SB3430 EnrolledLRB103 37615 KTG 67741 b

1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Public Aid Code is amended by
5adding Section 12-4.59 as follows:
 
6    (305 ILCS 5/12-4.59 new)
7    Sec. 12-4.59. Informational guide on Medicaid 5-year
8look-back period.
9    (a) Informational guide. On and after July 1, 2025, the
10Department of Healthcare and Family Services shall develop,
11post, and maintain on its official website a comprehensive
12informational guide that explains the Medicaid 5-year
13look-back period as it applies to eligibility for long-term
14care coverage under the medical assistance program established
15under Article V of this Code. The contents of the
16informational guide must include the following:
17        (1) Overview of the Medicaid 5-year look-back period:
18    A detailed explanation of the 5-year look-back period,
19    including its purpose and relevance to eligibility for
20    medical assistance.
21        (2) Eligibility criteria affected by the Medicaid
22    5-year look-back period: Clear information on how the
23    5-year look-back period affects eligibility criteria,

 

 

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1    including income and asset requirements.
2        (3) Calculation of the Medicaid 5-year look-back
3    period: Step-by-step guidance on how the 5-year look-back
4    period is calculated, including the start date and end
5    date considerations.
6        (4) Examples and scenarios: Real-life examples and
7    scenarios illustrating how the 5-year look-back period
8    applies in different situations, providing practical
9    insights for the public. The guide must include a
10    calculator that allows a user to enter the transfer dates
11    and monetary value of any assets the user transferred
12    during the 5-year look back period in order to estimate
13    the earliest date upon which the user may qualify for
14    medical assistance for long-term care services.
15        (5) Transfers or gifts during the Medicaid 5-year
16    look-back period: Explanation of the consequences and
17    implications of transfers or gifts made during the 5-year
18    look-back period, emphasizing the impact on eligibility
19    and potential penalties.
20        (6) Exceptions and exemptions: Information on
21    exceptions and exemptions to the 5-year look-back period,
22    clarifying circumstances where certain transfers or assets
23    may not be subject to scrutiny.
24        (7) Documentation requirements: Guidance on the
25    documentation individuals may need to provide or maintain
26    to demonstrate compliance with the 5-year look-back

 

 

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1    period.
2        (8) Planning for eligibility: Tips and considerations
3    for individuals and families on how to plan for
4    eligibility for medical assistance under Article V of this
5    Code, taking into account the 5-year look-back period.
6        (9) Appeals and dispute resolution: Information on the
7    process for appeals and dispute resolution related to
8    decisions made based on the 5-year look-back period.
9        (10) Contact information and resources: Clear and
10    accessible contact information for the Department of
11    Healthcare and Family Services, as well as a listing of
12    additional resources or agencies that individuals can
13    reach out to for assistance or further clarification.
14        (11) Frequently asked questions: A "Frequently Asked
15    Questions" section that lists common questions and
16    concerns related to the 5-year look-back period and
17    provides a quick reference for users.
18    (b) Accessibility of the guide. To ensure user-friendly
19navigation and visibility, the Department of Healthcare and
20Family Services shall post on its official website detailed
21information on how users can easily access the comprehensive
22guide on the website and a hyperlink that directs users to the
23comprehensive guide.