97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB1470

 

Introduced , by Rep. Thomas Holbrook

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-1.2

    Amends the Medical Assistance Article of the Illinois Public Aid Code. In regards to all changes in status of Medicaid recipients residing in Illinois nursing facilities, requires the Department of Healthcare and Family Services to report to the appropriation committees of both chambers hearing the agency's budget on the status of implementation, estimates of the cost of full implementation and recommendations for compliance no later than January 1, 2012. Effective immediately.


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A BILL FOR

 

HB1470LRB097 06486 KTG 46569 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 5-1.2 as follows:
 
6    (305 ILCS 5/5-1.2)
7    Sec. 5-1.2. Recipient eligibility verification.
8    (a) The Illinois Department shall initiate a statewide
9system by which providers and sites of medical care can
10electronically verify recipient eligibility for aid under this
11Article. High-volume providers and sites of medical care, as
12defined by the Illinois Department by rule, shall be required
13to participate in the eligibility verification system. Every
14non-high-volume provider and site of medical care shall be
15afforded the opportunity to participate in the eligibility
16verification system. The Illinois Department shall provide by
17rule for implementation of the system, which may be
18accomplished in phases over time and by geographic region,
19recipient classification, and provider type. The system shall
20initially be implemented in, but not limited to, the following
21zip codes in Cook County: 60601, 60602, 60603, 60604, 60605,
2260606, 60607, 60608, 60609, 60612, and 60616. The system shall
23be implemented within 6 months after approval by the federal

 

 

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1government. The Illinois Department shall report to the General
2Assembly by December 31, 1994 on the status of the Illinois
3Department's application to the federal government for
4approval of this system. The recipient eligibility
5verification system may be coordinated with the Electronic
6Benefits Transfer system established by Section 11-3.1 of this
7Code and compatible with any of the methods for the delivery of
8medical care and services authorized by this Article. The
9system shall make available to providers the history of claims
10for medical services submitted to the Illinois Department for
11those services provided to the recipient. The Illinois
12Department shall develop safeguards to protect each
13recipient's health information from misuse or unauthorized
14disclosure.
15    (b) The Illinois Department shall conduct a demonstration
16project in at least 2 geographic locations for the purpose of
17assessing the effectiveness of a recipient photo
18identification card in reducing abuses in the provision of
19services under this Article. In order to receive medical care,
20recipients included in this demonstration project must present
21a Medicaid card and photo identification card. The Illinois
22Department shall apply for any federal waivers or approvals
23necessary to conduct this demonstration project. The
24demonstration project shall become operational (i) 12 months
25after the effective date of this amendatory Act of 1994 or (ii)
26after the Illinois Department's receipt of all necessary

 

 

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1federal waivers and approvals, whichever occurs later, and
2shall operate for 12 months.
3    (c) Effective October 1, 2007, all changes in status of
4Medicaid recipients residing in Illinois nursing facilities
5after initial eligibility for Medicaid has been established
6shall be reported to the Department, using an Internet-based
7electronic data interchange system, by the nursing facilities,
8except for those changes made by personnel of the Department.
9Changes reported using the Internet-based electronic data
10interchange system shall be deemed valid and shall be used as
11the basis for future Medicaid payments unless Department
12approval of the transaction is required, or until such time as
13any review or audit conducted by the State establishes that the
14information is incorrect. The Department shall report to the
15appropriation committees of both chambers hearing the agency's
16budget on the status of implementation, estimates of the cost
17of full implementation and recommendations for compliance no
18later than January 1, 2012.
19(Source: P.A. 95-458, eff. 8-27-07.)
 
20    Section 99. Effective date. This Act takes effect upon
21becoming law.