HB1077 EnrolledLRB097 05581 KTG 45643 b

1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
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
17violation of this Article and shall be punished as provided in
18Section 8A-6.
19    (c) The Department may seek to recover any and all State
20and federal monies for which it has improperly and erroneously
21paid benefits as a result of a fraudulent action and any civil
22penalties authorized in this Section. Pursuant to Section
2311-14.5 of this Code, the Department may determine the monetary

 

 

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1value of benefits improperly and erroneously received. The
2Department may recover the monies paid for such benefits and
3interest on that amount at the rate of 5% per annum for the
4period from which payment was made to the date upon which
5repayment is made to the State. Prior to the recovery of any
6amount paid for benefits allegedly obtained by fraudulent
7means, the recipient of such benefits shall be afforded an
8opportunity for a hearing after reasonable notice. The notice
9shall be served personally or by certified or registered mail
10or as otherwise provided by law upon the parties or their
11agents appointed to receive service of process and shall
12include the following:
13        (1) A statement of the time, place and nature of the
14    hearing.
15        (2) A statement of the legal authority and jurisdiction
16    under which the hearing is to be held.
17        (3) A reference to the particular Sections of the
18    substantive and procedural statutes and rules involved.
19        (4) Except where a more detailed statement is otherwise
20    provided for by law, a short and plain statement of the
21    matters asserted, the consequences of a failure to respond,
22    and the official file or other reference number.
23        (5) A statement of the monetary value of the benefits
24    fraudulently received by the person accused.
25        (6) A statement that, in addition to any other
26    penalties provided by law, a civil penalty in an amount not

 

 

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1    to exceed $2,000 may be imposed for each fraudulent claim
2    for benefits or payments.
3        (7) A statement providing that the determination of the
4    monetary value may be contested by petitioning the
5    Department for an administrative hearing within 30 days
6    from the date of mailing the notice.
7        (8) The names and mailing addresses of the
8    administrative law judge, all parties, and all other
9    persons to whom the agency gives notice of the hearing
10    unless otherwise confidential by law.
11    An opportunity shall be afforded all parties to be
12represented by legal counsel and to respond and present
13evidence and argument.
14    Unless precluded by law, disposition may be made of any
15contested case by stipulation, agreed settlement, consent
16order, or default.
17    Any final order, decision, or other determination made,
18issued or executed by the Director under the provisions of this
19Article whereby any person is aggrieved shall be subject to
20review in accordance with the provisions of the Administrative
21Review Law, and the rules adopted pursuant thereto, which shall
22apply to and govern all proceedings for the judicial review of
23final administrative decisions of the Director.
24    Upon entry of a final administrative decision for repayment
25of any benefits obtained by fraudulent means, or for any civil
26penalties assessed, a lien shall attach to all property and

 

 

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1assets of such person, firm, corporation, association, agency,
2institution, or other legal entity until the judgment is
3satisfied.
4    Within 18 12 months of the effective date of this
5amendatory Act of the 96th General Assembly, the Department of
6Healthcare and Family Services will report to the General
7Assembly on the number of fraud cases identified and pursued,
8and the fines assessed and collected. The report will also
9include the Department's analysis as to the use of private
10sector resources to bring action, investigate, and collect
11monies owed.
12(Source: P.A. 96-1501, eff. 1-25-11.)