97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB4685

 

Introduced 2/3/2012, by Rep. Patricia R. Bellock

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 106/7
215 ILCS 170/7
305 ILCS 5/11-5.1

    Amends the Children's Health Insurance Program Act, the Covering ALL KIDS Health Insurance Act, and the Illinois Public Aid Code. Provides that in the event the Department of Healthcare and Family Services receives written correspondence from the federal government that the Department interprets as being a denial of authority to implement eligibility verification provisions enacted by Public Act 96-1501, the Department shall file, as soon as practical, a waiver request formally requesting to implement the provisions. Effective immediately.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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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 Children's Health Insurance Program Act is
5amended by changing Section 7 as follows:
 
6    (215 ILCS 106/7)
7    Sec. 7. Eligibility verification. Notwithstanding any
8other provision of this Act, with respect to applications for
9benefits provided under the Program, eligibility shall be
10determined in a manner that ensures program integrity and that
11complies with federal law and regulations while minimizing
12unnecessary barriers to enrollment. To this end, as soon as
13practicable, and unless the Department receives written denial
14from the federal government, this Section shall be implemented:
15    (a) The Department of Healthcare and Family Services or its
16designees shall:
17        (1) By no later than July 1, 2011, require verification
18    of, at a minimum, one month's income from all sources
19    required for determining the eligibility of applicants to
20    the Program. Such verification shall take the form of pay
21    stubs, business or income and expense records for
22    self-employed persons, letters from employers, and any
23    other valid documentation of income including data

 

 

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1    obtained electronically by the Department or its designees
2    from other sources as described in subsection (b) of this
3    Section.
4        (2) By no later than October 1, 2011, require
5    verification of, at a minimum, one month's income from all
6    sources required for determining the continued eligibility
7    of recipients at their annual review of eligibility under
8    the Program. Such verification shall take the form of pay
9    stubs, business or income and expense records for
10    self-employed persons, letters from employers, and any
11    other valid documentation of income including data
12    obtained electronically by the Department or its designees
13    from other sources as described in subsection (b) of this
14    Section. The Department shall send a notice to the
15    recipient at least 60 days prior to the end of the period
16    of eligibility that informs them of the requirements for
17    continued eligibility. If a recipient does not fulfill the
18    requirements for continued eligibility by the deadline
19    established in the notice, a notice of cancellation shall
20    be issued to the recipient and coverage shall end on the
21    last day of the eligibility period. A recipient's
22    eligibility may be reinstated without requiring a new
23    application if the recipient fulfills the requirements for
24    continued eligibility prior to the end of the month
25    following the last date of coverage. Nothing in this
26    Section shall prevent an individual whose coverage has been

 

 

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1    cancelled from reapplying for health benefits at any time.
2        (3) By no later than July 1, 2011, require verification
3    of Illinois residency.
4    (b) The Department shall establish or continue cooperative
5arrangements with the Social Security Administration, the
6Illinois Secretary of State, the Department of Human Services,
7the Department of Revenue, the Department of Employment
8Security, and any other appropriate entity to gain electronic
9access, to the extent allowed by law, to information available
10to those entities that may be appropriate for electronically
11verifying any factor of eligibility for benefits under the
12Program. Data relevant to eligibility shall be provided for no
13other purpose than to verify the eligibility of new applicants
14or current recipients of health benefits under the Program.
15Data will be requested or provided for any new applicant or
16current recipient only insofar as that individual's
17circumstances are relevant to that individual's or another
18individual's eligibility.
19    (c) Within 90 days of the effective date of this amendatory
20Act of the 96th General Assembly, the Department of Healthcare
21and Family Services shall send notice to current recipients
22informing them of the changes regarding their eligibility
23verification.
24    (d) In the event the Department receives written
25correspondence from the federal government that the Department
26interprets as being a denial of authority to implement this

 

 

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1Section, the Department shall file, as soon as practical, a
2waiver request formally requesting to implement the provisions
3of this Section.
4(Source: P.A. 96-1501, eff. 1-25-11.)
 
5    Section 10. The Covering ALL KIDS Health Insurance Act is
6amended by changing Section 7 as follows:
 
7    (215 ILCS 170/7)
8    (Section scheduled to be repealed on July 1, 2016)
9    Sec. 7. Eligibility verification. Notwithstanding any
10other provision of this Act, with respect to applications for
11benefits provided under the Program, eligibility shall be
12determined in a manner that ensures program integrity and that
13complies with federal law and regulations while minimizing
14unnecessary barriers to enrollment. To this end, as soon as
15practicable, and unless the Department receives written denial
16from the federal government, this Section shall be implemented:
17    (a) The Department of Healthcare and Family Services or its
18designees shall:
19        (1) By July 1, 2011, require verification of, at a
20    minimum, one month's income from all sources required for
21    determining the eligibility of applicants to the Program.
22    Such verification shall take the form of pay stubs,
23    business or income and expense records for self-employed
24    persons, letters from employers, and any other valid

 

 

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1    documentation of income including data obtained
2    electronically by the Department or its designees from
3    other sources as described in subsection (b) of this
4    Section.
5        (2) By October 1, 2011, require verification of, at a
6    minimum, one month's income from all sources required for
7    determining the continued eligibility of recipients at
8    their annual review of eligibility under the Program. Such
9    verification shall take the form of pay stubs, business or
10    income and expense records for self-employed persons,
11    letters from employers, and any other valid documentation
12    of income including data obtained electronically by the
13    Department or its designees from other sources as described
14    in subsection (b) of this Section. The Department shall
15    send a notice to recipients at least 60 days prior to the
16    end of their period of eligibility that informs them of the
17    requirements for continued eligibility. If a recipient
18    does not fulfill the requirements for continued
19    eligibility by the deadline established in the notice, a
20    notice of cancellation shall be issued to the recipient and
21    coverage shall end on the last day of the eligibility
22    period. A recipient's eligibility may be reinstated
23    without requiring a new application if the recipient
24    fulfills the requirements for continued eligibility prior
25    to the end of the month following the last date of
26    coverage. Nothing in this Section shall prevent an

 

 

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1    individual whose coverage has been cancelled from
2    reapplying for health benefits at any time.
3        (3) By July 1, 2011, require verification of Illinois
4    residency.
5    (b) The Department shall establish or continue cooperative
6arrangements with the Social Security Administration, the
7Illinois Secretary of State, the Department of Human Services,
8the Department of Revenue, the Department of Employment
9Security, and any other appropriate entity to gain electronic
10access, to the extent allowed by law, to information available
11to those entities that may be appropriate for electronically
12verifying any factor of eligibility for benefits under the
13Program. Data relevant to eligibility shall be provided for no
14other purpose than to verify the eligibility of new applicants
15or current recipients of health benefits under the Program.
16Data will be requested or provided for any new applicant or
17current recipient only insofar as that individual's
18circumstances are relevant to that individual's or another
19individual's eligibility.
20    (c) Within 90 days of the effective date of this amendatory
21Act of the 96th General Assembly, the Department of Healthcare
22and Family Services shall send notice to current recipients
23informing them of the changes regarding their eligibility
24verification.
25    (d) In the event the Department receives written
26correspondence from the federal government that the Department

 

 

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1interprets as being a denial of authority to implement this
2Section, the Department shall file, as soon as practical, a
3waiver request formally requesting to implement the provisions
4of this Section.
5(Source: P.A. 96-1501, eff. 1-25-11.)
 
6    Section 15. The Illinois Public Aid Code is amended by
7changing Section 11-5.1 as follows:
 
8    (305 ILCS 5/11-5.1)
9    Sec. 11-5.1. Eligibility verification. Notwithstanding any
10other provision of this Code, with respect to applications for
11medical assistance provided under Article V of this Code,
12eligibility shall be determined in a manner that ensures
13program integrity and complies with federal laws and
14regulations while minimizing unnecessary barriers to
15enrollment. To this end, as soon as practicable, and unless the
16Department receives written denial from the federal
17government, this Section shall be implemented:
18    (a) The Department of Healthcare and Family Services or its
19designees shall:
20        (1) By no later than July 1, 2011, require verification
21    of, at a minimum, one month's income from all sources
22    required for determining the eligibility of applicants for
23    medical assistance under this Code. Such verification
24    shall take the form of pay stubs, business or income and

 

 

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1    expense records for self-employed persons, letters from
2    employers, and any other valid documentation of income
3    including data obtained electronically by the Department
4    or its designees from other sources as described in
5    subsection (b) of this Section.
6        (2) By no later than October 1, 2011, require
7    verification of, at a minimum, one month's income from all
8    sources required for determining the continued eligibility
9    of recipients at their annual review of eligibility for
10    medical assistance under this Code. Such verification
11    shall take the form of pay stubs, business or income and
12    expense records for self-employed persons, letters from
13    employers, and any other valid documentation of income
14    including data obtained electronically by the Department
15    or its designees from other sources as described in
16    subsection (b) of this Section. The Department shall send a
17    notice to recipients at least 60 days prior to the end of
18    their period of eligibility that informs them of the
19    requirements for continued eligibility. If a recipient
20    does not fulfill the requirements for continued
21    eligibility by the deadline established in the notice a
22    notice of cancellation shall be issued to the recipient and
23    coverage shall end on the last day of the eligibility
24    period. A recipient's eligibility may be reinstated
25    without requiring a new application if the recipient
26    fulfills the requirements for continued eligibility prior

 

 

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1    to the end of the month following the last date of
2    coverage. Nothing in this Section shall prevent an
3    individual whose coverage has been cancelled from
4    reapplying for health benefits at any time.
5        (3) By no later than July 1, 2011, require verification
6    of Illinois residency.
7    (b) The Department shall establish or continue cooperative
8arrangements with the Social Security Administration, the
9Illinois Secretary of State, the Department of Human Services,
10the Department of Revenue, the Department of Employment
11Security, and any other appropriate entity to gain electronic
12access, to the extent allowed by law, to information available
13to those entities that may be appropriate for electronically
14verifying any factor of eligibility for benefits under the
15Program. Data relevant to eligibility shall be provided for no
16other purpose than to verify the eligibility of new applicants
17or current recipients of health benefits under the Program.
18Data shall be requested or provided for any new applicant or
19current recipient only insofar as that individual's
20circumstances are relevant to that individual's or another
21individual's eligibility.
22    (c) Within 90 days of the effective date of this amendatory
23Act of the 96th General Assembly, the Department of Healthcare
24and Family Services shall send notice to current recipients
25informing them of the changes regarding their eligibility
26verification.

 

 

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1    (d) In the event the Department of Healthcare and Family
2Services receives written correspondence from the federal
3government that the Department interprets as being a denial of
4authority to implement this Section, the Department shall file,
5as soon as practical, a waiver request formally requesting to
6implement the provisions of this Section.
7(Source: P.A. 96-1501, eff. 1-25-11.)
 
8    Section 99. Effective date. This Act takes effect upon
9becoming law.