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92_HB2438eng HB2438 Engrossed LRB9207067ACcdA 1 AN ACT in relation to senior citizens and disabled 2 persons. 3 Be it enacted by the People of the State of Illinois, 4 represented in the General Assembly: 5 Section 5. The Senior Citizens and Disabled Persons 6 Property Tax Relief and Pharmaceutical Assistance Act is 7 amended by changing Sections 3.07, 4, and 5 and by adding 8 Section 4.1 as follows: 9 (320 ILCS 25/3.07) (from Ch. 67 1/2, par. 403.07) 10 Sec. 3.07. "Income" means adjusted gross income, 11 properly reportable for federal income tax purposes under the 12 provisions of the Internal Revenue Code, modified by adding 13 thereto the sum of the following amounts to the extent 14 deducted or excluded from gross income in the computation of 15 adjusted gross income: 16 (A) An amount equal to all amounts paid or accrued 17 as interest or dividends during the taxable year; 18 (B) An amount equal to the amount of tax imposed by 19 the Illinois Income Tax Act paid for the taxable year; 20 (C) An amount equal to all amounts received during 21 the taxable year as an annuity under an annuity, 22 endowment or life insurance contract or under any other 23 contract or agreement; 24 (D) An amount equal to the amount of benefits paid 25 under the Federal Social Security Act during the taxable 26 year; 27 (E) An amount equal to the amount of benefits paid 28 under the Railroad Retirement Act during the taxable 29 year; 30 (F) An amount equal to the total amount of cash 31 public assistance payments received from any governmental HB2438 Engrossed -2- LRB9207067ACcdA 1 agency during the taxable year other than benefits 2 received pursuant to this Act; 3 (G) An amount equal to any net operating loss 4 carryover deduction or capital loss carryover deduction 5 during the taxable year; 6 (H) For claim years beginning on or after January 7 1, 2002, an amount equal to any benefits received under 8 the Workers' Compensation Act or the Workers' 9 Occupational Diseases Act during the taxable year. 10 "Income" does not include any grant assistance received 11 under the Nursing Home Grant Assistance Act or any 12 distributions or items of income described under subparagraph 13 (X) of paragraph (2) of subsection (a) of Section 203 of the 14 Illinois Income Tax Act. 15 This amendatory Act of 1987 shall be effective for 16 purposes of this Section for tax years ending on or after 17 December 31, 1987. 18 (Source: P.A. 90-491, eff. 1-1-98; 91-676, eff. 12-23-99.) 19 (320 ILCS 25/4) (from Ch. 67 1/2, par. 404) 20 Sec. 4. Amount of Grant. 21 (a) In general. Any individual 65 years or older or any 22 individual who will become 65 years old during the calendar 23 year in which a claim is filed, and any surviving spouse of 24 such a claimant, who at the time of death received or was 25 entitled to receive a grant pursuant to this Section, which 26 surviving spouse will become 65 years of age within the 24 27 months immediately following the death of such claimant and 28 which surviving spouse but for his or her age is otherwise 29 qualified to receive a grant pursuant to this Section, and 30 any disabled person whose annual household income is less 31 than $14,000 for grant years before the 1998 grant year, less 32 than $16,000 for the 1998 and 1999 grant years, and less than 33 (i) $21,218 for a household containing one person, (ii) HB2438 Engrossed -3- LRB9207067ACcdA 1 $28,480 for a household containing 2 persons, or (iii) 2 $35,740 for a household containing 3 or more persons for the 3 2000 grant year and thereafter and whose household is liable 4 for payment of property taxes accrued or has paid rent 5 constituting property taxes accrued and is domiciled in this 6 State at the time he files his claim is entitled to claim a 7 grant under this Act. With respect to claims filed by 8 individuals who will become 65 years old during the calendar 9 year in which a claim is filed, the amount of any grant to 10 which that household is entitled shall be an amount equal to 11 1/12 of the amount to which the claimant would otherwise be 12 entitled as provided in this Section, multiplied by the 13 number of months in which the claimant was 65 in the calendar 14 year in which the claim is filed. 15 (b) Limitation. Except as otherwise provided in 16 subsections (a) and (f) of this Section, the maximum amount 17 of grant which a claimant is entitled to claim is the amount 18 by which the property taxes accrued which were paid or 19 payable during the last preceding tax year or rent 20 constituting property taxes accrued upon the claimant's 21 residence for the last preceding taxable year exceeds 3 1/2% 22 of the claimant's household income for that year but in no 23 event is the grant to exceed (i) $700 less 4.5% of household 24 income for that year for those with a household income of 25 $14,000 or less or (ii) $70 if household income for that year 26 is more than $14,000. 27 (c) Public aid recipients. If household income in one 28 or more months during a year includes cash assistance in 29 excess of $55 per month from the Department of Public Aid or 30 the Department of Human Services (acting as successor to the 31 Department of Public Aid under the Department of Human 32 Services Act) which was determined under regulations of that 33 Department on a measure of need that included an allowance 34 for actual rent or property taxes paid by the recipient of HB2438 Engrossed -4- LRB9207067ACcdA 1 that assistance, the amount of grant to which that household 2 is entitled, except as otherwise provided in subsection (a), 3 shall be the product of (1) the maximum amount computed as 4 specified in subsection (b) of this Section and (2) the ratio 5 of the number of months in which household income did not 6 include such cash assistance over $55 to the number twelve. 7 If household income did not include such cash assistance over 8 $55 for any months during the year, the amount of the grant 9 to which the household is entitled shall be the maximum 10 amount computed as specified in subsection (b) of this 11 Section. For purposes of this paragraph (c), "cash 12 assistance" does not include any amount received under the 13 federal Supplemental Security Income (SSI) program. 14 (d) Joint ownership. If title to the residence is held 15 jointly by the claimant with a person who is not a member of 16 his household, the amount of property taxes accrued used in 17 computing the amount of grant to which he is entitled shall 18 be the same percentage of property taxes accrued as is the 19 percentage of ownership held by the claimant in the 20 residence. 21 (e) More than one residence. If a claimant has occupied 22 more than one residence in the taxable year, he may claim 23 only one residence for any part of a month. In the case of 24 property taxes accrued, he shall pro rate 1/12 of the total 25 property taxes accrued on his residence to each month that he 26 owned and occupied that residence; and, in the case of rent 27 constituting property taxes accrued, shall pro rate each 28 month's rent payments to the residence actually occupied 29 during that month. 30 (f) There is hereby established a program of 31 pharmaceutical assistance to the aged and disabled which 32 shall be administered by the Department in accordance with 33 this Act, to consist of payments to authorized pharmacies, on 34 behalf of beneficiaries of the program, for the reasonable HB2438 Engrossed -5- LRB9207067ACcdA 1 costs of covered prescription drugs. Each beneficiary who 2 pays $5 for an identification card shall pay no additional 3 prescription costs. Each beneficiary who pays $25 for an 4 identification card shall pay $3 per prescription. In 5 addition, after a beneficiary receives $2,000 in benefits 6 during a State fiscal year, that beneficiary shall also be 7 charged 20% of the cost of each prescription for which 8 payments are made by the program during the remainder of the 9 fiscal year. To become a beneficiary under this program a 10 person must be: (1) (i) 65 years or older, or (ii) the 11 surviving spouse of such a claimant, who at the time of death 12 received or was entitled to receive benefits pursuant to this 13 subsection, which surviving spouse will become 65 years of 14 age within the 24 months immediately following the death of 15 such claimant and which surviving spouse but for his or her 16 age is otherwise qualified to receive benefits pursuant to 17 this subsection, or (iii) disabled, and (2) is domiciled in 18 this State at the time he files his or her claim, and (3) has 19 a maximum household income of less than $14,000 for grant 20 years before the 1998 grant year, less than $16,000 for the 21 1998 and 1999 grant years, and less than (i) $21,218 for a 22 household containing one person, (ii) $28,480 for a household 23 containing 2 persons, or (iii) $35,740 for a household 24 containing 3 more persons for the 2000 grant year and 25 thereafter. In addition, each eligible person must (1) obtain 26 an identification card from the Department, (2) at the time 27 the card is obtained, sign a statement assigning to the State 28 of Illinois benefits which may be otherwise claimed under any 29 private insurance plans, (3) present the identification card 30 to the dispensing pharmacist. 31 Whenever a generic equivalent for a covered prescription 32 drug is available, the Department shall reimburse only for 33 the reasonable costs of the generic equivalent, less the 34 co-pay established in this Section, unless (i) the covered HB2438 Engrossed -6- LRB9207067ACcdA 1 prescription drug contains one or more ingredients defined as 2 a narrow therapeutic index drug at 21 CFR 320.33, (ii) the 3 prescriber indicates on the face of the prescription "brand 4 medically necessary", and (iii) the prescriber specifies that 5 a substitution is not permitted. When issuing an oral 6 prescription for covered prescription medication described in 7 item (i) of this paragraph, the prescriber shall stipulate 8 "brand medically necessary" and that a substitution is not 9 permitted. If the covered prescription drug and its 10 authorizing prescription do not meet the criteria listed 11 above, the beneficiary may purchase the non-generic 12 equivalent of the covered prescription drug by paying the 13 difference between the generic cost and the non-generic cost 14 plus the beneficiary co-pay. 15 Any person otherwise eligible for pharmaceutical 16 assistance under this Act whose covered drugs are covered by 17 any public program for assistance in purchasing any covered 18 prescription drugs shall be ineligible for assistance under 19 this Act to the extent such costs are covered by such other 20 plan. 21 The fee to be charged by the Department for the 22 identification card shall be equal to $5 per coverage year 23 for persons below the official poverty line as defined by the 24 United States Department of Health and Human Services and $25 25 per coverage year for all other persons. 26 In the event that 2 or more persons are eligible for any 27 benefit under this Act, and are members of the same 28 household, (1) each such person shall be entitled to 29 participate in the pharmaceutical assistance program, 30 provided that he or she meets all other requirements imposed 31 by this subsection and (2) each participating household 32 member contributes the fee required for that person by the 33 preceding paragraph for the purpose of obtaining an 34 identification card. HB2438 Engrossed -7- LRB9207067ACcdA 1 (Source: P.A. 90-650, eff. 7-27-98; 91-357, eff. 7-29-99; 2 91-699, eff. 1-1-01.) 3 (320 ILCS 25/4.1 new) 4 Sec. 4.1. Information to the Department. 5 Notwithstanding any other law to the contrary, entities 6 subject to the Illinois Insurance Code, Comprehensive Health 7 Insurance Plan Act, Dental Service Plan Act, Children's 8 Health Insurance Program Act, Health Care Purchasing Group 9 Act, Health Maintenance Organization Act, Limited Health 10 Service Organization Act, Voluntary Health Services Plans 11 Act, and the Workers' Compensation Act, including, but not 12 limited to, insurers, health maintenance organizations, 13 pharmacy benefit managers, third party administrators, 14 fraternal benefit societies, group-funded workers' 15 compensation pools, municipal group-funded pools, self-funded 16 or self-insured welfare or benefit plans or programs, and any 17 other entities that provide health coverage through an 18 employer, union, trade association or other organization or 19 source, or any other entities, must provide information to 20 the Department, or its designee, that is necessary to carry 21 out the purposes of this Act, including, but not limited to, 22 the name, social security number, address, date of birth, and 23 coverage of their policyholders, their subscribers, or the 24 beneficiaries of their plans, benefits, or services who 25 participate in the programs under this Act. The provision of 26 this information to the Department or its designee is subject 27 to the confidentiality provisions in Section 8a of this Act. 28 (320 ILCS 25/5) (from Ch. 67 1/2, par. 405) 29 Sec. 5. Procedure. 30 (a) In general. Claims must be filed after January 1, 31 on forms prescribed by the Department. No claim may be filed 32 more than one year after December 31 of the year for which HB2438 Engrossed -8- LRB9207067ACcdA 1 the claim is filed except that claims for 1976 may be filed 2 until December 31, 1978. The pharmaceutical assistance 3 identification card provided for in subsection (f) of Section 4 4 shall be valid for a period not to exceed one year. On and 5 after January 1, 2002, however, to enable the Department to 6 convert coverage for a pharmaceutical assistance program 7 participant to a fiscal year basis, a card shall be valid for 8 a longer or shorter period than 12 months, depending on the 9 date a timely claim is filed and as determined by the 10 Department. 11 (b) Claim is Personal. The right to file a claim under 12 this Act shall be personal to the claimant and shall not 13 survive his death, but such right may be exercised on behalf 14 of a claimant by his legal guardian or attorney-in-fact. If 15 a claimant dies after having filed a timely claim, the amount 16 thereof shall be disbursed to his surviving spouse or, if no 17 spouse survives, to his surviving dependent minor children in 18 equal parts, provided the spouse or child, as the case may 19 be, resided with the claimant at the time he filed his claim. 20 If at the time of disbursement neither the claimant nor his 21 spouse is surviving, and no dependent minor children of the 22 claimant are surviving the amount of the claim shall escheat 23 to the State. 24 (c) One claim per household. Only one member of a 25 household may file a claim under this Act in any calendar 26 year; where both members of a household are otherwise 27 entitled to claim a grant under this Act, they must agree as 28 to which of them will file a claim for that year. 29 (d) Content of application form. The form prescribed by 30 the Department for purposes of paragraph (a) shall include a 31 table, appropriately keyed to the parts of the form on which 32 the claimant is required to furnish information, which will 33 enable the claimant to determine readily the approximate 34 amount of grant to which he is entitled by relating levels of HB2438 Engrossed -9- LRB9207067ACcdA 1 household income to property taxes accrued or rent 2 constituting property taxes accrued. 3 (e) Pharmaceutical Assistance Procedures. The 4 Department shall establish the form and manner for 5 application, and establish by January 1, 1986 a procedure to 6 enable persons to apply for the additional grant or for the 7 pharmaceutical assistance identification card on the same 8 application form. The Department shall determine eligibility 9 for pharmaceutical assistance using the applicant's current 10 income. The Department shall determine a person's current 11 income in the manner provided by the Department by rule. 12 (Source: P.A. 91-533, eff. 8-13-99; 91-699, eff. 1-1-01.) 13 Section 99. Effective date. This Act takes effect upon 14 becoming law.