Illinois General Assembly - Full Text of SB3415
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Full Text of SB3415  98th General Assembly




State of Illinois
2013 and 2014


Introduced 2/14/2014, by Sen. Dale A. Righter


305 ILCS 5/11-5.2
305 ILCS 5/11-5.3

    Amends the Illinois Public Aid Code. In provisions concerning the State's proposed integrated eligibility system for medical assistance, requires the Governor to meet with the exclusive representative within 14 days after the effective date of the amendatory Act for the purpose of discussing the reasons for a potential proposal to subcontract bargaining unit work. Requires the Department of Human Services to determine, within a specified time period, whether or not labor relations between the State of Illinois and the Department's public employees are currently governed by a collective bargaining agreement. Provides that until the integrated eligibility system is operational "and in order to achieve greater efficiency and economy, if, after review of existing bargaining agreements the Department of Human Services determines that relations between the State and the Department's public employees are currently governed by a collective bargaining agreement", the Department "shall" enter into a contract with the vendor selected as necessary to obtain certain electronic data matching (rather than until the integrated eligibility system is operational, the Department may enter into a contract with the vendor selected as necessary to obtain certain electronic data matching). Contains provisions concerning notice requirements. Extends the time period within which the Department must procure a vendor to verify medical assistance eligibility. Effective immediately.

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SB3415LRB098 15783 KTG 50850 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
5changing Sections 11-5.2 and 11-5.3 as follows:
6    (305 ILCS 5/11-5.2)
7    Sec. 11-5.2. Income, Residency, and Identity Verification
8System. The General Assembly finds that the Department has made
9every reasonable effort to utilize State employees to perform
10eligibility determinations and redeterminations on applicants
11and recipients of assistance provided under Article V of this
12Code. However, the General Assembly declares that there exist
13conditions in the State that require the Department to procure
14a vendor to verify eligibility.
15    (a) The Department shall ensure that its proposed
16integrated eligibility system shall include the computerized
17functions of income, residency, and identity eligibility
18verification to verify eligibility, eliminate duplication of
19medical assistance, and deter fraud. The Governor shall meet
20with the exclusive representative as that term is defined in
21the Illinois Public Labor Relations Act within 14 days after
22the effective date of this amendatory Act of the 98th General
23Assembly for the purpose of discussing the reasons for a



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1potential proposal to subcontract bargaining unit work under
2this Section. Beginning on the 15th day after the effective
3date of this amendatory Act of the 98th General Assembly, the
4Department of Human Services shall begin the process of
5determining whether or not labor relations between the State of
6Illinois and the Department of Human Services' public employees
7are currently governed by a collective bargaining agreement as
8authorized by the Illinois Public Labor Relations Act and shall
9make a final determination by the 16th day after the effective
10date of this amendatory Act. Until the integrated eligibility
11system is operational and in order to achieve greater
12efficiency and economy, if, after review of existing bargaining
13agreements the Department of Human Services determines that
14relations between the State of Illinois and the Department of
15Human Services' public employees are currently governed by a
16collective bargaining agreement, the Department shall may
17enter into a contract with the vendor selected pursuant to
18Section 11-5.3 as necessary to obtain the electronic data
19matching described in this Section. This contract shall be
20exempt from the Illinois Procurement Code pursuant to
21subsection (h) of Section 1-10 of that Code.
22    Prior to fulfilling its obligations under this subsection,
23the Department shall comply with all notice and procedural
24requirements mandated by any labor agreement, if any exists.
25    Prior to issuing a request for services pursuant to its
26obligations under this subsection, the Department shall



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1provide advance notice, which shall not be less than 45 days,
2except in emergency situations, in writing, to the exclusive
3representative as that term is defined in the Illinois Public
4Labor Relations Act.
5    (b) Prior to awarding medical assistance at application
6under Article V of this Code, the Department shall, to the
7extent such databases are available to the Department, conduct
8data matches using the name, date of birth, address, and Social
9Security Number of each applicant or recipient or responsible
10relative of an applicant or recipient against the following:
11        (1) Income tax information.
12        (2) Employer reports of income and unemployment
13    insurance payment information maintained by the Department
14    of Employment Security.
15        (3) Earned and unearned income, citizenship and death,
16    and other relevant information maintained by the Social
17    Security Administration.
18        (4) Immigration status information maintained by the
19    United States Citizenship and Immigration Services.
20        (5) Wage reporting and similar information maintained
21    by states contiguous to this State.
22        (6) Employment information maintained by the
23    Department of Employment Security in its New Hire Directory
24    database.
25        (7) Employment information maintained by the United
26    States Department of Health and Human Services in its



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1    National Directory of New Hires database.
2        (8) Veterans' benefits information maintained by the
3    United States Department of Health and Human Services, in
4    coordination with the Department of Health and Human
5    Services and the Department of Veterans' Affairs, in the
6    federal Public Assistance Reporting Information System
7    (PARIS) database.
8        (9) Residency information maintained by the Illinois
9    Secretary of State.
10        (10) A database which is substantially similar to or a
11    successor of a database described in this Section that
12    contains information relevant for verifying eligibility
13    for medical assistance.
14    (c) (Blank).
15    (d) If a discrepancy results between information provided
16by an applicant, recipient, or responsible relative and
17information contained in one or more of the databases or
18information tools listed under subsection (b) or (c) of this
19Section or subsection (c) of Section 11-5.3 and that
20discrepancy calls into question the accuracy of information
21relevant to a condition of eligibility provided by the
22applicant, recipient, or responsible relative, the Department
23or its contractor shall review the applicant's or recipient's
24case using the following procedures:
25        (1) If the information discovered under subsection (b)
26    (c) of this Section or subsection (c) of Section 11-5.3



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1    does not result in the Department finding the applicant or
2    recipient ineligible for assistance under Article V of this
3    Code, the Department shall finalize the determination or
4    redetermination of eligibility.
5        (2) If the information discovered results in the
6    Department finding the applicant or recipient ineligible
7    for assistance, the Department shall provide notice as set
8    forth in Section 11-7 of this Article.
9        (3) If the information discovered is insufficient to
10    determine that the applicant or recipient is eligible or
11    ineligible, the Department shall provide written notice to
12    the applicant or recipient which shall describe in
13    sufficient detail the circumstances of the discrepancy,
14    the information or documentation required, the manner in
15    which the applicant or recipient may respond, and the
16    consequences of failing to take action. The applicant or
17    recipient shall have 10 business days to respond.
18        (4) If the applicant or recipient does not respond to
19    the notice, the Department shall deny assistance for
20    failure to cooperate, in which case the Department shall
21    provide notice as set forth in Section 11-7. Eligibility
22    for assistance shall not be established until the
23    discrepancy has been resolved.
24        (5) If an applicant or recipient responds to the
25    notice, the Department shall determine the effect of the
26    information or documentation provided on the applicant's



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1    or recipient's case and shall take appropriate action.
2    Written notice of the Department's action shall be provided
3    as set forth in Section 11-7 of this Article.
4        (6) Suspected cases of fraud shall be referred to the
5    Department's Inspector General.
6    (e) The Department shall adopt any rules necessary to
7implement this Section.
8(Source: P.A. 97-689, eff. 6-14-12; revised 11-12-13.)
9    (305 ILCS 5/11-5.3)
10    Sec. 11-5.3. Procurement of vendor to verify eligibility
11for assistance under Article V.
12    (a) No later than 70 60 days after the effective date of
13this amendatory Act of the 98th 97th General Assembly, the
14Chief Procurement Officer for General Services, in
15consultation with the Department of Healthcare and Family
16Services, shall conduct and complete any procurement necessary
17to procure a vendor to verify eligibility for assistance under
18Article V of this Code. Such authority shall include procuring
19a vendor to assist the Chief Procurement Officer in conducting
20the procurement. The Chief Procurement Officer and the
21Department shall jointly negotiate final contract terms with a
22vendor selected by the Chief Procurement Officer. Within 30
23days of selection of an eligibility verification vendor, the
24Department of Healthcare and Family Services shall enter into a
25contract with the selected vendor. The Department of Healthcare



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1and Family Services and the Department of Human Services shall
2cooperate with and provide any information requested by the
3Chief Procurement Officer to conduct the procurement.
4    (b) Notwithstanding any other provision of law, any
5procurement or contract necessary to comply with this Section
6shall be exempt from: (i) the Illinois Procurement Code
7pursuant to Section 1-10(h) of the Illinois Procurement Code,
8except that bidders shall comply with the disclosure
9requirement in Sections 50-10.5(a) through (d), 50-13, 50-35,
10and 50-37 of the Illinois Procurement Code and a vendor awarded
11a contract under this Section shall comply with Section 50-37
12of the Illinois Procurement Code; (ii) any administrative rules
13of this State pertaining to procurement or contract formation;
14and (iii) any State or Department policies or procedures
15pertaining to procurement, contract formation, contract award,
16and Business Enterprise Program approval.
17    (c) Upon becoming operational, the contractor shall
18conduct data matches using the name, date of birth, address,
19and Social Security Number of each applicant and recipient
20against public records to verify eligibility. The contractor,
21upon preliminary determination that an enrollee is eligible or
22ineligible, shall notify the Department, except that the
23contractor shall not make preliminary determinations regarding
24the eligibility of persons residing in long term care
25facilities whose income and resources were at or below the
26applicable financial eligibility standards at the time of their



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1last review. Within 20 business days of such notification, the
2Department shall accept the recommendation or reject it with a
3stated reason. The Department shall retain final authority over
4eligibility determinations. The contractor shall keep a record
5of all preliminary determinations of ineligibility
6communicated to the Department. Within 30 days of the end of
7each calendar quarter, the Department and contractor shall file
8a joint report on a quarterly basis to the Governor, the
9Speaker of the House of Representatives, the Minority Leader of
10the House of Representatives, the Senate President, and the
11Senate Minority Leader. The report shall include, but shall not
12be limited to, monthly recommendations of preliminary
13determinations of eligibility or ineligibility communicated by
14the contractor, the actions taken on those preliminary
15determinations by the Department, and the stated reasons for
16those recommendations that the Department rejected.
17    (d) An eligibility verification vendor contract shall be
18awarded for an initial 2-year period with up to a maximum of 2
19one-year renewal options. Nothing in this Section shall compel
20the award of a contract to a vendor that fails to meet the
21needs of the Department. A contract with a vendor to assist in
22the procurement shall be awarded for a period of time not to
23exceed 6 months.
24    (e) The provisions of this Section shall be administered in
25compliance with federal law.
26(Source: P.A. 97-689, eff. 6-14-12; 98-104, eff. 7-22-13.)



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1    Section 99. Effective date. This Act takes effect upon
2becoming law.