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1 | | AN ACT concerning abortion.
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2 | | Be it enacted by the People of the State of Illinois,
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3 | | represented in the General Assembly:
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4 | | Section 5. The State Employees Group Insurance Act of 1971 |
5 | | is amended by changing Sections 6 and 6.1 as follows:
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6 | | (5 ILCS 375/6) (from Ch. 127, par. 526)
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7 | | Sec. 6. Program of health benefits.
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8 | | (a) The program of health benefits shall provide for |
9 | | protection
against the financial costs of health care expenses |
10 | | incurred in and out
of hospital including basic |
11 | | hospital-surgical-medical coverages. The program
may include, |
12 | | but shall not be limited to, such supplemental coverages as
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13 | | out-patient diagnostic X-ray and laboratory expenses, |
14 | | prescription drugs,
dental services, hearing evaluations, |
15 | | hearing aids, the dispensing and
fitting
of hearing aids, and |
16 | | similar group benefits
as are now or may become available. |
17 | | However, nothing in this Act shall
be construed to permit, on |
18 | | or after July 1, 1980, the non-contributory portion
of any such |
19 | | program to include the expenses of obtaining an abortion, |
20 | | induced
miscarriage or induced premature birth unless, in the |
21 | | opinion of a physician,
such procedures are necessary for the |
22 | | preservation of the life of the woman
seeking such treatment, |
23 | | or except an induced premature birth intended to
produce a live |
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1 | | viable child and such procedure is necessary for the health
of |
2 | | the mother or the unborn child. The program may also include
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3 | | coverage for those who rely on treatment by prayer or spiritual |
4 | | means
alone for healing in accordance with the tenets and |
5 | | practice of a
recognized religious denomination.
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6 | | The program of health benefits shall be designed by the |
7 | | Director
(1) to provide a reasonable relationship between the |
8 | | benefits to be
included and the expected distribution of |
9 | | expenses of each such type to
be incurred by the covered |
10 | | members and dependents,
(2) to specify, as covered benefits and |
11 | | as optional benefits, the
medical services of practitioners in |
12 | | all categories licensed under the
Medical Practice Act of 1987, |
13 | | (3) to include
reasonable controls, which may include |
14 | | deductible and co-insurance
provisions, applicable to some or |
15 | | all of the benefits, or a coordination
of benefits provision, |
16 | | to prevent or minimize unnecessary utilization of
the various |
17 | | hospital, surgical and medical expenses to be provided and
to |
18 | | provide reasonable assurance of stability of the program, and |
19 | | (4) to
provide benefits to the extent possible to members |
20 | | throughout the
State, wherever located, on an equitable basis.
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21 | | Notwithstanding any other provision of this Section or Act,
for |
22 | | all members or dependents who are eligible for benefits under |
23 | | Social
Security or the
Railroad Retirement system or who had |
24 | | sufficient Medicare-covered government
employment,
the
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25 | | Department shall reduce benefits
which would otherwise be paid |
26 | | by Medicare, by the amount of benefits for
which the member or |
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1 | | dependents are eligible
under Medicare, except that such |
2 | | reduction in benefits shall apply only to
those members or |
3 | | dependents who (1) first become
eligible for such medicare |
4 | | coverage on or after the effective date of this
amendatory Act |
5 | | of 1992; or (2) are Medicare-eligible members or dependents of
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6 | | a local government unit which began participation in the |
7 | | program on or after
July 1, 1992; or (3) remain eligible for |
8 | | but no longer receive
Medicare coverage which they had been |
9 | | receiving on or after the effective date
of this amendatory Act |
10 | | of 1992.
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11 | | Notwithstanding any other provisions of this Act, where a |
12 | | covered member or
dependents are eligible for benefits under |
13 | | the federal Medicare health
insurance program (Title XVIII of |
14 | | the Social Security Act as added by
Public Law 89-97, 89th |
15 | | Congress), benefits paid under the State of Illinois
program or |
16 | | plan will be reduced by the amount of benefits paid by |
17 | | Medicare.
For members or dependents
who are eligible for |
18 | | benefits under Social Security
or the Railroad Retirement |
19 | | system or who had sufficient Medicare-covered
government |
20 | | employment, benefits shall be reduced by the amount for which
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21 | | the member or dependent is eligible under Medicare,
except that |
22 | | such reduction in benefits shall apply only to those
members or |
23 | | dependents who (1) first become eligible for such
Medicare |
24 | | coverage on or after the effective date of this amendatory Act
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25 | | of 1992; or (2) are Medicare-eligible members or dependents of |
26 | | a local
government unit which began participation in the |
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1 | | program on or after July 1,
1992; or (3) remain eligible for, |
2 | | but no longer receive Medicare
coverage which they had been |
3 | | receiving on or after the effective date of this
amendatory Act |
4 | | of 1992. Premiums may be adjusted, where applicable, to an
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5 | | amount deemed by the Director to be reasonably consistent with |
6 | | any reduction
of benefits.
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7 | | (b) A member, not otherwise covered by this Act, who has |
8 | | retired as a
participating member under Article 2 of the |
9 | | Illinois Pension Code
but is ineligible for the retirement |
10 | | annuity under Section 2-119 of the
Illinois
Pension Code, shall |
11 | | pay the premiums for coverage, not
exceeding the amount paid by |
12 | | the State for the non-contributory coverage for
other members, |
13 | | under the group health benefits program under this Act. The
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14 | | Director shall determine the premiums to be paid
by a member |
15 | | under this subsection (b).
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16 | | (Source: P.A. 93-47, eff. 7-1-03.)
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17 | | (5 ILCS 375/6.1) (from Ch. 127, par. 526.1)
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18 | | Sec. 6.1.
The program of health benefits may offer as an |
19 | | alternative,
available on an optional basis, coverage through
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20 | | health maintenance organizations. That part of the premium for
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21 | | such coverage which is in excess of the amount which would
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22 | | otherwise be paid by the State for the program of health |
23 | | benefits shall
be paid by the member who elects such |
24 | | alternative coverage and shall
be collected as provided for |
25 | | premiums for other optional coverages.
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1 | | However, nothing in this Act shall be construed to permit, |
2 | | after
the effective date of this amendatory Act of 1983, the |
3 | | noncontributory portion
of any such program to include the |
4 | | expenses of obtaining an abortion, induced
miscarriage or |
5 | | induced premature birth unless, in the opinion of a physician,
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6 | | such procedures are necessary for the preservation of the life |
7 | | of the woman
seeking such treatment, or except an induced |
8 | | premature birth intended to
produce a live viable child and |
9 | | such procedure is necessary for the health
of the mother or her |
10 | | unborn child.
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11 | | (Source: P.A. 85-848.)
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12 | | Section 10. The Illinois Public Aid Code is amended by |
13 | | changing Sections 5-5, 5-8, 5-9, and 6-1 as follows:
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14 | | (305 ILCS 5/5-5) (from Ch. 23, par. 5-5)
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15 | | Sec. 5-5. Medical services. The Illinois Department, by |
16 | | rule, shall
determine the quantity and quality of and the rate |
17 | | of reimbursement for the
medical assistance for which
payment |
18 | | will be authorized, and the medical services to be provided,
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19 | | which may include all or part of the following: (1) inpatient |
20 | | hospital
services; (2) outpatient hospital services; (3) other |
21 | | laboratory and
X-ray services; (4) skilled nursing home |
22 | | services; (5) physicians'
services whether furnished in the |
23 | | office, the patient's home, a
hospital, a skilled nursing home, |
24 | | or elsewhere; (6) medical care, or any
other type of remedial |
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1 | | care furnished by licensed practitioners; (7)
home health care |
2 | | services; (8) private duty nursing service; (9) clinic
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3 | | services; (10) dental services, including prevention and |
4 | | treatment of periodontal disease and dental caries disease for |
5 | | pregnant women, provided by an individual licensed to practice |
6 | | dentistry or dental surgery; for purposes of this item (10), |
7 | | "dental services" means diagnostic, preventive, or corrective |
8 | | procedures provided by or under the supervision of a dentist in |
9 | | the practice of his or her profession; (11) physical therapy |
10 | | and related
services; (12) prescribed drugs, dentures, and |
11 | | prosthetic devices; and
eyeglasses prescribed by a physician |
12 | | skilled in the diseases of the eye,
or by an optometrist, |
13 | | whichever the person may select; (13) other
diagnostic, |
14 | | screening, preventive, and rehabilitative services, including |
15 | | to ensure that the individual's need for intervention or |
16 | | treatment of mental disorders or substance use disorders or |
17 | | co-occurring mental health and substance use disorders is |
18 | | determined using a uniform screening, assessment, and |
19 | | evaluation process inclusive of criteria, for children and |
20 | | adults; for purposes of this item (13), a uniform screening, |
21 | | assessment, and evaluation process refers to a process that |
22 | | includes an appropriate evaluation and, as warranted, a |
23 | | referral; "uniform" does not mean the use of a singular |
24 | | instrument, tool, or process that all must utilize; (14)
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25 | | transportation and such other expenses as may be necessary; |
26 | | (15) medical
treatment of sexual assault survivors, as defined |
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1 | | in
Section 1a of the Sexual Assault Survivors Emergency |
2 | | Treatment Act, for
injuries sustained as a result of the sexual |
3 | | assault, including
examinations and laboratory tests to |
4 | | discover evidence which may be used in
criminal proceedings |
5 | | arising from the sexual assault; (16) the
diagnosis and |
6 | | treatment of sickle cell anemia; and (17)
any other medical |
7 | | care, and any other type of remedial care recognized
under the |
8 | | laws of this State , but not including abortions, or induced
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9 | | miscarriages or premature births, unless, in the opinion of a |
10 | | physician,
such procedures are necessary for the preservation |
11 | | of the life of the
woman seeking such treatment, or except an |
12 | | induced premature birth
intended to produce a live viable child |
13 | | and such procedure is necessary
for the health of the mother or |
14 | | her unborn child. The Illinois Department,
by rule, shall |
15 | | prohibit any physician from providing medical assistance
to |
16 | | anyone eligible therefor under this Code where such physician |
17 | | has been
found guilty of performing an abortion procedure in a |
18 | | wilful and wanton
manner upon a woman who was not pregnant at |
19 | | the time such abortion
procedure was performed . The term "any |
20 | | other type of remedial care" shall
include nursing care and |
21 | | nursing home service for persons who rely on
treatment by |
22 | | spiritual means alone through prayer for healing.
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23 | | Notwithstanding any other provision of this Section, a |
24 | | comprehensive
tobacco use cessation program that includes |
25 | | purchasing prescription drugs or
prescription medical devices |
26 | | approved by the Food and Drug Administration shall
be covered |
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1 | | under the medical assistance
program under this Article for |
2 | | persons who are otherwise eligible for
assistance under this |
3 | | Article.
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4 | | Notwithstanding any other provision of this Code, |
5 | | reproductive health care that is otherwise legal in Illinois |
6 | | shall be covered under the medical assistance program for |
7 | | persons who are otherwise eligible for medical assistance under |
8 | | this Article. |
9 | | Notwithstanding any other provision of this Code, the |
10 | | Illinois
Department may not require, as a condition of payment |
11 | | for any laboratory
test authorized under this Article, that a |
12 | | physician's handwritten signature
appear on the laboratory |
13 | | test order form. The Illinois Department may,
however, impose |
14 | | other appropriate requirements regarding laboratory test
order |
15 | | documentation.
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16 | | Upon receipt of federal approval of an amendment to the |
17 | | Illinois Title XIX State Plan for this purpose, the Department |
18 | | shall authorize the Chicago Public Schools (CPS) to procure a |
19 | | vendor or vendors to manufacture eyeglasses for individuals |
20 | | enrolled in a school within the CPS system. CPS shall ensure |
21 | | that its vendor or vendors are enrolled as providers in the |
22 | | medical assistance program and in any capitated Medicaid |
23 | | managed care entity (MCE) serving individuals enrolled in a |
24 | | school within the CPS system. Under any contract procured under |
25 | | this provision, the vendor or vendors must serve only |
26 | | individuals enrolled in a school within the CPS system. Claims |
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1 | | for services provided by CPS's vendor or vendors to recipients |
2 | | of benefits in the medical assistance program under this Code, |
3 | | the Children's Health Insurance Program, or the Covering ALL |
4 | | KIDS Health Insurance Program shall be submitted to the |
5 | | Department or the MCE in which the individual is enrolled for |
6 | | payment and shall be reimbursed at the Department's or the |
7 | | MCE's established rates or rate methodologies for eyeglasses. |
8 | | On and after July 1, 2012, the Department of Healthcare and |
9 | | Family Services may provide the following services to
persons
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10 | | eligible for assistance under this Article who are |
11 | | participating in
education, training or employment programs |
12 | | operated by the Department of Human
Services as successor to |
13 | | the Department of Public Aid:
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14 | | (1) dental services provided by or under the |
15 | | supervision of a dentist; and
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16 | | (2) eyeglasses prescribed by a physician skilled in the |
17 | | diseases of the
eye, or by an optometrist, whichever the |
18 | | person may select.
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19 | | Notwithstanding any other provision of this Code and |
20 | | subject to federal approval, the Department may adopt rules to |
21 | | allow a dentist who is volunteering his or her service at no |
22 | | cost to render dental services through an enrolled |
23 | | not-for-profit health clinic without the dentist personally |
24 | | enrolling as a participating provider in the medical assistance |
25 | | program. A not-for-profit health clinic shall include a public |
26 | | health clinic or Federally Qualified Health Center or other |
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1 | | enrolled provider, as determined by the Department, through |
2 | | which dental services covered under this Section are performed. |
3 | | The Department shall establish a process for payment of claims |
4 | | for reimbursement for covered dental services rendered under |
5 | | this provision. |
6 | | The Illinois Department, by rule, may distinguish and |
7 | | classify the
medical services to be provided only in accordance |
8 | | with the classes of
persons designated in Section 5-2.
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9 | | The Department of Healthcare and Family Services must |
10 | | provide coverage and reimbursement for amino acid-based |
11 | | elemental formulas, regardless of delivery method, for the |
12 | | diagnosis and treatment of (i) eosinophilic disorders and (ii) |
13 | | short bowel syndrome when the prescribing physician has issued |
14 | | a written order stating that the amino acid-based elemental |
15 | | formula is medically necessary.
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16 | | The Illinois Department shall authorize the provision of, |
17 | | and shall
authorize payment for, screening by low-dose |
18 | | mammography for the presence of
occult breast cancer for women |
19 | | 35 years of age or older who are eligible
for medical |
20 | | assistance under this Article, as follows: |
21 | | (A) A baseline
mammogram for women 35 to 39 years of |
22 | | age.
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23 | | (B) An annual mammogram for women 40 years of age or |
24 | | older. |
25 | | (C) A mammogram at the age and intervals considered |
26 | | medically necessary by the woman's health care provider for |
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1 | | women under 40 years of age and having a family history of |
2 | | breast cancer, prior personal history of breast cancer, |
3 | | positive genetic testing, or other risk factors. |
4 | | (D) A comprehensive ultrasound screening of an entire |
5 | | breast or breasts if a mammogram demonstrates |
6 | | heterogeneous or dense breast tissue, when medically |
7 | | necessary as determined by a physician licensed to practice |
8 | | medicine in all of its branches. |
9 | | (E) A screening MRI when medically necessary, as |
10 | | determined by a physician licensed to practice medicine in |
11 | | all of its branches. |
12 | | All screenings
shall
include a physical breast exam, |
13 | | instruction on self-examination and
information regarding the |
14 | | frequency of self-examination and its value as a
preventative |
15 | | tool. For purposes of this Section, "low-dose mammography" |
16 | | means
the x-ray examination of the breast using equipment |
17 | | dedicated specifically
for mammography, including the x-ray |
18 | | tube, filter, compression device,
and image receptor, with an |
19 | | average radiation exposure delivery
of less than one rad per |
20 | | breast for 2 views of an average size breast.
The term also |
21 | | includes digital mammography and includes breast |
22 | | tomosynthesis. As used in this Section, the term "breast |
23 | | tomosynthesis" means a radiologic procedure that involves the |
24 | | acquisition of projection images over the stationary breast to |
25 | | produce cross-sectional digital three-dimensional images of |
26 | | the breast. If, at any time, the Secretary of the United States |
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1 | | Department of Health and Human Services, or its successor |
2 | | agency, promulgates rules or regulations to be published in the |
3 | | Federal Register or publishes a comment in the Federal Register |
4 | | or issues an opinion, guidance, or other action that would |
5 | | require the State, pursuant to any provision of the Patient |
6 | | Protection and Affordable Care Act (Public Law 111-148), |
7 | | including, but not limited to, 42 U.S.C. 18031(d)(3)(B) or any |
8 | | successor provision, to defray the cost of any coverage for |
9 | | breast tomosynthesis outlined in this paragraph, then the |
10 | | requirement that an insurer cover breast tomosynthesis is |
11 | | inoperative other than any such coverage authorized under |
12 | | Section 1902 of the Social Security Act, 42 U.S.C. 1396a, and |
13 | | the State shall not assume any obligation for the cost of |
14 | | coverage for breast tomosynthesis set forth in this paragraph.
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15 | | On and after January 1, 2016, the Department shall ensure |
16 | | that all networks of care for adult clients of the Department |
17 | | include access to at least one breast imaging Center of Imaging |
18 | | Excellence as certified by the American College of Radiology. |
19 | | On and after January 1, 2012, providers participating in a |
20 | | quality improvement program approved by the Department shall be |
21 | | reimbursed for screening and diagnostic mammography at the same |
22 | | rate as the Medicare program's rates, including the increased |
23 | | reimbursement for digital mammography. |
24 | | The Department shall convene an expert panel including |
25 | | representatives of hospitals, free-standing mammography |
26 | | facilities, and doctors, including radiologists, to establish |
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1 | | quality standards for mammography. |
2 | | On and after January 1, 2017, providers participating in a |
3 | | breast cancer treatment quality improvement program approved |
4 | | by the Department shall be reimbursed for breast cancer |
5 | | treatment at a rate that is no lower than 95% of the Medicare |
6 | | program's rates for the data elements included in the breast |
7 | | cancer treatment quality program. |
8 | | The Department shall convene an expert panel, including |
9 | | representatives of hospitals, free standing breast cancer |
10 | | treatment centers, breast cancer quality organizations, and |
11 | | doctors, including breast surgeons, reconstructive breast |
12 | | surgeons, oncologists, and primary care providers to establish |
13 | | quality standards for breast cancer treatment. |
14 | | Subject to federal approval, the Department shall |
15 | | establish a rate methodology for mammography at federally |
16 | | qualified health centers and other encounter-rate clinics. |
17 | | These clinics or centers may also collaborate with other |
18 | | hospital-based mammography facilities. By January 1, 2016, the |
19 | | Department shall report to the General Assembly on the status |
20 | | of the provision set forth in this paragraph. |
21 | | The Department shall establish a methodology to remind |
22 | | women who are age-appropriate for screening mammography, but |
23 | | who have not received a mammogram within the previous 18 |
24 | | months, of the importance and benefit of screening mammography. |
25 | | The Department shall work with experts in breast cancer |
26 | | outreach and patient navigation to optimize these reminders and |
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1 | | shall establish a methodology for evaluating their |
2 | | effectiveness and modifying the methodology based on the |
3 | | evaluation. |
4 | | The Department shall establish a performance goal for |
5 | | primary care providers with respect to their female patients |
6 | | over age 40 receiving an annual mammogram. This performance |
7 | | goal shall be used to provide additional reimbursement in the |
8 | | form of a quality performance bonus to primary care providers |
9 | | who meet that goal. |
10 | | The Department shall devise a means of case-managing or |
11 | | patient navigation for beneficiaries diagnosed with breast |
12 | | cancer. This program shall initially operate as a pilot program |
13 | | in areas of the State with the highest incidence of mortality |
14 | | related to breast cancer. At least one pilot program site shall |
15 | | be in the metropolitan Chicago area and at least one site shall |
16 | | be outside the metropolitan Chicago area. On or after July 1, |
17 | | 2016, the pilot program shall be expanded to include one site |
18 | | in western Illinois, one site in southern Illinois, one site in |
19 | | central Illinois, and 4 sites within metropolitan Chicago. An |
20 | | evaluation of the pilot program shall be carried out measuring |
21 | | health outcomes and cost of care for those served by the pilot |
22 | | program compared to similarly situated patients who are not |
23 | | served by the pilot program. |
24 | | The Department shall require all networks of care to |
25 | | develop a means either internally or by contract with experts |
26 | | in navigation and community outreach to navigate cancer |
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1 | | patients to comprehensive care in a timely fashion. The |
2 | | Department shall require all networks of care to include access |
3 | | for patients diagnosed with cancer to at least one academic |
4 | | commission on cancer-accredited cancer program as an |
5 | | in-network covered benefit. |
6 | | Any medical or health care provider shall immediately |
7 | | recommend, to
any pregnant woman who is being provided prenatal |
8 | | services and is suspected
of drug abuse or is addicted as |
9 | | defined in the Alcoholism and Other Drug Abuse
and Dependency |
10 | | Act, referral to a local substance abuse treatment provider
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11 | | licensed by the Department of Human Services or to a licensed
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12 | | hospital which provides substance abuse treatment services. |
13 | | The Department of Healthcare and Family Services
shall assure |
14 | | coverage for the cost of treatment of the drug abuse or
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15 | | addiction for pregnant recipients in accordance with the |
16 | | Illinois Medicaid
Program in conjunction with the Department of |
17 | | Human Services.
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18 | | All medical providers providing medical assistance to |
19 | | pregnant women
under this Code shall receive information from |
20 | | the Department on the
availability of services under the Drug |
21 | | Free Families with a Future or any
comparable program providing |
22 | | case management services for addicted women,
including |
23 | | information on appropriate referrals for other social services
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24 | | that may be needed by addicted women in addition to treatment |
25 | | for addiction.
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26 | | The Illinois Department, in cooperation with the |
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1 | | Departments of Human
Services (as successor to the Department |
2 | | of Alcoholism and Substance
Abuse) and Public Health, through a |
3 | | public awareness campaign, may
provide information concerning |
4 | | treatment for alcoholism and drug abuse and
addiction, prenatal |
5 | | health care, and other pertinent programs directed at
reducing |
6 | | the number of drug-affected infants born to recipients of |
7 | | medical
assistance.
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8 | | Neither the Department of Healthcare and Family Services |
9 | | nor the Department of Human
Services shall sanction the |
10 | | recipient solely on the basis of
her substance abuse.
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11 | | The Illinois Department shall establish such regulations |
12 | | governing
the dispensing of health services under this Article |
13 | | as it shall deem
appropriate. The Department
should
seek the |
14 | | advice of formal professional advisory committees appointed by
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15 | | the Director of the Illinois Department for the purpose of |
16 | | providing regular
advice on policy and administrative matters, |
17 | | information dissemination and
educational activities for |
18 | | medical and health care providers, and
consistency in |
19 | | procedures to the Illinois Department.
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20 | | The Illinois Department may develop and contract with |
21 | | Partnerships of
medical providers to arrange medical services |
22 | | for persons eligible under
Section 5-2 of this Code. |
23 | | Implementation of this Section may be by
demonstration projects |
24 | | in certain geographic areas. The Partnership shall
be |
25 | | represented by a sponsor organization. The Department, by rule, |
26 | | shall
develop qualifications for sponsors of Partnerships. |
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1 | | Nothing in this
Section shall be construed to require that the |
2 | | sponsor organization be a
medical organization.
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3 | | The sponsor must negotiate formal written contracts with |
4 | | medical
providers for physician services, inpatient and |
5 | | outpatient hospital care,
home health services, treatment for |
6 | | alcoholism and substance abuse, and
other services determined |
7 | | necessary by the Illinois Department by rule for
delivery by |
8 | | Partnerships. Physician services must include prenatal and
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9 | | obstetrical care. The Illinois Department shall reimburse |
10 | | medical services
delivered by Partnership providers to clients |
11 | | in target areas according to
provisions of this Article and the |
12 | | Illinois Health Finance Reform Act,
except that:
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13 | | (1) Physicians participating in a Partnership and |
14 | | providing certain
services, which shall be determined by |
15 | | the Illinois Department, to persons
in areas covered by the |
16 | | Partnership may receive an additional surcharge
for such |
17 | | services.
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18 | | (2) The Department may elect to consider and negotiate |
19 | | financial
incentives to encourage the development of |
20 | | Partnerships and the efficient
delivery of medical care.
|
21 | | (3) Persons receiving medical services through |
22 | | Partnerships may receive
medical and case management |
23 | | services above the level usually offered
through the |
24 | | medical assistance program.
|
25 | | Medical providers shall be required to meet certain |
26 | | qualifications to
participate in Partnerships to ensure the |
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1 | | delivery of high quality medical
services. These |
2 | | qualifications shall be determined by rule of the Illinois
|
3 | | Department and may be higher than qualifications for |
4 | | participation in the
medical assistance program. Partnership |
5 | | sponsors may prescribe reasonable
additional qualifications |
6 | | for participation by medical providers, only with
the prior |
7 | | written approval of the Illinois Department.
|
8 | | Nothing in this Section shall limit the free choice of |
9 | | practitioners,
hospitals, and other providers of medical |
10 | | services by clients.
In order to ensure patient freedom of |
11 | | choice, the Illinois Department shall
immediately promulgate |
12 | | all rules and take all other necessary actions so that
provided |
13 | | services may be accessed from therapeutically certified |
14 | | optometrists
to the full extent of the Illinois Optometric |
15 | | Practice Act of 1987 without
discriminating between service |
16 | | providers.
|
17 | | The Department shall apply for a waiver from the United |
18 | | States Health
Care Financing Administration to allow for the |
19 | | implementation of
Partnerships under this Section.
|
20 | | The Illinois Department shall require health care |
21 | | providers to maintain
records that document the medical care |
22 | | and services provided to recipients
of Medical Assistance under |
23 | | this Article. Such records must be retained for a period of not |
24 | | less than 6 years from the date of service or as provided by |
25 | | applicable State law, whichever period is longer, except that |
26 | | if an audit is initiated within the required retention period |
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1 | | then the records must be retained until the audit is completed |
2 | | and every exception is resolved. The Illinois Department shall
|
3 | | require health care providers to make available, when |
4 | | authorized by the
patient, in writing, the medical records in a |
5 | | timely fashion to other
health care providers who are treating |
6 | | or serving persons eligible for
Medical Assistance under this |
7 | | Article. All dispensers of medical services
shall be required |
8 | | to maintain and retain business and professional records
|
9 | | sufficient to fully and accurately document the nature, scope, |
10 | | details and
receipt of the health care provided to persons |
11 | | eligible for medical
assistance under this Code, in accordance |
12 | | with regulations promulgated by
the Illinois Department. The |
13 | | rules and regulations shall require that proof
of the receipt |
14 | | of prescription drugs, dentures, prosthetic devices and
|
15 | | eyeglasses by eligible persons under this Section accompany |
16 | | each claim
for reimbursement submitted by the dispenser of such |
17 | | medical services.
No such claims for reimbursement shall be |
18 | | approved for payment by the Illinois
Department without such |
19 | | proof of receipt, unless the Illinois Department
shall have put |
20 | | into effect and shall be operating a system of post-payment
|
21 | | audit and review which shall, on a sampling basis, be deemed |
22 | | adequate by
the Illinois Department to assure that such drugs, |
23 | | dentures, prosthetic
devices and eyeglasses for which payment |
24 | | is being made are actually being
received by eligible |
25 | | recipients. Within 90 days after September 16, 1984 (the |
26 | | effective date of Public Act 83-1439), the Illinois Department |
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1 | | shall establish a
current list of acquisition costs for all |
2 | | prosthetic devices and any
other items recognized as medical |
3 | | equipment and supplies reimbursable under
this Article and |
4 | | shall update such list on a quarterly basis, except that
the |
5 | | acquisition costs of all prescription drugs shall be updated no
|
6 | | less frequently than every 30 days as required by Section |
7 | | 5-5.12.
|
8 | | The rules and regulations of the Illinois Department shall |
9 | | require
that a written statement including the required opinion |
10 | | of a physician
shall accompany any claim for reimbursement for |
11 | | abortions, or induced
miscarriages or premature births. This |
12 | | statement shall indicate what
procedures were used in providing |
13 | | such medical services.
|
14 | | Notwithstanding any other law to the contrary, the Illinois |
15 | | Department shall, within 365 days after July 22, 2013 (the |
16 | | effective date of Public Act 98-104), establish procedures to |
17 | | permit skilled care facilities licensed under the Nursing Home |
18 | | Care Act to submit monthly billing claims for reimbursement |
19 | | purposes. Following development of these procedures, the |
20 | | Department shall, by July 1, 2016, test the viability of the |
21 | | new system and implement any necessary operational or |
22 | | structural changes to its information technology platforms in |
23 | | order to allow for the direct acceptance and payment of nursing |
24 | | home claims. |
25 | | Notwithstanding any other law to the contrary, the Illinois |
26 | | Department shall, within 365 days after August 15, 2014 (the |
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1 | | effective date of Public Act 98-963), establish procedures to |
2 | | permit ID/DD facilities licensed under the ID/DD Community Care |
3 | | Act and MC/DD facilities licensed under the MC/DD Act to submit |
4 | | monthly billing claims for reimbursement purposes. Following |
5 | | development of these procedures, the Department shall have an |
6 | | additional 365 days to test the viability of the new system and |
7 | | to ensure that any necessary operational or structural changes |
8 | | to its information technology platforms are implemented. |
9 | | The Illinois Department shall require all dispensers of |
10 | | medical
services, other than an individual practitioner or |
11 | | group of practitioners,
desiring to participate in the Medical |
12 | | Assistance program
established under this Article to disclose |
13 | | all financial, beneficial,
ownership, equity, surety or other |
14 | | interests in any and all firms,
corporations, partnerships, |
15 | | associations, business enterprises, joint
ventures, agencies, |
16 | | institutions or other legal entities providing any
form of |
17 | | health care services in this State under this Article.
|
18 | | The Illinois Department may require that all dispensers of |
19 | | medical
services desiring to participate in the medical |
20 | | assistance program
established under this Article disclose, |
21 | | under such terms and conditions as
the Illinois Department may |
22 | | by rule establish, all inquiries from clients
and attorneys |
23 | | regarding medical bills paid by the Illinois Department, which
|
24 | | inquiries could indicate potential existence of claims or liens |
25 | | for the
Illinois Department.
|
26 | | Enrollment of a vendor
shall be
subject to a provisional |
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1 | | period and shall be conditional for one year. During the period |
2 | | of conditional enrollment, the Department may
terminate the |
3 | | vendor's eligibility to participate in, or may disenroll the |
4 | | vendor from, the medical assistance
program without cause. |
5 | | Unless otherwise specified, such termination of eligibility or |
6 | | disenrollment is not subject to the
Department's hearing |
7 | | process.
However, a disenrolled vendor may reapply without |
8 | | penalty.
|
9 | | The Department has the discretion to limit the conditional |
10 | | enrollment period for vendors based upon category of risk of |
11 | | the vendor. |
12 | | Prior to enrollment and during the conditional enrollment |
13 | | period in the medical assistance program, all vendors shall be |
14 | | subject to enhanced oversight, screening, and review based on |
15 | | the risk of fraud, waste, and abuse that is posed by the |
16 | | category of risk of the vendor. The Illinois Department shall |
17 | | establish the procedures for oversight, screening, and review, |
18 | | which may include, but need not be limited to: criminal and |
19 | | financial background checks; fingerprinting; license, |
20 | | certification, and authorization verifications; unscheduled or |
21 | | unannounced site visits; database checks; prepayment audit |
22 | | reviews; audits; payment caps; payment suspensions; and other |
23 | | screening as required by federal or State law. |
24 | | The Department shall define or specify the following: (i) |
25 | | by provider notice, the "category of risk of the vendor" for |
26 | | each type of vendor, which shall take into account the level of |
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1 | | screening applicable to a particular category of vendor under |
2 | | federal law and regulations; (ii) by rule or provider notice, |
3 | | the maximum length of the conditional enrollment period for |
4 | | each category of risk of the vendor; and (iii) by rule, the |
5 | | hearing rights, if any, afforded to a vendor in each category |
6 | | of risk of the vendor that is terminated or disenrolled during |
7 | | the conditional enrollment period. |
8 | | To be eligible for payment consideration, a vendor's |
9 | | payment claim or bill, either as an initial claim or as a |
10 | | resubmitted claim following prior rejection, must be received |
11 | | by the Illinois Department, or its fiscal intermediary, no |
12 | | later than 180 days after the latest date on the claim on which |
13 | | medical goods or services were provided, with the following |
14 | | exceptions: |
15 | | (1) In the case of a provider whose enrollment is in |
16 | | process by the Illinois Department, the 180-day period |
17 | | shall not begin until the date on the written notice from |
18 | | the Illinois Department that the provider enrollment is |
19 | | complete. |
20 | | (2) In the case of errors attributable to the Illinois |
21 | | Department or any of its claims processing intermediaries |
22 | | which result in an inability to receive, process, or |
23 | | adjudicate a claim, the 180-day period shall not begin |
24 | | until the provider has been notified of the error. |
25 | | (3) In the case of a provider for whom the Illinois |
26 | | Department initiates the monthly billing process. |
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1 | | (4) In the case of a provider operated by a unit of |
2 | | local government with a population exceeding 3,000,000 |
3 | | when local government funds finance federal participation |
4 | | for claims payments. |
5 | | For claims for services rendered during a period for which |
6 | | a recipient received retroactive eligibility, claims must be |
7 | | filed within 180 days after the Department determines the |
8 | | applicant is eligible. For claims for which the Illinois |
9 | | Department is not the primary payer, claims must be submitted |
10 | | to the Illinois Department within 180 days after the final |
11 | | adjudication by the primary payer. |
12 | | In the case of long term care facilities, within 5 days of |
13 | | receipt by the facility of required prescreening information, |
14 | | data for new admissions shall be entered into the Medical |
15 | | Electronic Data Interchange (MEDI) or the Recipient |
16 | | Eligibility Verification (REV) System or successor system, and |
17 | | within 15 days of receipt by the facility of required |
18 | | prescreening information, admission documents shall be |
19 | | submitted through MEDI or REV or shall be submitted directly to |
20 | | the Department of Human Services using required admission |
21 | | forms. Effective September
1, 2014, admission documents, |
22 | | including all prescreening
information, must be submitted |
23 | | through MEDI or REV. Confirmation numbers assigned to an |
24 | | accepted transaction shall be retained by a facility to verify |
25 | | timely submittal. Once an admission transaction has been |
26 | | completed, all resubmitted claims following prior rejection |
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1 | | are subject to receipt no later than 180 days after the |
2 | | admission transaction has been completed. |
3 | | Claims that are not submitted and received in compliance |
4 | | with the foregoing requirements shall not be eligible for |
5 | | payment under the medical assistance program, and the State |
6 | | shall have no liability for payment of those claims. |
7 | | To the extent consistent with applicable information and |
8 | | privacy, security, and disclosure laws, State and federal |
9 | | agencies and departments shall provide the Illinois Department |
10 | | access to confidential and other information and data necessary |
11 | | to perform eligibility and payment verifications and other |
12 | | Illinois Department functions. This includes, but is not |
13 | | limited to: information pertaining to licensure; |
14 | | certification; earnings; immigration status; citizenship; wage |
15 | | reporting; unearned and earned income; pension income; |
16 | | employment; supplemental security income; social security |
17 | | numbers; National Provider Identifier (NPI) numbers; the |
18 | | National Practitioner Data Bank (NPDB); program and agency |
19 | | exclusions; taxpayer identification numbers; tax delinquency; |
20 | | corporate information; and death records. |
21 | | The Illinois Department shall enter into agreements with |
22 | | State agencies and departments, and is authorized to enter into |
23 | | agreements with federal agencies and departments, under which |
24 | | such agencies and departments shall share data necessary for |
25 | | medical assistance program integrity functions and oversight. |
26 | | The Illinois Department shall develop, in cooperation with |
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1 | | other State departments and agencies, and in compliance with |
2 | | applicable federal laws and regulations, appropriate and |
3 | | effective methods to share such data. At a minimum, and to the |
4 | | extent necessary to provide data sharing, the Illinois |
5 | | Department shall enter into agreements with State agencies and |
6 | | departments, and is authorized to enter into agreements with |
7 | | federal agencies and departments, including but not limited to: |
8 | | the Secretary of State; the Department of Revenue; the |
9 | | Department of Public Health; the Department of Human Services; |
10 | | and the Department of Financial and Professional Regulation. |
11 | | Beginning in fiscal year 2013, the Illinois Department |
12 | | shall set forth a request for information to identify the |
13 | | benefits of a pre-payment, post-adjudication, and post-edit |
14 | | claims system with the goals of streamlining claims processing |
15 | | and provider reimbursement, reducing the number of pending or |
16 | | rejected claims, and helping to ensure a more transparent |
17 | | adjudication process through the utilization of: (i) provider |
18 | | data verification and provider screening technology; and (ii) |
19 | | clinical code editing; and (iii) pre-pay, pre- or |
20 | | post-adjudicated predictive modeling with an integrated case |
21 | | management system with link analysis. Such a request for |
22 | | information shall not be considered as a request for proposal |
23 | | or as an obligation on the part of the Illinois Department to |
24 | | take any action or acquire any products or services. |
25 | | The Illinois Department shall establish policies, |
26 | | procedures,
standards and criteria by rule for the acquisition, |
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1 | | repair and replacement
of orthotic and prosthetic devices and |
2 | | durable medical equipment. Such
rules shall provide, but not be |
3 | | limited to, the following services: (1)
immediate repair or |
4 | | replacement of such devices by recipients; and (2) rental, |
5 | | lease, purchase or lease-purchase of
durable medical equipment |
6 | | in a cost-effective manner, taking into
consideration the |
7 | | recipient's medical prognosis, the extent of the
recipient's |
8 | | needs, and the requirements and costs for maintaining such
|
9 | | equipment. Subject to prior approval, such rules shall enable a |
10 | | recipient to temporarily acquire and
use alternative or |
11 | | substitute devices or equipment pending repairs or
|
12 | | replacements of any device or equipment previously authorized |
13 | | for such
recipient by the Department. Notwithstanding any |
14 | | provision of Section 5-5f to the contrary, the Department may, |
15 | | by rule, exempt certain replacement wheelchair parts from prior |
16 | | approval and, for wheelchairs, wheelchair parts, wheelchair |
17 | | accessories, and related seating and positioning items, |
18 | | determine the wholesale price by methods other than actual |
19 | | acquisition costs. |
20 | | The Department shall require, by rule, all providers of |
21 | | durable medical equipment to be accredited by an accreditation |
22 | | organization approved by the federal Centers for Medicare and |
23 | | Medicaid Services and recognized by the Department in order to |
24 | | bill the Department for providing durable medical equipment to |
25 | | recipients. No later than 15 months after the effective date of |
26 | | the rule adopted pursuant to this paragraph, all providers must |
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1 | | meet the accreditation requirement.
|
2 | | The Department shall execute, relative to the nursing home |
3 | | prescreening
project, written inter-agency agreements with the |
4 | | Department of Human
Services and the Department on Aging, to |
5 | | effect the following: (i) intake
procedures and common |
6 | | eligibility criteria for those persons who are receiving
|
7 | | non-institutional services; and (ii) the establishment and |
8 | | development of
non-institutional services in areas of the State |
9 | | where they are not currently
available or are undeveloped; and |
10 | | (iii) notwithstanding any other provision of law, subject to |
11 | | federal approval, on and after July 1, 2012, an increase in the |
12 | | determination of need (DON) scores from 29 to 37 for applicants |
13 | | for institutional and home and community-based long term care; |
14 | | if and only if federal approval is not granted, the Department |
15 | | may, in conjunction with other affected agencies, implement |
16 | | utilization controls or changes in benefit packages to |
17 | | effectuate a similar savings amount for this population; and |
18 | | (iv) no later than July 1, 2013, minimum level of care |
19 | | eligibility criteria for institutional and home and |
20 | | community-based long term care; and (v) no later than October |
21 | | 1, 2013, establish procedures to permit long term care |
22 | | providers access to eligibility scores for individuals with an |
23 | | admission date who are seeking or receiving services from the |
24 | | long term care provider. In order to select the minimum level |
25 | | of care eligibility criteria, the Governor shall establish a |
26 | | workgroup that includes affected agency representatives and |
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1 | | stakeholders representing the institutional and home and |
2 | | community-based long term care interests. This Section shall |
3 | | not restrict the Department from implementing lower level of |
4 | | care eligibility criteria for community-based services in |
5 | | circumstances where federal approval has been granted.
|
6 | | The Illinois Department shall develop and operate, in |
7 | | cooperation
with other State Departments and agencies and in |
8 | | compliance with
applicable federal laws and regulations, |
9 | | appropriate and effective
systems of health care evaluation and |
10 | | programs for monitoring of
utilization of health care services |
11 | | and facilities, as it affects
persons eligible for medical |
12 | | assistance under this Code.
|
13 | | The Illinois Department shall report annually to the |
14 | | General Assembly,
no later than the second Friday in April of |
15 | | 1979 and each year
thereafter, in regard to:
|
16 | | (a) actual statistics and trends in utilization of |
17 | | medical services by
public aid recipients;
|
18 | | (b) actual statistics and trends in the provision of |
19 | | the various medical
services by medical vendors;
|
20 | | (c) current rate structures and proposed changes in |
21 | | those rate structures
for the various medical vendors; and
|
22 | | (d) efforts at utilization review and control by the |
23 | | Illinois Department.
|
24 | | The period covered by each report shall be the 3 years |
25 | | ending on the June
30 prior to the report. The report shall |
26 | | include suggested legislation
for consideration by the General |
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1 | | Assembly. The filing of one copy of the
report with the |
2 | | Speaker, one copy with the Minority Leader and one copy
with |
3 | | the Clerk of the House of Representatives, one copy with the |
4 | | President,
one copy with the Minority Leader and one copy with |
5 | | the Secretary of the
Senate, one copy with the Legislative |
6 | | Research Unit, and such additional
copies
with the State |
7 | | Government Report Distribution Center for the General
Assembly |
8 | | as is required under paragraph (t) of Section 7 of the State
|
9 | | Library Act shall be deemed sufficient to comply with this |
10 | | Section.
|
11 | | Rulemaking authority to implement Public Act 95-1045, if |
12 | | any, is conditioned on the rules being adopted in accordance |
13 | | with all provisions of the Illinois Administrative Procedure |
14 | | Act and all rules and procedures of the Joint Committee on |
15 | | Administrative Rules; any purported rule not so adopted, for |
16 | | whatever reason, is unauthorized. |
17 | | On and after July 1, 2012, the Department shall reduce any |
18 | | rate of reimbursement for services or other payments or alter |
19 | | any methodologies authorized by this Code to reduce any rate of |
20 | | reimbursement for services or other payments in accordance with |
21 | | Section 5-5e. |
22 | | Because kidney transplantation can be an appropriate, cost |
23 | | effective
alternative to renal dialysis when medically |
24 | | necessary and notwithstanding the provisions of Section 1-11 of |
25 | | this Code, beginning October 1, 2014, the Department shall |
26 | | cover kidney transplantation for noncitizens with end-stage |
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1 | | renal disease who are not eligible for comprehensive medical |
2 | | benefits, who meet the residency requirements of Section 5-3 of |
3 | | this Code, and who would otherwise meet the financial |
4 | | requirements of the appropriate class of eligible persons under |
5 | | Section 5-2 of this Code. To qualify for coverage of kidney |
6 | | transplantation, such person must be receiving emergency renal |
7 | | dialysis services covered by the Department. Providers under |
8 | | this Section shall be prior approved and certified by the |
9 | | Department to perform kidney transplantation and the services |
10 | | under this Section shall be limited to services associated with |
11 | | kidney transplantation. |
12 | | Notwithstanding any other provision of this Code to the |
13 | | contrary, on or after July 1, 2015, all FDA approved forms of |
14 | | medication assisted treatment prescribed for the treatment of |
15 | | alcohol dependence or treatment of opioid dependence shall be |
16 | | covered under both fee for service and managed care medical |
17 | | assistance programs for persons who are otherwise eligible for |
18 | | medical assistance under this Article and shall not be subject |
19 | | to any (1) utilization control, other than those established |
20 | | under the American Society of Addiction Medicine patient |
21 | | placement criteria,
(2) prior authorization mandate, or (3) |
22 | | lifetime restriction limit
mandate. |
23 | | On or after July 1, 2015, opioid antagonists prescribed for |
24 | | the treatment of an opioid overdose, including the medication |
25 | | product, administration devices, and any pharmacy fees related |
26 | | to the dispensing and administration of the opioid antagonist, |
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1 | | shall be covered under the medical assistance program for |
2 | | persons who are otherwise eligible for medical assistance under |
3 | | this Article. As used in this Section, "opioid antagonist" |
4 | | means a drug that binds to opioid receptors and blocks or |
5 | | inhibits the effect of opioids acting on those receptors, |
6 | | including, but not limited to, naloxone hydrochloride or any |
7 | | other similarly acting drug approved by the U.S. Food and Drug |
8 | | Administration. |
9 | | Upon federal approval, the Department shall provide |
10 | | coverage and reimbursement for all drugs that are approved for |
11 | | marketing by the federal Food and Drug Administration and that |
12 | | are recommended by the federal Public Health Service or the |
13 | | United States Centers for Disease Control and Prevention for |
14 | | pre-exposure prophylaxis and related pre-exposure prophylaxis |
15 | | services, including, but not limited to, HIV and sexually |
16 | | transmitted infection screening, treatment for sexually |
17 | | transmitted infections, medical monitoring, assorted labs, and |
18 | | counseling to reduce the likelihood of HIV infection among |
19 | | individuals who are not infected with HIV but who are at high |
20 | | risk of HIV infection. |
21 | | (Source: P.A. 98-104, Article 9, Section 9-5, eff. 7-22-13; |
22 | | 98-104, Article 12, Section 12-20, eff. 7-22-13; 98-303, eff. |
23 | | 8-9-13; 98-463, eff. 8-16-13; 98-651, eff. 6-16-14; 98-756, |
24 | | eff. 7-16-14; 98-963, eff. 8-15-14; 99-78, eff. 7-20-15; |
25 | | 99-180, eff. 7-29-15; 99-236, eff. 8-3-15; 99-407 (see Section |
26 | | 20 of P.A. 99-588 for the effective date of P.A. 99-407); |
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1 | | 99-433, eff. 8-21-15; 99-480, eff. 9-9-15; 99-588, eff. |
2 | | 7-20-16; 99-642, eff. 7-28-16; 99-772, eff. 1-1-17; 99-895, |
3 | | eff. 1-1-17; revised 9-20-16.) |
4 | | (305 ILCS 5/5-8) (from Ch. 23, par. 5-8)
|
5 | | Sec. 5-8. Practitioners. In supplying medical assistance, |
6 | | the Illinois
Department may provide for the legally authorized |
7 | | services of (i) persons
licensed under the Medical Practice Act |
8 | | of 1987, as amended, except as
hereafter in this Section |
9 | | stated, whether under a
general or limited license, (ii) |
10 | | persons licensed under the Nurse Practice Act as advanced |
11 | | practice nurses, regardless of whether or not the persons have |
12 | | written collaborative agreements, (iii) persons licensed or |
13 | | registered
under
other laws of this State to provide dental, |
14 | | medical, pharmaceutical,
optometric, podiatric, or nursing |
15 | | services, or other remedial care
recognized under State law, |
16 | | and (iv) persons licensed under other laws of
this State as a |
17 | | clinical social worker. The Department shall adopt rules, no |
18 | | later than 90 days after the effective date of this amendatory |
19 | | Act of the 99th General Assembly, for the legally authorized |
20 | | services of persons licensed under other laws of this State as |
21 | | a clinical social worker.
The Department may not provide for |
22 | | legally
authorized services of any physician who has been |
23 | | convicted of having performed
an abortion procedure in a wilful |
24 | | and wanton manner on a woman who was not
pregnant at the time |
25 | | such abortion procedure was performed. The
utilization of the |
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1 | | services of persons engaged in the treatment or care of
the |
2 | | sick, which persons are not required to be licensed or |
3 | | registered under
the laws of this State, is not prohibited by |
4 | | this Section.
|
5 | | (Source: P.A. 99-173, eff. 7-29-15; 99-621, eff. 1-1-17 .)
|
6 | | (305 ILCS 5/5-9) (from Ch. 23, par. 5-9)
|
7 | | Sec. 5-9. Choice of Medical Dispensers. Applicants and |
8 | | recipients shall
be entitled to free choice of those qualified |
9 | | practitioners, hospitals,
nursing homes, and other dispensers |
10 | | of medical services meeting the
requirements and complying with |
11 | | the rules and regulations of the Illinois
Department. However, |
12 | | the Director of Healthcare and Family Services may, after |
13 | | providing
reasonable notice and opportunity for hearing, deny, |
14 | | suspend or terminate
any otherwise qualified person, firm, |
15 | | corporation, association, agency,
institution, or other legal |
16 | | entity, from participation as a vendor of goods
or services |
17 | | under the medical assistance program authorized by this Article
|
18 | | if the Director finds such vendor of medical services in |
19 | | violation of this
Act or the policy or rules and regulations |
20 | | issued pursuant to this Act. Any
physician who has been |
21 | | convicted of performing an abortion procedure in a
wilful and |
22 | | wanton manner upon a woman who was not pregnant at the time |
23 | | such
abortion procedure was performed shall be automatically |
24 | | removed from the
list of physicians qualified to participate as |
25 | | a vendor of medical services
under the medical assistance |
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1 | | program authorized by this Article.
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2 | | (Source: P.A. 95-331, eff. 8-21-07.)
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3 | | (305 ILCS 5/6-1) (from Ch. 23, par. 6-1)
|
4 | | Sec. 6-1. Eligibility requirements. Financial aid in |
5 | | meeting basic
maintenance requirements shall be given under |
6 | | this Article to
or in behalf of persons who meet the |
7 | | eligibility conditions of Sections
6-1.1 through 6-1.10.
In |
8 | | addition, each unit of local government subject to this Article |
9 | | shall
provide persons receiving financial aid in meeting basic |
10 | | maintenance
requirements with financial aid for either (a) |
11 | | necessary treatment, care, and
supplies required because of |
12 | | illness or disability, or (b) acute medical
treatment, care, |
13 | | and supplies only. If a local governmental unit elects to
|
14 | | provide financial aid for acute medical treatment, care, and |
15 | | supplies only, the
general types of acute medical treatment, |
16 | | care, and supplies for which
financial
aid is provided shall be |
17 | | specified in the general assistance rules of the local
|
18 | | governmental unit, which rules shall provide that financial aid |
19 | | is provided, at
a minimum, for acute medical treatment, care, |
20 | | or supplies necessitated by a
medical condition for which prior |
21 | | approval or authorization of medical
treatment, care, or |
22 | | supplies is not required by the general assistance rules
of the |
23 | | Illinois Department.
Nothing in this Article shall be construed
|
24 | | to permit the granting of financial aid where the purpose of |
25 | | such aid is to
obtain an abortion, induced miscarriage or |
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1 | | induced premature birth
unless, in the opinion of a physician, |
2 | | such procedures are necessary for
the preservation of the life |
3 | | of the woman seeking such treatment, or
except an induced |
4 | | premature birth intended to produce a live viable
child and |
5 | | such procedure is necessary for the health of the mother or
her |
6 | | unborn child.
|
7 | | (Source: P.A. 92-111, eff. 1-1-02.)
|
8 | | Section 15. The Problem Pregnancy Health Services and Care |
9 | | Act is amended by changing Section 4-100 as follows:
|
10 | | (410 ILCS 230/4-100) (from Ch. 111 1/2, par. 4604-100)
|
11 | | Sec. 4-100.
The Department may make grants to nonprofit |
12 | | agencies and organizations
which do not use such grants to |
13 | | refer or counsel for, or perform, abortions
and which |
14 | | coordinate and establish linkages among services that will |
15 | | further
the purposes of this Act and, where appropriate, will |
16 | | provide,
supplement, or improve the quality of such services.
|
17 | | (Source: P.A. 83-51.)
|
18 | | Section 20. The Illinois Abortion Law of 1975 is amended by |
19 | | changing Section 1 as follows:
|
20 | | (720 ILCS 510/1) (from Ch. 38, par. 81-21)
|
21 | | Sec. 1.
It is the intention of the General Assembly of the |
22 | | State of
Illinois to reasonably regulate abortion in |
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1 | | conformance with the
legal standards set forth in the decisions |
2 | | of the United States Supreme Court of January 22, 1973.
Without |
3 | | in any way restricting the right of privacy of a woman or the
|
4 | | right of a woman to an abortion under those decisions, the |
5 | | General
Assembly of the State of Illinois do solemnly declare |
6 | | and find in
reaffirmation of the longstanding policy of this |
7 | | State, that the unborn
child is a human being from the time of |
8 | | conception and is, therefore, a
legal person for purposes of |
9 | | the unborn child's right to life and is
entitled to the right |
10 | | to life from conception under the laws and
Constitution of this |
11 | | State. Further, the General Assembly finds and
declares that |
12 | | longstanding policy of this State to protect the right to
life |
13 | | of the unborn child from conception by prohibiting abortion |
14 | | unless
necessary to preserve the life of the mother is |
15 | | impermissible only
because of the decisions of the United |
16 | | States Supreme Court and that,
therefore, if those decisions of |
17 | | the United States Supreme Court are
ever reversed or modified |
18 | | or the United States Constitution is amended
to allow |
19 | | protection of the unborn then the former policy of this State
|
20 | | to prohibit abortions unless necessary for the preservation of |
21 | | the
mother's life shall be reinstated.
|
22 | | It is the further intention of the General Assembly to |
23 | | assure and protect
the woman's health and the integrity of the |
24 | | woman's decision whether or
not to continue to bear a child, to |
25 | | protect the valid and compelling state
interest in the infant |
26 | | and unborn child, to assure the integrity of marital
and |
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1 | | familial relations and the rights and interests of persons who |
2 | | participate
in such relations, and to gather data for |
3 | | establishing criteria for medical
decisions. The General |
4 | | Assembly finds as fact, upon hearings and public
disclosures, |
5 | | that these rights and interests are not secure in the economic
|
6 | | and social context in which abortion is presently performed.
|
7 | | (Source: P.A. 81-1078.)
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| 1 | |
INDEX
| 2 | |
Statutes amended in order of appearance
| | 3 | | 5 ILCS 375/6 | from Ch. 127, par. 526 | | 4 | | 5 ILCS 375/6.1 | from Ch. 127, par. 526.1 | | 5 | | 305 ILCS 5/5-5 | from Ch. 23, par. 5-5 | | 6 | | 305 ILCS 5/5-8 | from Ch. 23, par. 5-8 | | 7 | | 305 ILCS 5/5-9 | from Ch. 23, par. 5-9 | | 8 | | 305 ILCS 5/6-1 | from Ch. 23, par. 6-1 | | 9 | | 410 ILCS 230/4-100 | from Ch. 111 1/2, par. 4604-100 | | 10 | | 720 ILCS 510/1 | from Ch. 38, par. 81-21 |
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|