Rep. Chapin Rose

Filed: 3/7/2011

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 1077

2    AMENDMENT NO. ______. Amend House Bill 1077 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Illinois Public Aid Code is amended by
5changing Section 8A-2.5 as follows:
 
6    (305 ILCS 5/8A-2.5)
7    Sec. 8A-2.5. Unauthorized use of medical assistance.
8    (a) Any person who knowingly uses, acquires, possesses, or
9transfers a medical card in any manner not authorized by law or
10by rules and regulations of the Illinois Department, or who
11knowingly alters a medical card, or who knowingly uses,
12acquires, possesses, or transfers an altered medical card, is
13guilty of a violation of this Article and shall be punished as
14provided in Section 8A-6.
15    (b) Any person who knowingly obtains unauthorized medical
16benefits with or without use of a medical card is guilty of a

 

 

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1violation of this Article and shall be punished as provided in
2Section 8A-6.
3    (c) The Department may seek to recover any and all State
4and federal monies for which it has improperly and erroneously
5paid benefits as a result of a fraudulent action and any civil
6penalties authorized in this Section. Pursuant to Section
711-14.5 of this Code, the Department may determine the monetary
8value of benefits improperly and erroneously received. The
9Department may recover the monies paid for such benefits and
10interest on that amount at the rate of 5% per annum for the
11period from which payment was made to the date upon which
12repayment is made to the State. Prior to the recovery of any
13amount paid for benefits allegedly obtained by fraudulent
14means, the recipient of such benefits shall be afforded an
15opportunity for a hearing after reasonable notice. The notice
16shall be served personally or by certified or registered mail
17or as otherwise provided by law upon the parties or their
18agents appointed to receive service of process and shall
19include the following:
20        (1) A statement of the time, place and nature of the
21    hearing.
22        (2) A statement of the legal authority and jurisdiction
23    under which the hearing is to be held.
24        (3) A reference to the particular Sections of the
25    substantive and procedural statutes and rules involved.
26        (4) Except where a more detailed statement is otherwise

 

 

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1    provided for by law, a short and plain statement of the
2    matters asserted, the consequences of a failure to respond,
3    and the official file or other reference number.
4        (5) A statement of the monetary value of the benefits
5    fraudulently received by the person accused.
6        (6) A statement that, in addition to any other
7    penalties provided by law, a civil penalty in an amount not
8    to exceed $2,000 may be imposed for each fraudulent claim
9    for benefits or payments.
10        (7) A statement providing that the determination of the
11    monetary value may be contested by petitioning the
12    Department for an administrative hearing within 30 days
13    from the date of mailing the notice.
14        (8) The names and mailing addresses of the
15    administrative law judge, all parties, and all other
16    persons to whom the agency gives notice of the hearing
17    unless otherwise confidential by law.
18    An opportunity shall be afforded all parties to be
19represented by legal counsel and to respond and present
20evidence and argument.
21    Unless precluded by law, disposition may be made of any
22contested case by stipulation, agreed settlement, consent
23order, or default.
24    Any final order, decision, or other determination made,
25issued or executed by the Director under the provisions of this
26Article whereby any person is aggrieved shall be subject to

 

 

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1review in accordance with the provisions of the Administrative
2Review Law, and the rules adopted pursuant thereto, which shall
3apply to and govern all proceedings for the judicial review of
4final administrative decisions of the Director.
5    Upon entry of a final administrative decision for repayment
6of any benefits obtained by fraudulent means, or for any civil
7penalties assessed, a lien shall attach to all property and
8assets of such person, firm, corporation, association, agency,
9institution, or other legal entity until the judgment is
10satisfied.
11    Within 18 12 months of the effective date of this
12amendatory Act of the 96th General Assembly, the Department of
13Healthcare and Family Services will report to the General
14Assembly on the number of fraud cases identified and pursued,
15and the fines assessed and collected. The report will also
16include the Department's analysis as to the use of private
17sector resources to bring action, investigate, and collect
18monies owed.
19(Source: P.A. 96-1501, eff. 1-25-11.)".