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Public Act 095-0200


 

Public Act 0200 95TH GENERAL ASSEMBLY



 


 
Public Act 095-0200
 
HB0517 Enrolled LRB095 07050 DRJ 27174 b

    AN ACT concerning long-term care.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 1. Short title. This Act may be cited as the
Illinois Long-Term Care Partnership Program Act.
 
    Section 5. Findings. The General Assembly finds that our
nation's current financing structure relies too heavily on
individuals and families to bear the financial burden of
long-term supportive services. The financial burden can be so
large that, for many individuals, particularly those with
moderate income, the only alternative is Medicaid, which
requires spending down all assets in order to qualify to
receive long-term care benefits.
    The General Assembly declares that Medicare is not intended
to cover the majority of long-term care expenses. Medicaid is
the largest source of funding for long-term care in the United
States, making the financing of long-term care costs a
significant issue for both State and federal budgets. The
growth in spending by the federal government and states for
long-term care services through Medicaid will continue to
increase as the American population ages.
    The General Assembly finds that one solution to help
address the spiraling Medicaid growth and encourage
individuals to plan for their long-term care is the Long Term
Care Partnership Program, a public-private partnership between
states and private insurance companies. It is the intent of
this program to reduce future Medicaid costs for long-term care
by delaying or eliminating dependence on Medicaid by providing
incentives for individuals to insure against the cost of
providing for their long-term care needs. The program,
including the treatment of assets for Medicaid eligibility and
estate recovery, shall be structured and administered in
accordance with federal law and applicable federal guidelines.
 
    Section 10. Definitions. As used in this Act:
    "Agency" means the Department of Healthcare and Family
Services.
    "Asset disregard" means, with respect to qualification for
State Medicaid benefits, the disregard of any assets or
resources in an amount equal to the insurance benefit payments
that are made to or on the behalf of an individual who is a
beneficiary under a qualified long-term care insurance
partnership policy.
    "Department" means the Department of Financial and
Professional Regulation.
    "Medicaid" means the federal medical assistance program
established under Title XIX of the Social Security Act.
    "Qualified long-term care insurance partnership policy"
means a policy that meets all of the following requirements:
        (1) it covers an insured who was a resident of Illinois
    when coverage first became effective under the policy;
        (2) it is a qualified long-term care insurance policy
    as defined in Section 7702B(b) of the Internal Revenue Code
    of 1986 issued not earlier than the effective date of the
    State plan amendment;
        (3) it meets the model regulations and requirements of
    the National Association of Insurance Commissioners model
    specified in paragraph (5) of Title VI, Section 6021 of the
    federal Deficit Reduction Act of 2005, and the Director of
    the Division of Insurance of the Department certifies it as
    meeting these requirements; and
        (4) if the policy is sold to an individual who:
            (A) has not attained age 61 as of the date of
        purchase, the policy provides compound annual
        inflation protection;
            (B) has attained age 61 but has not attained age 76
        as of such date, the policy provides some level of
        inflation protection; or
            (C) has attained age 76 as of such date, the policy
        may, but is not required to, provide some level of
        inflation protection.
    "State plan amendment" means a State Medicaid plan
amendment made to the federal Department of Health and Human
Services that provides for the disregard of any assets or
resources in an amount equal to the insurance benefit payments
that are made to or on the behalf of an individual who is a
beneficiary under a qualified long-term care insurance
partnership policy.
 
    Section 15. Illinois Long-term Care Partnership Program.
    (a) In accordance with Title VI, Section 6021 of the
federal Deficit Reduction Act of 2005, there shall be
established the Illinois Long-Term Care Partnership Program,
to be administered by the Agency with the assistance of the
Department to do the following:
        (1) provide incentives for individuals to insure
    against the costs of providing for their long-term care
    needs;
        (2) provide a mechanism for individuals to qualify for
    coverage of the cost of their long-term care needs under
    Medicaid without first being required to substantially
    exhaust their resources;
        (3) provide counseling services to individuals
    planning for their long-term care needs; and
        (4) alleviate the financial burden on the State's
    medical assistance program by encouraging the pursuit of
    private initiatives.
    (b) The Agency shall:
        (1) Within 180 days of the effective date of this Act,
    or as soon thereafter as possible, make application to the
    federal Department of Health and Human Services for a State
    plan amendment to establish that, if an individual is a
    beneficiary of a long-term care partnership program
    certified policy, the total assets an individual owns and
    may retain under Medicaid and still qualify for benefits
    under Medicaid at the time the individual applies for
    long-term care benefits are increased by $1 for each $1 of
    benefit paid out under the individual's long-term care
    partnership program certified insurance policy.
        (2) Provide information and technical assistance to
    the Department on the Department's role in assuring that
    any individual who sells a qualified long-term care
    insurance partnership policy receives training and
    demonstrates evidence of an understanding of such policies
    and how they relate to other public and private coverage of
    long-term care.
    (c) The Department may not impose any requirement affecting
the terms or benefits of qualified long-term care partnership
policies unless the Department imposes the requirement on all
long-term care policies sold in Illinois without regard to
whether the policy is covered under the partnership or is
offered in connection with the partnership.
    (d) The issuers of qualified long-term care partnership
policies in Illinois shall provide regular reports to the
Secretary of the federal Department of Health and Human
Services, in accordance with federal regulation. Issuers of
qualified long-term care partnership policies in Illinois
shall provide appropriate reports to the Agency and to the
Department as determined by those entities.
 
    Section 20. Administration.
    (a) The Agency and the Department are authorized to adopt
regulations to implement the provisions of this Act and rules
for its administration.
    (b) The Agency and Department must comply with all federal
rules developed in accordance with Title VI, Section 6021 of
the federal Deficit Reduction Act of 2005, regarding data
reporting, reciprocity with other states that develop
long-term care insurance partnership programs, and any other
matters, and shall have the authority to adopt regulations
relative to the provisions of any federal rules and their
administration.
 
    (320 ILCS 35/Act rep.)
    Section 25. The Partnership for Long-Term Care Act is
repealed.
 
    Section 99. Effective date. This Act takes effect upon
becoming law.

Effective Date: 8/16/2007