Illinois General Assembly - Full Text of SB3415
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Full Text of SB3415  98th General Assembly


Sen. Dale A. Righter

Filed: 3/18/2014





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2    AMENDMENT NO. ______. Amend Senate Bill 3415 by replacing
3everything after the enacting clause with the following:
4    "Section 5. The Illinois Public Aid Code is amended by
5changing Sections 11-5.2 and 11-5.3 as follows:
6    (305 ILCS 5/11-5.2)
7    Sec. 11-5.2. Income, Residency, and Identity Verification
8System. The General Assembly finds that the Department of Human
9Services has made every reasonable effort to utilize State
10employees to perform eligibility determinations and
11redeterminations on applicants and recipients of assistance
12provided under Article V of this Code. However, the General
13Assembly declares that there exist conditions in the State that
14require the Department of Healthcare and Family Services to
15procure a vendor to verify eligibility.
16    (a) The Department shall ensure that its proposed



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1integrated eligibility system shall include the computerized
2functions of income, residency, and identity eligibility
3verification to verify eligibility, eliminate duplication of
4medical assistance, and deter fraud. The Governor or his or her
5designee shall meet with the exclusive representative as that
6term is defined in the Illinois Public Labor Relations Act
7within 14 days after the effective date of this amendatory Act
8of the 98th General Assembly for the purpose of discussing the
9reasons for a potential proposal to subcontract bargaining unit
10work under this Section. Beginning on the 15th day after the
11effective date of this amendatory Act of the 98th General
12Assembly, the Department of Human Services shall begin the
13process of determining whether or not labor relations between
14the State of Illinois and the Department of Human Services'
15public employees are currently governed by a collective
16bargaining agreement as authorized by the Illinois Public Labor
17Relations Act and shall make a final determination by the 16th
18day after the effective date of this amendatory Act. Until the
19integrated eligibility system is operational and in order to
20achieve greater efficiency and economy, if, after review of
21existing bargaining agreements the Department of Human
22Services determines that relations between the State of
23Illinois and the Department of Human Services' public employees
24are currently governed by a collective bargaining agreement,
25the Department shall may enter into a contract with the vendor
26selected pursuant to Section 11-5.3 as necessary to obtain the



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1electronic data matching described in this Section. This
2contract shall be exempt from the Illinois Procurement Code
3pursuant to subsection (h) of Section 1-10 of that Code.
4    Prior to fulfilling their obligations under this
5subsection, the Department of Human Services and the Department
6of Healthcare and Family Services shall comply with all notice
7and procedural requirements mandated by any labor agreement, if
8any exists.
9    Prior to issuing a request for services pursuant to their
10obligations under this subsection, the Department of Human
11Services and the Department of Healthcare and Family Services
12shall provide advance notice, which shall not be less than 45
13days, except in emergency situations, in writing, to the
14exclusive representative as that term is defined in the
15Illinois Public Labor Relations Act.
16    (b) Prior to awarding medical assistance at application
17under Article V of this Code, the Department shall, to the
18extent such databases are available to the Department, conduct
19data matches using the name, date of birth, address, and Social
20Security Number of each applicant or recipient or responsible
21relative of an applicant or recipient against the following:
22        (1) Income tax information.
23        (2) Employer reports of income and unemployment
24    insurance payment information maintained by the Department
25    of Employment Security.
26        (3) Earned and unearned income, citizenship and death,



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1    and other relevant information maintained by the Social
2    Security Administration.
3        (4) Immigration status information maintained by the
4    United States Citizenship and Immigration Services.
5        (5) Wage reporting and similar information maintained
6    by states contiguous to this State.
7        (6) Employment information maintained by the
8    Department of Employment Security in its New Hire Directory
9    database.
10        (7) Employment information maintained by the United
11    States Department of Health and Human Services in its
12    National Directory of New Hires database.
13        (8) Veterans' benefits information maintained by the
14    United States Department of Health and Human Services, in
15    coordination with the Department of Health and Human
16    Services and the Department of Veterans' Affairs, in the
17    federal Public Assistance Reporting Information System
18    (PARIS) database.
19        (9) Residency information maintained by the Illinois
20    Secretary of State.
21        (10) A database which is substantially similar to or a
22    successor of a database described in this Section that
23    contains information relevant for verifying eligibility
24    for medical assistance.
25    (c) (Blank).
26    (d) If a discrepancy results between information provided



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1by an applicant, recipient, or responsible relative and
2information contained in one or more of the databases or
3information tools listed under subsection (b) or (c) of this
4Section or subsection (c) of Section 11-5.3 and that
5discrepancy calls into question the accuracy of information
6relevant to a condition of eligibility provided by the
7applicant, recipient, or responsible relative, the Department
8or its contractor shall review the applicant's or recipient's
9case using the following procedures:
10        (1) If the information discovered under subsection (b)
11    (c) of this Section or subsection (c) of Section 11-5.3
12    does not result in the Department finding the applicant or
13    recipient ineligible for assistance under Article V of this
14    Code, the Department shall finalize the determination or
15    redetermination of eligibility.
16        (2) If the information discovered results in the
17    Department finding the applicant or recipient ineligible
18    for assistance, the Department shall provide notice as set
19    forth in Section 11-7 of this Article.
20        (3) If the information discovered is insufficient to
21    determine that the applicant or recipient is eligible or
22    ineligible, the Department shall provide written notice to
23    the applicant or recipient which shall describe in
24    sufficient detail the circumstances of the discrepancy,
25    the information or documentation required, the manner in
26    which the applicant or recipient may respond, and the



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1    consequences of failing to take action. The applicant or
2    recipient shall have 10 business days to respond.
3        (4) If the applicant or recipient does not respond to
4    the notice, the Department shall deny assistance for
5    failure to cooperate, in which case the Department shall
6    provide notice as set forth in Section 11-7. Eligibility
7    for assistance shall not be established until the
8    discrepancy has been resolved.
9        (5) If an applicant or recipient responds to the
10    notice, the Department shall determine the effect of the
11    information or documentation provided on the applicant's
12    or recipient's case and shall take appropriate action.
13    Written notice of the Department's action shall be provided
14    as set forth in Section 11-7 of this Article.
15        (6) Suspected cases of fraud shall be referred to the
16    Department's Inspector General.
17    (e) The Department shall adopt any rules necessary to
18implement this Section.
19(Source: P.A. 97-689, eff. 6-14-12; revised 11-12-13.)
20    (305 ILCS 5/11-5.3)
21    Sec. 11-5.3. Procurement of vendor to verify eligibility
22for assistance under Article V.
23    (a) No later than 70 60 days after the effective date of
24this amendatory Act of the 98th 97th General Assembly, the
25Chief Procurement Officer for General Services, in



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1consultation with the Department of Healthcare and Family
2Services, shall conduct and complete any procurement necessary
3to procure a vendor to verify eligibility for assistance under
4Article V of this Code. Such authority shall include procuring
5a vendor to assist the Chief Procurement Officer in conducting
6the procurement. The Chief Procurement Officer and the
7Department shall jointly negotiate final contract terms with a
8vendor selected by the Chief Procurement Officer. Within 30
9days of selection of an eligibility verification vendor, the
10Department of Healthcare and Family Services shall enter into a
11contract with the selected vendor. The Department of Healthcare
12and Family Services and the Department of Human Services shall
13cooperate with and provide any information requested by the
14Chief Procurement Officer to conduct the procurement.
15    (b) Notwithstanding any other provision of law, any
16procurement or contract necessary to comply with this Section
17shall be exempt from: (i) the Illinois Procurement Code
18pursuant to Section 1-10(h) of the Illinois Procurement Code,
19except that bidders shall comply with the disclosure
20requirement in Sections 50-10.5(a) through (d), 50-13, 50-35,
21and 50-37 of the Illinois Procurement Code and a vendor awarded
22a contract under this Section shall comply with Section 50-37
23of the Illinois Procurement Code; (ii) any administrative rules
24of this State pertaining to procurement or contract formation;
25and (iii) any State or Department policies or procedures
26pertaining to procurement, contract formation, contract award,



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1and Business Enterprise Program approval.
2    (c) Upon becoming operational, the contractor shall
3conduct data matches using the name, date of birth, address,
4and Social Security Number of each applicant and recipient
5against public records to verify eligibility. The contractor,
6upon preliminary determination that an enrollee is eligible or
7ineligible, shall notify the Department, except that the
8contractor shall not make preliminary determinations regarding
9the eligibility of persons residing in long term care
10facilities whose income and resources were at or below the
11applicable financial eligibility standards at the time of their
12last review. Within 20 business days of such notification, the
13Department shall accept the recommendation or reject it with a
14stated reason. The Department shall retain final authority over
15eligibility determinations. The contractor shall keep a record
16of all preliminary determinations of ineligibility
17communicated to the Department. Within 30 days of the end of
18each calendar quarter, the Department and contractor shall file
19a joint report on a quarterly basis to the Governor, the
20Speaker of the House of Representatives, the Minority Leader of
21the House of Representatives, the Senate President, and the
22Senate Minority Leader. The report shall include, but shall not
23be limited to, monthly recommendations of preliminary
24determinations of eligibility or ineligibility communicated by
25the contractor, the actions taken on those preliminary
26determinations by the Department, and the stated reasons for



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1those recommendations that the Department rejected.
2    (d) An eligibility verification vendor contract shall be
3awarded for an initial 2-year period with up to a maximum of 2
4one-year renewal options. Nothing in this Section shall compel
5the award of a contract to a vendor that fails to meet the
6needs of the Department. A contract with a vendor to assist in
7the procurement shall be awarded for a period of time not to
8exceed 6 months.
9    (e) The provisions of this Section shall be administered in
10compliance with federal law.
11(Source: P.A. 97-689, eff. 6-14-12; 98-104, eff. 7-22-13.)
12    Section 99. Effective date. This Act takes effect upon
13becoming law.".