CHAPTER I: DEPARTMENT OF REVENUE
PART 530 SENIOR CITIZENS AND DISABLED PERSONS PROPERTY TAX RELIEF AND PHARMACEUTICAL ASSISTANCE ACT
SUBPART A: PHARMACEUTICAL ASSISTANCE PROGRAM
Section 530.101 Purpose of the Pharmaceutical Assistance Program (Transferred)
Section 530.105 Definitions (Transferred)
Section 530.110 Covered Prescription Drugs (Transferred)
Section 530.115 Eligibility Qualifications
Section 530.116 Fees and Co-payments (Transferred)
Section 530.117 Claim Filing Procedures
Section 530.120 Cards
Section 530.125 Determination of Cost of Covered Prescription Drugs (Transferred)
Section 530.130 Authorized Pharmacy Qualifications (Transferred)
Section 530.135 Assignment and Coordination of Benefits (Transferred)
Section 530.140 Payments to Authorized Pharmacies (Transferred)
Section 530.145 Execution of Contracts (Transferred)
Section 530.150 Limitation on Prescription Size (Transferred)
Section 530.155 Inspection and Disclosure of Records (Transferred)
Section 530.160 Establishment of Liens (Transferred)
Section 530.165 Penalties
SUBPART B: PROPERTY TAX RELIEF PROGRAM ("CIRCUIT BREAKER")
Section 530.201 Purpose of the Property Tax Relief Program
Section 530.205 Definitions
Section 530.210 Claimant Eligibility Qualifications
Section 530.215 Claim Filing Procedures
Section 530.220 Property Tax Grant Determinations
Section 530.225 Penalties
SUBPART C: ELECTRONIC FILING
Section 530.301 Electronic Filing Program Via Internet
Section 530.305 Eligible Electronic Documents
Section 530.310 Internet Filer Eligibility Qualifications
Section 530.315 Electronic Applications
Section 530.320 Electronic Signature Code
Section 530.325 Transmission of Electronic Applications
Section 530.330 Transmission Confirmations
SUBPART A: PHARMACEUTICAL ASSISTANCE PROGRAM
ADMINISTRATIVE CODE TITLE 86: REVENUE CHAPTER I: DEPARTMENT OF REVENUE PART 530 SENIOR CITIZENS AND DISABLED PERSONS PROPERTY TAX RELIEF AND PHARMACEUTICAL ASSISTANCE ACT SECTION 530.101 PURPOSE OF THE PHARMACEUTICAL ASSISTANCE PROGRAM (TRANSFERRED)
Section 530.101 Purpose of the Pharmaceutical Assistance Program (Transferred)
(Source: Amended at 28 Ill. Reg. 1133, effective January 2, 2004; transferred from the Department of Revenue to the Department of Public Aid (89 Ill. Adm. Code 126.101)) |
ADMINISTRATIVE CODE TITLE 86: REVENUE CHAPTER I: DEPARTMENT OF REVENUE PART 530 SENIOR CITIZENS AND DISABLED PERSONS PROPERTY TAX RELIEF AND PHARMACEUTICAL ASSISTANCE ACT SECTION 530.105 DEFINITIONS (TRANSFERRED)
Section 530.105 Definitions (Transferred)
(Source: Amended at 27 Ill. Reg. 2699, effective January 31, 2003; transferred from the Department of Revenue to the Department of Public Aid (89 Ill. Adm. Code 126.105)) |
ADMINISTRATIVE CODE TITLE 86: REVENUE CHAPTER I: DEPARTMENT OF REVENUE PART 530 SENIOR CITIZENS AND DISABLED PERSONS PROPERTY TAX RELIEF AND PHARMACEUTICAL ASSISTANCE ACT SECTION 530.110 COVERED PRESCRIPTION DRUGS (TRANSFERRED)
Section 530.110 Covered Prescription Drugs (Transferred)
(Source: Amended at 28 Ill. Reg. 1133, effective January 2, 2004; transferred from the Department of Revenue to the Department of Public Aid (89 Ill. Adm. Code 126.110)) |
ADMINISTRATIVE CODE TITLE 86: REVENUE CHAPTER I: DEPARTMENT OF REVENUE PART 530 SENIOR CITIZENS AND DISABLED PERSONS PROPERTY TAX RELIEF AND PHARMACEUTICAL ASSISTANCE ACT SECTION 530.115 ELIGIBILITY QUALIFICATIONS
Section 530.115 Eligibility Qualifications
a) 1998 and 1999 Claim Years
1) In order to be eligible to participate in this program for the 1998 and 1999 claim years, each claimant must:
A) be 65 years of age or older or disabled prior to January 1 of the year in which a claim is filed, or be the surviving spouse of a claimant, who at the time of death received or was entitled to receive pharmaceutical assistance benefits, which surviving spouse will become 65 years of age within the 24 months immediately following the death of a claimant and which surviving spouse, but for his or her age, is otherwise qualified to receive pharmaceutical assistance benefits;
B) be domiciled in Illinois at the time he or she files a claim;
C) have a maximum household income of less than $16,000;
D) obtain a card from the Department; and
E) at the time a card is obtained, execute an assignment to the Department of all benefits which might be claimed under any private insurance plan in purchasing covered prescription drugs. [320 ILCS 25/4(f)]
2) If two or more persons living in the same household are eligible to participate in this program, all the requirements of subsection (a)(1) above must be met by each person. [320 ILCS 25/4(f)
3) Persons who participate in some other program of public assistance are ineligible to participate in this program to the extent that the other program provides pharmaceutical assistance benefits for a covered prescription drug under this program. [320 ILCS 25/4(f)]
b) 2000 Claim Year and Later Claim Years
1) In order to be eligible to participate in this program for the 2000 claim year and later claim years, each applicant must:
A) file a timely claim in accordance with the dates designated in Section 530.117(a)(1); and
B) meet one of the following requirements:
i) be 65 years of age or older prior to January 1 of the calendar year in which a claim is filed; or
ii) become 65 years of age during the calendar year in which a claim is filed; or
iii) be the surviving spouse of an applicant, who at the time of death received or was entitled to receive pharmaceutical assistance benefits, which surviving spouse will become 65 years of age within the 24 months immediately following the death of an applicant and which surviving spouse, but for his or her age, is otherwise qualified to receive pharmaceutical assistance; or
iv) be disabled prior to January 1 of the calendar year in which a claim is filed; and
C) be domiciled in Illinois at the time he or she files a claim; and
D) have a current income of less than $21,218 for a household consisting of one person, $28,480 for a household consisting of either two persons or one person and one additional resident, or $35,740 for a household consisting of either two persons and one or more additional resident or one person and two or more additional residents; and
E) authorize the release of medical, pharmaceutical, and Social Security records for audit or verification purposes; and
F) obtain a card from the Department; and
G) execute an assignment to the Department of all benefits which might be claimed under any private plan of assistance, including any insurance plan or public assistance program, or from a third party in purchasing covered prescription drugs. [320 ILCS 25/4(f)]
2) If more than one person in a household or any additional resident is eligible to participate in this program, all the requirements of subsection (b)(1) above must be met by each applicant. [320 ILCS 25/4(f)]
3) Persons who participate in some other program of public assistance are ineligible to participate in this program to the extent that the other program provides pharmaceutical assistance benefits for a covered prescription drug under this program. [320 ILCS 35/4(f)]
(Source: Amended at 26 Ill. Reg. 8437, effective May 24, 2002) |
ADMINISTRATIVE CODE TITLE 86: REVENUE CHAPTER I: DEPARTMENT OF REVENUE PART 530 SENIOR CITIZENS AND DISABLED PERSONS PROPERTY TAX RELIEF AND PHARMACEUTICAL ASSISTANCE ACT SECTION 530.116 FEES AND CO-PAYMENTS (TRANSFERRED)
Section 530.116 Fees and Co-payments (Transferred)
(Source: Amended at 25 Ill. Reg. 16508, effective December 18, 2001; transferred from the Department of Revenue to the Department of Public Aid (89 Ill. Adm. Code 126.116)) |
ADMINISTRATIVE CODE TITLE 86: REVENUE CHAPTER I: DEPARTMENT OF REVENUE PART 530 SENIOR CITIZENS AND DISABLED PERSONS PROPERTY TAX RELIEF AND PHARMACEUTICAL ASSISTANCE ACT SECTION 530.117 CLAIM FILING PROCEDURES
Section 530.117 Claim Filing Procedures
a) Pharmaceutical Assistance Claims
1) A claim for pharmaceutical assistance benefits under the Act must be filed on the appropriate paper or electronic forms approved by the Department in a timely manner. The claim must be filed after January 1 but on or before December 31 of the calendar year following the claim year as evidenced by the postmark on metered and posted claims, or the date-stamp of receipt on hand-delivered claims at the Department or its regional offices, or the transmission date to confirm receipt of facsimile claims and electronic applications filed with the Department via the Internet. [320 ILCS 25/5(a)]
2) Only one applicant may file a claim for each household for a claim year. If more than one person in a household and, for the 2000 claim year and later claim years, any additional resident, is eligible to file a claim under the Act, they must agree as to which of them will file the claim for the claim year as the claimant and the other person or additional resident must sign the claim as an applicant. [320 ILCS 25/5(c)]
3) An applicant must submit proof of his or her eligibility qualifications as set forth in Section 530.115.
A) Examples of proof of date of birth include:
i) a baptismal record; or
ii) a birth certificate; or
iii) a driver's license; or
iv) an identification card from the Secretary of State's office; or
v) an insurance policy; or
vi) naturalization papers; or
vii) a passport.
B) Examples of proof of disability include:
i) proof that an applicant is eligible to receive disability benefits under the federal Social Security Act of 1935 (see 42 USC 423); or
ii) issuance of an Illinois Disabled Person Identification Card stating that an applicant is under a Class 2 disability, as defined in Section 4A of the Illinois Identification Card Act [15 ILCS 335/4A]; or
iii) status of applicant as a disabled person determined by a physician designated by the Department using the same standards as used by the Social Security Administration with the costs of any required examination paid by the applicant (see 42 USC 423); or
iv) receipt by applicant of Railroad (see 45 USC 231), Civil Service, or Veterans' total disability benefits (see 38 USC 101). [320 ILCS 25/3.14]
4) For the 2000 claim year and thereafter, an applicant may request that projected income for the coverage year be used as current income in determining eligibility at the time a claim is filed if projected income for the coverage year will be lower than current income for the claim year. The claim must be filed in a timely manner and the request must include an itemized listing of current income for the claim year and projected income for the coverage year, together with documentation for the lost sources of income used in calculating projected income. The Department will allow such a request and use projected income as current income in processing the claim if its use will enable an applicant to qualify for this program. (See 320 ILCS 25/5(e).)
b) Amended Pharmaceutical Assistance Claims
1) For the 2000 claim year and thereafter, an applicant whose claim has been denied for exceeding maximum household income eligibility qualifications may file an amended claim requesting use of projected income for the coverage year as current income for the claim year in re-determining eligibility if projected income for the coverage year will be lower than current income for the claim year. The amended claim must be filed in a timely manner and the request must include an itemized listing of current income for the claim year and projected income for the coverage year, together with documentation for the lost sources of income used in calculating projected income. The Department will allow such a request and use projected income as current income in processing the amended claim if its use will enable an applicant to qualify for this program. (See 320 ILCS 25/5(e).)
2) For the 2000 claim year and thereafter, a beneficiary whose claim has been approved may file an amended claim requesting use of projected income for the coverage year as current income for the claim year in re-determining the co-payment for covered prescription drugs if projected income for the coverage year will be lower than current income for the claim year. The amended claim must be filed in a timely manner and the request must include an itemized listing of current income for the claim year and projected income for the coverage year, together with documentation for the lost sources of income used in calculating projected income. The Department will allow such a request and use projected income as current income in processing the amended claim if its use will enable a beneficiary to qualify for a lower co-payment for covered prescription drugs. (See 320 ILCS 25/5(e).)
3) Amended claims for pharmaceutical assistance benefits must be filed on the appropriate paper forms approved by the Department prior to the expiration of the coverage year for the claim year at issue.
4) For the 2000 claim year and later claim years, in the event that a beneficiary has been issued a card for the coverage year and an amended claim using projected income as current income is processed and approved subsequently by the Department, the amount of the co-payment will be reduced accordingly at the beginning of the next qualifying month of coverage. There will be no change in the fee that has already been paid for a card.
c) Refunds A beneficiary may submit a written request prior to the expiration of the coverage year for a refund of the card fee if pharmaceutical assistance benefits have not been used.
d) Appeal Rights
1) Any applicant or beneficiary aggrieved by action of the Department under the Act, whether in the denial of a claim or amended claim, or in the determination of the fee for a card or the amount of a deductible, co-payment, or ancillary charge, may request in writing that the Department reconsider its action, setting out the facts on which the request is based. The Department will consider the request and either affirm or modify its action. [320 ILCS 25/7(c)]
2) The decision of the Department to affirm its action, or the failure of the Department to act on a request for reconsideration within 60 days, is a final administrative decision that is subject to judicial review under the Administrative Review Law [735 ILCS 5/Art. III]. [320 ILCS 25/7(d)]
(Source: Amended at 26 Ill. Reg. 8437, effective May 24, 2002) |
ADMINISTRATIVE CODE TITLE 86: REVENUE CHAPTER I: DEPARTMENT OF REVENUE PART 530 SENIOR CITIZENS AND DISABLED PERSONS PROPERTY TAX RELIEF AND PHARMACEUTICAL ASSISTANCE ACT SECTION 530.120 CARDS
Section 530.120 Cards
a) A card containing, at a minimum, the following information, will be issued to each beneficiary:
1) name of beneficiary;
2) identification number;
3) effective date of coverage; and
4) expiration date of coverage.
b) A card will not be valid for more than one year from the effective date of coverage; however, beginning January 1, 2002, coverage may be extended or restricted for a longer or shorter period of time in order to enable the Department to convert coverage for a beneficiary to a fiscal year basis and have an opportunity to check for erroneous or fraudulent claims. [320 ILCS 25/5(a)]
(Source: Amended at 25 Ill. Reg. 16508, effective December 18, 2001) |
ADMINISTRATIVE CODE TITLE 86: REVENUE CHAPTER I: DEPARTMENT OF REVENUE PART 530 SENIOR CITIZENS AND DISABLED PERSONS PROPERTY TAX RELIEF AND PHARMACEUTICAL ASSISTANCE ACT SECTION 530.125 DETERMINATION OF COST OF COVERED PRESCRIPTION DRUGS (TRANSFERRED)
Section 530.125 Determination of Cost of Covered Prescription Drugs (Transferred)
(Source: Amended at 28 Ill. Reg. 1133, effective January 2, 2004; transferred from the Department of Revenue to the Department of Public Aid (89 Ill. Adm. Code 126.125)) |
ADMINISTRATIVE CODE TITLE 86: REVENUE CHAPTER I: DEPARTMENT OF REVENUE PART 530 SENIOR CITIZENS AND DISABLED PERSONS PROPERTY TAX RELIEF AND PHARMACEUTICAL ASSISTANCE ACT SECTION 530.130 AUTHORIZED PHARMACY QUALIFICATIONS (TRANSFERRED)
Section 530.130 Authorized Pharmacy Qualifications (Transferred)
(Source: Amended at 24 Ill. Reg. 17562, effective November 16, 2000; transferred from the Department of Revenue to the Department of Public Aid (89 Ill. Adm. Code 126.130)) |
ADMINISTRATIVE CODE TITLE 86: REVENUE CHAPTER I: DEPARTMENT OF REVENUE PART 530 SENIOR CITIZENS AND DISABLED PERSONS PROPERTY TAX RELIEF AND PHARMACEUTICAL ASSISTANCE ACT SECTION 530.135 ASSIGNMENT AND COORDINATION OF BENEFITS (TRANSFERRED)
Section 530.135 Assignment and Coordination of Benefits (Transferred)
(Source: Amended at 24 Ill. Reg. 17562, effective November 16, 2000; transferred from the Department of Revenue to the Department of Public Aid (89 Ill. Adm. Code 126.135)) |
ADMINISTRATIVE CODE TITLE 86: REVENUE CHAPTER I: DEPARTMENT OF REVENUE PART 530 SENIOR CITIZENS AND DISABLED PERSONS PROPERTY TAX RELIEF AND PHARMACEUTICAL ASSISTANCE ACT SECTION 530.140 PAYMENTS TO AUTHORIZED PHARMACIES (TRANSFERRED)
Section 530.140 Payments to Authorized Pharmacies (Transferred)
(Source: Amended at 24 Ill. Reg. 17562, effective November 16, 2000; transferred from the Department of Revenue to the Department of Public Aid (89 Ill. Adm. Code 126.140)) |
ADMINISTRATIVE CODE TITLE 86: REVENUE CHAPTER I: DEPARTMENT OF REVENUE PART 530 SENIOR CITIZENS AND DISABLED PERSONS PROPERTY TAX RELIEF AND PHARMACEUTICAL ASSISTANCE ACT SECTION 530.145 EXECUTION OF CONTRACTS (TRANSFERRED)
Section 530.145 Execution of Contracts (Transferred)
(Source: Amended at 24 Ill. Reg. 17562, effective November 16, 2000; transferred from the Department of Revenue to the Department of Public Aid (89 Ill. Adm. Code 126.145)) |
ADMINISTRATIVE CODE TITLE 86: REVENUE CHAPTER I: DEPARTMENT OF REVENUE PART 530 SENIOR CITIZENS AND DISABLED PERSONS PROPERTY TAX RELIEF AND PHARMACEUTICAL ASSISTANCE ACT SECTION 530.150 LIMITATION ON PRESCRIPTION SIZE (TRANSFERRED)
Section 530.150 Limitation on Prescription Size (Transferred)
(Source: Amended at 24 Ill. Reg. 17562, effective November 16, 2000; transferred from the Department of Revenue to the Department of Public Aid (89 Ill. Adm. Code 126.150)) |
ADMINISTRATIVE CODE TITLE 86: REVENUE CHAPTER I: DEPARTMENT OF REVENUE PART 530 SENIOR CITIZENS AND DISABLED PERSONS PROPERTY TAX RELIEF AND PHARMACEUTICAL ASSISTANCE ACT SECTION 530.155 INSPECTION AND DISCLOSURE OF RECORDS (TRANSFERRED)
Section 530.155 Inspection and Disclosure of Records (Transferred)
(Source: Amended at 25 Ill. Reg. 16508, effective December 18, 2001; transferred from the Department of Revenue to the Department of Public Aid (89 Ill. Adm. Code 126.155)) |
ADMINISTRATIVE CODE TITLE 86: REVENUE CHAPTER I: DEPARTMENT OF REVENUE PART 530 SENIOR CITIZENS AND DISABLED PERSONS PROPERTY TAX RELIEF AND PHARMACEUTICAL ASSISTANCE ACT SECTION 530.160 ESTABLISHMENT OF LIENS (TRANSFERRED)
Section 530.160 Establishment of Liens (Transferred)
(Source: Amended at 24 Ill. Reg. 17562, effective November 16, 2000; transferred from the Department of Revenue to the Department of Public Aid (89 Ill. Adm. Code 126.160)) |
ADMINISTRATIVE CODE TITLE 86: REVENUE CHAPTER I: DEPARTMENT OF REVENUE PART 530 SENIOR CITIZENS AND DISABLED PERSONS PROPERTY TAX RELIEF AND PHARMACEUTICAL ASSISTANCE ACT SECTION 530.165 PENALTIES
Section 530.165 Penalties
a) The Department shall suspend the use of a card if any beneficiary or other person is suspected of fraudulent procurement or fraudulent use of a card. [320 ILCS 25/9] Evidence of fraudulent procurement or fraudulent use includes, but is not limited to, false information in a claim, use of a card by someone other than the person to whom it was issued, use of a card after its expiration date, and use of a card at too frequent intervals for the same medication.
b) The Department will revoke a card of any beneficiary convicted of fradulent procurement or fraudulent use of a card. Persons convicted of fraud under the Senior Citizens and Disabled Persons Property Tax Relief and Pharmaceutical Assistance Act shall be permanently barred from participating in this program. [320 ILCS 25/9]
(Source: Amended at 24 Ill. Reg. 17562, effective November 16, 2000; subsections (a), (d) and (e) transferred from the Department of Revenue to the Department of Public Aid (89 Ill. Adm. Code 126.165)) |
SUBPART B: PROPERTY TAX RELIEF PROGRAM ("CIRCUIT BREAKER")
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TITLE 86: REVENUE
CHAPTER I: DEPARTMENT OF REVENUE PART 530 SENIOR CITIZENS AND DISABLED PERSONS PROPERTY TAX RELIEF AND PHARMACEUTICAL ASSISTANCE ACT SECTION 530.201 PURPOSE OF THE PROPERTY TAX RELIEF PROGRAM
Section 530.201 Purpose of the Property Tax Relief Program
The Senior Citizens and Disabled Persons Property Tax Relief and Pharmaceutical Assistance Act (Act) [320 ILCS 25] provides for the establishment of a program of property tax relief ("Circuit Breaker") to be administered by the Illinois Department of Revenue. The purpose for this program is to provide incentives to low-income senior citizens and disabled persons to acquire and retain private housing of their choice and at the same time to relieve those citizens from the burdens of extraordinary property taxes against their increasingly restricted earning power, and thereby to reduce the requirements for public housing in Illinois. [320 ILCS 25/2]
(Source: Added at 26 Ill. Reg. 8437, effective May 24, 2002)
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