| ||||
Public Act 097-0023 | ||||
| ||||
| ||||
AN ACT concerning public aid.
| ||||
Be it enacted by the People of the State of Illinois,
| ||||
represented in the General Assembly:
| ||||
Section 5. The Illinois Public Aid Code is amended by | ||||
changing Section 8A-2.5 as follows:
| ||||
(305 ILCS 5/8A-2.5)
| ||||
Sec. 8A-2.5. Unauthorized use of medical assistance.
| ||||
(a) Any person who knowingly uses, acquires, possesses, or | ||||
transfers a
medical card in any manner not authorized by law or | ||||
by rules and regulations of
the Illinois Department, or who | ||||
knowingly alters a medical card, or who
knowingly uses, | ||||
acquires, possesses, or transfers an altered medical card, is
| ||||
guilty of a violation of this Article and shall be punished as | ||||
provided in
Section 8A-6.
| ||||
(b) Any person who knowingly obtains unauthorized medical | ||||
benefits with or
without use of a medical card is guilty of a | ||||
violation of this Article and
shall be punished as provided in | ||||
Section 8A-6.
| ||||
(c) The Department may seek to recover any and all State | ||||
and federal monies for which it has improperly and erroneously | ||||
paid benefits as a result of a fraudulent action and any civil | ||||
penalties authorized in this Section. Pursuant to Section | ||||
11-14.5 of this Code, the Department may determine the monetary |
value of benefits improperly and erroneously received. The | ||
Department may recover the monies paid for such benefits and | ||
interest on that amount at the rate of 5% per annum for the | ||
period from which payment was made to the date upon which | ||
repayment is made to the State. Prior to the recovery of any | ||
amount paid for benefits allegedly obtained by fraudulent | ||
means, the recipient of such benefits shall be afforded an | ||
opportunity for a hearing after reasonable notice. The notice | ||
shall be served personally or by certified or registered mail | ||
or as otherwise provided by law upon the parties or their | ||
agents appointed to receive service of process and shall | ||
include the following: | ||
(1) A statement of the time, place and nature of the | ||
hearing. | ||
(2) A statement of the legal authority and jurisdiction | ||
under which the hearing is to be held. | ||
(3) A reference to the particular Sections of the | ||
substantive and procedural statutes and rules involved. | ||
(4) Except where a more detailed statement is otherwise | ||
provided for by law, a short and plain statement of the | ||
matters asserted, the consequences of a failure to respond, | ||
and the official file or other reference number. | ||
(5) A statement of the monetary value of the benefits | ||
fraudulently received by the person accused. | ||
(6) A statement that, in addition to any other | ||
penalties provided by law, a civil penalty in an amount not |
to exceed $2,000 may be imposed for each fraudulent claim | ||
for benefits or payments. | ||
(7) A statement providing that the determination of the | ||
monetary value may be contested by petitioning the | ||
Department for an administrative hearing within 30 days | ||
from the date of mailing the notice. | ||
(8) The names and mailing addresses of the | ||
administrative law judge, all parties, and all other | ||
persons to whom the agency gives notice of the hearing | ||
unless otherwise confidential by law. | ||
An opportunity shall be afforded all parties to be | ||
represented by legal counsel and to respond and present | ||
evidence and argument. | ||
Unless precluded by law, disposition may be made of any | ||
contested case by stipulation, agreed settlement, consent | ||
order, or default. | ||
Any final order, decision, or other determination made, | ||
issued or executed by the Director under the provisions of this | ||
Article whereby any person is aggrieved shall be subject to | ||
review in accordance with the provisions of the Administrative | ||
Review Law, and the rules adopted pursuant thereto, which shall | ||
apply to and govern all proceedings for the judicial review of | ||
final administrative decisions of the Director. | ||
Upon entry of a final administrative decision for repayment | ||
of any benefits obtained by fraudulent means, or for any civil | ||
penalties assessed, a lien shall attach to all property and |
assets of such person, firm, corporation, association, agency, | ||
institution, or other legal entity until the judgment is | ||
satisfied. | ||
Within 18 12 months of the effective date of this | ||
amendatory Act of the 96th General Assembly, the Department of | ||
Healthcare and Family Services will report to the General | ||
Assembly on the number of fraud cases identified and pursued, | ||
and the fines assessed and collected. The report will also | ||
include the Department's analysis as to the use of private | ||
sector resources to bring action, investigate, and collect | ||
monies owed. | ||
(Source: P.A. 96-1501, eff. 1-25-11.)
|