Full Text of SB3745 96th General Assembly
SB3745eng 96TH GENERAL ASSEMBLY
|
|
|
SB3745 Engrossed |
|
LRB096 20859 KTG 36630 b |
|
| 1 |
| AN ACT concerning aging.
| 2 |
| Be it enacted by the People of the State of Illinois,
| 3 |
| represented in the General Assembly:
| 4 |
| Section 5. The Senior Citizens and Disabled Persons | 5 |
| Property Tax Relief and
Pharmaceutical Assistance Act is | 6 |
| amended by changing Section 4 as follows:
| 7 |
| (320 ILCS 25/4) (from Ch. 67 1/2, par. 404)
| 8 |
| Sec. 4. Amount of Grant.
| 9 |
| (a) In general. Any individual 65 years or older or any | 10 |
| individual who will
become 65 years old during the calendar | 11 |
| year in which a claim is filed, and any
surviving spouse of | 12 |
| such a claimant, who at the time of death received or was
| 13 |
| entitled to receive a grant pursuant to this Section, which | 14 |
| surviving spouse
will become 65 years of age within the 24 | 15 |
| months immediately following the
death of such claimant and | 16 |
| which surviving spouse but for his or her age is
otherwise | 17 |
| qualified to receive a grant pursuant to this Section, and any
| 18 |
| disabled person whose annual household income is less than the | 19 |
| income eligibility limitation, as defined in subsection (a-5)
| 20 |
| and whose household is liable for payment of property taxes | 21 |
| accrued or has
paid rent constituting property taxes accrued | 22 |
| and is domiciled in this State
at the time he or she files his | 23 |
| or her claim is entitled to claim a
grant under this Act.
With |
|
|
|
SB3745 Engrossed |
- 2 - |
LRB096 20859 KTG 36630 b |
|
| 1 |
| respect to claims filed by individuals who will become 65 years | 2 |
| old
during the calendar year in which a claim is filed, the | 3 |
| amount of any grant
to which that household is entitled shall | 4 |
| be an amount equal to 1/12 of the
amount to which the claimant | 5 |
| would otherwise be entitled as provided in
this Section, | 6 |
| multiplied by the number of months in which the claimant was
65 | 7 |
| in the calendar year in which the claim is filed.
| 8 |
| (a-5) Income eligibility limitation. For purposes of this | 9 |
| Section, "income eligibility limitation" means an amount for | 10 |
| grant years 2008 and thereafter: | 11 |
| (1) less than $22,218 for a household containing one | 12 |
| person; | 13 |
| (2) less than $29,480 for a household containing 2 | 14 |
| persons; or | 15 |
| (3) less than $36,740 for a
household containing 3 or | 16 |
| more persons. | 17 |
| For 2009 claim year applications submitted during calendar | 18 |
| year 2010, a household must have annual household income of | 19 |
| less than $27,610 for a household containing one person; less | 20 |
| than $36,635 for a household containing 2 persons; or less than | 21 |
| $45,657 for a household containing 3 or more persons. | 22 |
| The Department on Aging may adopt rules such that on | 23 |
| January 1, 2011, and thereafter, the foregoing household income | 24 |
| eligibility limits may be changed to reflect the annual cost of | 25 |
| living adjustment in Social Security and Supplemental Security | 26 |
| Income benefits that are applicable to the year for which those |
|
|
|
SB3745 Engrossed |
- 3 - |
LRB096 20859 KTG 36630 b |
|
| 1 |
| benefits are being reported as income on an application. | 2 |
| If a person files as a surviving spouse, then only his or | 3 |
| her income shall be counted in determining his or her household | 4 |
| income. | 5 |
| For the 2011 claim year and each claim year thereafter, if | 6 |
| a person files a claim for a grant under this Act and | 7 |
| represents on the claim form that (i) he or she is a surviving | 8 |
| spouse and (ii) his or her marital status is "single", then | 9 |
| only his or her individual income for the applicable year shall | 10 |
| be counted in determining his or her eligibility for a grant. | 11 |
| (b) Limitation. Except as otherwise provided in | 12 |
| subsections (a) and (f)
of this Section, the maximum amount of | 13 |
| grant which a claimant is
entitled to claim is the amount by | 14 |
| which the property taxes accrued which
were paid or payable | 15 |
| during the last preceding tax year or rent
constituting | 16 |
| property taxes accrued upon the claimant's residence for the
| 17 |
| last preceding taxable year exceeds 3 1/2% of the claimant's | 18 |
| household
income for that year but in no event is the grant to | 19 |
| exceed (i) $700 less
4.5% of household income for that year for | 20 |
| those with a household income of
$14,000 or less or (ii) $70 if | 21 |
| household income for that year is more than
$14,000.
| 22 |
| (c) Public aid recipients. If household income in one or | 23 |
| more
months during a year includes cash assistance in excess of | 24 |
| $55 per month
from the Department of Healthcare and Family | 25 |
| Services or the Department of Human Services (acting
as | 26 |
| successor to the Department of Public Aid under the Department |
|
|
|
SB3745 Engrossed |
- 4 - |
LRB096 20859 KTG 36630 b |
|
| 1 |
| of Human
Services Act) which was determined under regulations | 2 |
| of
that Department on a measure of need that included an | 3 |
| allowance for actual
rent or property taxes paid by the | 4 |
| recipient of that assistance, the amount
of grant to which that | 5 |
| household is entitled, except as otherwise provided in
| 6 |
| subsection (a), shall be the product of (1) the maximum amount | 7 |
| computed as
specified in subsection (b) of this Section and (2) | 8 |
| the ratio of the number of
months in which household income did | 9 |
| not include such cash assistance over $55
to the number twelve. | 10 |
| If household income did not include such cash assistance
over | 11 |
| $55 for any months during the year, the amount of the grant to | 12 |
| which the
household is entitled shall be the maximum amount | 13 |
| computed as specified in
subsection (b) of this Section. For | 14 |
| purposes of this paragraph (c), "cash
assistance" does not | 15 |
| include any amount received under the federal Supplemental
| 16 |
| Security Income (SSI) program.
| 17 |
| (d) Joint ownership. If title to the residence is held | 18 |
| jointly by
the claimant with a person who is not a member of | 19 |
| his or her household,
the amount of property taxes accrued used | 20 |
| in computing the amount of grant
to which he or she is entitled | 21 |
| shall be the same percentage of property
taxes accrued as is | 22 |
| the percentage of ownership held by the claimant in the
| 23 |
| residence.
| 24 |
| (e) More than one residence. If a claimant has occupied | 25 |
| more than
one residence in the taxable year, he or she may | 26 |
| claim only one residence
for any part of a month. In the case |
|
|
|
SB3745 Engrossed |
- 5 - |
LRB096 20859 KTG 36630 b |
|
| 1 |
| of property taxes accrued, he or she
shall prorate 1/12 of the | 2 |
| total property taxes accrued on
his or her residence to each | 3 |
| month that he or she owned and occupied
that residence; and, in | 4 |
| the case of rent constituting property taxes accrued,
shall | 5 |
| prorate each month's rent payments to the residence
actually | 6 |
| occupied during that month.
| 7 |
| (f) (Blank).
| 8 |
| (g) Effective January 1, 2006, there is hereby established | 9 |
| a program of pharmaceutical assistance to the aged and | 10 |
| disabled, entitled the Illinois Seniors and Disabled Drug | 11 |
| Coverage Program, which shall be administered by the Department | 12 |
| of Healthcare and Family Services and the Department on Aging | 13 |
| in accordance with this subsection, to consist of coverage of | 14 |
| specified prescription drugs on behalf of beneficiaries of the | 15 |
| program as set forth in this subsection. | 16 |
| To become a beneficiary under the program established under | 17 |
| this subsection, a person must: | 18 |
| (1) be (i) 65 years of age or older or (ii) disabled; | 19 |
| and | 20 |
| (2) be domiciled in this State; and | 21 |
| (3) enroll with a qualified Medicare Part D | 22 |
| Prescription Drug Plan if eligible and apply for all | 23 |
| available subsidies under Medicare Part D; and | 24 |
| (4) for the 2006 and 2007 claim years, have a maximum | 25 |
| household income of (i) less than $21,218 for a household | 26 |
| containing one person, (ii) less than $28,480 for a |
|
|
|
SB3745 Engrossed |
- 6 - |
LRB096 20859 KTG 36630 b |
|
| 1 |
| household containing 2 persons, or (iii) less than $35,740 | 2 |
| for a household containing 3 or more persons; and | 3 |
| (5) for the 2008 claim year, have a maximum household | 4 |
| income of (i) less than $22,218 for a household containing | 5 |
| one person, (ii) $29,480 for a household containing 2 | 6 |
| persons, or (iii) $36,740 for a household containing 3 or | 7 |
| more persons; and | 8 |
| (6) for 2009 claim year applications submitted during | 9 |
| calendar year 2010, have annual household income of less | 10 |
| than (i) $27,610 for a household containing one person; | 11 |
| (ii) less than $36,635 for a household containing 2 | 12 |
| persons; or (iii) less than $45,657 for a household | 13 |
| containing 3 or more persons. | 14 |
| The Department of Healthcare and Family Services may adopt | 15 |
| rules such that on January 1, 2011, and thereafter, the | 16 |
| foregoing household income eligibility limits may be changed to | 17 |
| reflect the annual cost of living adjustment in Social Security | 18 |
| and Supplemental Security Income benefits that are applicable | 19 |
| to the year for which those benefits are being reported as | 20 |
| income on an application. | 21 |
| For the 2011 claim year and each claim year thereafter, if | 22 |
| a person files a claim for pharmaceutical assistance and | 23 |
| represents on the claim form that (i) he or she is a surviving | 24 |
| spouse and (ii) his or her marital status is "single", then | 25 |
| only his or her individual income for the applicable year shall | 26 |
| be counted in determining his or her eligibility for |
|
|
|
SB3745 Engrossed |
- 7 - |
LRB096 20859 KTG 36630 b |
|
| 1 |
| assistance. | 2 |
| All individuals enrolled as of December 31, 2005, in the | 3 |
| pharmaceutical assistance program operated pursuant to | 4 |
| subsection (f) of this Section and all individuals enrolled as | 5 |
| of December 31, 2005, in the SeniorCare Medicaid waiver program | 6 |
| operated pursuant to Section 5-5.12a of the Illinois Public Aid | 7 |
| Code shall be automatically enrolled in the program established | 8 |
| by this subsection for the first year of operation without the | 9 |
| need for further application, except that they must apply for | 10 |
| Medicare Part D and the Low Income Subsidy under Medicare Part | 11 |
| D. A person enrolled in the pharmaceutical assistance program | 12 |
| operated pursuant to subsection (f) of this Section as of | 13 |
| December 31, 2005, shall not lose eligibility in future years | 14 |
| due only to the fact that they have not reached the age of 65. | 15 |
| To the extent permitted by federal law, the Department may | 16 |
| act as an authorized representative of a beneficiary in order | 17 |
| to enroll the beneficiary in a Medicare Part D Prescription | 18 |
| Drug Plan if the beneficiary has failed to choose a plan and, | 19 |
| where possible, to enroll beneficiaries in the low-income | 20 |
| subsidy program under Medicare Part D or assist them in | 21 |
| enrolling in that program. | 22 |
| Beneficiaries under the program established under this | 23 |
| subsection shall be divided into the following 4 eligibility | 24 |
| groups: | 25 |
| (A) Eligibility Group 1 shall consist of beneficiaries | 26 |
| who are not eligible for Medicare Part D coverage and who
|
|
|
|
SB3745 Engrossed |
- 8 - |
LRB096 20859 KTG 36630 b |
|
| 1 |
| are: | 2 |
| (i) disabled and under age 65; or | 3 |
| (ii) age 65 or older, with incomes over 200% of the | 4 |
| Federal Poverty Level; or | 5 |
| (iii) age 65 or older, with incomes at or below | 6 |
| 200% of the Federal Poverty Level and not eligible for | 7 |
| federally funded means-tested benefits due to | 8 |
| immigration status. | 9 |
| (B) Eligibility Group 2 shall consist of beneficiaries | 10 |
| who are eligible for Medicare Part D coverage. | 11 |
| (C) Eligibility Group 3 shall consist of beneficiaries | 12 |
| age 65 or older, with incomes at or below 200% of the | 13 |
| Federal Poverty Level, who are not barred from receiving | 14 |
| federally funded means-tested benefits due to immigration | 15 |
| status and are not eligible for Medicare Part D coverage. | 16 |
| If the State applies and receives federal approval for | 17 |
| a waiver under Title XIX of the Social Security Act, | 18 |
| persons in Eligibility Group 3 shall continue to receive | 19 |
| benefits through the approved waiver, and Eligibility | 20 |
| Group 3 may be expanded to include disabled persons under | 21 |
| age 65 with incomes under 200% of the Federal Poverty Level | 22 |
| who are not eligible for Medicare and who are not barred | 23 |
| from receiving federally funded means-tested benefits due | 24 |
| to immigration status. | 25 |
| (D) Eligibility Group 4 shall consist of beneficiaries | 26 |
| who are otherwise described in Eligibility Group 2 who have |
|
|
|
SB3745 Engrossed |
- 9 - |
LRB096 20859 KTG 36630 b |
|
| 1 |
| a diagnosis of HIV or AIDS.
| 2 |
| The program established under this subsection shall cover | 3 |
| the cost of covered prescription drugs in excess of the | 4 |
| beneficiary cost-sharing amounts set forth in this paragraph | 5 |
| that are not covered by Medicare. In 2006, beneficiaries shall | 6 |
| pay a co-payment of $2 for each prescription of a generic drug | 7 |
| and $5 for each prescription of a brand-name drug. In future | 8 |
| years, beneficiaries shall pay co-payments equal to the | 9 |
| co-payments required under Medicare Part D for "other | 10 |
| low-income subsidy eligible individuals" pursuant to 42 CFR | 11 |
| 423.782(b). For individuals in Eligibility Groups 1, 2, and 3, | 12 |
| once the program established under this subsection and Medicare | 13 |
| combined have paid $1,750 in a year for covered prescription | 14 |
| drugs, the beneficiary shall pay 20% of the cost of each | 15 |
| prescription in addition to the co-payments set forth in this | 16 |
| paragraph. For individuals in Eligibility Group 4, once the | 17 |
| program established under this subsection and Medicare | 18 |
| combined have paid $1,750 in a year for covered prescription | 19 |
| drugs, the beneficiary shall pay 20% of the cost of each | 20 |
| prescription in addition to the co-payments set forth in this | 21 |
| paragraph unless the drug is included in the formulary of the | 22 |
| Illinois AIDS Drug Assistance Program operated by the Illinois | 23 |
| Department of Public Health and covered by the Medicare Part D | 24 |
| Prescription Drug Plan in which the beneficiary is enrolled. If | 25 |
| the drug is included in the formulary of the Illinois AIDS Drug | 26 |
| Assistance Program and covered by the Medicare Part D |
|
|
|
SB3745 Engrossed |
- 10 - |
LRB096 20859 KTG 36630 b |
|
| 1 |
| Prescription Drug Plan in which the beneficiary is enrolled, | 2 |
| individuals in Eligibility Group 4 shall continue to pay the | 3 |
| co-payments set forth in this paragraph after the program | 4 |
| established under this subsection and Medicare combined have | 5 |
| paid $1,750 in a year for covered prescription drugs.
| 6 |
| For beneficiaries eligible for Medicare Part D coverage, | 7 |
| the program established under this subsection shall pay 100% of | 8 |
| the premiums charged by a qualified Medicare Part D | 9 |
| Prescription Drug Plan for Medicare Part D basic prescription | 10 |
| drug coverage, not including any late enrollment penalties. | 11 |
| Qualified Medicare Part D Prescription Drug Plans may be | 12 |
| limited by the Department of Healthcare and Family Services to | 13 |
| those plans that sign a coordination agreement with the | 14 |
| Department. | 15 |
| Notwithstanding Section 3.15, for purposes of the program | 16 |
| established under this subsection, the term "covered | 17 |
| prescription drug" has the following meanings: | 18 |
| For Eligibility Group 1, "covered prescription drug" | 19 |
| means: (1) any cardiovascular agent or drug; (2) any | 20 |
| insulin or other prescription drug used in the treatment of | 21 |
| diabetes, including syringe and needles used to administer | 22 |
| the insulin; (3) any prescription drug used in the | 23 |
| treatment of arthritis; (4) any prescription drug used in | 24 |
| the treatment of cancer; (5) any prescription drug used in | 25 |
| the treatment of Alzheimer's disease; (6) any prescription | 26 |
| drug used in the treatment of Parkinson's disease; (7) any |
|
|
|
SB3745 Engrossed |
- 11 - |
LRB096 20859 KTG 36630 b |
|
| 1 |
| prescription drug used in the treatment of glaucoma; (8) | 2 |
| any prescription drug used in the treatment of lung disease | 3 |
| and smoking-related illnesses; (9) any prescription drug | 4 |
| used in the treatment of osteoporosis; and (10) any | 5 |
| prescription drug used in the treatment of multiple | 6 |
| sclerosis. The Department may add additional therapeutic | 7 |
| classes by rule. The Department may adopt a preferred drug | 8 |
| list within any of the classes of drugs described in items | 9 |
| (1) through (10) of this paragraph. The specific drugs or | 10 |
| therapeutic classes of covered prescription drugs shall be | 11 |
| indicated by rule. | 12 |
| For Eligibility Group 2, "covered prescription drug" | 13 |
| means those drugs covered by the Medicare Part D | 14 |
| Prescription Drug Plan in which the beneficiary is | 15 |
| enrolled. | 16 |
| For Eligibility Group 3, "covered prescription drug" | 17 |
| means those drugs covered by the Medical Assistance Program | 18 |
| under Article V of the Illinois Public Aid Code. | 19 |
| For Eligibility Group 4, "covered prescription drug" | 20 |
| means those drugs covered by the Medicare Part D | 21 |
| Prescription Drug Plan in which the beneficiary is | 22 |
| enrolled. | 23 |
| An individual in Eligibility Group 1, 2, 3, or 4 may opt to | 24 |
| receive a $25 monthly payment in lieu of the direct coverage | 25 |
| described in this subsection. | 26 |
| Any person otherwise eligible for pharmaceutical |
|
|
|
SB3745 Engrossed |
- 12 - |
LRB096 20859 KTG 36630 b |
|
| 1 |
| assistance under this subsection whose covered drugs are | 2 |
| covered by any public program is ineligible for assistance | 3 |
| under this subsection to the extent that the cost of those | 4 |
| drugs is covered by the other program. | 5 |
| The Department of Healthcare and Family Services shall | 6 |
| establish by rule the methods by which it will provide for the | 7 |
| coverage called for in this subsection. Those methods may | 8 |
| include direct reimbursement to pharmacies or the payment of a | 9 |
| capitated amount to Medicare Part D Prescription Drug Plans. | 10 |
| For a pharmacy to be reimbursed under the program | 11 |
| established under this subsection, it must comply with rules | 12 |
| adopted by the Department of Healthcare and Family Services | 13 |
| regarding coordination of benefits with Medicare Part D | 14 |
| Prescription Drug Plans. A pharmacy may not charge a | 15 |
| Medicare-enrolled beneficiary of the program established under | 16 |
| this subsection more for a covered prescription drug than the | 17 |
| appropriate Medicare cost-sharing less any payment from or on | 18 |
| behalf of the Department of Healthcare and Family Services. | 19 |
| The Department of Healthcare and Family Services or the | 20 |
| Department on Aging, as appropriate, may adopt rules regarding | 21 |
| applications, counting of income, proof of Medicare status, | 22 |
| mandatory generic policies, and pharmacy reimbursement rates | 23 |
| and any other rules necessary for the cost-efficient operation | 24 |
| of the program established under this subsection. | 25 |
| (h) A qualified individual is not entitled to duplicate
| 26 |
| benefits in a coverage period as a result of the changes made
|
|
|
|
SB3745 Engrossed |
- 13 - |
LRB096 20859 KTG 36630 b |
|
| 1 |
| by this amendatory Act of the 96th General Assembly.
| 2 |
| (Source: P.A. 95-208, eff. 8-16-07; 95-644, eff. 10-12-07; | 3 |
| 95-876, eff. 8-21-08; 96-804, eff. 1-1-10.)
| 4 |
| Section 99. Effective date. This Act takes effect upon | 5 |
| becoming law.
|
|