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Full Text of SB2047  97th General Assembly

SB2047 97TH GENERAL ASSEMBLY

  
  

 


 
97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
SB2047

 

Introduced 2/10/2011, by Sen. Carole Pankau - Kirk W. Dillard - Kyle McCarter

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 106/20
215 ILCS 106/40
215 ILCS 170/20
305 ILCS 5/8A-6  from Ch. 23, par. 8A-6

    Amends the Children's Health Insurance Program Act, the Covering ALL KIDS Health Insurance Act, and the Illinois Public Aid Code. In connection with eligibility for the KidCare and Covering ALL KIDS programs, sets an asset limit of $10,000, excluding the value of the child's residence and the value of a vehicle (other than a recreational vehicle) used for transportation. Makes changes concerning the reporting of changes in income and other circumstances that affect eligibility, and provides that a failure to report is a Class A misdemeanor with a maximum fine of $10,000 under the public assistance fraud provisions of the Illinois Public Aid Code; also provides for repayment of an amount equal to benefits that were wrongly received. Requires the Department of Healthcare and Family Services to promulgate rules necessary to implement the changes made by this amendatory Act. Further provides that the Department shall implement these rules by January 1, 2012. Makes the reporting, penalty, and rulemaking provisions also applicable to the FamilyCare program under the Children's Health Insurance Program Act. Effective immediately.


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CORRECTIONAL BUDGET AND IMPACT NOTE ACT MAY APPLY
FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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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 10. The Children's Health Insurance Program Act is
5amended by changing Sections 20 and 40 as follows:
 
6    (215 ILCS 106/20)
7    Sec. 20. Eligibility.
8    (a) To be eligible for this Program, a person must be a
9person who has a child eligible under this Act and who is
10eligible under a waiver of federal requirements pursuant to an
11application made pursuant to subdivision (a)(1) of Section 40
12of this Act or who is a child who:
13        (1) is a child who is not eligible for medical
14    assistance;
15        (2) is a child whose annual household income, as
16    determined by the Department, is above 133% of the federal
17    poverty level and at or below 200% of the federal poverty
18    level;
19        (2.5) is a child whose household assets do not exceed
20    $10,000, excluding (i) the value of the residence in which
21    the child lives and (ii) the value of a vehicle used by the
22    household for transportation purposes; for purposes of
23    this paragraph (2.5), "vehicle" does not include a

 

 

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1    recreational vehicle as defined in the Campground
2    Licensing and Recreational Area Act;
3        (3) is a resident of the State of Illinois; and
4        (4) is a child who is either a United States citizen or
5    included in one of the following categories of
6    non-citizens:
7            (A) unmarried dependent children of either a
8        United States Veteran honorably discharged or a person
9        on active military duty;
10            (B) refugees under Section 207 of the Immigration
11        and Nationality Act;
12            (C) asylees under Section 208 of the Immigration
13        and Nationality Act;
14            (D) persons for whom deportation has been withheld
15        under Section 243(h) of the Immigration and
16        Nationality Act;
17            (E) persons granted conditional entry under
18        Section 203(a)(7) of the Immigration and Nationality
19        Act as in effect prior to April 1, 1980;
20            (F) persons lawfully admitted for permanent
21        residence under the Immigration and Nationality Act;
22        and
23            (G) parolees, for at least one year, under Section
24        212(d)(5) of the Immigration and Nationality Act.
25    Those children who are in the categories set forth in
26subdivisions (4)(F) and (4)(G) of this subsection, who enter

 

 

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1the United States on or after August 22, 1996, shall not be
2eligible for 5 years beginning on the date the child entered
3the United States.
4    (b) A child who is determined to be eligible for assistance
5may remain eligible for 12 months, provided the child maintains
6his or her residence in the State, has not yet attained 19
7years of age, and is not excluded pursuant to subsection (c). A
8child who has been determined to be eligible for assistance
9must reapply or otherwise establish eligibility at least
10annually. An eligible child shall be required, as determined by
11the Department by rule, to report promptly those changes in
12income and other circumstances that affect eligibility within
1330 days after the occurrence of the change. A failure to report
14such a change to the Department within 30 days, without good
15cause, is punishable as provided in Section 8A-6 of the
16Illinois Public Aid Code. The eligibility of a child may be
17redetermined based on the information reported or may be
18terminated based on the failure to report or failure to report
19accurately. A child's responsible relative or caretaker may
20also be held liable to the Department for any payments made by
21the Department on such child's behalf that were inappropriate.
22An applicant shall be provided with notice of these
23obligations.
24    (c) A child shall not be eligible for coverage under this
25Program if:
26        (1) the premium required pursuant to Section 30 of this

 

 

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1    Act has not been paid. If the required premiums are not
2    paid the liability of the Program shall be limited to
3    benefits incurred under the Program for the time period for
4    which premiums had been paid. Re-enrollment shall be
5    completed prior to the next covered medical visit and the
6    first month's required premium shall be paid in advance of
7    the next covered medical visit. The Department shall
8    promulgate rules regarding grace periods, notice
9    requirements, and hearing procedures pursuant to this
10    subsection;
11        (2) the child is an inmate of a public institution or a
12    patient in an institution for mental diseases; or
13        (3) the child is a member of a family that is eligible
14    for health benefits covered under the State of Illinois
15    health benefits plan on the basis of a member's employment
16    with a public agency.
17    (d) The Department shall promulgate rules necessary to
18implement the changes made by this amendatory Act of the 97th
19General Assembly. The Department shall implement these rules by
20January 1, 2012.
21(Source: P.A. 96-1272, eff. 1-1-11.)
 
22    (215 ILCS 106/40)
23    Sec. 40. Waivers.
24    (a) The Department shall request any necessary waivers of
25federal requirements in order to allow receipt of federal

 

 

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1funding for:
2        (1) the coverage of families with eligible children
3    under this Act; and
4        (2) the coverage of children who would otherwise be
5    eligible under this Act, but who have health insurance.
6    (b) The failure of the responsible federal agency to
7approve a waiver for children who would otherwise be eligible
8under this Act but who have health insurance shall not prevent
9the implementation of any Section of this Act provided that
10there are sufficient appropriated funds.
11    (c) Eligibility of a person under an approved waiver due to
12the relationship with a child pursuant to Article V of the
13Illinois Public Aid Code or this Act shall be limited to such a
14person whose countable income is determined by the Department
15to be at or below such income eligibility standard as the
16Department by rule shall establish. The income level
17established by the Department shall not be below 90% of the
18federal poverty level. Such persons who are determined to be
19eligible must reapply, or otherwise establish eligibility, at
20least annually. An eligible person shall be required, as
21determined by the Department by rule, to report promptly those
22changes in income and other circumstances that affect
23eligibility to the Department within 30 days after the
24occurrence of the change. A failure to report such a change to
25the Department within 30 days, without good cause, is
26punishable as provided in Section 8A-6 of the Illinois Public

 

 

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1Aid Code. The eligibility of a person may be redetermined based
2on the information reported or may be terminated based on the
3failure to report or failure to report accurately. A person may
4also be held liable to the Department for any payments made by
5the Department on such person's behalf that were inappropriate.
6An applicant shall be provided with notice of these
7obligations.
8    (d) The Department shall promulgate rules necessary to
9implement the changes made by this amendatory Act of the 97th
10General Assembly. The Department shall implement these rules by
11January 1, 2012.
12(Source: P.A. 96-328, eff. 8-11-09.)
 
13    Section 15. The Covering ALL KIDS Health Insurance Act is
14amended by changing Section 20 as follows:
 
15    (215 ILCS 170/20)
16    (Section scheduled to be repealed on July 1, 2016)
17    Sec. 20. Eligibility.
18    (a) To be eligible for the Program, a person must be a
19child:
20        (1) who is a resident of the State of Illinois;
21        (2) who is ineligible for medical assistance under the
22    Illinois Public Aid Code or benefits under the Children's
23    Health Insurance Program Act;
24        (3) either (i) who has been without health insurance

 

 

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1    coverage for 12 months, (ii) whose parent has lost
2    employment that made available affordable dependent health
3    insurance coverage, until such time as affordable
4    employer-sponsored dependent health insurance coverage is
5    again available for the child as set forth by the
6    Department in rules, (iii) who is a newborn whose
7    responsible relative does not have available affordable
8    private or employer-sponsored health insurance, or (iv)
9    who, within one year of applying for coverage under this
10    Act, lost medical benefits under the Illinois Public Aid
11    Code or the Children's Health Insurance Program Act; and
12        (3.5) whose household income, as determined by the
13    Department, is at or below 300% of the federal poverty
14    level. This item (3.5) is effective July 1, 2011; and .
15        (4) whose household assets do not exceed $10,000,
16    excluding (i) the value of the residence in which the child
17    lives and (ii) the value of a vehicle used by the household
18    for transportation purposes; for purposes of this
19    paragraph (4), "vehicle" does not include a recreational
20    vehicle as defined in the Campground Licensing and
21    Recreational Area Act.
22    An entity that provides health insurance coverage (as
23defined in Section 2 of the Comprehensive Health Insurance Plan
24Act) to Illinois residents shall provide health insurance data
25match to the Department of Healthcare and Family Services as
26provided by and subject to Section 5.5 of the Illinois

 

 

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1Insurance Code.
2    The Department of Healthcare and Family Services, in
3collaboration with the Department of Insurance, shall adopt
4rules governing the exchange of information under this Section.
5The rules shall be consistent with all laws relating to the
6confidentiality or privacy of personal information or medical
7records, including provisions under the Federal Health
8Insurance Portability and Accountability Act (HIPAA).
9    (b) The Department shall monitor the availability and
10retention of employer-sponsored dependent health insurance
11coverage and shall modify the period described in subdivision
12(a)(3) if necessary to promote retention of private or
13employer-sponsored health insurance and timely access to
14healthcare services, but at no time shall the period described
15in subdivision (a)(3) be less than 6 months.
16    (c) The Department, at its discretion, may take into
17account the affordability of dependent health insurance when
18determining whether employer-sponsored dependent health
19insurance coverage is available upon reemployment of a child's
20parent as provided in subdivision (a)(3).
21    (d) A child who is determined to be eligible for the
22Program shall remain eligible for 12 months, provided that the
23child maintains his or her residence in this State, has not yet
24attained 19 years of age, and is not excluded under subsection
25(e). A child who has been determined to be eligible for the
26Program must reapply or otherwise establish eligibility at

 

 

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1least annually. An eligible child shall be required to report
2those changes in income and other circumstances that affect
3eligibility within 30 days after the occurrence of the change.
4A failure to report such a change to the Department within 30
5days, without good cause, is punishable as provided in Section
68A-6 of the Illinois Public Aid Code. The eligibility of a
7child may be redetermined based on the information reported or
8may be terminated based on the failure to report or failure to
9report accurately. A child's responsible relative or caretaker
10may also be held liable to the Department for any payments made
11by the Department on the child's behalf that were
12inappropriate. An applicant shall be provided with notice of
13these obligations.
14    (e) A child is not eligible for coverage under the Program
15if:
16        (1) the premium required under Section 40 has not been
17    timely paid; if the required premiums are not paid, the
18    liability of the Program shall be limited to benefits
19    incurred under the Program for the time period for which
20    premiums have been paid; re-enrollment shall be completed
21    before the next covered medical visit, and the first
22    month's required premium shall be paid in advance of the
23    next covered medical visit; or
24        (2) the child is an inmate of a public institution or
25    an institution for mental diseases.
26    (f) The Department may adopt rules, including, but not

 

 

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1limited to: rules regarding annual renewals of eligibility for
2the Program in conformance with Section 7 of this Act; rules
3providing for re-enrollment, grace periods, notice
4requirements, and hearing procedures under subdivision (e)(1)
5of this Section; and rules regarding what constitutes
6availability and affordability of private or
7employer-sponsored health insurance, with consideration of
8such factors as the percentage of income needed to purchase
9children or family health insurance, the availability of
10employer subsidies, and other relevant factors.
11    (g) Each child enrolled in the Program as of July 1, 2011
12whose family income, as established by the Department, exceeds
13300% of the federal poverty level may remain enrolled in the
14Program for 12 additional months commencing July 1, 2011.
15Continued enrollment pursuant to this subsection shall be
16available only if the child continues to meet all eligibility
17criteria established under the Program as of the effective date
18of this amendatory Act of the 96th General Assembly without a
19break in coverage. Nothing contained in this subsection shall
20prevent a child from qualifying for any other health benefits
21program operated by the Department.
22    The Department shall promulgate rules necessary to
23implement the changes made by this amendatory Act of the 97th
24General Assembly. The Department shall implement these rules by
25January 1, 2012.
26(Source: P.A. 96-1272, eff. 1-1-11; 96-1501, eff. 1-25-11.)
 

 

 

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1    Section 20. The Illinois Public Aid Code is amended by
2changing Section 8A-6 as follows:
 
3    (305 ILCS 5/8A-6)  (from Ch. 23, par. 8A-6)
4    Sec. 8A-6. Classification of violations.
5    (a) Any person, firm, corporation, association, agency,
6institution or other legal entity that has been found by a
7court to have engaged in an act, practice or course of conduct
8declared unlawful under Sections 8A-2 through 8A-5 or Section
98A-13 or 8A-14 where:
10        (1) the total amount of money involved in the
11    violation, including the monetary value of federal food
12    stamps and the value of commodities, is less than $150,
13    shall be guilty of a Class A misdemeanor;
14        (2) the total amount of money involved in the
15    violation, including the monetary value of federal food
16    stamps and the value of commodities, is $150 or more but
17    less than $1,000, shall be guilty of a Class 4 felony;
18        (3) the total amount of money involved in the
19    violation, including the monetary value of federal food
20    stamps and the value of commodities, is $1,000 or more but
21    less than $5,000, shall be guilty of a Class 3 felony;
22        (4) the total amount of money involved in the
23    violation, including the monetary value of federal food
24    stamps and the value of commodities, is $5,000 or more but

 

 

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1    less than $10,000, shall be guilty of a Class 2 felony; or
2        (5) the total amount of money involved in the
3    violation, including the monetary value of federal food
4    stamps and the value of commodities, is $10,000 or more,
5    shall be guilty of a Class 1 felony and, notwithstanding
6    the provisions of Section 8A-8 except for Subsection (c) of
7    Section 8A-8, shall be ineligible for financial aid under
8    this Article for a period of two years following conviction
9    or until the total amount of money, including the value of
10    federal food stamps, is repaid, whichever first occurs.
11    (b) Any person, firm, corporation, association, agency,
12institution or other legal entity that commits a subsequent
13violation of any of the provisions of Sections 8A-2 through
148A-5 and:
15        (1) the total amount of money involved in the
16    subsequent violation, including the monetary value of
17    federal food stamps and the value of commodities, is less
18    than $150, shall be guilty of a Class 4 felony;
19        (2) the total amount of money involved in the
20    subsequent violation, including the monetary value of
21    federal food stamps and the value of commodities, is $150
22    or more but less than $1,000, shall be guilty of a Class 3
23    felony;
24        (3) the total amount of money involved in the
25    subsequent violation, including the monetary value of
26    federal food stamps and the value of commodities, is $1,000

 

 

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1    or more but less than $5,000, shall be guilty of a Class 2
2    felony;
3        (4) the total amount of money involved in the
4    subsequent violation, including the monetary value of
5    federal food stamps and the value of commodities, is $5,000
6    or more but less than $10,000, shall be guilty of a Class 1
7    felony.
8    (c) For purposes of determining the classification of
9offense under this Section, all of the money received as a
10result of the unlawful act, practice or course of conduct can
11be accumulated.
12    (d) A failure to report a change in income or other
13circumstances to the Department of Healthcare and Family
14Services within 30 days as required under subsection (b) of
15Section 20 or subsection (c) of Section 40 of the Children's
16Health Insurance Program Act, or subsection (d) of Section 20
17of the Covering ALL KIDS Health Insurance Act, without good
18cause, is a Class A misdemeanor for which a fine not to exceed
19$10,000 may be imposed. In addition, if a person receives
20benefits under Section 20 or 40 of the Children's Health
21Insurance Program Act or Section 20 of the Covering ALL KIDS
22Health Insurance Act to which he or she was not entitled
23because of the person's failure, without good cause, to report
24a change in income or other circumstances that would have
25rendered the person ineligible for those benefits, the person
26must repay to the Department of Healthcare and Family Services

 

 

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1the amount of benefits wrongly received.
2(Source: P.A. 90-538, eff. 12-1-97.)
 
3    Section 99. Effective date. This Act takes effect upon
4becoming law.