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Public Act 097-0023


 

Public Act 0023 97TH GENERAL ASSEMBLY

  
  
  

 


 
Public Act 097-0023
 
HB1077 EnrolledLRB097 05581 KTG 45643 b

    AN ACT concerning public aid.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The Illinois Public Aid Code is amended by
changing Section 8A-2.5 as follows:
 
    (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 18 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. 96-1501, eff. 1-25-11.)

Effective Date: 1/1/2012