Full Text of SB0810 97th General Assembly
SB0810 97TH GENERAL ASSEMBLY |
| | 97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012 SB0810 Introduced 2/8/2011, by Sen. John J. Cullerton SYNOPSIS AS INTRODUCED: | | 320 ILCS 25/4 | from Ch. 67 1/2, par. 404 |
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Amends the Senior Citizens and Disabled Persons Property Tax Relief and
Pharmaceutical Assistance Act. Makes a technical change in a Section concerning
the amount of the grant.
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| | A BILL FOR |
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| 1 | | AN ACT concerning aging.
| 2 | | Be it enacted by the People of the State of Illinois, | 3 | | represented in the General Assembly:
| 4 | | Section 5. The Senior Citizens and Disabled Persons | 5 | | Property Tax Relief and
Pharmaceutical Assistance Act is | 6 | | amended by changing Section 4 as follows:
| 7 | | (320 ILCS 25/4) (from Ch. 67 1/2, par. 404)
| 8 | | Sec. 4. Amount of Grant.
| 9 | | (a) In general. Any individual 65 years or older or any | 10 | | individual who will
become 65 years old during the
the calendar | 11 | | year in which a claim is filed, and any
surviving spouse of | 12 | | such a claimant, who at the time of death received or was
| 13 | | entitled to receive a grant pursuant to this Section, which | 14 | | surviving spouse
will become 65 years of age within the 24 | 15 | | months immediately following the
death of such claimant and | 16 | | which surviving spouse but for his or her age is
otherwise | 17 | | qualified to receive a grant pursuant to this Section, and any
| 18 | | disabled person whose annual household income is less than the | 19 | | income eligibility limitation, as defined in subsection (a-5)
| 20 | | and whose household is liable for payment of property taxes | 21 | | accrued or has
paid rent constituting property taxes accrued | 22 | | and is domiciled in this State
at the time he or she files his | 23 | | or her claim is entitled to claim a
grant under this Act.
With |
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| 1 | | respect to claims filed by individuals who will become 65 years | 2 | | old
during the calendar year in which a claim is filed, the | 3 | | amount of any grant
to which that household is entitled shall | 4 | | be an amount equal to 1/12 of the
amount to which the claimant | 5 | | would otherwise be entitled as provided in
this Section, | 6 | | multiplied by the number of months in which the claimant was
65 | 7 | | in the calendar year in which the claim is filed. | 8 | | (a-5) Income eligibility limitation. For purposes of this | 9 | | Section, "income eligibility limitation" means an amount for | 10 | | grant years 2008 and thereafter: | 11 | | (1) less than $22,218 for a household containing one | 12 | | person; | 13 | | (2) less than $29,480 for a household containing 2 | 14 | | persons; or | 15 | | (3) less than $36,740 for a
household containing 3 or | 16 | | more persons. | 17 | | For 2009 claim year applications submitted during calendar | 18 | | year 2010, a household must have annual household income of | 19 | | less than $27,610 for a household containing one person; less | 20 | | than $36,635 for a household containing 2 persons; or less than | 21 | | $45,657 for a household containing 3 or more persons. | 22 | | The Department on Aging may adopt rules such that on | 23 | | January 1, 2011, and thereafter, the foregoing household income | 24 | | eligibility limits may be changed to reflect the annual cost of | 25 | | living adjustment in Social Security and Supplemental Security | 26 | | Income benefits that are applicable to the year for which those |
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| 1 | | benefits are being reported as income on an application. | 2 | | If a person files as a surviving spouse, then only his or | 3 | | her income shall be counted in determining his or her household | 4 | | income. | 5 | | (b) Limitation. Except as otherwise provided in | 6 | | subsections (a) and (f)
of this Section, the maximum amount of | 7 | | grant which a claimant is
entitled to claim is the amount by | 8 | | which the property taxes accrued which
were paid or payable | 9 | | during the last preceding tax year or rent
constituting | 10 | | property taxes accrued upon the claimant's residence for the
| 11 | | last preceding taxable year exceeds 3 1/2% of the claimant's | 12 | | household
income for that year but in no event is the grant to | 13 | | exceed (i) $700 less
4.5% of household income for that year for | 14 | | those with a household income of
$14,000 or less or (ii) $70 if | 15 | | household income for that year is more than
$14,000.
| 16 | | (c) Public aid recipients. If household income in one or | 17 | | more
months during a year includes cash assistance in excess of | 18 | | $55 per month
from the Department of Healthcare and Family | 19 | | Services or the Department of Human Services (acting
as | 20 | | successor to the Department of Public Aid under the Department | 21 | | of Human
Services Act) which was determined under regulations | 22 | | of
that Department on a measure of need that included an | 23 | | allowance for actual
rent or property taxes paid by the | 24 | | recipient of that assistance, the amount
of grant to which that | 25 | | household is entitled, except as otherwise provided in
| 26 | | subsection (a), shall be the product of (1) the maximum amount |
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| 1 | | computed as
specified in subsection (b) of this Section and (2) | 2 | | the ratio of the number of
months in which household income did | 3 | | not include such cash assistance over $55
to the number twelve. | 4 | | If household income did not include such cash assistance
over | 5 | | $55 for any months during the year, the amount of the grant to | 6 | | which the
household is entitled shall be the maximum amount | 7 | | computed as specified in
subsection (b) of this Section. For | 8 | | purposes of this paragraph (c), "cash
assistance" does not | 9 | | include any amount received under the federal Supplemental
| 10 | | Security Income (SSI) program.
| 11 | | (d) Joint ownership. If title to the residence is held | 12 | | jointly by
the claimant with a person who is not a member of | 13 | | his or her household,
the amount of property taxes accrued used | 14 | | in computing the amount of grant
to which he or she is entitled | 15 | | shall be the same percentage of property
taxes accrued as is | 16 | | the percentage of ownership held by the claimant in the
| 17 | | residence.
| 18 | | (e) More than one residence. If a claimant has occupied | 19 | | more than
one residence in the taxable year, he or she may | 20 | | claim only one residence
for any part of a month. In the case | 21 | | of property taxes accrued, he or she
shall prorate 1/12 of the | 22 | | total property taxes accrued on
his or her residence to each | 23 | | month that he or she owned and occupied
that residence; and, in | 24 | | the case of rent constituting property taxes accrued,
shall | 25 | | prorate each month's rent payments to the residence
actually | 26 | | occupied during that month.
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| 1 | | (f) (Blank).
| 2 | | (g) Effective January 1, 2006, there is hereby established | 3 | | a program of pharmaceutical assistance to the aged and | 4 | | disabled, entitled the Illinois Seniors and Disabled Drug | 5 | | Coverage Program, which shall be administered by the Department | 6 | | of Healthcare and Family Services and the Department on Aging | 7 | | in accordance with this subsection, to consist of coverage of | 8 | | specified prescription drugs on behalf of beneficiaries of the | 9 | | program as set forth in this subsection. | 10 | | To become a beneficiary under the program established under | 11 | | this subsection, a person must: | 12 | | (1) be (i) 65 years of age or older or (ii) disabled; | 13 | | and | 14 | | (2) be domiciled in this State; and | 15 | | (3) enroll with a qualified Medicare Part D | 16 | | Prescription Drug Plan if eligible and apply for all | 17 | | available subsidies under Medicare Part D; and | 18 | | (4) for the 2006 and 2007 claim years, have a maximum | 19 | | household income of (i) less than $21,218 for a household | 20 | | containing one person, (ii) less than $28,480 for a | 21 | | household containing 2 persons, or (iii) less than $35,740 | 22 | | for a household containing 3 or more persons; and | 23 | | (5) for the 2008 claim year, have a maximum household | 24 | | income of (i) less than $22,218 for a household containing | 25 | | one person, (ii) $29,480 for a household containing 2 | 26 | | persons, or (iii) $36,740 for a household containing 3 or |
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| 1 | | more persons; and | 2 | | (6) for 2009 claim year applications submitted during | 3 | | calendar year 2010, have annual household income of less | 4 | | than (i) $27,610 for a household containing one person; | 5 | | (ii) less than $36,635 for a household containing 2 | 6 | | persons; or (iii) less than $45,657 for a household | 7 | | containing 3 or more persons. | 8 | | The Department of Healthcare and Family Services may adopt | 9 | | rules such that on January 1, 2011, and thereafter, the | 10 | | foregoing household income eligibility limits may be changed to | 11 | | reflect the annual cost of living adjustment in Social Security | 12 | | and Supplemental Security Income benefits that are applicable | 13 | | to the year for which those benefits are being reported as | 14 | | income on an application. | 15 | | All individuals enrolled as of December 31, 2005, in the | 16 | | pharmaceutical assistance program operated pursuant to | 17 | | subsection (f) of this Section and all individuals enrolled as | 18 | | of December 31, 2005, in the SeniorCare Medicaid waiver program | 19 | | operated pursuant to Section 5-5.12a of the Illinois Public Aid | 20 | | Code shall be automatically enrolled in the program established | 21 | | by this subsection for the first year of operation without the | 22 | | need for further application, except that they must apply for | 23 | | Medicare Part D and the Low Income Subsidy under Medicare Part | 24 | | D. A person enrolled in the pharmaceutical assistance program | 25 | | operated pursuant to subsection (f) of this Section as of | 26 | | December 31, 2005, shall not lose eligibility in future years |
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| 1 | | due only to the fact that they have not reached the age of 65. | 2 | | To the extent permitted by federal law, the Department may | 3 | | act as an authorized representative of a beneficiary in order | 4 | | to enroll the beneficiary in a Medicare Part D Prescription | 5 | | Drug Plan if the beneficiary has failed to choose a plan and, | 6 | | where possible, to enroll beneficiaries in the low-income | 7 | | subsidy program under Medicare Part D or assist them in | 8 | | enrolling in that program. | 9 | | Beneficiaries under the program established under this | 10 | | subsection shall be divided into the following 4 eligibility | 11 | | groups: | 12 | | (A) Eligibility Group 1 shall consist of beneficiaries | 13 | | who are not eligible for Medicare Part D coverage and who
| 14 | | are: | 15 | | (i) disabled and under age 65; or | 16 | | (ii) age 65 or older, with incomes over 200% of the | 17 | | Federal Poverty Level; or | 18 | | (iii) age 65 or older, with incomes at or below | 19 | | 200% of the Federal Poverty Level and not eligible for | 20 | | federally funded means-tested benefits due to | 21 | | immigration status. | 22 | | (B) Eligibility Group 2 shall consist of beneficiaries | 23 | | who are eligible for Medicare Part D coverage. | 24 | | (C) Eligibility Group 3 shall consist of beneficiaries | 25 | | age 65 or older, with incomes at or below 200% of the | 26 | | Federal Poverty Level, who are not barred from receiving |
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| 1 | | federally funded means-tested benefits due to immigration | 2 | | status and are not eligible for Medicare Part D coverage. | 3 | | If the State applies and receives federal approval for | 4 | | a waiver under Title XIX of the Social Security Act, | 5 | | persons in Eligibility Group 3 shall continue to receive | 6 | | benefits through the approved waiver, and Eligibility | 7 | | Group 3 may be expanded to include disabled persons under | 8 | | age 65 with incomes under 200% of the Federal Poverty Level | 9 | | who are not eligible for Medicare and who are not barred | 10 | | from receiving federally funded means-tested benefits due | 11 | | to immigration status. | 12 | | (D) Eligibility Group 4 shall consist of beneficiaries | 13 | | who are otherwise described in Eligibility Group 2 who have | 14 | | a diagnosis of HIV or AIDS.
| 15 | | The program established under this subsection shall cover | 16 | | the cost of covered prescription drugs in excess of the | 17 | | beneficiary cost-sharing amounts set forth in this paragraph | 18 | | that are not covered by Medicare. In 2006, beneficiaries shall | 19 | | pay a co-payment of $2 for each prescription of a generic drug | 20 | | and $5 for each prescription of a brand-name drug. In future | 21 | | years, beneficiaries shall pay co-payments equal to the | 22 | | co-payments required under Medicare Part D for "other | 23 | | low-income subsidy eligible individuals" pursuant to 42 CFR | 24 | | 423.782(b). For individuals in Eligibility Groups 1, 2, and 3, | 25 | | once the program established under this subsection and Medicare | 26 | | combined have paid $1,750 in a year for covered prescription |
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| 1 | | drugs, the beneficiary shall pay 20% of the cost of each | 2 | | prescription in addition to the co-payments set forth in this | 3 | | paragraph. For individuals in Eligibility Group 4, once the | 4 | | program established under this subsection and Medicare | 5 | | combined have paid $1,750 in a year for covered prescription | 6 | | drugs, the beneficiary shall pay 20% of the cost of each | 7 | | prescription in addition to the co-payments set forth in this | 8 | | paragraph unless the drug is included in the formulary of the | 9 | | Illinois AIDS Drug Assistance Program operated by the Illinois | 10 | | Department of Public Health and covered by the Medicare Part D | 11 | | Prescription Drug Plan in which the beneficiary is enrolled. If | 12 | | the drug is included in the formulary of the Illinois AIDS Drug | 13 | | Assistance Program and covered by the Medicare Part D | 14 | | Prescription Drug Plan in which the beneficiary is enrolled, | 15 | | individuals in Eligibility Group 4 shall continue to pay the | 16 | | co-payments set forth in this paragraph after the program | 17 | | established under this subsection and Medicare combined have | 18 | | paid $1,750 in a year for covered prescription drugs.
| 19 | | For beneficiaries eligible for Medicare Part D coverage, | 20 | | the program established under this subsection shall pay 100% of | 21 | | the premiums charged by a qualified Medicare Part D | 22 | | Prescription Drug Plan for Medicare Part D basic prescription | 23 | | drug coverage, not including any late enrollment penalties. | 24 | | Qualified Medicare Part D Prescription Drug Plans may be | 25 | | limited by the Department of Healthcare and Family Services to | 26 | | those plans that sign a coordination agreement with the |
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| 1 | | Department. | 2 | | For
Notwithstanding Section 3.15, for purposes of the | 3 | | program established under this subsection, the term "covered | 4 | | prescription drug" has the following meanings: | 5 | | For Eligibility Group 1, "covered prescription drug" | 6 | | means: (1) any cardiovascular agent or drug; (2) any | 7 | | insulin or other prescription drug used in the treatment of | 8 | | diabetes, including syringe and needles used to administer | 9 | | the insulin; (3) any prescription drug used in the | 10 | | treatment of arthritis; (4) any prescription drug used in | 11 | | the treatment of cancer; (5) any prescription drug used in | 12 | | the treatment of Alzheimer's disease; (6) any prescription | 13 | | drug used in the treatment of Parkinson's disease; (7) any | 14 | | prescription drug used in the treatment of glaucoma; (8) | 15 | | any prescription drug used in the treatment of lung disease | 16 | | and smoking-related illnesses; (9) any prescription drug | 17 | | used in the treatment of osteoporosis; and (10) any | 18 | | prescription drug used in the treatment of multiple | 19 | | sclerosis. The Department may add additional therapeutic | 20 | | classes by rule. The Department may adopt a preferred drug | 21 | | list within any of the classes of drugs described in items | 22 | | (1) through (10) of this paragraph. The specific drugs or | 23 | | therapeutic classes of covered prescription drugs shall be | 24 | | indicated by rule. | 25 | | For Eligibility Group 2, "covered prescription drug" | 26 | | means those drugs covered by the Medicare Part D |
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| 1 | | Prescription Drug Plan in which the beneficiary is | 2 | | enrolled. | 3 | | For Eligibility Group 3, "covered prescription drug" | 4 | | means those drugs covered by the Medical Assistance Program | 5 | | under Article V of the Illinois Public Aid Code. | 6 | | For Eligibility Group 4, "covered prescription drug" | 7 | | means those drugs covered by the Medicare Part D | 8 | | Prescription Drug Plan in which the beneficiary is | 9 | | enrolled. | 10 | | An individual in Eligibility Group 1, 2, 3, or 4 may opt to | 11 | | receive a $25 monthly payment in lieu of the direct coverage | 12 | | described in this subsection. | 13 | | Any person otherwise eligible for pharmaceutical | 14 | | assistance under this subsection whose covered drugs are | 15 | | covered by any public program is ineligible for assistance | 16 | | under this subsection to the extent that the cost of those | 17 | | drugs is covered by the other program. | 18 | | The Department of Healthcare and Family Services shall | 19 | | establish by rule the methods by which it will provide for the | 20 | | coverage called for in this subsection. Those methods may | 21 | | include direct reimbursement to pharmacies or the payment of a | 22 | | capitated amount to Medicare Part D Prescription Drug Plans. | 23 | | For a pharmacy to be reimbursed under the program | 24 | | established under this subsection, it must comply with rules | 25 | | adopted by the Department of Healthcare and Family Services | 26 | | regarding coordination of benefits with Medicare Part D |
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| 1 | | Prescription Drug Plans. A pharmacy may not charge a | 2 | | Medicare-enrolled beneficiary of the program established under | 3 | | this subsection more for a covered prescription drug than the | 4 | | appropriate Medicare cost-sharing less any payment from or on | 5 | | behalf of the Department of Healthcare and Family Services. | 6 | | The Department of Healthcare and Family Services or the | 7 | | Department on Aging, as appropriate, may adopt rules regarding | 8 | | applications, counting of income, proof of Medicare status, | 9 | | mandatory generic policies, and pharmacy reimbursement rates | 10 | | and any other rules necessary for the cost-efficient operation | 11 | | of the program established under this subsection. | 12 | | (h) A qualified individual is not entitled to duplicate
| 13 | | benefits in a coverage period as a result of the changes made
| 14 | | by this amendatory Act of the 96th General Assembly.
| 15 | | (Source: P.A. 95-208, eff. 8-16-07; 95-644, eff. 10-12-07; | 16 | | 95-876, eff. 8-21-08; 96-804, eff. 1-1-10; revised 9-16-10.)
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