Full Text of SB1349 95th General Assembly
SB1349enr 95TH GENERAL ASSEMBLY
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SB1349 Enrolled |
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LRB095 09503 DRJ 29701 b |
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| AN ACT concerning public aid.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Section 5. The Illinois Public Aid Code is amended by | 5 |
| changing Section 5-1.2 as follows:
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| (305 ILCS 5/5-1.2)
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| Sec. 5-1.2. Recipient eligibility verification.
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| (a) The Illinois Department shall initiate a statewide | 9 |
| system by which
providers and sites of medical care can | 10 |
| electronically verify recipient
eligibility for aid under this | 11 |
| Article.
High-volume providers and sites of medical care, as | 12 |
| defined by the Illinois
Department by rule, shall be required | 13 |
| to participate in the eligibility
verification system.
Every | 14 |
| non-high-volume provider and site of medical
care shall be | 15 |
| afforded the opportunity to participate in the eligibility
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| verification system.
The Illinois Department shall provide by | 17 |
| rule for
implementation of the system, which may be | 18 |
| accomplished in phases over time and
by geographic region, | 19 |
| recipient classification, and provider type.
The system shall | 20 |
| initially be implemented in, but not limited to, the
following | 21 |
| zip codes in Cook County: 60601, 60602, 60603, 60604, 60605, | 22 |
| 60606,
60607, 60608, 60609, 60612, and 60616. The system shall | 23 |
| be implemented within
6
months after approval by the federal |
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SB1349 Enrolled |
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LRB095 09503 DRJ 29701 b |
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| government. The Illinois Department shall
report to the General | 2 |
| Assembly by December 31, 1994 on the status of the
Illinois | 3 |
| Department's application to the federal government for | 4 |
| approval of
this system.
The recipient eligibility | 5 |
| verification system may be coordinated with the
Electronic | 6 |
| Benefits Transfer system established by Section 11-3.1 of this | 7 |
| Code
and compatible with any of the methods for the delivery of | 8 |
| medical care and
services authorized by this Article.
The | 9 |
| system shall make available to providers the history of claims | 10 |
| for
medical services submitted to the Illinois Department for | 11 |
| those services
provided to the recipient. The Illinois | 12 |
| Department shall develop safeguards to
protect each | 13 |
| recipient's health information from misuse or unauthorized
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| disclosure.
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| (b) The Illinois Department shall conduct a demonstration | 16 |
| project in at
least 2 geographic locations for the purpose of | 17 |
| assessing the effectiveness of
a recipient photo | 18 |
| identification card in reducing abuses in the provision of
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| services under this Article. In order to receive medical care, | 20 |
| recipients
included in this demonstration project must present | 21 |
| a Medicaid card and photo
identification card. The Illinois | 22 |
| Department shall apply for any federal
waivers or approvals | 23 |
| necessary to conduct this demonstration project. The
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| demonstration project shall become operational (i) 12 months | 25 |
| after the
effective
date of this amendatory Act of 1994 or (ii) | 26 |
| after the Illinois Department's
receipt
of all necessary |
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LRB095 09503 DRJ 29701 b |
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| federal waivers and approvals, whichever occurs later, and
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| shall operate for 12 months.
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| (c) Effective October 1, 2007, all changes in status of | 4 |
| Medicaid recipients
residing in Illinois nursing facilities | 5 |
| after initial eligibility for
Medicaid has been established | 6 |
| shall be reported to the Department, using an
Internet-based | 7 |
| electronic data interchange system, by the nursing facilities,
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| except for those changes made by personnel of the Department. | 9 |
| Changes reported
using the Internet-based electronic data | 10 |
| interchange system shall be deemed
valid and shall be used as | 11 |
| the basis for future Medicaid payments unless
Department | 12 |
| approval of the transaction is required, or until such time as
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| any review or audit conducted by the State establishes that the
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| information is incorrect.
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| (Source: P.A. 88-554, eff. 7-26-94.)
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| Section 99. Effective date. This Act takes effect upon | 17 |
| becoming law.
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