Illinois-2011-HB4685-Introduced

97TH GENERAL ASSEMBLY State of Illinois 2011 and 2012 HB4685

Introduced , 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,

3 represented in the General Assembly:

4 Section 5. The Children's Health Insurance Program Act is

5 amended by changing Section 7 as follows:

6 (215 ILCS 106/7)

7 Sec. 7. Eligibility verification. Notwithstanding any

8 other provision of this Act, with respect to applications for

9 benefits provided under the Program, eligibility shall be

10 determined in a manner that ensures program integrity and that

11 complies with federal law and regulations while minimizing

12 unnecessary barriers to enrollment. To this end, as soon as

13 practicable, and unless the Department receives written denial

14 from the federal government, this Section shall be implemented:

15 (a) The Department of Healthcare and Family Services or its

16 designees 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

5 arrangements with the Social Security Administration, the

6 Illinois Secretary of State, the Department of Human Services,

7 the Department of Revenue, the Department of Employment

8 Security, and any other appropriate entity to gain electronic

9 access, to the extent allowed by law, to information available

10 to those entities that may be appropriate for electronically

11 verifying any factor of eligibility for benefits under the

12 Program. Data relevant to eligibility shall be provided for no

13 other purpose than to verify the eligibility of new applicants

14 or current recipients of health benefits under the Program.

15 Data will be requested or provided for any new applicant or

16 current recipient only insofar as that individual's

17 circumstances are relevant to that individual's or another

18 individual's eligibility.

19 (c) Within 90 days of the effective date of this amendatory

20 Act of the 96th General Assembly, the Department of Healthcare

21 and Family Services shall send notice to current recipients

22 informing them of the changes regarding their eligibility

23 verification.

24 (d) In the event the Department receives written

25 correspondence from the federal government that the Department

26 interprets as being a denial of authority to implement this

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1 Section, the Department shall file, as soon as practical, a

2 waiver request formally requesting to implement the provisions

3 of this Section.

4 (Source: P.A. 96-1501, eff. 1-25-11.)

5 Section 10. The Covering ALL KIDS Health Insurance Act is

6 amended 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

10 other provision of this Act, with respect to applications for

11 benefits provided under the Program, eligibility shall be

12 determined in a manner that ensures program integrity and that

13 complies with federal law and regulations while minimizing

14 unnecessary barriers to enrollment. To this end, as soon as

15 practicable, and unless the Department receives written denial

16 from the federal government, this Section shall be implemented:

17 (a) The Department of Healthcare and Family Services or its

18 designees 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

6 arrangements with the Social Security Administration, the

7 Illinois Secretary of State, the Department of Human Services,

8 the Department of Revenue, the Department of Employment

9 Security, and any other appropriate entity to gain electronic

10 access, to the extent allowed by law, to information available

11 to those entities that may be appropriate for electronically

12 verifying any factor of eligibility for benefits under the

13 Program. Data relevant to eligibility shall be provided for no

14 other purpose than to verify the eligibility of new applicants

15 or current recipients of health benefits under the Program.

16 Data will be requested or provided for any new applicant or

17 current recipient only insofar as that individual's

18 circumstances are relevant to that individual's or another

19 individual's eligibility.

20 (c) Within 90 days of the effective date of this amendatory

21 Act of the 96th General Assembly, the Department of Healthcare

22 and Family Services shall send notice to current recipients

23 informing them of the changes regarding their eligibility

24 verification.

25 (d) In the event the Department receives written

26 correspondence from the federal government that the Department

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1 interprets as being a denial of authority to implement this

2 Section, the Department shall file, as soon as practical, a

3 waiver request formally requesting to implement the provisions

4 of this Section.

5 (Source: P.A. 96-1501, eff. 1-25-11.)

6 Section 15. The Illinois Public Aid Code is amended by

7 changing Section 11-5.1 as follows:

8 (305 ILCS 5/11-5.1)

9 Sec. 11-5.1. Eligibility verification. Notwithstanding any

10 other provision of this Code, with respect to applications for

11 medical assistance provided under Article V of this Code,

12 eligibility shall be determined in a manner that ensures

13 program integrity and complies with federal laws and

14 regulations while minimizing unnecessary barriers to

15 enrollment. To this end, as soon as practicable, and unless the

16 Department receives written denial from the federal

17 government, this Section shall be implemented:

18 (a) The Department of Healthcare and Family Services or its

19 designees 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

8 arrangements with the Social Security Administration, the

9 Illinois Secretary of State, the Department of Human Services,

10 the Department of Revenue, the Department of Employment

11 Security, and any other appropriate entity to gain electronic

12 access, to the extent allowed by law, to information available

13 to those entities that may be appropriate for electronically

14 verifying any factor of eligibility for benefits under the

15 Program. Data relevant to eligibility shall be provided for no

16 other purpose than to verify the eligibility of new applicants

17 or current recipients of health benefits under the Program.

18 Data shall be requested or provided for any new applicant or

19 current recipient only insofar as that individual's

20 circumstances are relevant to that individual's or another

21 individual's eligibility.

22 (c) Within 90 days of the effective date of this amendatory

23 Act of the 96th General Assembly, the Department of Healthcare

24 and Family Services shall send notice to current recipients

25 informing them of the changes regarding their eligibility

26 verification.

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1 (d) In the event the Department of Healthcare and Family

2 Services receives written correspondence from the federal

3 government that the Department interprets as being a denial of

4 authority to implement this Section, the Department shall file,

5 as soon as practical, a waiver request formally requesting to

6 implement 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

9 becoming law.