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

    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.


LRB097 04549 KTG 44588 b

 

 

A BILL FOR

 

SB0810LRB097 04549 KTG 44588 b

1    AN ACT concerning aging.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Senior Citizens and Disabled Persons
5Property Tax Relief and Pharmaceutical Assistance Act is
6amended 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
10individual who will become 65 years old during the the calendar
11year in which a claim is filed, and any surviving spouse of
12such a claimant, who at the time of death received or was
13entitled to receive a grant pursuant to this Section, which
14surviving spouse will become 65 years of age within the 24
15months immediately following the death of such claimant and
16which surviving spouse but for his or her age is otherwise
17qualified to receive a grant pursuant to this Section, and any
18disabled person whose annual household income is less than the
19income eligibility limitation, as defined in subsection (a-5)
20and whose household is liable for payment of property taxes
21accrued or has paid rent constituting property taxes accrued
22and is domiciled in this State at the time he or she files his
23or her claim is entitled to claim a grant under this Act. With

 

 

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1respect to claims filed by individuals who will become 65 years
2old during the calendar year in which a claim is filed, the
3amount of any grant to which that household is entitled shall
4be an amount equal to 1/12 of the amount to which the claimant
5would otherwise be entitled as provided in this Section,
6multiplied by the number of months in which the claimant was 65
7in the calendar year in which the claim is filed.
8    (a-5) Income eligibility limitation. For purposes of this
9Section, "income eligibility limitation" means an amount for
10grant 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
18year 2010, a household must have annual household income of
19less than $27,610 for a household containing one person; less
20than $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
23January 1, 2011, and thereafter, the foregoing household income
24eligibility limits may be changed to reflect the annual cost of
25living adjustment in Social Security and Supplemental Security
26Income benefits that are applicable to the year for which those

 

 

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1benefits are being reported as income on an application.
2    If a person files as a surviving spouse, then only his or
3her income shall be counted in determining his or her household
4income.
5    (b) Limitation. Except as otherwise provided in
6subsections (a) and (f) of this Section, the maximum amount of
7grant which a claimant is entitled to claim is the amount by
8which the property taxes accrued which were paid or payable
9during the last preceding tax year or rent constituting
10property taxes accrued upon the claimant's residence for the
11last preceding taxable year exceeds 3 1/2% of the claimant's
12household income for that year but in no event is the grant to
13exceed (i) $700 less 4.5% of household income for that year for
14those with a household income of $14,000 or less or (ii) $70 if
15household income for that year is more than $14,000.
16    (c) Public aid recipients. If household income in one or
17more months during a year includes cash assistance in excess of
18$55 per month from the Department of Healthcare and Family
19Services or the Department of Human Services (acting as
20successor to the Department of Public Aid under the Department
21of Human Services Act) which was determined under regulations
22of that Department on a measure of need that included an
23allowance for actual rent or property taxes paid by the
24recipient of that assistance, the amount of grant to which that
25household is entitled, except as otherwise provided in
26subsection (a), shall be the product of (1) the maximum amount

 

 

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1computed as specified in subsection (b) of this Section and (2)
2the ratio of the number of months in which household income did
3not include such cash assistance over $55 to the number twelve.
4If household income did not include such cash assistance over
5$55 for any months during the year, the amount of the grant to
6which the household is entitled shall be the maximum amount
7computed as specified in subsection (b) of this Section. For
8purposes of this paragraph (c), "cash assistance" does not
9include any amount received under the federal Supplemental
10Security Income (SSI) program.
11    (d) Joint ownership. If title to the residence is held
12jointly by the claimant with a person who is not a member of
13his or her household, the amount of property taxes accrued used
14in computing the amount of grant to which he or she is entitled
15shall be the same percentage of property taxes accrued as is
16the percentage of ownership held by the claimant in the
17residence.
18    (e) More than one residence. If a claimant has occupied
19more than one residence in the taxable year, he or she may
20claim only one residence for any part of a month. In the case
21of property taxes accrued, he or she shall prorate 1/12 of the
22total property taxes accrued on his or her residence to each
23month that he or she owned and occupied that residence; and, in
24the case of rent constituting property taxes accrued, shall
25prorate each month's rent payments to the residence actually
26occupied during that month.

 

 

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1    (f) (Blank).
2    (g) Effective January 1, 2006, there is hereby established
3a program of pharmaceutical assistance to the aged and
4disabled, entitled the Illinois Seniors and Disabled Drug
5Coverage Program, which shall be administered by the Department
6of Healthcare and Family Services and the Department on Aging
7in accordance with this subsection, to consist of coverage of
8specified prescription drugs on behalf of beneficiaries of the
9program as set forth in this subsection.
10    To become a beneficiary under the program established under
11this 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
9rules such that on January 1, 2011, and thereafter, the
10foregoing household income eligibility limits may be changed to
11reflect the annual cost of living adjustment in Social Security
12and Supplemental Security Income benefits that are applicable
13to the year for which those benefits are being reported as
14income on an application.
15    All individuals enrolled as of December 31, 2005, in the
16pharmaceutical assistance program operated pursuant to
17subsection (f) of this Section and all individuals enrolled as
18of December 31, 2005, in the SeniorCare Medicaid waiver program
19operated pursuant to Section 5-5.12a of the Illinois Public Aid
20Code shall be automatically enrolled in the program established
21by this subsection for the first year of operation without the
22need for further application, except that they must apply for
23Medicare Part D and the Low Income Subsidy under Medicare Part
24D. A person enrolled in the pharmaceutical assistance program
25operated pursuant to subsection (f) of this Section as of
26December 31, 2005, shall not lose eligibility in future years

 

 

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1due only to the fact that they have not reached the age of 65.
2    To the extent permitted by federal law, the Department may
3act as an authorized representative of a beneficiary in order
4to enroll the beneficiary in a Medicare Part D Prescription
5Drug Plan if the beneficiary has failed to choose a plan and,
6where possible, to enroll beneficiaries in the low-income
7subsidy program under Medicare Part D or assist them in
8enrolling in that program.
9    Beneficiaries under the program established under this
10subsection shall be divided into the following 4 eligibility
11groups:
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
16the cost of covered prescription drugs in excess of the
17beneficiary cost-sharing amounts set forth in this paragraph
18that are not covered by Medicare. In 2006, beneficiaries shall
19pay a co-payment of $2 for each prescription of a generic drug
20and $5 for each prescription of a brand-name drug. In future
21years, beneficiaries shall pay co-payments equal to the
22co-payments required under Medicare Part D for "other
23low-income subsidy eligible individuals" pursuant to 42 CFR
24423.782(b). For individuals in Eligibility Groups 1, 2, and 3,
25once the program established under this subsection and Medicare
26combined have paid $1,750 in a year for covered prescription

 

 

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1drugs, the beneficiary shall pay 20% of the cost of each
2prescription in addition to the co-payments set forth in this
3paragraph. For individuals in Eligibility Group 4, once the
4program established under this subsection and Medicare
5combined have paid $1,750 in a year for covered prescription
6drugs, the beneficiary shall pay 20% of the cost of each
7prescription in addition to the co-payments set forth in this
8paragraph unless the drug is included in the formulary of the
9Illinois AIDS Drug Assistance Program operated by the Illinois
10Department of Public Health and covered by the Medicare Part D
11Prescription Drug Plan in which the beneficiary is enrolled. If
12the drug is included in the formulary of the Illinois AIDS Drug
13Assistance Program and covered by the Medicare Part D
14Prescription Drug Plan in which the beneficiary is enrolled,
15individuals in Eligibility Group 4 shall continue to pay the
16co-payments set forth in this paragraph after the program
17established under this subsection and Medicare combined have
18paid $1,750 in a year for covered prescription drugs.
19    For beneficiaries eligible for Medicare Part D coverage,
20the program established under this subsection shall pay 100% of
21the premiums charged by a qualified Medicare Part D
22Prescription Drug Plan for Medicare Part D basic prescription
23drug coverage, not including any late enrollment penalties.
24Qualified Medicare Part D Prescription Drug Plans may be
25limited by the Department of Healthcare and Family Services to
26those plans that sign a coordination agreement with the

 

 

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1Department.
2    For Notwithstanding Section 3.15, for purposes of the
3program established under this subsection, the term "covered
4prescription 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
11receive a $25 monthly payment in lieu of the direct coverage
12described in this subsection.
13    Any person otherwise eligible for pharmaceutical
14assistance under this subsection whose covered drugs are
15covered by any public program is ineligible for assistance
16under this subsection to the extent that the cost of those
17drugs is covered by the other program.
18    The Department of Healthcare and Family Services shall
19establish by rule the methods by which it will provide for the
20coverage called for in this subsection. Those methods may
21include direct reimbursement to pharmacies or the payment of a
22capitated amount to Medicare Part D Prescription Drug Plans.
23    For a pharmacy to be reimbursed under the program
24established under this subsection, it must comply with rules
25adopted by the Department of Healthcare and Family Services
26regarding coordination of benefits with Medicare Part D

 

 

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1Prescription Drug Plans. A pharmacy may not charge a
2Medicare-enrolled beneficiary of the program established under
3this subsection more for a covered prescription drug than the
4appropriate Medicare cost-sharing less any payment from or on
5behalf of the Department of Healthcare and Family Services.
6    The Department of Healthcare and Family Services or the
7Department on Aging, as appropriate, may adopt rules regarding
8applications, counting of income, proof of Medicare status,
9mandatory generic policies, and pharmacy reimbursement rates
10and any other rules necessary for the cost-efficient operation
11of the program established under this subsection.
12    (h) A qualified individual is not entitled to duplicate
13benefits in a coverage period as a result of the changes made
14by this amendatory Act of the 96th General Assembly.
15(Source: P.A. 95-208, eff. 8-16-07; 95-644, eff. 10-12-07;
1695-876, eff. 8-21-08; 96-804, eff. 1-1-10; revised 9-16-10.)