Public Act 096-1501
 
HB5420 EnrolledLRB096 18878 JDS 34265 b

    AN ACT concerning State government.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The State Budget Law of the Civil Administrative
Code of Illinois is amended by adding Section 50-30 as follows:
 
    (15 ILCS 20/50-30 new)
    Sec. 50-30. Long-term care rebalancing. In light of the
increasing demands confronting the State in meeting the needs
of individuals utilizing long-term care services under the
medical assistance program and any other long-term care related
benefit program administered by the State, it is the intent of
the General Assembly to address the needs of both the State and
the individuals eligible for such services by cost effective
and efficient means through the advancement of a long-term care
rebalancing initiative. Notwithstanding any State law to the
contrary, and subject to federal laws, regulations, and court
decrees, the following shall apply to the long-term care
rebalancing initiative:
        (1) "Long-term care rebalancing", as used in this
    Section, means removing barriers to community living for
    people of all ages with disabilities and long-term
    illnesses by offering individuals utilizing long-term care
    services a reasonable array of options, in particular
    adequate choices of community and institutional options,
    to achieve a balance between the proportion of total
    Medicaid long-term support expenditures used for
    institutional services and those used for community-based
    supports.
        (2) Subject to the provisions of this Section, the
    Governor shall create a unified budget report identifying
    the budgets of all State agencies offering long-term care
    services to persons in either institutional or community
    settings, including the budgets of State-operated
    facilities for persons with developmental disabilities
    that shall include, but not be limited to, the following
    service and financial data:
            (A) A breakdown of long-term care services,
        defined as institutional or community care, by the
        State agency primarily responsible for administration
        of the program.
            (B) Actual and estimated enrollment, caseload,
        service hours, or service days provided for long-term
        care services described in a consistent format for
        those services, for each of the following age groups:
        older adults 65 years of age and older, younger adults
        21 years of age through 64 years of age, and children
        under 21 years of age.
            (C) Funding sources for long-term care services.
            (D) Comparison of service and expenditure data, by
        services, both in aggregate and per person enrolled.
        (3) For each fiscal year, the unified budget report
    described in subdivision (2) shall be prepared with
    reference to the prioritized outcomes for that fiscal year
    contemplated by Sections 50-5 and 50-25 of this Code.
        (4) Each State agency responsible for the
    administration of long-term care services shall provide an
    analysis of the progress being made by the agency to
    transition persons from institutional to community
    settings, where appropriate, as part of the State's
    long-term care rebalancing initiative.
        (5) The Governor may designate amounts set aside for
    institutional services appropriated from the General
    Revenue Fund or any other State fund that receives monies
    for long-term care services to be transferred to all State
    agencies responsible for the administration of
    community-based long-term care programs, including, but
    not limited to, community-based long-term care programs
    administered by the Department of Healthcare and Family
    Services, the Department of Human Services, and the
    Department on Aging, provided that the Director of
    Healthcare and Family Services first certifies that the
    amounts being transferred are necessary for the purpose of
    assisting persons in or at risk of being in institutional
    care to transition to community-based settings, including
    the financial data needed to prove the need for the
    transfer of funds. The total amounts transferred shall not
    exceed 4% in total of the amounts appropriated from the
    General Revenue Fund or any other State fund that receives
    monies for long-term care services for each fiscal year. A
    notice of the fund transfer must be made to the General
    Assembly and posted at a minimum on the Department of
    Healthcare and Family Services website, the Governor's
    Office of Management and Budget website, and any other
    website the Governor sees fit. These postings shall serve
    as notice to the General Assembly of the amounts to be
    transferred. Notice shall be given at least 30 days prior
    to transfer.
        (6) This Section shall be liberally construed and
    interpreted in a manner that allows the State to advance
    its long-term care rebalancing initiatives.
 
    Section 10. The State Finance Act is amended by changing
Sections 13.2 and 25 as follows:
 
    (30 ILCS 105/13.2)  (from Ch. 127, par. 149.2)
    Sec. 13.2. Transfers among line item appropriations.
    (a) Transfers among line item appropriations from the same
treasury fund for the objects specified in this Section may be
made in the manner provided in this Section when the balance
remaining in one or more such line item appropriations is
insufficient for the purpose for which the appropriation was
made.
    (a-1) No transfers may be made from one agency to another
agency, nor may transfers be made from one institution of
higher education to another institution of higher education
except as provided by subsection (a-4).
    (a-2) Except as otherwise provided in this Section,
transfers may be made only among the objects of expenditure
enumerated in this Section, except that no funds may be
transferred from any appropriation for personal services, from
any appropriation for State contributions to the State
Employees' Retirement System, from any separate appropriation
for employee retirement contributions paid by the employer, nor
from any appropriation for State contribution for employee
group insurance. During State fiscal year 2005, an agency may
transfer amounts among its appropriations within the same
treasury fund for personal services, employee retirement
contributions paid by employer, and State Contributions to
retirement systems; notwithstanding and in addition to the
transfers authorized in subsection (c) of this Section, the
fiscal year 2005 transfers authorized in this sentence may be
made in an amount not to exceed 2% of the aggregate amount
appropriated to an agency within the same treasury fund. During
State fiscal year 2007, the Departments of Children and Family
Services, Corrections, Human Services, and Juvenile Justice
may transfer amounts among their respective appropriations
within the same treasury fund for personal services, employee
retirement contributions paid by employer, and State
contributions to retirement systems. During State fiscal year
2010, the Department of Transportation may transfer amounts
among their respective appropriations within the same treasury
fund for personal services, employee retirement contributions
paid by employer, and State contributions to retirement
systems. During State fiscal year 2010 only, an agency may
transfer amounts among its respective appropriations within
the same treasury fund for personal services, employee
retirement contributions paid by employer, and State
contributions to retirement systems. Notwithstanding, and in
addition to, the transfers authorized in subsection (c) of this
Section, these transfers may be made in an amount not to exceed
2% of the aggregate amount appropriated to an agency within the
same treasury fund.
    (a-3) Further, if an agency receives a separate
appropriation for employee retirement contributions paid by
the employer, any transfer by that agency into an appropriation
for personal services must be accompanied by a corresponding
transfer into the appropriation for employee retirement
contributions paid by the employer, in an amount sufficient to
meet the employer share of the employee contributions required
to be remitted to the retirement system.
    (a-4) Long-Term Care Rebalancing. The Governor may
designate amounts set aside for institutional services
appropriated from the General Revenue Fund or any other State
fund that receives monies for long-term care services to be
transferred to all State agencies responsible for the
administration of community-based long-term care programs,
including, but not limited to, community-based long-term care
programs administered by the Department of Healthcare and
Family Services, the Department of Human Services, and the
Department on Aging, provided that the Director of Healthcare
and Family Services first certifies that the amounts being
transferred are necessary for the purpose of assisting persons
in or at risk of being in institutional care to transition to
community-based settings, including the financial data needed
to prove the need for the transfer of funds. The total amounts
transferred shall not exceed 4% in total of the amounts
appropriated from the General Revenue Fund or any other State
fund that receives monies for long-term care services for each
fiscal year. A notice of the fund transfer must be made to the
General Assembly and posted at a minimum on the Department of
Healthcare and Family Services website, the Governor's Office
of Management and Budget website, and any other website the
Governor sees fit. These postings shall serve as notice to the
General Assembly of the amounts to be transferred. Notice shall
be given at least 30 days prior to transfer.
    (b) In addition to the general transfer authority provided
under subsection (c), the following agencies have the specific
transfer authority granted in this subsection:
    The Department of Healthcare and Family Services is
authorized to make transfers representing savings attributable
to not increasing grants due to the births of additional
children from line items for payments of cash grants to line
items for payments for employment and social services for the
purposes outlined in subsection (f) of Section 4-2 of the
Illinois Public Aid Code.
    The Department of Children and Family Services is
authorized to make transfers not exceeding 2% of the aggregate
amount appropriated to it within the same treasury fund for the
following line items among these same line items: Foster Home
and Specialized Foster Care and Prevention, Institutions and
Group Homes and Prevention, and Purchase of Adoption and
Guardianship Services.
    The Department on Aging is authorized to make transfers not
exceeding 2% of the aggregate amount appropriated to it within
the same treasury fund for the following Community Care Program
line items among these same line items: Homemaker and Senior
Companion Services, Alternative Senior Services, Case
Coordination Units, and Adult Day Care Services.
    The State Treasurer is authorized to make transfers among
line item appropriations from the Capital Litigation Trust
Fund, with respect to costs incurred in fiscal years 2002 and
2003 only, when the balance remaining in one or more such line
item appropriations is insufficient for the purpose for which
the appropriation was made, provided that no such transfer may
be made unless the amount transferred is no longer required for
the purpose for which that appropriation was made.
    The State Board of Education is authorized to make
transfers from line item appropriations within the same
treasury fund for General State Aid and General State Aid -
Hold Harmless, provided that no such transfer may be made
unless the amount transferred is no longer required for the
purpose for which that appropriation was made, to the line item
appropriation for Transitional Assistance when the balance
remaining in such line item appropriation is insufficient for
the purpose for which the appropriation was made.
    The State Board of Education is authorized to make
transfers between the following line item appropriations
within the same treasury fund: Disabled Student
Services/Materials (Section 14-13.01 of the School Code),
Disabled Student Transportation Reimbursement (Section
14-13.01 of the School Code), Disabled Student Tuition -
Private Tuition (Section 14-7.02 of the School Code),
Extraordinary Special Education (Section 14-7.02b of the
School Code), Reimbursement for Free Lunch/Breakfast Program,
Summer School Payments (Section 18-4.3 of the School Code), and
Transportation - Regular/Vocational Reimbursement (Section
29-5 of the School Code). Such transfers shall be made only
when the balance remaining in one or more such line item
appropriations is insufficient for the purpose for which the
appropriation was made and provided that no such transfer may
be made unless the amount transferred is no longer required for
the purpose for which that appropriation was made.
    During State fiscal years 2010 and 2011 only, the
Department of Healthcare and Family Services is authorized to
make transfers not exceeding 4% of the aggregate amount
appropriated to it, within the same treasury fund, among the
various line items appropriated for Medical Assistance.
    (c) The sum of such transfers for an agency in a fiscal
year shall not exceed 2% of the aggregate amount appropriated
to it within the same treasury fund for the following objects:
Personal Services; Extra Help; Student and Inmate
Compensation; State Contributions to Retirement Systems; State
Contributions to Social Security; State Contribution for
Employee Group Insurance; Contractual Services; Travel;
Commodities; Printing; Equipment; Electronic Data Processing;
Operation of Automotive Equipment; Telecommunications
Services; Travel and Allowance for Committed, Paroled and
Discharged Prisoners; Library Books; Federal Matching Grants
for Student Loans; Refunds; Workers' Compensation,
Occupational Disease, and Tort Claims; and, in appropriations
to institutions of higher education, Awards and Grants.
Notwithstanding the above, any amounts appropriated for
payment of workers' compensation claims to an agency to which
the authority to evaluate, administer and pay such claims has
been delegated by the Department of Central Management Services
may be transferred to any other expenditure object where such
amounts exceed the amount necessary for the payment of such
claims.
    (c-1) Special provisions for State fiscal year 2003.
Notwithstanding any other provision of this Section to the
contrary, for State fiscal year 2003 only, transfers among line
item appropriations to an agency from the same treasury fund
may be made provided that the sum of such transfers for an
agency in State fiscal year 2003 shall not exceed 3% of the
aggregate amount appropriated to that State agency for State
fiscal year 2003 for the following objects: personal services,
except that no transfer may be approved which reduces the
aggregate appropriations for personal services within an
agency; extra help; student and inmate compensation; State
contributions to retirement systems; State contributions to
social security; State contributions for employee group
insurance; contractual services; travel; commodities;
printing; equipment; electronic data processing; operation of
automotive equipment; telecommunications services; travel and
allowance for committed, paroled, and discharged prisoners;
library books; federal matching grants for student loans;
refunds; workers' compensation, occupational disease, and tort
claims; and, in appropriations to institutions of higher
education, awards and grants.
    (c-2) Special provisions for State fiscal year 2005.
Notwithstanding subsections (a), (a-2), and (c), for State
fiscal year 2005 only, transfers may be made among any line
item appropriations from the same or any other treasury fund
for any objects or purposes, without limitation, when the
balance remaining in one or more such line item appropriations
is insufficient for the purpose for which the appropriation was
made, provided that the sum of those transfers by a State
agency shall not exceed 4% of the aggregate amount appropriated
to that State agency for fiscal year 2005.
    (d) Transfers among appropriations made to agencies of the
Legislative and Judicial departments and to the
constitutionally elected officers in the Executive branch
require the approval of the officer authorized in Section 10 of
this Act to approve and certify vouchers. Transfers among
appropriations made to the University of Illinois, Southern
Illinois University, Chicago State University, Eastern
Illinois University, Governors State University, Illinois
State University, Northeastern Illinois University, Northern
Illinois University, Western Illinois University, the Illinois
Mathematics and Science Academy and the Board of Higher
Education require the approval of the Board of Higher Education
and the Governor. Transfers among appropriations to all other
agencies require the approval of the Governor.
    The officer responsible for approval shall certify that the
transfer is necessary to carry out the programs and purposes
for which the appropriations were made by the General Assembly
and shall transmit to the State Comptroller a certified copy of
the approval which shall set forth the specific amounts
transferred so that the Comptroller may change his records
accordingly. The Comptroller shall furnish the Governor with
information copies of all transfers approved for agencies of
the Legislative and Judicial departments and transfers
approved by the constitutionally elected officials of the
Executive branch other than the Governor, showing the amounts
transferred and indicating the dates such changes were entered
on the Comptroller's records.
    (e) The State Board of Education, in consultation with the
State Comptroller, may transfer line item appropriations for
General State Aid between the Common School Fund and the
Education Assistance Fund. With the advice and consent of the
Governor's Office of Management and Budget, the State Board of
Education, in consultation with the State Comptroller, may
transfer line item appropriations between the General Revenue
Fund and the Education Assistance Fund for the following
programs:
        (1) Disabled Student Personnel Reimbursement (Section
    14-13.01 of the School Code);
        (2) Disabled Student Transportation Reimbursement
    (subsection (b) of Section 14-13.01 of the School Code);
        (3) Disabled Student Tuition - Private Tuition
    (Section 14-7.02 of the School Code);
        (4) Extraordinary Special Education (Section 14-7.02b
    of the School Code);
        (5) Reimbursement for Free Lunch/Breakfast Programs;
        (6) Summer School Payments (Section 18-4.3 of the
    School Code);
        (7) Transportation - Regular/Vocational Reimbursement
    (Section 29-5 of the School Code);
        (8) Regular Education Reimbursement (Section 18-3 of
    the School Code); and
        (9) Special Education Reimbursement (Section 14-7.03
    of the School Code).
(Source: P.A. 95-707, eff. 1-11-08; 96-37, eff. 7-13-09;
96-820, eff. 11-18-09; 96-959, eff. 7-1-10; 96-1086, eff.
7-16-10.)
 
    (30 ILCS 105/25)  (from Ch. 127, par. 161)
    Sec. 25. Fiscal year limitations.
    (a) All appropriations shall be available for expenditure
for the fiscal year or for a lesser period if the Act making
that appropriation so specifies. A deficiency or emergency
appropriation shall be available for expenditure only through
June 30 of the year when the Act making that appropriation is
enacted unless that Act otherwise provides.
    (b) Outstanding liabilities as of June 30, payable from
appropriations which have otherwise expired, may be paid out of
the expiring appropriations during the 2-month period ending at
the close of business on August 31. Any service involving
professional or artistic skills or any personal services by an
employee whose compensation is subject to income tax
withholding must be performed as of June 30 of the fiscal year
in order to be considered an "outstanding liability as of June
30" that is thereby eligible for payment out of the expiring
appropriation.
    (b-1) However, payment of tuition reimbursement claims
under Section 14-7.03 or 18-3 of the School Code may be made by
the State Board of Education from its appropriations for those
respective purposes for any fiscal year, even though the claims
reimbursed by the payment may be claims attributable to a prior
fiscal year, and payments may be made at the direction of the
State Superintendent of Education from the fund from which the
appropriation is made without regard to any fiscal year
limitations, except as required by subsection (j) of this
Section. Beginning on June 30, 2021, payment of tuition
reimbursement claims under Section 14-7.03 or 18-3 of the
School Code as of June 30, payable from appropriations that
have otherwise expired, may be paid out of the expiring
appropriation during the 4-month period ending at the close of
business on October 31.
    (b-2) All outstanding liabilities as of June 30, 2010,
payable from appropriations that would otherwise expire at the
conclusion of the lapse period for fiscal year 2010, and
interest penalties payable on those liabilities under the State
Prompt Payment Act, may be paid out of the expiring
appropriations until December 31, 2010, without regard to the
fiscal year in which the payment is made, as long as vouchers
for the liabilities are received by the Comptroller no later
than August 31, 2010.
    (b-3) Medical payments may be made by the Department of
Veterans' Affairs from its appropriations for those purposes
for any fiscal year, without regard to the fact that the
medical services being compensated for by such payment may have
been rendered in a prior fiscal year, except as required by
subsection (j) of this Section. Beginning on June 30, 2021,
medical payments payable from appropriations that have
otherwise expired may be paid out of the expiring appropriation
during the 4-month period ending at the close of business on
October 31.
    (b-4) Medical payments may be made by the Department of
Healthcare and Family Services and medical payments and child
care payments may be made by the Department of Human Services
(as successor to the Department of Public Aid) from
appropriations for those purposes for any fiscal year, without
regard to the fact that the medical or child care services
being compensated for by such payment may have been rendered in
a prior fiscal year; and payments may be made at the direction
of the Department of Healthcare and Family Services Central
Management Services from the Health Insurance Reserve Fund and
the Local Government Health Insurance Reserve Fund without
regard to any fiscal year limitations, except as required by
subsection (j) of this Section. Beginning on June 30, 2021,
medical payments made by the Department of Healthcare and
Family Services, child care payments made by the Department of
Human Services, and payments made at the discretion of the
Department of Healthcare and Family Services from the Health
Insurance Reserve Fund and the Local Government Health
Insurance Reserve Fund payable from appropriations that have
otherwise expired may be paid out of the expiring appropriation
during the 4-month period ending at the close of business on
October 31.
    (b-5) Medical payments may be made by the Department of
Human Services from its appropriations relating to substance
abuse treatment services for any fiscal year, without regard to
the fact that the medical services being compensated for by
such payment may have been rendered in a prior fiscal year,
provided the payments are made on a fee-for-service basis
consistent with requirements established for Medicaid
reimbursement by the Department of Healthcare and Family
Services, except as required by subsection (j) of this Section.
Beginning on June 30, 2021, medical payments made by the
Department of Human Services relating to substance abuse
treatment services payable from appropriations that have
otherwise expired may be paid out of the expiring appropriation
during the 4-month period ending at the close of business on
October 31.
    (b-6) Additionally, payments may be made by the Department
of Human Services from its appropriations, or any other State
agency from its appropriations with the approval of the
Department of Human Services, from the Immigration Reform and
Control Fund for purposes authorized pursuant to the
Immigration Reform and Control Act of 1986, without regard to
any fiscal year limitations, except as required by subsection
(j) of this Section. Beginning on June 30, 2021, payments made
by the Department of Human Services from the Immigration Reform
and Control Fund for purposes authorized pursuant to the
Immigration Reform and Control Act of 1986 payable from
appropriations that have otherwise expired may be paid out of
the expiring appropriation during the 4-month period ending at
the close of business on October 31.
    Further, with respect to costs incurred in fiscal years
2002 and 2003 only, payments may be made by the State Treasurer
from its appropriations from the Capital Litigation Trust Fund
without regard to any fiscal year limitations.
    Lease payments may be made by the Department of Central
Management Services under the sale and leaseback provisions of
Section 7.4 of the State Property Control Act with respect to
the James R. Thompson Center and the Elgin Mental Health Center
and surrounding land from appropriations for that purpose
without regard to any fiscal year limitations.
    Lease payments may be made under the sale and leaseback
provisions of Section 7.5 of the State Property Control Act
with respect to the Illinois State Toll Highway Authority
headquarters building and surrounding land without regard to
any fiscal year limitations.
    (b-7) Payments may be made in accordance with a plan
authorized by paragraph (11) or (12) of Section 405-105 of the
Department of Central Management Services Law from
appropriations for those payments without regard to fiscal year
limitations.
    (c) Further, payments may be made by the Department of
Public Health, and the Department of Human Services (acting as
successor to the Department of Public Health under the
Department of Human Services Act), and the Department of
Healthcare and Family Services from their respective
appropriations for grants for medical care to or on behalf of
persons suffering from chronic renal disease, persons
suffering from hemophilia, rape victims, and premature and
high-mortality risk infants and their mothers and for grants
for supplemental food supplies provided under the United States
Department of Agriculture Women, Infants and Children
Nutrition Program, for any fiscal year without regard to the
fact that the services being compensated for by such payment
may have been rendered in a prior fiscal year, except as
required by subsection (j) of this Section. Beginning on June
30, 2021, payments made by the Department of Public Health, the
Department of Human Services, and the Department of Healthcare
and Family Services from their respective appropriations for
grants for medical care to or on behalf of persons suffering
from chronic renal disease, persons suffering from hemophilia,
rape victims, and premature and high-mortality risk infants and
their mothers and for grants for supplemental food supplies
provided under the United States Department of Agriculture
Women, Infants and Children Nutrition Program payable from
appropriations that have otherwise expired may be paid out of
the expiring appropriations during the 4-month period ending at
the close of business on October 31.
    (d) The Department of Public Health and the Department of
Human Services (acting as successor to the Department of Public
Health under the Department of Human Services Act) shall each
annually submit to the State Comptroller, Senate President,
Senate Minority Leader, Speaker of the House, House Minority
Leader, and the respective Chairmen and Minority Spokesmen of
the Appropriations Committees of the Senate and the House, on
or before December 31, a report of fiscal year funds used to
pay for services provided in any prior fiscal year. This report
shall document by program or service category those
expenditures from the most recently completed fiscal year used
to pay for services provided in prior fiscal years.
    (e) The Department of Healthcare and Family Services, the
Department of Human Services (acting as successor to the
Department of Public Aid), and the Department of Human Services
making fee-for-service payments relating to substance abuse
treatment services provided during a previous fiscal year shall
each annually submit to the State Comptroller, Senate
President, Senate Minority Leader, Speaker of the House, House
Minority Leader, the respective Chairmen and Minority
Spokesmen of the Appropriations Committees of the Senate and
the House, on or before November 30, a report that shall
document by program or service category those expenditures from
the most recently completed fiscal year used to pay for (i)
services provided in prior fiscal years and (ii) services for
which claims were received in prior fiscal years.
    (f) The Department of Human Services (as successor to the
Department of Public Aid) shall annually submit to the State
Comptroller, Senate President, Senate Minority Leader, Speaker
of the House, House Minority Leader, and the respective
Chairmen and Minority Spokesmen of the Appropriations
Committees of the Senate and the House, on or before December
31, a report of fiscal year funds used to pay for services
(other than medical care) provided in any prior fiscal year.
This report shall document by program or service category those
expenditures from the most recently completed fiscal year used
to pay for services provided in prior fiscal years.
    (g) In addition, each annual report required to be
submitted by the Department of Healthcare and Family Services
under subsection (e) shall include the following information
with respect to the State's Medicaid program:
        (1) Explanations of the exact causes of the variance
    between the previous year's estimated and actual
    liabilities.
        (2) Factors affecting the Department of Healthcare and
    Family Services' liabilities, including but not limited to
    numbers of aid recipients, levels of medical service
    utilization by aid recipients, and inflation in the cost of
    medical services.
        (3) The results of the Department's efforts to combat
    fraud and abuse.
    (h) As provided in Section 4 of the General Assembly
Compensation Act, any utility bill for service provided to a
General Assembly member's district office for a period
including portions of 2 consecutive fiscal years may be paid
from funds appropriated for such expenditure in either fiscal
year.
    (i) An agency which administers a fund classified by the
Comptroller as an internal service fund may issue rules for:
        (1) billing user agencies in advance for payments or
    authorized inter-fund transfers based on estimated charges
    for goods or services;
        (2) issuing credits, refunding through inter-fund
    transfers, or reducing future inter-fund transfers during
    the subsequent fiscal year for all user agency payments or
    authorized inter-fund transfers received during the prior
    fiscal year which were in excess of the final amounts owed
    by the user agency for that period; and
        (3) issuing catch-up billings to user agencies during
    the subsequent fiscal year for amounts remaining due when
    payments or authorized inter-fund transfers received from
    the user agency during the prior fiscal year were less than
    the total amount owed for that period.
User agencies are authorized to reimburse internal service
funds for catch-up billings by vouchers drawn against their
respective appropriations for the fiscal year in which the
catch-up billing was issued or by increasing an authorized
inter-fund transfer during the current fiscal year. For the
purposes of this Act, "inter-fund transfers" means transfers
without the use of the voucher-warrant process, as authorized
by Section 9.01 of the State Comptroller Act.
    (i-1) Beginning on July 1, 2021, all outstanding
liabilities, not payable during the 4-month lapse period as
described in subsections (b-1), (b-3), (b-4), (b-5), (b-6), and
(c) of this Section, that are made from appropriations for that
purpose for any fiscal year, without regard to the fact that
the services being compensated for by those payments may have
been rendered in a prior fiscal year, are limited to only those
claims that have been incurred but for which a proper bill or
invoice as defined by the State Prompt Payment Act has not been
received by September 30th following the end of the fiscal year
in which the service was rendered.
    (j) Notwithstanding any other provision of this Act, the
aggregate amount of payments to be made without regard for
fiscal year limitations as contained in subsections (b-1),
(b-3), (b-4), (b-5), (b-6), and (c) of this Section, and
determined by using Generally Accepted Accounting Principles,
shall not exceed the following amounts:
        (1) $6,000,000,000 for outstanding liabilities related
    to fiscal year 2012;
        (2) $5,300,000,000 for outstanding liabilities related
    to fiscal year 2013;
        (3) $4,600,000,000 for outstanding liabilities related
    to fiscal year 2014;
        (4) $4,000,000,000 for outstanding liabilities related
    to fiscal year 2015;
        (5) $3,300,000,000 for outstanding liabilities related
    to fiscal year 2016;
        (6) $2,600,000,000 for outstanding liabilities related
    to fiscal year 2017;
        (7) $2,000,000,000 for outstanding liabilities related
    to fiscal year 2018;
        (8) $1,300,000,000 for outstanding liabilities related
    to fiscal year 2019;
        (9) $600,000,000 for outstanding liabilities related
    to fiscal year 2020; and
        (10) $0 for outstanding liabilities related to fiscal
    year 2021 and fiscal years thereafter.
(Source: P.A. 95-331, eff. 8-21-07; 96-928, eff. 6-15-10;
96-958, eff. 7-1-10; revised 7-22-10.)
 
    Section 15. The State Prompt Payment Act is amended by
changing Section 3-2 as follows:
 
    (30 ILCS 540/3-2)
    Sec. 3-2. Beginning July 1, 1993, in any instance where a
State official or agency is late in payment of a vendor's bill
or invoice for goods or services furnished to the State, as
defined in Section 1, properly approved in accordance with
rules promulgated under Section 3-3, the State official or
agency shall pay interest to the vendor in accordance with the
following:
        (1) Any bill, except a bill submitted under Article V
    of the Illinois Public Aid Code, approved for payment under
    this Section must be paid or the payment issued to the
    payee within 60 days of receipt of a proper bill or
    invoice. If payment is not issued to the payee within this
    60 day period, an interest penalty of 1.0% of any amount
    approved and unpaid shall be added for each month or
    fraction thereof after the end of this 60 day period, until
    final payment is made. Any bill, except a bill for pharmacy
    services or goods, submitted under Article V of the
    Illinois Public Aid Code approved for payment under this
    Section must be paid or the payment issued to the payee
    within 60 days after receipt of a proper bill or invoice,
    and, if payment is not issued to the payee within this
    60-day period, an interest penalty of 2.0% of any amount
    approved and unpaid shall be added for each month or
    fraction thereof after the end of this 60-day period, until
    final payment is made. Any bill for pharmacy services or
    goods submitted under Article V of the Illinois Public Aid
    Code, approved for payment under this Section must be paid
    or the payment issued to the payee within 60 days of
    receipt of a proper bill or invoice. If payment is not
    issued to the payee within this 60 day period, an interest
    penalty of 1.0% of any amount approved and unpaid shall be
    added for each month or fraction thereof after the end of
    this 60 day period, until final payment is made.
        (1.1) A State agency shall review in a timely manner
    each bill or invoice after its receipt. If the State agency
    determines that the bill or invoice contains a defect
    making it unable to process the payment request, the agency
    shall notify the vendor requesting payment as soon as
    possible after discovering the defect pursuant to rules
    promulgated under Section 3-3; provided, however, that the
    notice for construction related bills or invoices must be
    given not later than 30 days after the bill or invoice was
    first submitted. The notice shall identify the defect and
    any additional information necessary to correct the
    defect. If one or more items on a construction related bill
    or invoice are disapproved, but not the entire bill or
    invoice, then the portion that is not disapproved shall be
    paid.
        (2) Where a State official or agency is late in payment
    of a vendor's bill or invoice properly approved in
    accordance with this Act, and different late payment terms
    are not reduced to writing as a contractual agreement, the
    State official or agency shall automatically pay interest
    penalties required by this Section amounting to $50 or more
    to the appropriate vendor. Each agency shall be responsible
    for determining whether an interest penalty is owed and for
    paying the interest to the vendor. Interest due to a vendor
    that amounts to less than $50 shall not be paid but shall
    be accrued until all interest due the vendor for all
    similar warrants exceeds $50, at which time the accrued
    interest shall be payable and interest will begin accruing
    again, except that interest accrued as of the end of the
    fiscal year that does not exceed $50 shall be payable at
    that time. In the event an individual has paid a vendor for
    services in advance, the provisions of this Section shall
    apply until payment is made to that individual.
        (3) The provisions of this amendatory Act of the 96th
    General Assembly reducing the interest rate on pharmacy
    claims under Article V of the Illinois Public Aid Code to
    1.0% per month shall apply to any pharmacy bills for
    services and goods under Article V of the Illinois Public
    Aid Code received on or after the date 60 days before the
    effective date of this amendatory Act of the 96th General
    Assembly.
(Source: P.A. 96-555, eff. 8-18-09; 96-802, eff. 1-1-10;
96-959, eff. 7-1-10; 96-1000, eff. 7-2-10.)
 
    Section 20. The Illinois Income Tax Act is amended by
changing Section 917 as follows:
 
    (35 ILCS 5/917)  (from Ch. 120, par. 9-917)
    Sec. 917. Confidentiality and information sharing.
    (a) Confidentiality. Except as provided in this Section,
all information received by the Department from returns filed
under this Act, or from any investigation conducted under the
provisions of this Act, shall be confidential, except for
official purposes within the Department or pursuant to official
procedures for collection of any State tax or pursuant to an
investigation or audit by the Illinois State Scholarship
Commission of a delinquent student loan or monetary award or
enforcement of any civil or criminal penalty or sanction
imposed by this Act or by another statute imposing a State tax,
and any person who divulges any such information in any manner,
except for such purposes and pursuant to order of the Director
or in accordance with a proper judicial order, shall be guilty
of a Class A misdemeanor. However, the provisions of this
paragraph are not applicable to information furnished to (i)
the Department of Healthcare and Family Services (formerly
Department of Public Aid), State's Attorneys, and the Attorney
General for child support enforcement purposes and (ii) a
licensed attorney representing the taxpayer where an appeal or
a protest has been filed on behalf of the taxpayer. If it is
necessary to file information obtained pursuant to this Act in
a child support enforcement proceeding, the information shall
be filed under seal.
    (b) Public information. Nothing contained in this Act shall
prevent the Director from publishing or making available to the
public the names and addresses of persons filing returns under
this Act, or from publishing or making available reasonable
statistics concerning the operation of the tax wherein the
contents of returns are grouped into aggregates in such a way
that the information contained in any individual return shall
not be disclosed.
    (c) Governmental agencies. The Director may make available
to the Secretary of the Treasury of the United States or his
delegate, or the proper officer or his delegate of any other
state imposing a tax upon or measured by income, for
exclusively official purposes, information received by the
Department in the administration of this Act, but such
permission shall be granted only if the United States or such
other state, as the case may be, grants the Department
substantially similar privileges. The Director may exchange
information with the Department of Healthcare and Family
Services and the Department of Human Services (acting as
successor to the Department of Public Aid under the Department
of Human Services Act) for the purpose of verifying sources and
amounts of income and for other purposes directly connected
with the administration of this Act, the Illinois Public Aid
Code, and any other health benefit program administered by the
State and the Illinois Public Aid Code. The Director may
exchange information with the Director of the Department of
Employment Security for the purpose of verifying sources and
amounts of income and for other purposes directly connected
with the administration of this Act and Acts administered by
the Department of Employment Security. The Director may make
available to the Illinois Workers' Compensation Commission
information regarding employers for the purpose of verifying
the insurance coverage required under the Workers'
Compensation Act and Workers' Occupational Diseases Act. The
Director may exchange information with the Illinois Department
on Aging for the purpose of verifying sources and amounts of
income for purposes directly related to confirming eligibility
for participation in the programs of benefits authorized by the
Senior Citizens and Disabled Persons Property Tax Relief and
Pharmaceutical Assistance Act.
    The Director may make available to any State agency,
including the Illinois Supreme Court, which licenses persons to
engage in any occupation, information that a person licensed by
such agency has failed to file returns under this Act or pay
the tax, penalty and interest shown therein, or has failed to
pay any final assessment of tax, penalty or interest due under
this Act. The Director may make available to any State agency,
including the Illinois Supreme Court, information regarding
whether a bidder, contractor, or an affiliate of a bidder or
contractor has failed to file returns under this Act or pay the
tax, penalty, and interest shown therein, or has failed to pay
any final assessment of tax, penalty, or interest due under
this Act, for the limited purpose of enforcing bidder and
contractor certifications. For purposes of this Section, the
term "affiliate" means any entity that (1) directly,
indirectly, or constructively controls another entity, (2) is
directly, indirectly, or constructively controlled by another
entity, or (3) is subject to the control of a common entity.
For purposes of this subsection (a), an entity controls another
entity if it owns, directly or individually, more than 10% of
the voting securities of that entity. As used in this
subsection (a), the term "voting security" means a security
that (1) confers upon the holder the right to vote for the
election of members of the board of directors or similar
governing body of the business or (2) is convertible into, or
entitles the holder to receive upon its exercise, a security
that confers such a right to vote. A general partnership
interest is a voting security.
    The Director may make available to any State agency,
including the Illinois Supreme Court, units of local
government, and school districts, information regarding
whether a bidder or contractor is an affiliate of a person who
is not collecting and remitting Illinois Use taxes, for the
limited purpose of enforcing bidder and contractor
certifications.
    The Director may also make available to the Secretary of
State information that a corporation which has been issued a
certificate of incorporation by the Secretary of State has
failed to file returns under this Act or pay the tax, penalty
and interest shown therein, or has failed to pay any final
assessment of tax, penalty or interest due under this Act. An
assessment is final when all proceedings in court for review of
such assessment have terminated or the time for the taking
thereof has expired without such proceedings being instituted.
For taxable years ending on or after December 31, 1987, the
Director may make available to the Director or principal
officer of any Department of the State of Illinois, information
that a person employed by such Department has failed to file
returns under this Act or pay the tax, penalty and interest
shown therein. For purposes of this paragraph, the word
"Department" shall have the same meaning as provided in Section
3 of the State Employees Group Insurance Act of 1971.
    (d) The Director shall make available for public inspection
in the Department's principal office and for publication, at
cost, administrative decisions issued on or after January 1,
1995. These decisions are to be made available in a manner so
that the following taxpayer information is not disclosed:
        (1) The names, addresses, and identification numbers
    of the taxpayer, related entities, and employees.
        (2) At the sole discretion of the Director, trade
    secrets or other confidential information identified as
    such by the taxpayer, no later than 30 days after receipt
    of an administrative decision, by such means as the
    Department shall provide by rule.
    The Director shall determine the appropriate extent of the
deletions allowed in paragraph (2). In the event the taxpayer
does not submit deletions, the Director shall make only the
deletions specified in paragraph (1).
    The Director shall make available for public inspection and
publication an administrative decision within 180 days after
the issuance of the administrative decision. The term
"administrative decision" has the same meaning as defined in
Section 3-101 of Article III of the Code of Civil Procedure.
Costs collected under this Section shall be paid into the Tax
Compliance and Administration Fund.
    (e) Nothing contained in this Act shall prevent the
Director from divulging information to any person pursuant to a
request or authorization made by the taxpayer, by an authorized
representative of the taxpayer, or, in the case of information
related to a joint return, by the spouse filing the joint
return with the taxpayer.
(Source: P.A. 94-1074, eff. 12-26-06; 95-331, eff. 8-21-07.)
 
    Section 25. The Illinois Insurance Code is amended by
changing Section 5.5 as follows:
 
    (215 ILCS 5/5.5)
    Sec. 5.5. Compliance with the Department of Healthcare and
Family Services. A company authorized to do business in this
State or accredited by the State to issue policies of health
insurance, including but not limited to, self-insured plans,
group health plans (as defined in Section 607(1) of the
Employee Retirement Income Security Act of 1974), service
benefit plans, managed care organizations, pharmacy benefit
managers, or other parties that are by statute, contract, or
agreement legally responsible for payment of a claim for a
health care item or service as a condition of doing business in
the State must:
        (1) provide to the Department of Healthcare and Family
    Services, or any successor agency, on at least a quarterly
    basis if so requested by the Department, information upon
    request information to determine during what period any
    individual may be, or may have been, covered by a health
    insurer and the nature of the coverage that is or was
    provided by the health insurer, including the name,
    address, and identifying number of the plan;
        (2) accept the State's right of recovery and the
    assignment to the State of any right of an individual or
    other entity to payment from the party for an item or
    service for which payment has been made under the medical
    programs of the Department of Healthcare and Family
    Services, or any successor agency, under this Code or the
    Illinois Public Aid Code;
        (3) respond to any inquiry by the Department of
    Healthcare and Family Services regarding a claim for
    payment for any health care item or service that is
    submitted not later than 3 years after the date of the
    provision of such health care item or service; and
        (4) agree not to deny a claim submitted by the
    Department of Healthcare and Family Services solely on the
    basis of the date of submission of the claim, the type or
    format of the claim form, or a failure to present proper
    documentation at the point-of-sale that is the basis of the
    claim if (i) the claim is submitted by the Department of
    Healthcare and Family Services within the 3-year period
    beginning on the date on which the item or service was
    furnished and (ii) any action by the Department of
    Healthcare and Family Services to enforce its rights with
    respect to such claim is commenced within 6 years of its
    submission of such claim.
    In cases in which the Department of Healthcare and Family
Services has determined that an entity that provides health
insurance coverage has established a pattern of failure to
provide the information required under this Section, and has
subsequently certified that determination, along with
supporting documentation, to the Director of the Department of
Insurance, the Director of the Department of Insurance, based
upon the certification of determination made by the Department
of Healthcare and Family Services, may commence regulatory
proceedings in accordance with all applicable provisions of the
Illinois Insurance Code.
(Source: P.A. 95-632, eff. 9-25-07.)
 
    Section 30. The Children's Health Insurance Program Act is
amended by changing Section 15 and by adding Sections 7, 21,
23, and 26 as follows:
 
    (215 ILCS 106/7 new)
    Sec. 7. Eligibility verification. Notwithstanding any
other provision of this Act, with respect to applications for
benefits provided under the Program, eligibility shall be
determined in a manner that ensures program integrity and that
complies with federal law and regulations while minimizing
unnecessary barriers to enrollment. To this end, as soon as
practicable, and unless the Department receives written denial
from the federal government, this Section shall be implemented:
    (a) The Department of Healthcare and Family Services or its
designees shall:
        (1) By no later than July 1, 2011, require verification
    of, at a minimum, one month's income from all sources
    required for determining the eligibility of applicants to
    the Program. Such verification shall take the form of pay
    stubs, business or income and expense records for
    self-employed persons, letters from employers, and any
    other valid documentation of income including data
    obtained electronically by the Department or its designees
    from other sources as described in subsection (b) of this
    Section.
        (2) By no later than October 1, 2011, require
    verification of, at a minimum, one month's income from all
    sources required for determining the continued eligibility
    of recipients at their annual review of eligibility under
    the Program. Such verification shall take the form of pay
    stubs, business or income and expense records for
    self-employed persons, letters from employers, and any
    other valid documentation of income including data
    obtained electronically by the Department or its designees
    from other sources as described in subsection (b) of this
    Section. The Department shall send a notice to the
    recipient at least 60 days prior to the end of the period
    of eligibility that informs them of the requirements for
    continued eligibility. If a recipient does not fulfill the
    requirements for continued eligibility by the deadline
    established in the notice, a notice of cancellation shall
    be issued to the recipient and coverage shall end on the
    last day of the eligibility period. A recipient's
    eligibility may be reinstated without requiring a new
    application if the recipient fulfills the requirements for
    continued eligibility prior to the end of the month
    following the last date of coverage. Nothing in this
    Section shall prevent an individual whose coverage has been
    cancelled from reapplying for health benefits at any time.
        (3) By no later than July 1, 2011, require verification
    of Illinois residency.
    (b) The Department shall establish or continue cooperative
arrangements with the Social Security Administration, the
Illinois Secretary of State, the Department of Human Services,
the Department of Revenue, the Department of Employment
Security, and any other appropriate entity to gain electronic
access, to the extent allowed by law, to information available
to those entities that may be appropriate for electronically
verifying any factor of eligibility for benefits under the
Program. Data relevant to eligibility shall be provided for no
other purpose than to verify the eligibility of new applicants
or current recipients of health benefits under the Program.
Data will be requested or provided for any new applicant or
current recipient only insofar as that individual's
circumstances are relevant to that individual's or another
individual's eligibility.
    (c) Within 90 days of the effective date of this amendatory
Act of the 96th General Assembly, the Department of Healthcare
and Family Services shall send notice to current recipients
informing them of the changes regarding their eligibility
verification.
 
    (215 ILCS 106/15)
    Sec. 15. Operation of the Program. There is hereby created
a Children's Health Insurance Program. The Program shall
operate subject to appropriation and shall be administered by
the Department of Healthcare and Family Services. The
Department shall have the powers and authority granted to the
Department under the Illinois Public Aid Code, including, but
not limited to, Section 11-5.1 of the Code. The Department may
contract with a Third Party Administrator or other entities to
administer and oversee any portion of this Program.
(Source: P.A. 95-331, eff. 8-21-07.)
 
    (215 ILCS 106/21 new)
    Sec. 21. Presumptive eligibility. Beginning on the
effective date of this amendatory Act of the 96th General
Assembly and except where federal law requires presumptive
eligibility, no adult may be presumed eligible for health care
coverage under the Program, and the Department may not cover
any service rendered to an adult unless the adult has completed
an application for benefits, all required verifications have
been received and the Department or its designee has found the
adult eligible for the date on which that service was provided.
Nothing in this Section shall apply to pregnant women.
 
    (215 ILCS 106/23 new)
    Sec. 23. Care coordination.
    (a) At least 50% of recipients eligible for comprehensive
medical benefits in all medical assistance programs or other
health benefit programs administered by the Department,
including the Children's Health Insurance Program Act and the
Covering ALL KIDS Health Insurance Act, shall be enrolled in a
care coordination program by no later than January 1, 2015. For
purposes of this Section, "coordinated care" or "care
coordination" means delivery systems where recipients will
receive their care from providers who participate under
contract in integrated delivery systems that are responsible
for providing or arranging the majority of care, including
primary care physician services, referrals from primary care
physicians, diagnostic and treatment services, behavioral
health services, in-patient and outpatient hospital services,
dental services, and rehabilitation and long-term care
services. The Department shall designate or contract for such
integrated delivery systems (i) to ensure enrollees have a
choice of systems and of primary care providers within such
systems; (ii) to ensure that enrollees receive quality care in
a culturally and linguistically appropriate manner; and (iii)
to ensure that coordinated care programs meet the diverse needs
of enrollees with developmental, mental health, physical, and
age-related disabilities.
    (b) Payment for such coordinated care shall be based on
arrangements where the State pays for performance related to
health care outcomes, the use of evidence-based practices, the
use of primary care delivered through comprehensive medical
homes, the use of electronic medical records, and the
appropriate exchange of health information electronically made
either on a capitated basis in which a fixed monthly premium
per recipient is paid and full financial risk is assumed for
the delivery of services, or through other risk-based payment
arrangements.
    (c) To qualify for compliance with this Section, the 50%
goal shall be achieved by enrolling medical assistance
enrollees from each medical assistance enrollment category,
including parents, children, seniors, and people with
disabilities to the extent that current State Medicaid payment
laws would not limit federal matching funds for recipients in
care coordination programs. In addition, services must be more
comprehensively defined and more risk shall be assumed than in
the Department's primary care case management program as of the
effective date of this amendatory Act of the 96th General
Assembly.
    (d) The Department shall report to the General Assembly in
a separate part of its annual medical assistance program
report, beginning April, 2012 until April, 2016, on the
progress and implementation of the care coordination program
initiatives established by the provisions of this amendatory
Act of the 96th General Assembly. The Department shall include
in its April 2011 report a full analysis of federal laws or
regulations regarding upper payment limitations to providers
and the necessary revisions or adjustments in rate
methodologies and payments to providers under this Code that
would be necessary to implement coordinated care with full
financial risk by a party other than the Department.
 
    (215 ILCS 106/26 new)
    Sec. 26. Moratorium on eligibility expansions. Beginning
on the effective date of this amendatory Act of the 96th
General Assembly, there shall be a 2-year moratorium on the
expansion of eligibility through increasing financial
eligibility standards, or through increasing income
disregards, or through the creation of new programs that would
add new categories of eligible individuals under the medical
assistance program under the Illinois Public Aid Code in
addition to those categories covered on January 1, 2011. This
moratorium shall not apply to expansions required as a federal
condition of State participation in the medical assistance
program.
 
    Section 35. The Covering ALL KIDS Health Insurance Act is
amended by changing Sections 15, 20, and 98 and by adding
Sections 7, 21, 36, and 56 as follows:
 
    (215 ILCS 170/7 new)
    Sec. 7. Eligibility verification. Notwithstanding any
other provision of this Act, with respect to applications for
benefits provided under the Program, eligibility shall be
determined in a manner that ensures program integrity and that
complies with federal law and regulations while minimizing
unnecessary barriers to enrollment. To this end, as soon as
practicable, and unless the Department receives written denial
from the federal government, this Section shall be implemented:
    (a) The Department of Healthcare and Family Services or its
designees shall:
        (1) By July 1, 2011, require verification of, at a
    minimum, one month's income from all sources required for
    determining the eligibility of applicants to the Program.
    Such verification shall take the form of pay stubs,
    business or income and expense records for self-employed
    persons, letters from employers, and any other valid
    documentation of income including data obtained
    electronically by the Department or its designees from
    other sources as described in subsection (b) of this
    Section.
        (2) By October 1, 2011, require verification of, at a
    minimum, one month's income from all sources required for
    determining the continued eligibility of recipients at
    their annual review of eligibility under the Program. Such
    verification shall take the form of pay stubs, business or
    income and expense records for self-employed persons,
    letters from employers, and any other valid documentation
    of income including data obtained electronically by the
    Department or its designees from other sources as described
    in subsection (b) of this Section. The Department shall
    send a notice to recipients at least 60 days prior to the
    end of their period of eligibility that informs them of the
    requirements for continued eligibility. If a recipient
    does not fulfill the requirements for continued
    eligibility by the deadline established in the notice, a
    notice of cancellation shall be issued to the recipient and
    coverage shall end on the last day of the eligibility
    period. A recipient's eligibility may be reinstated
    without requiring a new application if the recipient
    fulfills the requirements for continued eligibility prior
    to the end of the month following the last date of
    coverage. Nothing in this Section shall prevent an
    individual whose coverage has been cancelled from
    reapplying for health benefits at any time.
        (3) By July 1, 2011, require verification of Illinois
    residency.
    (b) The Department shall establish or continue cooperative
arrangements with the Social Security Administration, the
Illinois Secretary of State, the Department of Human Services,
the Department of Revenue, the Department of Employment
Security, and any other appropriate entity to gain electronic
access, to the extent allowed by law, to information available
to those entities that may be appropriate for electronically
verifying any factor of eligibility for benefits under the
Program. Data relevant to eligibility shall be provided for no
other purpose than to verify the eligibility of new applicants
or current recipients of health benefits under the Program.
Data will be requested or provided for any new applicant or
current recipient only insofar as that individual's
circumstances are relevant to that individual's or another
individual's eligibility.
    (c) Within 90 days of the effective date of this amendatory
Act of the 96th General Assembly, the Department of Healthcare
and Family Services shall send notice to current recipients
informing them of the changes regarding their eligibility
verification.
 
    (215 ILCS 170/15)
    (Section scheduled to be repealed on July 1, 2011)
    Sec. 15. Operation of Program. The Covering ALL KIDS Health
Insurance Program is created. The Program shall be administered
by the Department of Healthcare and Family Services. The
Department shall have the same powers and authority to
administer the Program as are provided to the Department in
connection with the Department's administration of the
Illinois Public Aid Code, including, but not limited to, the
provisions under Section 11-5.1 of the Code, and the Children's
Health Insurance Program Act. The Department shall coordinate
the Program with the existing children's health programs
operated by the Department and other State agencies.
(Source: P.A. 94-693, eff. 7-1-06.)
 
    (215 ILCS 170/20)
    (Section scheduled to be repealed on July 1, 2011)
    Sec. 20. Eligibility.
    (a) To be eligible for the Program, a person must be a
child:
        (1) who is a resident of the State of Illinois; and
        (2) who is ineligible for medical assistance under the
    Illinois Public Aid Code or benefits under the Children's
    Health Insurance Program Act; and
        (3) either (i) who has been without health insurance
    coverage for a period set forth by the Department in rules,
    but not less than 6 months during the first month of
    operation of the Program, 7 months during the second month
    of operation, 8 months during the third month of operation,
    9 months during the fourth month of operation, 10 months
    during the fifth month of operation, 11 months during the
    sixth month of operation, and 12 months thereafter, (ii)
    whose parent has lost employment that made available
    affordable dependent health insurance coverage, until such
    time as affordable employer-sponsored dependent health
    insurance coverage is again available for the child as set
    forth by the Department in rules, (iii) who is a newborn
    whose responsible relative does not have available
    affordable private or employer-sponsored health insurance,
    or (iv) who, within one year of applying for coverage under
    this Act, lost medical benefits under the Illinois Public
    Aid Code or the Children's Health Insurance Program Act;
    and .
        (3.5) whose household income, as determined by the
    Department, is at or below 300% of the federal poverty
    level. This item (3.5) is effective July 1, 2011.
    An entity that provides health insurance coverage (as
defined in Section 2 of the Comprehensive Health Insurance Plan
Act) to Illinois residents shall provide health insurance data
match to the Department of Healthcare and Family Services as
provided by and subject to Section 5.5 of the Illinois
Insurance Code for the purpose of determining eligibility for
the Program under this Act.
    The Department of Healthcare and Family Services, in
collaboration with the Department of Financial and
Professional Regulation, Division of Insurance, shall adopt
rules governing the exchange of information under this Section.
The rules shall be consistent with all laws relating to the
confidentiality or privacy of personal information or medical
records, including provisions under the Federal Health
Insurance Portability and Accountability Act (HIPAA).
    (b) The Department shall monitor the availability and
retention of employer-sponsored dependent health insurance
coverage and shall modify the period described in subdivision
(a)(3) if necessary to promote retention of private or
employer-sponsored health insurance and timely access to
healthcare services, but at no time shall the period described
in subdivision (a)(3) be less than 6 months.
    (c) The Department, at its discretion, may take into
account the affordability of dependent health insurance when
determining whether employer-sponsored dependent health
insurance coverage is available upon reemployment of a child's
parent as provided in subdivision (a)(3).
    (d) A child who is determined to be eligible for the
Program shall remain eligible for 12 months, provided that the
child maintains his or her residence in this State, has not yet
attained 19 years of age, and is not excluded under subsection
(e).
    (e) A child is not eligible for coverage under the Program
if:
        (1) the premium required under Section 40 has not been
    timely paid; if the required premiums are not paid, the
    liability of the Program shall be limited to benefits
    incurred under the Program for the time period for which
    premiums have been paid; re-enrollment shall be completed
    before the next covered medical visit, and the first
    month's required premium shall be paid in advance of the
    next covered medical visit; or
        (2) the child is an inmate of a public institution or
    an institution for mental diseases.
    (f) The Department may shall adopt eligibility rules,
including, but not limited to: rules regarding annual renewals
of eligibility for the Program in conformance with Section 7 of
this Act; rules regarding annual renewals of eligibility for
the Program; rules providing for re-enrollment, grace periods,
notice requirements, and hearing procedures under subdivision
(e)(1) of this Section; and rules regarding what constitutes
availability and affordability of private or
employer-sponsored health insurance, with consideration of
such factors as the percentage of income needed to purchase
children or family health insurance, the availability of
employer subsidies, and other relevant factors.
    (g) Each child enrolled in the Program as of July 1, 2011
whose family income, as established by the Department, exceeds
300% of the federal poverty level may remain enrolled in the
Program for 12 additional months commencing July 1, 2011.
Continued enrollment pursuant to this subsection shall be
available only if the child continues to meet all eligibility
criteria established under the Program as of the effective date
of this amendatory Act of the 96th General Assembly without a
break in coverage. Nothing contained in this subsection shall
prevent a child from qualifying for any other health benefits
program operated by the Department.
(Source: P.A. 96-1272, eff. 1-1-11.)
 
    (215 ILCS 170/21 new)
    Sec. 21. Presumptive eligibility. Beginning on the
effective date of this amendatory Act of the 96th General
Assembly and except where federal law or regulation requires
presumptive eligibility, no adult may be presumed eligible for
health care coverage under the Program and the Department may
not cover any service rendered to an adult unless the adult has
completed an application for benefits, all required
verifications have been received, and the Department or its
designee has found the adult eligible for the date on which
that service was provided. Nothing in this Section shall apply
to pregnant women.
 
    (215 ILCS 170/36 new)
    Sec. 36. Moratorium on eligibility expansions. Beginning
on the effective date of this amendatory Act of the 96th
General Assembly, there shall be a 2-year moratorium on the
expansion of eligibility through increasing financial
eligibility standards, or through increasing income
disregards, or through the creation of new programs that would
add new categories of eligible individuals under the medical
assistance program under the Illinois Public Aid Code in
addition to those categories covered on January 1, 2011. This
moratorium shall not apply to expansions required as a federal
condition of State participation in the medical assistance
program.
 
    (215 ILCS 170/56 new)
    Sec. 56. Care coordination.
    (a) At least 50% of recipients eligible for comprehensive
medical benefits in all medical assistance programs or other
health benefit programs administered by the Department,
including the Children's Health Insurance Program Act and the
Covering ALL KIDS Health Insurance Act, shall be enrolled in a
care coordination program by no later than January 1, 2015. For
purposes of this Section, "coordinated care" or "care
coordination" means delivery systems where recipients will
receive their care from providers who participate under
contract in integrated delivery systems that are responsible
for providing or arranging the majority of care, including
primary care physician services, referrals from primary care
physicians, diagnostic and treatment services, behavioral
health services, in-patient and outpatient hospital services,
dental services, and rehabilitation and long-term care
services. The Department shall designate or contract for such
integrated delivery systems (i) to ensure enrollees have a
choice of systems and of primary care providers within such
systems; (ii) to ensure that enrollees receive quality care in
a culturally and linguistically appropriate manner; and (iii)
to ensure that coordinated care programs meet the diverse needs
of enrollees with developmental, mental health, physical, and
age-related disabilities.
    (b) Payment for such coordinated care shall be based on
arrangements where the State pays for performance related to
health care outcomes, the use of evidence-based practices, the
use of primary care delivered through comprehensive medical
homes, the use of electronic medical records, and the
appropriate exchange of health information electronically made
either on a capitated basis in which a fixed monthly premium
per recipient is paid and full financial risk is assumed for
the delivery of services, or through other risk-based payment
arrangements.
    (c) To qualify for compliance with this Section, the 50%
goal shall be achieved by enrolling medical assistance
enrollees from each medical assistance enrollment category,
including parents, children, seniors, and people with
disabilities to the extent that current State Medicaid payment
laws would not limit federal matching funds for recipients in
care coordination programs. In addition, services must be more
comprehensively defined and more risk shall be assumed than in
the Department's primary care case management program as of the
effective date of this amendatory Act of the 96th General
Assembly.
    (d) The Department shall report to the General Assembly in
a separate part of its annual medical assistance program
report, beginning April, 2012 until April, 2016, on the
progress and implementation of the care coordination program
initiatives established by the provisions of this amendatory
Act of the 96th General Assembly. The Department shall include
in its April 2011 report a full analysis of federal laws or
regulations regarding upper payment limitations to providers
and the necessary revisions or adjustments in rate
methodologies and payments to providers under this Code that
would be necessary to implement coordinated care with full
financial risk by a party other than the Department.
 
    (215 ILCS 170/98)
    (Section scheduled to be repealed on July 1, 2011)
    Sec. 98. Repealer. This Act is repealed on July 1, 2016
July 1, 2011.
(Source: P.A. 94-693, eff. 7-1-06.)
 
    Section 40. The Illinois Public Aid Code is amended by
changing Sections 5-4.1, 5-5.12, 5-11, 8A-2.5, and 11-26 and by
adding Sections 5-1.3, 5-1.4, 5-2.03, 5-11a, 5-29, 5-30, and
11-5.1 as follows:
 
    (305 ILCS 5/5-1.3 new)
    Sec. 5-1.3. Payer of last resort. To the extent permissible
under federal law, the State may pay for medical services only
after payment from all other sources of payment have been
exhausted, or after the Department has determined that pursuit
of such payment is economically unfeasible. Applicants for, and
recipients of, medical assistance under this Code shall
disclose to the State all insurance coverage they have. To the
extent permissible under federal law, the State shall require
vendors of medical services to bill third-party payers for
services that may be covered by those third-party payers prior
to submission of a request for payment to the State. The
Department shall, to the extent permissible under federal law,
reject a request for payment of a medical service that should
first have been submitted to a third-party payer.
 
    (305 ILCS 5/5-1.4 new)
    Sec. 5-1.4. Moratorium on eligibility expansions.
Beginning on the effective date of this amendatory Act of the
96th General Assembly, there shall be a 2-year moratorium on
the expansion of eligibility through increasing financial
eligibility standards, or through increasing income
disregards, or through the creation of new programs which would
add new categories of eligible individuals under the medical
assistance program in addition to those categories covered on
January 1, 2011. This moratorium shall not apply to expansions
required as a federal condition of State participation in the
medical assistance program.
 
    (305 ILCS 5/5-2.03 new)
    Sec. 5-2.03. Presumptive eligibility. Beginning on the
effective date of this amendatory Act of the 96th General
Assembly and except where federal law requires presumptive
eligibility, no adult may be presumed eligible for medical
assistance under this Code and the Department may not cover any
service rendered to an adult unless the adult has completed an
application for benefits, all required verifications have been
received, and the Department or its designee has found the
adult eligible for the date on which that service was provided.
Nothing in this Section shall apply to pregnant women.
 
    (305 ILCS 5/5-4.1)  (from Ch. 23, par. 5-4.1)
    Sec. 5-4.1. Co-payments. The Department may by rule provide
that recipients under any Article of this Code shall pay a fee
as a co-payment for services. Co-payments shall be maximized to
the extent permitted by federal law may not exceed $3 for brand
name drugs, $1 for other pharmacy services other than for
generic drugs, and $2 for physicians services, dental services,
optical services and supplies, chiropractic services, podiatry
services, and encounter rate clinic services. There shall be no
co-payment for generic drugs. Co-payments may not exceed $3 for
hospital outpatient and clinic services. Provided, however,
that any such rule must provide that no co-payment requirement
can exist for renal dialysis, radiation therapy, cancer
chemotherapy, or insulin, and other products necessary on a
recurring basis, the absence of which would be life
threatening, or where co-payment expenditures for required
services and/or medications for chronic diseases that the
Illinois Department shall by rule designate shall cause an
extensive financial burden on the recipient, and provided no
co-payment shall exist for emergency room encounters which are
for medical emergencies. The Department shall seek approval of
a State plan amendment that allows pharmacies to refuse to
dispense drugs in circumstances where the recipient does not
pay the required co-payment. In the event the State plan
amendment is rejected, co-payments may not exceed $3 for brand
name drugs, $1 for other pharmacy services other than for
generic drugs, and $2 for physician services, dental services,
optical services and supplies, chiropractic services, podiatry
services, and encounter rate clinic services. There shall be no
co-payment for generic drugs. Co-payments may not exceed $3 for
hospital outpatient and clinic services.
(Source: P.A. 92-597, eff. 6-28-02; 93-593, eff. 8-25-03.)
 
    (305 ILCS 5/5-5.12)  (from Ch. 23, par. 5-5.12)
    Sec. 5-5.12. Pharmacy payments.
    (a) Every request submitted by a pharmacy for reimbursement
under this Article for prescription drugs provided to a
recipient of aid under this Article shall include the name of
the prescriber or an acceptable identification number as
established by the Department.
    (b) Pharmacies providing prescription drugs under this
Article shall be reimbursed at a rate which shall include a
professional dispensing fee as determined by the Illinois
Department, plus the current acquisition cost of the
prescription drug dispensed. The Illinois Department shall
update its information on the acquisition costs of all
prescription drugs no less frequently than every 30 days.
However, the Illinois Department may set the rate of
reimbursement for the acquisition cost, by rule, at a
percentage of the current average wholesale acquisition cost.
    (c) (Blank).
    (d) The Department shall not impose requirements for prior
approval based on a preferred drug list for anti-retroviral,
anti-hemophilic factor concentrates, or any atypical
antipsychotics, conventional antipsychotics, or
anticonvulsants used for the treatment of serious mental
illnesses until 30 days after it has conducted a study of the
impact of such requirements on patient care and submitted a
report to the Speaker of the House of Representatives and the
President of the Senate. The Department shall review
utilization of narcotic medications in the medical assistance
program and impose utilization controls that protect against
abuse.
    (e) When making determinations as to which drugs shall be
on a prior approval list, the Department shall include as part
of the analysis for this determination, the degree to which a
drug may affect individuals in different ways based on factors
including the gender of the person taking the medication.
    (f) (e) The Department shall cooperate with the Department
of Public Health and the Department of Human Services Division
of Mental Health in identifying psychotropic medications that,
when given in a particular form, manner, duration, or frequency
(including "as needed") in a dosage, or in conjunction with
other psychotropic medications to a nursing home resident, may
constitute a chemical restraint or an "unnecessary drug" as
defined by the Nursing Home Care Act or Titles XVIII and XIX of
the Social Security Act and the implementing rules and
regulations. The Department shall require prior approval for
any such medication prescribed for a nursing home resident that
appears to be a chemical restraint or an unnecessary drug. The
Department shall consult with the Department of Human Services
Division of Mental Health in developing a protocol and criteria
for deciding whether to grant such prior approval.
    (g) The Department may by rule provide for reimbursement of
the dispensing of a 90-day supply of a generic, non-narcotic
maintenance medication in circumstances where it is cost
effective.
(Source: P.A. 96-1269, eff. 7-26-10; 96-1372, eff. 7-29-10;
revised 9-2-10.)
 
    (305 ILCS 5/5-11)  (from Ch. 23, par. 5-11)
    Sec. 5-11. Co-operative arrangements; contracts with other
State agencies, health care and rehabilitation organizations,
and fiscal intermediaries.
    (a) The Illinois Department may enter into co-operative
arrangements with State agencies responsible for administering
or supervising the administration of health services and
vocational rehabilitation services to the end that there may be
maximum utilization of such services in the provision of
medical assistance.
    The Illinois Department shall, not later than June 30,
1993, enter into one or more co-operative arrangements with the
Department of Mental Health and Developmental Disabilities
providing that the Department of Mental Health and
Developmental Disabilities will be responsible for
administering or supervising all programs for services to
persons in community care facilities for persons with
developmental disabilities, including but not limited to
intermediate care facilities, that are supported by State funds
or by funding under Title XIX of the federal Social Security
Act. The responsibilities of the Department of Mental Health
and Developmental Disabilities under these agreements are
transferred to the Department of Human Services as provided in
the Department of Human Services Act.
    The Department may also contract with such State health and
rehabilitation agencies and other public or private health care
and rehabilitation organizations to act for it in supplying
designated medical services to persons eligible therefor under
this Article. Any contracts with health services or health
maintenance organizations shall be restricted to organizations
which have been certified as being in compliance with standards
promulgated pursuant to the laws of this State governing the
establishment and operation of health services or health
maintenance organizations. The Department shall renegotiate
the contracts with health maintenance organizations and
managed care community networks that took effect August 1,
2003, so as to produce $70,000,000 savings to the Department
net of resulting increases to the fee-for-service program for
State fiscal year 2006. The Department may also contract with
insurance companies or other corporate entities serving as
fiscal intermediaries in this State for the Federal Government
in respect to Medicare payments under Title XVIII of the
Federal Social Security Act to act for the Department in paying
medical care suppliers. The provisions of Section 9 of "An Act
in relation to State finance", approved June 10, 1919, as
amended, notwithstanding, such contracts with State agencies,
other health care and rehabilitation organizations, or fiscal
intermediaries may provide for advance payments.
    (b) For purposes of this subsection (b), "managed care
community network" means an entity, other than a health
maintenance organization, that is owned, operated, or governed
by providers of health care services within this State and that
provides or arranges primary, secondary, and tertiary managed
health care services under contract with the Illinois
Department exclusively to persons participating in programs
administered by the Illinois Department.
    The Illinois Department may certify managed care community
networks, including managed care community networks owned,
operated, managed, or governed by State-funded medical
schools, as risk-bearing entities eligible to contract with the
Illinois Department as Medicaid managed care organizations.
The Illinois Department may contract with those managed care
community networks to furnish health care services to or
arrange those services for individuals participating in
programs administered by the Illinois Department. The rates for
those provider-sponsored organizations may be determined on a
prepaid, capitated basis. A managed care community network may
choose to contract with the Illinois Department to provide only
pediatric health care services. The Illinois Department shall
by rule adopt the criteria, standards, and procedures by which
a managed care community network may be permitted to contract
with the Illinois Department and shall consult with the
Department of Insurance in adopting these rules.
    A county provider as defined in Section 15-1 of this Code
may contract with the Illinois Department to provide primary,
secondary, or tertiary managed health care services as a
managed care community network without the need to establish a
separate entity and shall be deemed a managed care community
network for purposes of this Code only to the extent it
provides services to participating individuals. A county
provider is entitled to contract with the Illinois Department
with respect to any contracting region located in whole or in
part within the county. A county provider is not required to
accept enrollees who do not reside within the county.
    In order to (i) accelerate and facilitate the development
of integrated health care in contracting areas outside counties
with populations in excess of 3,000,000 and counties adjacent
to those counties and (ii) maintain and sustain the high
quality of education and residency programs coordinated and
associated with local area hospitals, the Illinois Department
may develop and implement a demonstration program from managed
care community networks owned, operated, managed, or governed
by State-funded medical schools. The Illinois Department shall
prescribe by rule the criteria, standards, and procedures for
effecting this demonstration program.
    A managed care community network that contracts with the
Illinois Department to furnish health care services to or
arrange those services for enrollees participating in programs
administered by the Illinois Department shall do all of the
following:
        (1) Provide that any provider affiliated with the
    managed care community network may also provide services on
    a fee-for-service basis to Illinois Department clients not
    enrolled in such managed care entities.
        (2) Provide client education services as determined
    and approved by the Illinois Department, including but not
    limited to (i) education regarding appropriate utilization
    of health care services in a managed care system, (ii)
    written disclosure of treatment policies and restrictions
    or limitations on health services, including, but not
    limited to, physical services, clinical laboratory tests,
    hospital and surgical procedures, prescription drugs and
    biologics, and radiological examinations, and (iii)
    written notice that the enrollee may receive from another
    provider those covered services that are not provided by
    the managed care community network.
        (3) Provide that enrollees within the system may choose
    the site for provision of services and the panel of health
    care providers.
        (4) Not discriminate in enrollment or disenrollment
    practices among recipients of medical services or
    enrollees based on health status.
        (5) Provide a quality assurance and utilization review
    program that meets the requirements established by the
    Illinois Department in rules that incorporate those
    standards set forth in the Health Maintenance Organization
    Act.
        (6) Issue a managed care community network
    identification card to each enrollee upon enrollment. The
    card must contain all of the following:
            (A) The enrollee's health plan.
            (B) The name and telephone number of the enrollee's
        primary care physician or the site for receiving
        primary care services.
            (C) A telephone number to be used to confirm
        eligibility for benefits and authorization for
        services that is available 24 hours per day, 7 days per
        week.
        (7) Ensure that every primary care physician and
    pharmacy in the managed care community network meets the
    standards established by the Illinois Department for
    accessibility and quality of care. The Illinois Department
    shall arrange for and oversee an evaluation of the
    standards established under this paragraph (7) and may
    recommend any necessary changes to these standards.
        (8) Provide a procedure for handling complaints that
    meets the requirements established by the Illinois
    Department in rules that incorporate those standards set
    forth in the Health Maintenance Organization Act.
        (9) Maintain, retain, and make available to the
    Illinois Department records, data, and information, in a
    uniform manner determined by the Illinois Department,
    sufficient for the Illinois Department to monitor
    utilization, accessibility, and quality of care.
        (10) (Blank) Provide that the pharmacy formulary used
    by the managed care community network and its contract
    providers be no more restrictive than the Illinois
    Department's pharmaceutical program on the effective date
    of this amendatory Act of 1998 and as amended after that
    date.
    The Illinois Department shall contract with an entity or
entities to provide external peer-based quality assurance
review for the managed health care programs administered by the
Illinois Department. The entity shall meet all federal
requirements for an external quality review organization be
representative of Illinois physicians licensed to practice
medicine in all its branches and have statewide geographic
representation in all specialities of medical care that are
provided in managed health care programs administered by the
Illinois Department. The entity may not be a third party payer
and shall maintain offices in locations around the State in
order to provide service and continuing medical education to
physician participants within those managed health care
programs administered by the Illinois Department. The review
process shall be developed and conducted by Illinois physicians
licensed to practice medicine in all its branches. In
consultation with the entity, the Illinois Department may
contract with other entities for professional peer-based
quality assurance review of individual categories of services
other than services provided, supervised, or coordinated by
physicians licensed to practice medicine in all its branches.
The Illinois Department shall establish, by rule, criteria to
avoid conflicts of interest in the conduct of quality assurance
activities consistent with professional peer-review standards.
All quality assurance activities shall be coordinated by the
Illinois Department.
    Each managed care community network must demonstrate its
ability to bear the financial risk of serving individuals under
this program. The Illinois Department shall by rule adopt
standards for assessing the solvency and financial soundness of
each managed care community network. Any solvency and financial
standards adopted for managed care community networks shall be
no more restrictive than the solvency and financial standards
adopted under Section 1856(a) of the Social Security Act for
provider-sponsored organizations under Part C of Title XVIII of
the Social Security Act.
    The Illinois Department may implement the amendatory
changes to this Code made by this amendatory Act of 1998
through the use of emergency rules in accordance with Section
5-45 of the Illinois Administrative Procedure Act. For purposes
of that Act, the adoption of rules to implement these changes
is deemed an emergency and necessary for the public interest,
safety, and welfare.
    (c) Not later than June 30, 1996, the Illinois Department
shall enter into one or more cooperative arrangements with the
Department of Public Health for the purpose of developing a
single survey for nursing facilities, including but not limited
to facilities funded under Title XVIII or Title XIX of the
federal Social Security Act or both, which shall be
administered and conducted solely by the Department of Public
Health. The Departments shall test the single survey process on
a pilot basis, with both the Departments of Public Aid and
Public Health represented on the consolidated survey team. The
pilot will sunset June 30, 1997. After June 30, 1997, unless
otherwise determined by the Governor, a single survey shall be
implemented by the Department of Public Health which would not
preclude staff from the Department of Healthcare and Family
Services (formerly Department of Public Aid) from going on-site
to nursing facilities to perform necessary audits and reviews
which shall not replicate the single State agency survey
required by this Act. This Section shall not apply to community
or intermediate care facilities for persons with developmental
disabilities.
    (d) Nothing in this Code in any way limits or otherwise
impairs the authority or power of the Illinois Department to
enter into a negotiated contract pursuant to this Section with
a managed care community network or a health maintenance
organization, as defined in the Health Maintenance
Organization Act, that provides for termination or nonrenewal
of the contract without cause, upon notice as provided in the
contract, and without a hearing.
(Source: P.A. 94-48, eff. 7-1-05; 95-331, eff. 8-21-07.)
 
    (305 ILCS 5/5-11a new)
    Sec. 5-11a. Health Benefit Information Systems.
    (a) It is the intent of the General Assembly to support
unified electronic systems initiatives that will improve
management of information related to medical assistance
programs. This will include improved management capabilities
and new systems for Eligibility, Verification, and Enrollment
(EVE) that will simplify and increase efficiencies in and
access to the medical assistance programs and ensure program
integrity. The Department of Healthcare and Family Services, in
coordination with the Department of Human Services and other
appropriate state agencies, shall develop a plan by July 1,
2011, that will:
        (1) Subject to federal and State privacy and
    confidentiality laws and regulations, meet standards for
    timely eligibility verification and enrollment, and annual
    redetermination of eligibility, of applicants for and
    recipients of means-tested health benefits sponsored by
    the State, including medical assistance under this Code.
        (2) Receive and update data electronically from the
    Social Security Administration, the U.S. Postal Service,
    the Illinois Secretary of State, the Department of Revenue,
    the Department of Employment Security, and other
    governmental entities, as appropriate and to the extent
    allowed by law, for verification of any factor of
    eligibility for medical assistance and for updating
    addresses of applicants and recipients of medical
    assistance and other health benefit programs administered
    by the Department. Data relevant to eligibility shall be
    provided for no other purpose than to verify the
    eligibility of new applicants or current recipients of
    health benefits provided by the State. Data shall be
    requested or provided for any individual only insofar as
    that new applicant or current recipient's circumstances
    are relevant to that individual's or another individual's
    eligibility for State-sponsored health benefits.
        (3) Meet federal requirements for timely installation
    by January 1, 2014 to provide integration with a Health
    Benefits Exchange pursuant to the requirements of the
    federal Affordable Care Act and the Reconciliation Act and
    any subsequent amendments thereto and to ensure capture of
    the maximum available federal financial participation
    (FFP).
        (4) Meet federal requirements for compliance with
    architectural standards, including, but not limited to,
    (i) the use of a module development as outlined by the
    Medicaid Information Technology Architecture standards,
    (ii) the use of federally approved open-interfaces where
    they exist, (iii) the use or the creation of
    open-interfaces where necessary, and (iv) the use of rules
    technology that can dynamically accept and modify rules in
    standard formats.
        (5) Include plans to ensure coordination with the State
    of Illinois Framework Project that will (i) expedite and
    simplify access to services provided by Illinois human
    services programs; (ii) streamline administration and data
    sharing; (iii) enhance planning capacity, program
    evaluation, and fraud detection or prevention with access
    to cross-agency data; and (iv) simplify service reporting
    for contracted providers.
    (b) The Department of Healthcare and Family Services shall
continue to plan for and implement a new Medicaid Management
Information System (MMIS) and upgrade the capabilities of the
MMIS data warehouse. Upgrades shall include, among other
things, enhanced capabilities in data analysis including the
ability to identify risk factors that could impact the
treatment and resulting quality of care, and tools that perform
predictive analytics on data applying to newborns, women with
high risk pregnancies, and other populations served by the
Department.
    (c) The Department of Healthcare and Family Services shall
report in its annual Medical Assistance program report each
April through April, 2015 on the progress and implementation of
this plan.
 
    (305 ILCS 5/5-29 new)
    Sec. 5-29. Income Limits and Parental Responsibility. In
light of the unprecedented fiscal crisis confronting the State,
it is the intent of the General Assembly to explore whether the
income limits and income counting methods established for
children under the Covering ALL KIDS Health Insurance Act,
pursuant to this amendatory Act of the 96th General Assembly,
should apply to medical assistance programs available to
children made eligible under the Illinois Public Aid Code,
including through home and community based services waiver
programs authorized under Section 1915(c) of the Social
Security Act, where parental income is currently not considered
in determining a child's eligibility for medical assistance.
The Department of Healthcare and Family Services is hereby
directed, with the participation of the Department of Human
Services and stakeholders, to conduct an analysis of these
programs to determine parental cost sharing opportunities, how
these opportunities may impact the children currently in the
programs, waivers and on the waiting list, and any other
factors which may increase efficiencies and decrease State
costs. The Department is further directed to review how
services under these programs and waivers may be provided by
the use of a combination of skilled, unskilled, and
uncompensated care and to advise as to what revisions to the
Nurse Practice Act, and Acts regulating other relevant
professions, are necessary to accomplish this combination of
care. The Department shall submit a written analysis on the
children's programs and waivers as part of the Department's
annual Medicaid reports due to the General Assembly in 2011 and
2012.
 
    (305 ILCS 5/5-30 new)
    Sec. 5-30. Care coordination.
    (a) At least 50% of recipients eligible for comprehensive
medical benefits in all medical assistance programs or other
health benefit programs administered by the Department,
including the Children's Health Insurance Program Act and the
Covering ALL KIDS Health Insurance Act, shall be enrolled in a
care coordination program by no later than January 1, 2015. For
purposes of this Section, "coordinated care" or "care
coordination" means delivery systems where recipients will
receive their care from providers who participate under
contract in integrated delivery systems that are responsible
for providing or arranging the majority of care, including
primary care physician services, referrals from primary care
physicians, diagnostic and treatment services, behavioral
health services, in-patient and outpatient hospital services,
dental services, and rehabilitation and long-term care
services. The Department shall designate or contract for such
integrated delivery systems (i) to ensure enrollees have a
choice of systems and of primary care providers within such
systems; (ii) to ensure that enrollees receive quality care in
a culturally and linguistically appropriate manner; and (iii)
to ensure that coordinated care programs meet the diverse needs
of enrollees with developmental, mental health, physical, and
age-related disabilities.
    (b) Payment for such coordinated care shall be based on
arrangements where the State pays for performance related to
health care outcomes, the use of evidence-based practices, the
use of primary care delivered through comprehensive medical
homes, the use of electronic medical records, and the
appropriate exchange of health information electronically made
either on a capitated basis in which a fixed monthly premium
per recipient is paid and full financial risk is assumed for
the delivery of services, or through other risk-based payment
arrangements.
    (c) To qualify for compliance with this Section, the 50%
goal shall be achieved by enrolling medical assistance
enrollees from each medical assistance enrollment category,
including parents, children, seniors, and people with
disabilities to the extent that current State Medicaid payment
laws would not limit federal matching funds for recipients in
care coordination programs. In addition, services must be more
comprehensively defined and more risk shall be assumed than in
the Department's primary care case management program as of the
effective date of this amendatory Act of the 96th General
Assembly.
    (d) The Department shall report to the General Assembly in
a separate part of its annual medical assistance program
report, beginning April, 2012 until April, 2016, on the
progress and implementation of the care coordination program
initiatives established by the provisions of this amendatory
Act of the 96th General Assembly. The Department shall include
in its April 2011 report a full analysis of federal laws or
regulations regarding upper payment limitations to providers
and the necessary revisions or adjustments in rate
methodologies and payments to providers under this Code that
would be necessary to implement coordinated care with full
financial risk by a party other than the Department.
 
    (305 ILCS 5/8A-2.5)
    Sec. 8A-2.5. Unauthorized use of medical assistance.
    (a) Any person who knowingly uses, acquires, possesses, or
transfers a medical card in any manner not authorized by law or
by rules and regulations of the Illinois Department, or who
knowingly alters a medical card, or who knowingly uses,
acquires, possesses, or transfers an altered medical card, is
guilty of a violation of this Article and shall be punished as
provided in Section 8A-6.
    (b) Any person who knowingly obtains unauthorized medical
benefits with or without use of a medical card is guilty of a
violation of this Article and shall be punished as provided in
Section 8A-6.
    (c) The Department may seek to recover any and all State
and federal monies for which it has improperly and erroneously
paid benefits as a result of a fraudulent action and any civil
penalties authorized in this Section. Pursuant to Section
11-14.5 of this Code, the Department may determine the monetary
value of benefits improperly and erroneously received. The
Department may recover the monies paid for such benefits and
interest on that amount at the rate of 5% per annum for the
period from which payment was made to the date upon which
repayment is made to the State. Prior to the recovery of any
amount paid for benefits allegedly obtained by fraudulent
means, the recipient of such benefits shall be afforded an
opportunity for a hearing after reasonable notice. The notice
shall be served personally or by certified or registered mail
or as otherwise provided by law upon the parties or their
agents appointed to receive service of process and shall
include the following:
        (1) A statement of the time, place and nature of the
    hearing.
        (2) A statement of the legal authority and jurisdiction
    under which the hearing is to be held.
        (3) A reference to the particular Sections of the
    substantive and procedural statutes and rules involved.
        (4) Except where a more detailed statement is otherwise
    provided for by law, a short and plain statement of the
    matters asserted, the consequences of a failure to respond,
    and the official file or other reference number.
        (5) A statement of the monetary value of the benefits
    fraudulently received by the person accused.
        (6) A statement that, in addition to any other
    penalties provided by law, a civil penalty in an amount not
    to exceed $2,000 may be imposed for each fraudulent claim
    for benefits or payments.
        (7) A statement providing that the determination of the
    monetary value may be contested by petitioning the
    Department for an administrative hearing within 30 days
    from the date of mailing the notice.
        (8) The names and mailing addresses of the
    administrative law judge, all parties, and all other
    persons to whom the agency gives notice of the hearing
    unless otherwise confidential by law.
    An opportunity shall be afforded all parties to be
represented by legal counsel and to respond and present
evidence and argument.
    Unless precluded by law, disposition may be made of any
contested case by stipulation, agreed settlement, consent
order, or default.
    Any final order, decision, or other determination made,
issued or executed by the Director under the provisions of this
Article whereby any person is aggrieved shall be subject to
review in accordance with the provisions of the Administrative
Review Law, and the rules adopted pursuant thereto, which shall
apply to and govern all proceedings for the judicial review of
final administrative decisions of the Director.
    Upon entry of a final administrative decision for repayment
of any benefits obtained by fraudulent means, or for any civil
penalties assessed, a lien shall attach to all property and
assets of such person, firm, corporation, association, agency,
institution, or other legal entity until the judgment is
satisfied.
    Within 12 months of the effective date of this amendatory
Act of the 96th General Assembly, the Department of Healthcare
and Family Services will report to the General Assembly on the
number of fraud cases identified and pursued, and the fines
assessed and collected. The report will also include the
Department's analysis as to the use of private sector resources
to bring action, investigate, and collect monies owed.
(Source: P.A. 89-289, eff. 1-1-96.)
 
    (305 ILCS 5/11-5.1 new)
    Sec. 11-5.1. Eligibility verification. Notwithstanding any
other provision of this Code, with respect to applications for
medical assistance provided under Article V of this Code,
eligibility shall be determined in a manner that ensures
program integrity and complies with federal laws and
regulations while minimizing unnecessary barriers to
enrollment. To this end, as soon as practicable, and unless the
Department receives written denial from the federal
government, this Section shall be implemented:
    (a) The Department of Healthcare and Family Services or its
designees shall:
        (1) By no later than July 1, 2011, require verification
    of, at a minimum, one month's income from all sources
    required for determining the eligibility of applicants for
    medical assistance under this Code. Such verification
    shall take the form of pay stubs, business or income and
    expense records for self-employed persons, letters from
    employers, and any other valid documentation of income
    including data obtained electronically by the Department
    or its designees from other sources as described in
    subsection (b) of this Section.
        (2) By no later than October 1, 2011, require
    verification of, at a minimum, one month's income from all
    sources required for determining the continued eligibility
    of recipients at their annual review of eligibility for
    medical assistance under this Code. Such verification
    shall take the form of pay stubs, business or income and
    expense records for self-employed persons, letters from
    employers, and any other valid documentation of income
    including data obtained electronically by the Department
    or its designees from other sources as described in
    subsection (b) of this Section. The Department shall send a
    notice to recipients at least 60 days prior to the end of
    their period of eligibility that informs them of the
    requirements for continued eligibility. If a recipient
    does not fulfill the requirements for continued
    eligibility by the deadline established in the notice a
    notice of cancellation shall be issued to the recipient and
    coverage shall end on the last day of the eligibility
    period. A recipient's eligibility may be reinstated
    without requiring a new application if the recipient
    fulfills the requirements for continued eligibility prior
    to the end of the month following the last date of
    coverage. Nothing in this Section shall prevent an
    individual whose coverage has been cancelled from
    reapplying for health benefits at any time.
        (3) By no later than July 1, 2011, require verification
    of Illinois residency.
    (b) The Department shall establish or continue cooperative
arrangements with the Social Security Administration, the
Illinois Secretary of State, the Department of Human Services,
the Department of Revenue, the Department of Employment
Security, and any other appropriate entity to gain electronic
access, to the extent allowed by law, to information available
to those entities that may be appropriate for electronically
verifying any factor of eligibility for benefits under the
Program. Data relevant to eligibility shall be provided for no
other purpose than to verify the eligibility of new applicants
or current recipients of health benefits under the Program.
Data shall be requested or provided for any new applicant or
current recipient only insofar as that individual's
circumstances are relevant to that individual's or another
individual's eligibility.
    (c) Within 90 days of the effective date of this amendatory
Act of the 96th General Assembly, the Department of Healthcare
and Family Services shall send notice to current recipients
informing them of the changes regarding their eligibility
verification.
 
    (305 ILCS 5/11-26)  (from Ch. 23, par. 11-26)
    Sec. 11-26. Recipient's abuse of medical care;
restrictions on access to medical care.
    (a) When the Department determines, on the basis of
statistical norms and medical judgment, that a medical care
recipient has received medical services in excess of need and
with such frequency or in such a manner as to constitute an
abuse of the recipient's medical care privileges, the
recipient's access to medical care may be restricted.
    (b) When the Department has determined that a recipient is
abusing his or her medical care privileges as described in this
Section, it may require that the recipient designate a primary
provider type primary care provider, primary care pharmacy, or
health maintenance organization of the recipient's own
choosing to assume responsibility for the recipient's care. For
the purposes of this subsection, "primary provider type" means
a primary care provider, primary care pharmacy, primary
dentist, primary podiatrist, or primary durable medical
equipment provider. Instead of requiring a recipient to make a
designation as provided in this subsection, the Department,
pursuant to rules adopted by the Department and without regard
to any choice of an entity that the recipient might otherwise
make, may initially designate a primary provider type provided
that the primary provider type is willing to provide that care
primary care provider, primary care pharmacy, or health
maintenance organization to assume responsibility for the
recipient's care, provided that the primary care provider,
primary care pharmacy, or health maintenance organization is
willing to provide that care.
    (c) When the Department has requested that a recipient
designate a primary provider type primary care provider,
primary care pharmacy or health maintenance organization and
the recipient fails or refuses to do so, the Department may,
after a reasonable period of time, assign the recipient to a
primary provider type of its own choice and determination,
provided such primary provider type is willing to provide such
care primary care provider, primary care pharmacy or health
maintenance organization of its own choice and determination,
provided such primary care provider, primary care pharmacy or
health maintenance organization is willing to provide such
care.
    (d) When a recipient has been restricted to a designated
primary provider type primary care provider, primary care
pharmacy or health maintenance organization, the recipient may
change the primary provider type primary care provider, primary
care pharmacy or health maintenance organization:
        (1) when the designated source becomes unavailable, as
    the Department shall determine by rule; or
        (2) when the designated primary provider type primary
    care provider, primary care pharmacy or health maintenance
    organization notifies the Department that it wishes to
    withdraw from any obligation as primary provider type
    primary care provider, primary care pharmacy or health
    maintenance organization; or
        (3) in other situations, as the Department shall
    provide by rule.
    The Department shall, by rule, establish procedures for
providing medical or pharmaceutical services when the
designated source becomes unavailable or wishes to withdraw
from any obligation as primary provider type primary care
provider, primary care pharmacy or health maintenance
organization, shall, by rule, take into consideration the need
for emergency or temporary medical assistance and shall ensure
that the recipient has continuous and unrestricted access to
medical care from the date on which such unavailability or
withdrawal becomes effective until such time as the recipient
designates a primary provider type or a primary provider type
care source or a primary care source willing to provide such
care is designated by the Department consistent with
subsections (b) and (c) and such restriction becomes effective.
    (e) Prior to initiating any action to restrict a
recipient's access to medical or pharmaceutical care, the
Department shall notify the recipient of its intended action.
Such notification shall be in writing and shall set forth the
reasons for and nature of the proposed action. In addition, the
notification shall:
        (1) inform the recipient that (i) the recipient has a
    right to designate a primary provider type primary care
    provider, primary care pharmacy, or health maintenance
    organization of the recipient's own choosing willing to
    accept such designation and that the recipient's failure to
    do so within a reasonable time may result in such
    designation being made by the Department or (ii) the
    Department has designated a primary provider type primary
    care provider, primary care pharmacy, or health
    maintenance organization to assume responsibility for the
    recipient's care; and
        (2) inform the recipient that the recipient has a right
    to appeal the Department's determination to restrict the
    recipient's access to medical care and provide the
    recipient with an explanation of how such appeal is to be
    made. The notification shall also inform the recipient of
    the circumstances under which unrestricted medical
    eligibility shall continue until a decision is made on
    appeal and that if the recipient chooses to appeal, the
    recipient will be able to review the medical payment data
    that was utilized by the Department to decide that the
    recipient's access to medical care should be restricted.
    (f) The Department shall, by rule or regulation, establish
procedures for appealing a determination to restrict a
recipient's access to medical care, which procedures shall, at
a minimum, provide for a reasonable opportunity to be heard
and, where the appeal is denied, for a written statement of the
reason or reasons for such denial.
    (g) Except as otherwise provided in this subsection, when a
recipient has had his or her medical card restricted for 4 full
quarters (without regard to any period of ineligibility for
medical assistance under this Code, or any period for which the
recipient voluntarily terminates his or her receipt of medical
assistance, that may occur before the expiration of those 4
full quarters), the Department shall reevaluate the
recipient's medical usage to determine whether it is still in
excess of need and with such frequency or in such a manner as
to constitute an abuse of the receipt of medical assistance. If
it is still in excess of need, the restriction shall be
continued for another 4 full quarters. If it is no longer in
excess of need, the restriction shall be discontinued. If a
recipient's access to medical care has been restricted under
this Section and the Department then determines, either at
reevaluation or after the restriction has been discontinued, to
restrict the recipient's access to medical care a second or
subsequent time, the second or subsequent restriction may be
imposed for a period of more than 4 full quarters. If the
Department restricts a recipient's access to medical care for a
period of more than 4 full quarters, as determined by rule, the
Department shall reevaluate the recipient's medical usage
after the end of the restriction period rather than after the
end of 4 full quarters. The Department shall notify the
recipient, in writing, of any decision to continue the
restriction and the reason or reasons therefor. A "quarter",
for purposes of this Section, shall be defined as one of the
following 3-month periods of time: January-March, April-June,
July-September or October-December.
    (h) In addition to any other recipient whose acquisition of
medical care is determined to be in excess of need, the
Department may restrict the medical care privileges of the
following persons:
        (1) recipients found to have loaned or altered their
    cards or misused or falsely represented medical coverage;
        (2) recipients found in possession of blank or forged
    prescription pads;
        (3) recipients who knowingly assist providers in
    rendering excessive services or defrauding the medical
    assistance program.
    The procedural safeguards in this Section shall apply to
the above individuals.
    (i) Restrictions under this Section shall be in addition to
and shall not in any way be limited by or limit any actions
taken under Article VIII-A of this Code.
(Source: P.A. 88-554, eff. 7-26-94.)
 
    (305 ILCS 5/5-5.15 rep.)
    Section 45. The Illinois Public Aid Code is amended by
repealing Section 5-5.15.
 
    Section 50. The Illinois Vehicle Code is amended by
changing Section 2-123 as follows:
 
    (625 ILCS 5/2-123)  (from Ch. 95 1/2, par. 2-123)
    Sec. 2-123. Sale and Distribution of Information.
    (a) Except as otherwise provided in this Section, the
Secretary may make the driver's license, vehicle and title
registration lists, in part or in whole, and any statistical
information derived from these lists available to local
governments, elected state officials, state educational
institutions, and all other governmental units of the State and
Federal Government requesting them for governmental purposes.
The Secretary shall require any such applicant for services to
pay for the costs of furnishing such services and the use of
the equipment involved, and in addition is empowered to
establish prices and charges for the services so furnished and
for the use of the electronic equipment utilized.
    (b) The Secretary is further empowered to and he may, in
his discretion, furnish to any applicant, other than listed in
subsection (a) of this Section, vehicle or driver data on a
computer tape, disk, other electronic format or computer
processable medium, or printout at a fixed fee of $250 for
orders received before October 1, 2003 and $500 for orders
received on or after October 1, 2003, in advance, and require
in addition a further sufficient deposit based upon the
Secretary of State's estimate of the total cost of the
information requested and a charge of $25 for orders received
before October 1, 2003 and $50 for orders received on or after
October 1, 2003, per 1,000 units or part thereof identified or
the actual cost, whichever is greater. The Secretary is
authorized to refund any difference between the additional
deposit and the actual cost of the request. This service shall
not be in lieu of an abstract of a driver's record nor of a
title or registration search. This service may be limited to
entities purchasing a minimum number of records as required by
administrative rule. The information sold pursuant to this
subsection shall be the entire vehicle or driver data list, or
part thereof. The information sold pursuant to this subsection
shall not contain personally identifying information unless
the information is to be used for one of the purposes
identified in subsection (f-5) of this Section. Commercial
purchasers of driver and vehicle record databases shall enter
into a written agreement with the Secretary of State that
includes disclosure of the commercial use of the information to
be purchased.
    (b-1) The Secretary is further empowered to and may, in his
or her discretion, furnish vehicle or driver data on a computer
tape, disk, or other electronic format or computer processible
medium, at no fee, to any State or local governmental agency
that uses the information provided by the Secretary to transmit
data back to the Secretary that enables the Secretary to
maintain accurate driving records, including dispositions of
traffic cases. This information may be provided without fee not
more often than once every 6 months.
    (c) Secretary of State may issue registration lists. The
Secretary of State may compile a list of all registered
vehicles. Each list of registered vehicles shall be arranged
serially according to the registration numbers assigned to
registered vehicles and may contain in addition the names and
addresses of registered owners and a brief description of each
vehicle including the serial or other identifying number
thereof. Such compilation may be in such form as in the
discretion of the Secretary of State may seem best for the
purposes intended.
    (d) The Secretary of State shall furnish no more than 2
current available lists of such registrations to the sheriffs
of all counties and to the chiefs of police of all cities and
villages and towns of 2,000 population and over in this State
at no cost. Additional copies may be purchased by the sheriffs
or chiefs of police at the fee of $500 each or at the cost of
producing the list as determined by the Secretary of State.
Such lists are to be used for governmental purposes only.
    (e) (Blank).
    (e-1) (Blank).
    (f) The Secretary of State shall make a title or
registration search of the records of his office and a written
report on the same for any person, upon written application of
such person, accompanied by a fee of $5 for each registration
or title search. The written application shall set forth the
intended use of the requested information. No fee shall be
charged for a title or registration search, or for the
certification thereof requested by a government agency. The
report of the title or registration search shall not contain
personally identifying information unless the request for a
search was made for one of the purposes identified in
subsection (f-5) of this Section. The report of the title or
registration search shall not contain highly restricted
personal information unless specifically authorized by this
Code.
    The Secretary of State shall certify a title or
registration record upon written request. The fee for
certification shall be $5 in addition to the fee required for a
title or registration search. Certification shall be made under
the signature of the Secretary of State and shall be
authenticated by Seal of the Secretary of State.
    The Secretary of State may notify the vehicle owner or
registrant of the request for purchase of his title or
registration information as the Secretary deems appropriate.
    No information shall be released to the requestor until
expiration of a 10 day period. This 10 day period shall not
apply to requests for information made by law enforcement
officials, government agencies, financial institutions,
attorneys, insurers, employers, automobile associated
businesses, persons licensed as a private detective or firms
licensed as a private detective agency under the Private
Detective, Private Alarm, Private Security, Fingerprint
Vendor, and Locksmith Act of 2004, who are employed by or are
acting on behalf of law enforcement officials, government
agencies, financial institutions, attorneys, insurers,
employers, automobile associated businesses, and other
business entities for purposes consistent with the Illinois
Vehicle Code, the vehicle owner or registrant or other entities
as the Secretary may exempt by rule and regulation.
    Any misrepresentation made by a requestor of title or
vehicle information shall be punishable as a petty offense,
except in the case of persons licensed as a private detective
or firms licensed as a private detective agency which shall be
subject to disciplinary sanctions under Section 40-10 of the
Private Detective, Private Alarm, Private Security,
Fingerprint Vendor, and Locksmith Act of 2004.
    (f-5) The Secretary of State shall not disclose or
otherwise make available to any person or entity any personally
identifying information obtained by the Secretary of State in
connection with a driver's license, vehicle, or title
registration record unless the information is disclosed for one
of the following purposes:
        (1) For use by any government agency, including any
    court or law enforcement agency, in carrying out its
    functions, or any private person or entity acting on behalf
    of a federal, State, or local agency in carrying out its
    functions.
        (2) For use in connection with matters of motor vehicle
    or driver safety and theft; motor vehicle emissions; motor
    vehicle product alterations, recalls, or advisories;
    performance monitoring of motor vehicles, motor vehicle
    parts, and dealers; and removal of non-owner records from
    the original owner records of motor vehicle manufacturers.
        (3) For use in the normal course of business by a
    legitimate business or its agents, employees, or
    contractors, but only:
            (A) to verify the accuracy of personal information
        submitted by an individual to the business or its
        agents, employees, or contractors; and
            (B) if such information as so submitted is not
        correct or is no longer correct, to obtain the correct
        information, but only for the purposes of preventing
        fraud by, pursuing legal remedies against, or
        recovering on a debt or security interest against, the
        individual.
        (4) For use in research activities and for use in
    producing statistical reports, if the personally
    identifying information is not published, redisclosed, or
    used to contact individuals.
        (5) For use in connection with any civil, criminal,
    administrative, or arbitral proceeding in any federal,
    State, or local court or agency or before any
    self-regulatory body, including the service of process,
    investigation in anticipation of litigation, and the
    execution or enforcement of judgments and orders, or
    pursuant to an order of a federal, State, or local court.
        (6) For use by any insurer or insurance support
    organization or by a self-insured entity or its agents,
    employees, or contractors in connection with claims
    investigation activities, antifraud activities, rating, or
    underwriting.
        (7) For use in providing notice to the owners of towed
    or impounded vehicles.
        (8) For use by any person licensed as a private
    detective or firm licensed as a private detective agency
    under the Private Detective, Private Alarm, Private
    Security, Fingerprint Vendor, and Locksmith Act of 2004,
    private investigative agency or security service licensed
    in Illinois for any purpose permitted under this
    subsection.
        (9) For use by an employer or its agent or insurer to
    obtain or verify information relating to a holder of a
    commercial driver's license that is required under chapter
    313 of title 49 of the United States Code.
        (10) For use in connection with the operation of
    private toll transportation facilities.
        (11) For use by any requester, if the requester
    demonstrates it has obtained the written consent of the
    individual to whom the information pertains.
        (12) For use by members of the news media, as defined
    in Section 1-148.5, for the purpose of newsgathering when
    the request relates to the operation of a motor vehicle or
    public safety.
        (13) For any other use specifically authorized by law,
    if that use is related to the operation of a motor vehicle
    or public safety.
    (f-6) The Secretary of State shall not disclose or
otherwise make available to any person or entity any highly
restricted personal information obtained by the Secretary of
State in connection with a driver's license, vehicle, or title
registration record unless specifically authorized by this
Code.
    (g) 1. The Secretary of State may, upon receipt of a
    written request and a fee of $6 before October 1, 2003 and
    a fee of $12 on and after October 1, 2003, furnish to the
    person or agency so requesting a driver's record. Such
    document may include a record of: current driver's license
    issuance information, except that the information on
    judicial driving permits shall be available only as
    otherwise provided by this Code; convictions; orders
    entered revoking, suspending or cancelling a driver's
    license or privilege; and notations of accident
    involvement. All other information, unless otherwise
    permitted by this Code, shall remain confidential.
    Information released pursuant to a request for a driver's
    record shall not contain personally identifying
    information, unless the request for the driver's record was
    made for one of the purposes set forth in subsection (f-5)
    of this Section. The Secretary of State may, without fee,
    allow a parent or guardian of a person under the age of 18
    years, who holds an instruction permit or graduated
    driver's license, to view that person's driving record
    online, through a computer connection. The parent or
    guardian's online access to the driving record will
    terminate when the instruction permit or graduated
    driver's license holder reaches the age of 18.
        2. The Secretary of State shall not disclose or
    otherwise make available to any person or entity any highly
    restricted personal information obtained by the Secretary
    of State in connection with a driver's license, vehicle, or
    title registration record unless specifically authorized
    by this Code. The Secretary of State may certify an
    abstract of a driver's record upon written request
    therefor. Such certification shall be made under the
    signature of the Secretary of State and shall be
    authenticated by the Seal of his office.
        3. All requests for driving record information shall be
    made in a manner prescribed by the Secretary and shall set
    forth the intended use of the requested information.
        The Secretary of State may notify the affected driver
    of the request for purchase of his driver's record as the
    Secretary deems appropriate.
        No information shall be released to the requester until
    expiration of a 10 day period. This 10 day period shall not
    apply to requests for information made by law enforcement
    officials, government agencies, financial institutions,
    attorneys, insurers, employers, automobile associated
    businesses, persons licensed as a private detective or
    firms licensed as a private detective agency under the
    Private Detective, Private Alarm, Private Security,
    Fingerprint Vendor, and Locksmith Act of 2004, who are
    employed by or are acting on behalf of law enforcement
    officials, government agencies, financial institutions,
    attorneys, insurers, employers, automobile associated
    businesses, and other business entities for purposes
    consistent with the Illinois Vehicle Code, the affected
    driver or other entities as the Secretary may exempt by
    rule and regulation.
        Any misrepresentation made by a requestor of driver
    information shall be punishable as a petty offense, except
    in the case of persons licensed as a private detective or
    firms licensed as a private detective agency which shall be
    subject to disciplinary sanctions under Section 40-10 of
    the Private Detective, Private Alarm, Private Security,
    Fingerprint Vendor, and Locksmith Act of 2004.
        4. The Secretary of State may furnish without fee, upon
    the written request of a law enforcement agency, any
    information from a driver's record on file with the
    Secretary of State when such information is required in the
    enforcement of this Code or any other law relating to the
    operation of motor vehicles, including records of
    dispositions; documented information involving the use of
    a motor vehicle; whether such individual has, or previously
    had, a driver's license; and the address and personal
    description as reflected on said driver's record.
        5. Except as otherwise provided in this Section, the
    Secretary of State may furnish, without fee, information
    from an individual driver's record on file, if a written
    request therefor is submitted by any public transit system
    or authority, public defender, law enforcement agency, a
    state or federal agency, or an Illinois local
    intergovernmental association, if the request is for the
    purpose of a background check of applicants for employment
    with the requesting agency, or for the purpose of an
    official investigation conducted by the agency, or to
    determine a current address for the driver so public funds
    can be recovered or paid to the driver, or for any other
    purpose set forth in subsection (f-5) of this Section.
        The Secretary may also furnish the courts a copy of an
    abstract of a driver's record, without fee, subsequent to
    an arrest for a violation of Section 11-501 or a similar
    provision of a local ordinance. Such abstract may include
    records of dispositions; documented information involving
    the use of a motor vehicle as contained in the current
    file; whether such individual has, or previously had, a
    driver's license; and the address and personal description
    as reflected on said driver's record.
        6. Any certified abstract issued by the Secretary of
    State or transmitted electronically by the Secretary of
    State pursuant to this Section, to a court or on request of
    a law enforcement agency, for the record of a named person
    as to the status of the person's driver's license shall be
    prima facie evidence of the facts therein stated and if the
    name appearing in such abstract is the same as that of a
    person named in an information or warrant, such abstract
    shall be prima facie evidence that the person named in such
    information or warrant is the same person as the person
    named in such abstract and shall be admissible for any
    prosecution under this Code and be admitted as proof of any
    prior conviction or proof of records, notices, or orders
    recorded on individual driving records maintained by the
    Secretary of State.
        7. Subject to any restrictions contained in the
    Juvenile Court Act of 1987, and upon receipt of a proper
    request and a fee of $6 before October 1, 2003 and a fee of
    $12 on or after October 1, 2003, the Secretary of State
    shall provide a driver's record to the affected driver, or
    the affected driver's attorney, upon verification. Such
    record shall contain all the information referred to in
    paragraph 1 of this subsection (g) plus: any recorded
    accident involvement as a driver; information recorded
    pursuant to subsection (e) of Section 6-117 and paragraph
    (4) of subsection (a) of Section 6-204 of this Code. All
    other information, unless otherwise permitted by this
    Code, shall remain confidential.
    (h) The Secretary shall not disclose social security
numbers or any associated information obtained from the Social
Security Administration except pursuant to a written request
by, or with the prior written consent of, the individual
except: (1) to officers and employees of the Secretary who have
a need to know the social security numbers in performance of
their official duties, (2) to law enforcement officials for a
lawful, civil or criminal law enforcement investigation, and if
the head of the law enforcement agency has made a written
request to the Secretary specifying the law enforcement
investigation for which the social security numbers are being
sought, (3) to the United States Department of Transportation,
or any other State, pursuant to the administration and
enforcement of the Commercial Motor Vehicle Safety Act of 1986,
(4) pursuant to the order of a court of competent jurisdiction,
(5) to the Department of Healthcare and Family Services
(formerly Department of Public Aid) for utilization in the
child support enforcement duties assigned to that Department
under provisions of the Illinois Public Aid Code after the
individual has received advanced meaningful notification of
what redisclosure is sought by the Secretary in accordance with
the federal Privacy Act, (5.5) to the Department of Healthcare
and Family Services and the Department of Human Services solely
for the purpose of verifying Illinois residency where such
residency is an eligibility requirement for benefits under the
Illinois Public Aid Code or any other health benefit program
administered by the Department of Healthcare and Family
Services or the Department of Human Services, or (6) to the
Illinois Department of Revenue solely for use by the Department
in the collection of any tax or debt that the Department of
Revenue is authorized or required by law to collect, provided
that the Department shall not disclose the social security
number to any person or entity outside of the Department.
    (i) (Blank).
    (j) Medical statements or medical reports received in the
Secretary of State's Office shall be confidential. No
confidential information may be open to public inspection or
the contents disclosed to anyone, except officers and employees
of the Secretary who have a need to know the information
contained in the medical reports and the Driver License Medical
Advisory Board, unless so directed by an order of a court of
competent jurisdiction.
    (k) All fees collected under this Section shall be paid
into the Road Fund of the State Treasury, except that (i) for
fees collected before October 1, 2003, $3 of the $6 fee for a
driver's record shall be paid into the Secretary of State
Special Services Fund, (ii) for fees collected on and after
October 1, 2003, of the $12 fee for a driver's record, $3 shall
be paid into the Secretary of State Special Services Fund and
$6 shall be paid into the General Revenue Fund, and (iii) for
fees collected on and after October 1, 2003, 50% of the amounts
collected pursuant to subsection (b) shall be paid into the
General Revenue Fund.
    (l) (Blank).
    (m) Notations of accident involvement that may be disclosed
under this Section shall not include notations relating to
damage to a vehicle or other property being transported by a
tow truck. This information shall remain confidential,
provided that nothing in this subsection (m) shall limit
disclosure of any notification of accident involvement to any
law enforcement agency or official.
    (n) Requests made by the news media for driver's license,
vehicle, or title registration information may be furnished
without charge or at a reduced charge, as determined by the
Secretary, when the specific purpose for requesting the
documents is deemed to be in the public interest. Waiver or
reduction of the fee is in the public interest if the principal
purpose of the request is to access and disseminate information
regarding the health, safety, and welfare or the legal rights
of the general public and is not for the principal purpose of
gaining a personal or commercial benefit. The information
provided pursuant to this subsection shall not contain
personally identifying information unless the information is
to be used for one of the purposes identified in subsection
(f-5) of this Section.
    (o) The redisclosure of personally identifying information
obtained pursuant to this Section is prohibited, except to the
extent necessary to effectuate the purpose for which the
original disclosure of the information was permitted.
    (p) The Secretary of State is empowered to adopt rules to
effectuate this Section.
(Source: P.A. 95-201, eff. 1-1-08; 95-287, eff. 1-1-08; 95-331,
eff. 8-21-07; 95-613, eff. 9-11-07; 95-876, eff. 8-21-08;
96-1383, eff. 1-1-11.)
 
    Section 95. Severability. If any provision of this Act or
application thereof to any person or circumstance is held
invalid, such invalidity does not affect other provisions or
applications of this Act which can be given effect without the
invalid application or provision, and to this end the
provisions of this Act are declared to be severable.
 
    Section 99. Effective date. This Act takes effect upon
becoming law.