(305 ILCS 5/6-2) (from Ch. 23, par. 6-2)
Sec. 6-2. Amount of aid. The amount and nature of General Assistance
for basic maintenance requirements shall be determined in accordance
with local budget standards for local governmental units which do not receive
State funds. For local governmental units which do receive State funds,
the amount and nature of General Assistance for basic maintenance requirements
shall be determined in accordance with the standards, rules and regulations
of the Illinois Department. However,
the amount and nature of any
financial aid is not affected by the payment of any grant under the
Senior Citizens and Persons with Disabilities Property Tax Relief Act, any rebate authorized under Section 2201(a) of the Coronavirus Aid, Relief, and Economic Security Act (Public Law 116-136) or under any other federal economic stimulus program created in response to the COVID-19 emergency,
or any distributions or items of income described under subparagraph (X) of
paragraph (2) of subsection (a) of Section 203 of the Illinois Income Tax
Act. Due regard shall be given to the
requirements and the conditions existing in each case, and to the income,
money contributions and other support and resources available, from
whatever source. In local governmental units which do not receive State
funds, the grant shall be sufficient when added to all other income, money
contributions and support in excess of any excluded income or resources, to
provide the person with a grant in the amount established for such a person
by the local governmental unit based upon standards meeting basic
maintenance requirements. In local governmental units which
do receive State funds, the grant shall be sufficient when added to all
other income, money contributions and support in excess of any excluded
income or resources, to provide the person with a grant in the amount
established for such a person by Department regulation based upon standards
providing a livelihood compatible with health and well-being, as directed
by Section 12-4.11 of this Code.
The Illinois Department may conduct special projects, which may be
known as Grant Diversion Projects, under which recipients of financial aid
under this Article are placed in jobs and their grants are diverted to the
employer who in turn makes payments to the recipients in the form of salary
or other employment benefits. The Illinois Department shall by rule specify
the terms and conditions of such Grant Diversion Projects. Such projects
shall take into consideration and be coordinated with the programs
administered under the Illinois Emergency Employment Development Act.
The allowances provided under Article IX for recipients participating in
the training and rehabilitation programs shall be in addition to such
maximum payment.
Payments may also be made to provide persons receiving basic
maintenance support with necessary treatment, care and supplies required
because of illness or disability or with acute medical treatment, care,
and supplies.
Payments for necessary or acute medical
care under
this paragraph may be made to or in behalf of the person. Obligations
incurred for such services but not paid for at the time of a recipient's
death may be paid, subject to the rules and regulations of the Illinois
Department, after the death of the recipient.
(Source: P.A. 101-632, eff. 6-5-20.)
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(305 ILCS 5/6-2.1) (from Ch. 23, par. 6-2.1)
Sec. 6-2.1.
Assets of homeless persons.
(a) For the purpose of assisting homeless persons in securing housing,
all assistance units that include a homeless person shall have an asset
disregard no less than that applicable to recipients of benefits under
Article 4 of this Code. For purposes of this Section, "homeless" or
"homeless person" means either of the following:
(1) An individual who lacks a fixed, regular, and |
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(2) An individual who has a primary nighttime
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(A) A supervised publicly or privately operated
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(B) An institution that provides a temporary
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(C) A public or private place not designed for,
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(b) While the Illinois Department shall consider other indicia of
homelessness in determining whether a person is homeless, a letter from a
shelter provider stating that a person is homeless or residing in its
shelter shall create a rebuttable presumption that the person is homeless.
(Source: P.A. 87-1185.)
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(305 ILCS 5/6-9) (from Ch. 23, par. 6-9)
Sec. 6-9.
(a)(1) A local governmental unit may provide assistance to
households under its General Assistance program following a declaration by
the President of the United States of a major disaster or emergency
pursuant to the Federal Disaster Relief Act of 1974, as now or hereafter
amended, if the local governmental unit is within the area designated under
the declaration. A local government unit may also provide assistance to households under its General Assistance program following a disaster proclamation issued by the Governor if the local governmental unit is within the area designated under the proclamation. Assistance under this Section may be provided to
households which have suffered damage, loss or hardships as a result of the
major disaster or emergency. Assistance under this Section may be provided
to households without regard to the eligibility requirements and other
requirements of this Code. Assistance under this Section may be provided
only during the 90-day period following the date of declaration of a major
disaster or emergency.
(2) A local governmental unit
shall not use State funds to provide assistance under this Section. If a local
governmental unit receives State funds to provide General Assistance under this
Article, assistance provided by the local governmental unit under this
Section shall not be considered in determining whether a local governmental
unit has qualified to receive State funds under Article XII.
A local governmental unit which provides assistance under this
Section shall not, as a result of payment of such assistance, change the
nature or amount of assistance provided to any other individual or family
under this Article.
(3) This Section shall not apply to any municipality of more than 500,000
population in which a separate program has been established by the Illinois
Department under Section 6-1.
(b)(1) A local governmental unit may provide assistance to households
for food and temporary shelter. To qualify for assistance a household
shall submit to the local governmental unit: (A) such application as the
local governmental unit may require; (B) a copy of an application to the
Federal Emergency Management Agency (hereinafter "FEMA") or the Small
Business Administration (hereinafter "SBA") for assistance; (C) such other
proof of damage, loss or hardship as the local governmental unit may
require; and (D) an agreement to reimburse the local governmental unit for
the amount of any assistance received by the household under this subsection (b).
(2) Assistance under this subsection (b) may be in the form of cash or
vouchers. The amount of assistance provided to a household in any month
under this subsection (b) shall not exceed the maximum amount payable under Section 6-2.
(3) No assistance shall be provided to a household after it receives a
determination of its application to FEMA or SBA for assistance.
(4) A household which has received assistance under this subsection (b)
shall reimburse the local governmental unit in full for any assistance
received under this subsection. If the household receives
assistance from FEMA or SBA in the form of loans or grants, the household
shall reimburse the local governmental unit from those funds. If the
household's request for assistance is denied or rejected by the FEMA or
SBA, the household shall repay the local governmental unit in accordance with a
repayment schedule prescribed by the local governmental unit.
(c)(1) A local governmental unit may provide assistance to households
for structural repairs to homes or for repair or replacement of home electrical
or heating systems, bedding and food refrigeration equipment. To qualify
for assistance a household shall submit to the local governmental unit:
(A) such application as the local governmental unit may require; (B) a
copy of claim to an insurance company for reimbursement for the damage or
loss for which assistance is sought; (C) such other proof of damage, loss
or hardship as the local governmental unit may require; and (D) an
agreement to reimburse the local governmental unit for the amount of any
assistance received by the household under this subsection (c).
(2) Any assistance provided under this subsection (c) shall be in the
form of direct payments to vendors, and shall not be made directly to a
household. The total amount of assistance provided to a household under
this subsection (c) shall not exceed $1,500.
(3) No assistance shall be provided to a household after it receives a
determination of its insurance claims.
(4) A household which has received assistance under this subsection (c)
shall reimburse the local governmental unit in full for any assistance
received under this subsection. If the household's insurance claim is
approved, the household shall reimburse the local governmental unit from
the proceeds. If the household's insurance claim is denied, the household
shall repay the local governmental unit in accordance with a repayment
schedule prescribed by the local governmental unit.
(Source: P.A. 103-192, eff. 1-1-24 .)
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(305 ILCS 5/6-11) (from Ch. 23, par. 6-11)
Sec. 6-11. General Assistance.
(a) Effective July 1, 1992, all State funded General Assistance and related
medical benefits shall be governed by this Section, provided that, notwithstanding any other provisions of this Code to the contrary, on and after July 1, 2012, the State shall not fund the programs outlined in this Section. Other parts of this Code
or other laws related to General Assistance shall remain in effect to the
extent they do not conflict with the provisions of this Section. If any other
part of this Code or other laws of this State conflict with the provisions of
this Section, the provisions of this Section shall control.
(b) General Assistance may consist of 2 separate
programs. One program shall be for adults with no children and shall be
known as Transitional Assistance. The other program may be for
families with children and for pregnant women and shall be known as
Family and Children Assistance.
(c) (1) To be eligible for Transitional Assistance on or after July
1, 1992, an individual must be ineligible for assistance under any other
Article of this Code, must be determined chronically needy, and must be one of
the following:
(A) age 18 or over or
(B) married and living with a spouse, regardless of |
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(2) The local governmental unit shall determine
whether individuals are chronically needy as follows:
(A) Individuals who have applied for Supplemental
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| Security Income (SSI) and are awaiting a decision on eligibility for SSI who are determined to be a person with a disability by the Illinois Department using the SSI standard shall be considered chronically needy, except that individuals whose disability is based solely on substance use disorders and whose disability would cease were their addictions to end shall be eligible only for medical assistance and shall not be eligible for cash assistance under the Transitional Assistance program.
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(B) (Blank).
(C) The unit of local government may specify other
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| categories of individuals as chronically needy; nothing in this Section, however, shall be deemed to require the inclusion of any specific category other than as specified in paragraph (A).
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(3) For individuals in Transitional Assistance, medical assistance may
be provided by the unit of local government in an amount and nature determined by the unit of local government. Nothing in this paragraph (3) shall be construed to require the coverage of
any particular medical service. In addition, the amount and nature of medical
assistance provided may be different for different categories of individuals
determined chronically needy.
(4) (Blank).
(5) (Blank).
(d) (1) To be eligible for Family and Children Assistance, a
family unit must be ineligible for assistance under any other Article of
this Code and must contain a child who is:
(A) under age 18 or
(B) age 18 and a full-time student in a secondary
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Those children shall be eligible for Family and Children Assistance.
(2) The natural or adoptive parents of the child living in the same
household may be eligible for Family and Children Assistance.
(3) A pregnant woman whose pregnancy has been verified shall be
eligible for income maintenance assistance under the Family and
Children Assistance program.
(4) The amount and nature of medical assistance provided under the
Family and Children Assistance program shall be determined by the unit of local government. The amount and nature of medical
assistance provided
need not be the same as that provided under paragraph (3) of
subsection (c) of this Section, and nothing in this paragraph (4) shall be
construed to require the coverage of any particular medical service.
(5) (Blank).
(e) A local governmental unit that chooses to participate in a
General Assistance program under this Section shall provide
funding in accordance with Section 12-21.13 of this Act.
Local governmental funds used to qualify for State funding may only be
expended for clients eligible for assistance under this Section 6-11 and
related administrative expenses.
(f) (Blank).
(g) (Blank).
(Source: P.A. 99-143, eff. 7-27-15; 100-759, eff. 1-1-19 .)
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(305 ILCS 5/8A-2.5)
Sec. 8A-2.5. Unauthorized use of medical assistance.
(a) Any person who knowingly uses, acquires, possesses, or transfers a
medical card in any manner not authorized by law or by rules and regulations of
the Illinois Department, or who knowingly alters a medical card, or who
knowingly uses, acquires, possesses, or transfers an altered medical card, is
guilty of a violation of this Article and shall be punished as provided in
Section 8A-6.
(b) Any person who knowingly obtains unauthorized medical benefits or causes to be obtained unauthorized medical benefits with or
without use of a medical card is guilty of a violation of this Article and
shall be punished as provided in Section 8A-6.
(b-5) Any vendor that knowingly assists a person in committing a violation under subsection (a) or (b) of this Section is guilty of a violation of this Article and shall be punished as provided in Section 8A-6. (b-6) Any person (including a vendor, organization, agency, or other entity) that, in any matter related to the medical assistance program, knowingly or willfully falsifies, conceals, or omits by any trick, scheme, artifice, or device a material fact, or makes any false, fictitious, or fraudulent statement or representation, or makes or uses any false writing or document, knowing the same to contain any false, fictitious, or fraudulent statement or entry in connection with the provision of health care or related services, is guilty of a violation of this Article and shall be punished as provided in Section 8A-6. (c) The Department may seek to recover any and all State and federal monies for which it has improperly and erroneously paid benefits as a result of a fraudulent action and any civil penalties authorized in this Section. Pursuant to Section 11-14.5 of this Code, the Department may determine the monetary value of benefits improperly and erroneously received. The Department may recover the monies paid for such benefits and interest on that amount at the rate of 5% per annum for the period from which payment was made to the date upon which repayment is made to the State. Prior to the recovery of any amount paid for benefits allegedly obtained by fraudulent means, the recipient or payee of such benefits shall be afforded an opportunity for a hearing after reasonable notice. The notice shall be served personally or by certified or registered mail or as otherwise provided by law upon the parties or their agents appointed to receive service of process and shall include the following: (1) A statement of the time, place and nature of the |
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(2) A statement of the legal authority and
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(3) A reference to the particular Sections of the
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(4) Except where a more detailed statement is
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(5) A statement of the monetary value of the benefits
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(6) A statement that, in addition to any other
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| penalties provided by law, a civil penalty in an amount not to exceed $2,000 may be imposed for each fraudulent claim for benefits or payments.
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(7) A statement providing that the determination of
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| the monetary value may be contested by petitioning the Department for an administrative hearing within 30 days from the date of mailing the notice.
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(8) The names and mailing addresses of the
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| administrative law judge, all parties, and all other persons to whom the agency gives notice of the hearing unless otherwise confidential by law.
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An opportunity shall be afforded all parties to be represented by legal counsel and to respond and present evidence and argument.
Unless precluded by law, disposition may be made of any contested case by stipulation, agreed settlement, consent order, or default.
Any final order, decision, or other determination made, issued or executed by the Director under the provisions of this Article whereby any person is aggrieved shall be subject to review in accordance with the provisions of the Administrative Review Law, and the rules adopted pursuant thereto, which shall apply to and govern all proceedings for the judicial review of final administrative decisions of the Director.
Upon entry of a final administrative decision for repayment of any benefits obtained by fraudulent means, or for any civil penalties assessed, a lien shall attach to all property and assets of such person, firm, corporation, association, agency, institution, vendor, or other legal entity until the judgment is satisfied.
Within 18 months of the effective date of this amendatory Act of the 96th General Assembly, the Department of Healthcare and Family Services will report to the General Assembly on the number of fraud cases identified and pursued, and the fines assessed and collected. The report will also include the Department's analysis as to the use of private sector resources to bring action, investigate, and collect monies owed.
(d) In subsections (a), (b), (b-5) and (b-6), "knowledge" has the meaning ascribed to that term in Section 4-5 of the Criminal Code of 2012. For any administrative action brought under subsection (c) pursuant to a violation of this Section, the Department shall define "knowing" by rule.
(Source: P.A. 97-23, eff. 1-1-12; 98-354, eff. 8-16-13.)
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(305 ILCS 5/8A-3) (from Ch. 23, par. 8A-3)
Sec. 8A-3.
Vendor Fraud and Kickbacks.
(a) Any person, firm, corporation,
association, agency, institution or other legal entity that willfully, by
means of a false statement or representation, or by concealment of any material
fact or by other fraudulent scheme or device on behalf of himself or others,
obtains or attempts to obtain benefits or payments under this Code to which
he or it is not entitled, or in a greater amount than that to which he or
it is entitled, is guilty of a violation of this Article and shall be punished
as provided in Section 8A-6.
(b) A person shall be guilty of a violation of this Article and shall
be punished as provided in Section 8A-6 if he solicits or receives any
remuneration, including any kickback,
bribe, or rebate, directly or indirectly, overtly or covertly, in cash or in kind:
(1) in return for referring an individual to a person for the
furnishing or arranging for the furnishing of any item or service for which
payment may be made in whole or in part under this Code; or
(2) in return for purchasing, leasing, ordering, or arranging for or
recommending purchasing, leasing, or ordering any good, facility, service
or item for which payment may be made in whole or in part under this Code.
(c) A person shall be guilty of a violation of this Article and shall
be punished as provided in Section 8A-6 if he offers or pays any
remuneration, including any kickback,
bribe, or rebate, directly or indirectly, overtly or covertly, in cash or
in kind to any person to induce such person:
(1) to refer an individual to a person for the furnishing or arranging
for the furnishing of any item or service for which payment may be made in
whole or in part under this Code; or
(2) to purchase, lease, order, or arrange for or recommend purchasing,
leasing, or ordering any good, facility, service, or item for which payment
may be made in whole or in part under this Code.
(d) Subsections (b) and (c) shall not apply to:
(1) a discount or other reduction in price obtained by a provider of
services or other entity under this Code if the reduction in price is
properly disclosed and appropriately reflected in the costs claimed or
charges made by the provider or entity under this Code;
(2) any amount paid by an employer to an employee who has a bona fide
employment relationship with such employer for employment in the provision
of covered items or services; or
(3) any amount
paid to or received by a physician for professional
services rendered if a physician, pursuant to a bona fide contract with
a health maintenance organization, as defined by the Health
Maintenance Organization Act, has referred a patient to another physician
for rendering professional services not covered by the health maintenance
organization.
(Source: P.A. 85-818.)
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