents who | 15 |
| has received
benefits or will be provided benefits under this | 16 |
| Code ,
or under the Covering ALL KIDS Health Insurance Act , or | 17 |
| under the Veterans' Health Insurance Program Act
because of an | 18 |
| injury for
which another person may be liable. It includes such | 19 |
| beneficiary's guardian,
conservator or other personal | 20 |
| representative, his estate or survivors.
| 21 |
| (b) (1) When benefits are provided or will be provided to a | 22 |
| beneficiary
under this Code ,
or under the Covering ALL KIDS | 23 |
| Health Insurance Act , or under the Veterans' Health Insurance | 24 |
| Program Act because of an injury for which another person is | 25 |
| liable, or
for which a carrier is liable in accordance with the | 26 |
| provisions of any
policy of insurance issued pursuant to the | 27 |
| Illinois Insurance Code, the
Illinois Department shall have a | 28 |
| right to recover from such person or carrier
the reasonable | 29 |
| value of benefits so provided. The Attorney General may, to
| 30 |
| enforce such right, institute and prosecute legal proceedings | 31 |
| against the
third person or carrier who may be liable for the | 32 |
| injury in an appropriate
court, either in the name of the | 33 |
| Illinois Department or in the name of the
injured person, his | 34 |
| guardian, personal representative, estate, or survivors.
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| (2) The Department may:
| 2 |
| (A) compromise or settle and release any such claim | 3 |
| for benefits
provided under this Code, or
| 4 |
| (B) waive any such claims for benefits provided | 5 |
| under this Code, in
whole or in part, for the | 6 |
| convenience of the Department or if the Department
| 7 |
| determines that collection would result in undue | 8 |
| hardship upon the person who
suffered the injury or, in | 9 |
| a wrongful death action, upon the heirs of the
| 10 |
| deceased.
| 11 |
| (3) No action taken on behalf of the Department | 12 |
| pursuant to this Section
or any judgment rendered in such | 13 |
| action shall be a bar to any action upon
the claim or cause | 14 |
| of action of the beneficiary, his guardian, conservator,
| 15 |
| personal representative, estate, dependents or survivors | 16 |
| against the third
person who may be liable for the injury, | 17 |
| or shall operate to deny to the
beneficiary the recovery | 18 |
| for that portion of any damages not covered hereunder.
| 19 |
| (c) (1) When an action is brought by the Department | 20 |
| pursuant to
subsection (b), it shall be commenced within the | 21 |
| period prescribed by
Article XIII of the Code of Civil | 22 |
| Procedure.
| 23 |
| However, the Department may not commence the action | 24 |
| prior to 5 months
before the end of the applicable period | 25 |
| prescribed by Article XIII of the
Code of Civil Procedure. | 26 |
| Thirty days prior to commencing an action, the
Department | 27 |
| shall notify the beneficiary of the Department's intent to
| 28 |
| commence such an action.
| 29 |
| (2) The death of the beneficiary does not abate any | 30 |
| right of action
established by subsection (b).
| 31 |
| (3) When an action or claim is brought by persons | 32 |
| entitled to bring such
actions or assert such claims | 33 |
| against a third person who may be liable for
causing the | 34 |
| death of a beneficiary, any settlement, judgment or award
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| obtained is subject to the Department's claim for | 2 |
| reimbursement of the
benefits provided to the beneficiary | 3 |
| under this Code ,
or under the Covering ALL KIDS Health | 4 |
| Insurance Act , or under the Veterans' Health Insurance | 5 |
| Program Act .
| 6 |
| (4) When the action or claim is brought by the | 7 |
| beneficiary alone and
the beneficiary incurs a personal | 8 |
| liability to pay attorney's fees and
costs of litigation, | 9 |
| the Department's claim for reimbursement of the
benefits | 10 |
| provided to the beneficiary shall be the full amount of | 11 |
| benefits
paid on behalf of the beneficiary under this Code ,
| 12 |
| or under the Covering ALL KIDS Health Insurance Act , or | 13 |
| under the Veterans' Health Insurance Program Act less a pro | 14 |
| rata
share which represents the Department's reasonable | 15 |
| share of attorney's fees
paid by the beneficiary and that | 16 |
| portion of the cost of litigation expenses
determined by | 17 |
| multiplying by the ratio of the full amount of the
| 18 |
| expenditures of the full amount of the judgment, award or | 19 |
| settlement.
| 20 |
| (d) (1) If either the beneficiary or the Department brings | 21 |
| an action or
claim against such third party or carrier, the | 22 |
| beneficiary or the
Department shall within 30 days of filing | 23 |
| the action give to the other
written notice by personal service | 24 |
| or registered mail of the action or
claim and of the name of | 25 |
| the court in which the
action or claim is brought. Proof of | 26 |
| such notice shall be filed in such
action or claim. If an | 27 |
| action or claim is brought by either the Department
or the | 28 |
| beneficiary, the other may, at any time before trial on the | 29 |
| facts,
become a party to such action or claim or shall | 30 |
| consolidate his action or
claim with the other if brought | 31 |
| independently.
| 32 |
| (2) If an action or claim is brought by the Department | 33 |
| pursuant to
subsection (b)(1), written notice to the | 34 |
| beneficiary, guardian, personal
representative, estate or |
|
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| survivor given pursuant to this Section shall
advise him of | 2 |
| his right to intervene in the proceeding, his right to | 3 |
| obtain
a private attorney of his choice and the | 4 |
| Department's right to recover the
reasonable value of the | 5 |
| benefits provided.
| 6 |
| (e) In the event of judgment or award in a suit or claim | 7 |
| against such
third person or carrier:
| 8 |
| (1) If the action or claim is prosecuted by the | 9 |
| beneficiary alone, the
court shall first order paid from | 10 |
| any judgment or award the
reasonable litigation expenses | 11 |
| incurred in preparation and prosecution of
such action or | 12 |
| claim, together with reasonable attorney's fees, when an
| 13 |
| attorney has been retained. After payment of such expenses | 14 |
| and attorney's
fees the court shall, on the application of | 15 |
| the Department, allow
as a first lien against the amount of | 16 |
| such judgment or award the amount of
the Department's | 17 |
| expenditures for the benefit of the beneficiary under this
| 18 |
| Code ,
or under the Covering ALL KIDS Health Insurance Act , | 19 |
| or under the Veterans' Health Insurance Program Act , as | 20 |
| provided in subsection (c)(4).
| 21 |
| (2) If the action or claim is prosecuted both by the | 22 |
| beneficiary and the
Department, the court shall first order | 23 |
| paid from any judgment or
award the reasonable litigation | 24 |
| expenses incurred in preparation and
prosecution of such | 25 |
| action or claim, together with reasonable attorney's
fees | 26 |
| for plaintiffs attorneys based solely on the services | 27 |
| rendered for the
benefit of the beneficiary. After payment | 28 |
| of such expenses and attorney's
fees, the court shall apply | 29 |
| out of the balance of such judgment or award an
amount | 30 |
| sufficient to reimburse the Department the full amount of | 31 |
| benefits
paid on behalf of the beneficiary under this Code ,
| 32 |
| or under the Covering ALL KIDS Health Insurance Act , or | 33 |
| under the Veterans' Health Insurance Program Act .
| 34 |
| (f) The court shall, upon further application at any time
|
|
|
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| before the judgment or award is satisfied, allow as a further | 2 |
| lien the
amount of any expenditures of the Department in | 3 |
| payment of additional
benefits arising out of the same cause of | 4 |
| action or claim provided on
behalf of the beneficiary under | 5 |
| this Code ,
or under the Covering ALL KIDS Health Insurance Act , | 6 |
| or under the Veterans' Health Insurance Program Act , when such | 7 |
| benefits were
provided or became payable subsequent to the | 8 |
| original order.
| 9 |
| (g) No judgment, award, or settlement in any action or | 10 |
| claim by a
beneficiary to recover damages for injuries, when | 11 |
| the Department has an
interest, shall be satisfied without | 12 |
| first giving the Department notice and
a reasonable opportunity | 13 |
| to perfect and satisfy its lien.
| 14 |
| (h) When the Department has perfected a lien upon a | 15 |
| judgment or award in
favor of a beneficiary against any third | 16 |
| party for an injury for which the
beneficiary has received | 17 |
| benefits under this Code ,
or under the Covering ALL KIDS Health | 18 |
| Insurance Act , or under the Veterans' Health Insurance Program | 19 |
| Act , the Department shall be
entitled to a writ of execution as | 20 |
| lien claimant to enforce payment of said
lien against such | 21 |
| third party with interest and other accruing costs as in
the | 22 |
| case of other executions. In the event the amount of such | 23 |
| judgment or
award so recovered has been paid to the | 24 |
| beneficiary, the Department shall
be entitled to a writ of | 25 |
| execution against such beneficiary to the extent of
the | 26 |
| Department's lien, with interest and other accruing costs as in | 27 |
| the case
of other executions.
| 28 |
| (i) Except as otherwise provided in this Section, | 29 |
| notwithstanding any
other provision of law, the entire amount | 30 |
| of any settlement of the injured
beneficiary's action or claim, | 31 |
| with or without suit, is subject to the
Department's claim for | 32 |
| reimbursement of the benefits provided and any lien
filed | 33 |
| pursuant thereto to the same extent and subject to the same
| 34 |
| limitations as in Section 11-22 of this Code.
|
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| (Source: P.A. 94-693, eff. 7-1-06.)
| 2 |
| (305 ILCS 5/11-22c) (from Ch. 23, par. 11-22c)
| 3 |
| (Text of Section after amendment by P.A. 94-693 )
| 4 |
| Sec. 11-22c. (a) As used in this Section, "recipient" means | 5 |
| any person
receiving financial assistance under Article IV or | 6 |
| Article VI of this Code ,
or receiving health care benefits | 7 |
| under the Covering ALL KIDS Health Insurance Act , or receiving | 8 |
| health care benefits under the Veterans' Health Insurance | 9 |
| Program Act .
| 10 |
| (b) If a recipient maintains any suit, charge or other | 11 |
| court or
administrative action against an employer seeking back | 12 |
| pay for a period
during which the recipient received financial | 13 |
| assistance under Article IV
or Article VI of this Code ,
or | 14 |
| health care benefits under the Covering ALL KIDS Health | 15 |
| Insurance Act , or health care benefits under the Veterans' | 16 |
| Health Insurance Program Act , the recipient shall report such | 17 |
| fact to the
Department. To the extent of the amount of | 18 |
| assistance provided to or on
behalf of the recipient under | 19 |
| Article IV or Article VI ,
or health care benefits provided | 20 |
| under the Covering ALL KIDS Health Insurance Act , or health | 21 |
| care benefits provided under the Veterans' Health Insurance | 22 |
| Program Act , the Department may
by intervention or otherwise | 23 |
| without the necessity of assignment of claim,
attach a lien on | 24 |
| the recovery of back wages equal to the amount of
assistance | 25 |
| provided by the Department to the recipient under Article IV or
| 26 |
| Article VI ,
or under the Covering ALL KIDS Health Insurance | 27 |
| Act , or under the Veterans' Health Insurance Program Act .
| 28 |
| (Source: P.A. 94-693, eff. 7-1-06.)
| 29 |
| Section 97. Severability. The provisions of this Act are | 30 |
| severable under Section 1.31 of the Statute on Statutes.
| 31 |
| Section 99. Effective date. This Act takes effect September |
|
|
|
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| 1 |
| 1, 2006.".
|
|