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Public Act 097-0687


 

Public Act 0687 97TH GENERAL ASSEMBLY

  
  
  

 


 
Public Act 097-0687
 
HB5007 EnrolledLRB097 18977 KTG 64216 b

    AN ACT concerning public aid.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. If and only if both Senate Bill 2840, AS
AMENDED, of the 97th General Assembly and Senate Bill 3397, AS
AMENDED, of the 97th General Assembly become law, then the
Illinois Public Aid Code is amended by changing Sections 5-1.4,
5-2, 5-2.03, 15-1, 15-2, 15-5, and 15-11 as follows:
 
    (305 ILCS 5/5-1.4)
    Sec. 5-1.4. Moratorium on eligibility expansions.
Beginning on January 25, 2011 (the effective date of Public Act
96-1501) this amendatory Act of the 96th General Assembly,
there shall be a 4-year 2-year moratorium on the expansion of
eligibility through increasing financial eligibility
standards, or through increasing income disregards, or through
the creation of new programs which would add new categories of
eligible individuals under the medical assistance program in
addition to those categories covered on January 1, 2011 or
above the level of any subsequent reduction in eligibility.
This moratorium shall not apply to expansions required as a
federal condition of State participation in the medical
assistance program or to expansions approved by the federal
government that are financed entirely by units of local
government and federal matching funds. If the State of Illinois
finds that the State has borne a cost related to such an
expansion, the unit of local government shall reimburse the
State. All federal funds associated with an expansion funded by
a unit of local government shall be returned to the local
government entity funding the expansion, pursuant to an
intergovernmental agreement between the Department of
Healthcare and Family Services and the local government entity.
Within 10 calendar days of the effective date of this
amendatory Act of the 97th General Assembly, the Department of
Healthcare and Family Services shall formally advise the
Centers for Medicare and Medicaid Services of the passage of
this amendatory Act of the 97th General Assembly. The State is
prohibited from submitting additional waiver requests that
expand or allow for an increase in the classes of persons
eligible for medical assistance under this Article to the
federal government for its consideration beginning on the 20th
calendar day following the effective date of this amendatory
Act of the 97th General Assembly until January 25, 2015.
(Source: P.A. 96-1501, eff. 1-25-11.)
 
    (305 ILCS 5/5-2)  (from Ch. 23, par. 5-2)
    Sec. 5-2. Classes of Persons Eligible. Medical assistance
under this Article shall be available to any of the following
classes of persons in respect to whom a plan for coverage has
been submitted to the Governor by the Illinois Department and
approved by him:
        1. Recipients of basic maintenance grants under
    Articles III and IV.
        2. Persons otherwise eligible for basic maintenance
    under Articles III and IV, excluding any eligibility
    requirements that are inconsistent with any federal law or
    federal regulation, as interpreted by the U.S. Department
    of Health and Human Services, but who fail to qualify
    thereunder on the basis of need or who qualify but are not
    receiving basic maintenance under Article IV, and who have
    insufficient income and resources to meet the costs of
    necessary medical care, including but not limited to the
    following:
            (a) All persons otherwise eligible for basic
        maintenance under Article III but who fail to qualify
        under that Article on the basis of need and who meet
        either of the following requirements:
                (i) their income, as determined by the
            Illinois Department in accordance with any federal
            requirements, is equal to or less than 70% in
            fiscal year 2001, equal to or less than 85% in
            fiscal year 2002 and until a date to be determined
            by the Department by rule, and equal to or less
            than 100% beginning on the date determined by the
            Department by rule, of the nonfarm income official
            poverty line, as defined by the federal Office of
            Management and Budget and revised annually in
            accordance with Section 673(2) of the Omnibus
            Budget Reconciliation Act of 1981, applicable to
            families of the same size; or
                (ii) their income, after the deduction of
            costs incurred for medical care and for other types
            of remedial care, is equal to or less than 70% in
            fiscal year 2001, equal to or less than 85% in
            fiscal year 2002 and until a date to be determined
            by the Department by rule, and equal to or less
            than 100% beginning on the date determined by the
            Department by rule, of the nonfarm income official
            poverty line, as defined in item (i) of this
            subparagraph (a).
            (b) All persons who, excluding any eligibility
        requirements that are inconsistent with any federal
        law or federal regulation, as interpreted by the U.S.
        Department of Health and Human Services, would be
        determined eligible for such basic maintenance under
        Article IV by disregarding the maximum earned income
        permitted by federal law.
        3. Persons who would otherwise qualify for Aid to the
    Medically Indigent under Article VII.
        4. Persons not eligible under any of the preceding
    paragraphs who fall sick, are injured, or die, not having
    sufficient money, property or other resources to meet the
    costs of necessary medical care or funeral and burial
    expenses.
        5.(a) Women during pregnancy, after the fact of
    pregnancy has been determined by medical diagnosis, and
    during the 60-day period beginning on the last day of the
    pregnancy, together with their infants and children born
    after September 30, 1983, whose income and resources are
    insufficient to meet the costs of necessary medical care to
    the maximum extent possible under Title XIX of the Federal
    Social Security Act.
        (b) The Illinois Department and the Governor shall
    provide a plan for coverage of the persons eligible under
    paragraph 5(a) by April 1, 1990. Such plan shall provide
    ambulatory prenatal care to pregnant women during a
    presumptive eligibility period and establish an income
    eligibility standard that is equal to 133% of the nonfarm
    income official poverty line, as defined by the federal
    Office of Management and Budget and revised annually in
    accordance with Section 673(2) of the Omnibus Budget
    Reconciliation Act of 1981, applicable to families of the
    same size, provided that costs incurred for medical care
    are not taken into account in determining such income
    eligibility.
        (c) The Illinois Department may conduct a
    demonstration in at least one county that will provide
    medical assistance to pregnant women, together with their
    infants and children up to one year of age, where the
    income eligibility standard is set up to 185% of the
    nonfarm income official poverty line, as defined by the
    federal Office of Management and Budget. The Illinois
    Department shall seek and obtain necessary authorization
    provided under federal law to implement such a
    demonstration. Such demonstration may establish resource
    standards that are not more restrictive than those
    established under Article IV of this Code.
        6. Persons under the age of 18 who fail to qualify as
    dependent under Article IV and who have insufficient income
    and resources to meet the costs of necessary medical care
    to the maximum extent permitted under Title XIX of the
    Federal Social Security Act.
        7. Persons who are under 21 years of age and would
    qualify as disabled as defined under the Federal
    Supplemental Security Income Program, provided medical
    service for such persons would be eligible for Federal
    Financial Participation, and provided the Illinois
    Department determines that:
            (a) the person requires a level of care provided by
        a hospital, skilled nursing facility, or intermediate
        care facility, as determined by a physician licensed to
        practice medicine in all its branches;
            (b) it is appropriate to provide such care outside
        of an institution, as determined by a physician
        licensed to practice medicine in all its branches;
            (c) the estimated amount which would be expended
        for care outside the institution is not greater than
        the estimated amount which would be expended in an
        institution.
        8. Persons who become ineligible for basic maintenance
    assistance under Article IV of this Code in programs
    administered by the Illinois Department due to employment
    earnings and persons in assistance units comprised of
    adults and children who become ineligible for basic
    maintenance assistance under Article VI of this Code due to
    employment earnings. The plan for coverage for this class
    of persons shall:
            (a) extend the medical assistance coverage for up
        to 12 months following termination of basic
        maintenance assistance; and
            (b) offer persons who have initially received 6
        months of the coverage provided in paragraph (a) above,
        the option of receiving an additional 6 months of
        coverage, subject to the following:
                (i) such coverage shall be pursuant to
            provisions of the federal Social Security Act;
                (ii) such coverage shall include all services
            covered while the person was eligible for basic
            maintenance assistance;
                (iii) no premium shall be charged for such
            coverage; and
                (iv) such coverage shall be suspended in the
            event of a person's failure without good cause to
            file in a timely fashion reports required for this
            coverage under the Social Security Act and
            coverage shall be reinstated upon the filing of
            such reports if the person remains otherwise
            eligible.
        9. Persons with acquired immunodeficiency syndrome
    (AIDS) or with AIDS-related conditions with respect to whom
    there has been a determination that but for home or
    community-based services such individuals would require
    the level of care provided in an inpatient hospital,
    skilled nursing facility or intermediate care facility the
    cost of which is reimbursed under this Article. Assistance
    shall be provided to such persons to the maximum extent
    permitted under Title XIX of the Federal Social Security
    Act.
        10. Participants in the long-term care insurance
    partnership program established under the Illinois
    Long-Term Care Partnership Program Act who meet the
    qualifications for protection of resources described in
    Section 15 of that Act.
        11. Persons with disabilities who are employed and
    eligible for Medicaid, pursuant to Section
    1902(a)(10)(A)(ii)(xv) of the Social Security Act, and,
    subject to federal approval, persons with a medically
    improved disability who are employed and eligible for
    Medicaid pursuant to Section 1902(a)(10)(A)(ii)(xvi) of
    the Social Security Act, as provided by the Illinois
    Department by rule. In establishing eligibility standards
    under this paragraph 11, the Department shall, subject to
    federal approval:
            (a) set the income eligibility standard at not
        lower than 350% of the federal poverty level;
            (b) exempt retirement accounts that the person
        cannot access without penalty before the age of 59 1/2,
        and medical savings accounts established pursuant to
        26 U.S.C. 220;
            (c) allow non-exempt assets up to $25,000 as to
        those assets accumulated during periods of eligibility
        under this paragraph 11; and
            (d) continue to apply subparagraphs (b) and (c) in
        determining the eligibility of the person under this
        Article even if the person loses eligibility under this
        paragraph 11.
        12. Subject to federal approval, persons who are
    eligible for medical assistance coverage under applicable
    provisions of the federal Social Security Act and the
    federal Breast and Cervical Cancer Prevention and
    Treatment Act of 2000. Those eligible persons are defined
    to include, but not be limited to, the following persons:
            (1) persons who have been screened for breast or
        cervical cancer under the U.S. Centers for Disease
        Control and Prevention Breast and Cervical Cancer
        Program established under Title XV of the federal
        Public Health Services Act in accordance with the
        requirements of Section 1504 of that Act as
        administered by the Illinois Department of Public
        Health; and
            (2) persons whose screenings under the above
        program were funded in whole or in part by funds
        appropriated to the Illinois Department of Public
        Health for breast or cervical cancer screening.
        "Medical assistance" under this paragraph 12 shall be
    identical to the benefits provided under the State's
    approved plan under Title XIX of the Social Security Act.
    The Department must request federal approval of the
    coverage under this paragraph 12 within 30 days after the
    effective date of this amendatory Act of the 92nd General
    Assembly.
        In addition to the persons who are eligible for medical
    assistance pursuant to subparagraphs (1) and (2) of this
    paragraph 12, and to be paid from funds appropriated to the
    Department for its medical programs, any uninsured person
    as defined by the Department in rules residing in Illinois
    who is younger than 65 years of age, who has been screened
    for breast and cervical cancer in accordance with standards
    and procedures adopted by the Department of Public Health
    for screening, and who is referred to the Department by the
    Department of Public Health as being in need of treatment
    for breast or cervical cancer is eligible for medical
    assistance benefits that are consistent with the benefits
    provided to those persons described in subparagraphs (1)
    and (2). Medical assistance coverage for the persons who
    are eligible under the preceding sentence is not dependent
    on federal approval, but federal moneys may be used to pay
    for services provided under that coverage upon federal
    approval.
        13. Subject to appropriation and to federal approval,
    persons living with HIV/AIDS who are not otherwise eligible
    under this Article and who qualify for services covered
    under Section 5-5.04 as provided by the Illinois Department
    by rule.
        14. Subject to the availability of funds for this
    purpose, the Department may provide coverage under this
    Article to persons who reside in Illinois who are not
    eligible under any of the preceding paragraphs and who meet
    the income guidelines of paragraph 2(a) of this Section and
    (i) have an application for asylum pending before the
    federal Department of Homeland Security or on appeal before
    a court of competent jurisdiction and are represented
    either by counsel or by an advocate accredited by the
    federal Department of Homeland Security and employed by a
    not-for-profit organization in regard to that application
    or appeal, or (ii) are receiving services through a
    federally funded torture treatment center. Medical
    coverage under this paragraph 14 may be provided for up to
    24 continuous months from the initial eligibility date so
    long as an individual continues to satisfy the criteria of
    this paragraph 14. If an individual has an appeal pending
    regarding an application for asylum before the Department
    of Homeland Security, eligibility under this paragraph 14
    may be extended until a final decision is rendered on the
    appeal. The Department may adopt rules governing the
    implementation of this paragraph 14.
        15. Family Care Eligibility.
            (a) Through December 31, 2013, a caretaker
        relative who is 19 years of age or older when countable
        income is at or below 185% of the Federal Poverty Level
        Guidelines, as published annually in the Federal
        Register, for the appropriate family size. Beginning
        January 1, 2014, a caretaker relative who is 19 years
        of age or older when countable income is at or below
        133% of the Federal Poverty Level Guidelines, as
        published annually in the Federal Register, for the
        appropriate family size. A person may not spend down to
        become eligible under this paragraph 15.
            (b) Eligibility shall be reviewed annually.
            (c) Caretaker relatives enrolled under this
        paragraph 15 in families with countable income above
        150% and at or below 185% of the Federal Poverty Level
        Guidelines shall be counted as family members and pay
        premiums as established under the Children's Health
        Insurance Program Act.
            (d) Premiums shall be billed by and payable to the
        Department or its authorized agent, on a monthly basis.
            (e) The premium due date is the last day of the
        month preceding the month of coverage.
            (f) Individuals shall have a grace period through
        60 days of coverage to pay the premium.
            (g) Failure to pay the full monthly premium by the
        last day of the grace period shall result in
        termination of coverage.
            (h) Partial premium payments shall not be
        refunded.
            (i) Following termination of an individual's
        coverage under this paragraph 15, the following action
        is required before the individual can be re-enrolled:
                (1) A new application must be completed and the
            individual must be determined otherwise eligible.
                (2) There must be full payment of premiums due
            under this Code, the Children's Health Insurance
            Program Act, the Covering ALL KIDS Health
            Insurance Act, or any other healthcare program
            administered by the Department for periods in
            which a premium was owed and not paid for the
            individual.
                (3) The first month's premium must be paid if
            there was an unpaid premium on the date the
            individual's previous coverage was canceled.
        The Department is authorized to implement the
    provisions of this amendatory Act of the 95th General
    Assembly by adopting the medical assistance rules in effect
    as of October 1, 2007, at 89 Ill. Admin. Code 125, and at
    89 Ill. Admin. Code 120.32 along with only those changes
    necessary to conform to federal Medicaid requirements,
    federal laws, and federal regulations, including but not
    limited to Section 1931 of the Social Security Act (42
    U.S.C. Sec. 1396u-1), as interpreted by the U.S. Department
    of Health and Human Services, and the countable income
    eligibility standard authorized by this paragraph 15. The
    Department may not otherwise adopt any rule to implement
    this increase except as authorized by law, to meet the
    eligibility standards authorized by the federal government
    in the Medicaid State Plan or the Title XXI Plan, or to
    meet an order from the federal government or any court.
        16. Subject to appropriation, uninsured persons who
    are not otherwise eligible under this Section who have been
    certified and referred by the Department of Public Health
    as having been screened and found to need diagnostic
    evaluation or treatment, or both diagnostic evaluation and
    treatment, for prostate or testicular cancer. For the
    purposes of this paragraph 16, uninsured persons are those
    who do not have creditable coverage, as defined under the
    Health Insurance Portability and Accountability Act, or
    have otherwise exhausted any insurance benefits they may
    have had, for prostate or testicular cancer diagnostic
    evaluation or treatment, or both diagnostic evaluation and
    treatment. To be eligible, a person must furnish a Social
    Security number. A person's assets are exempt from
    consideration in determining eligibility under this
    paragraph 16. Such persons shall be eligible for medical
    assistance under this paragraph 16 for so long as they need
    treatment for the cancer. A person shall be considered to
    need treatment if, in the opinion of the person's treating
    physician, the person requires therapy directed toward
    cure or palliation of prostate or testicular cancer,
    including recurrent metastatic cancer that is a known or
    presumed complication of prostate or testicular cancer and
    complications resulting from the treatment modalities
    themselves. Persons who require only routine monitoring
    services are not considered to need treatment. "Medical
    assistance" under this paragraph 16 shall be identical to
    the benefits provided under the State's approved plan under
    Title XIX of the Social Security Act. Notwithstanding any
    other provision of law, the Department (i) does not have a
    claim against the estate of a deceased recipient of
    services under this paragraph 16 and (ii) does not have a
    lien against any homestead property or other legal or
    equitable real property interest owned by a recipient of
    services under this paragraph 16.
        17. Persons who, pursuant to a waiver approved by the
    Secretary of the U.S. Department of Health and Human
    Services, are eligible for medical assistance under Title
    XIX or XXI of the federal Social Security Act.
    Notwithstanding any other provision of this Code and
    consistent with the terms of the approved waiver, the
    Illinois Department, may by rule:
            (a) Limit the geographic areas in which the waiver
        program operates.
            (b) Determine the scope, quantity, duration, and
        quality, and the rate and method of reimbursement, of
        the medical services to be provided, which may differ
        from those for other classes of persons eligible for
        assistance under this Article.
            (c) Restrict the persons' freedom in choice of
        providers.
    In implementing the provisions of Public Act 96-20, the
Department is authorized to adopt only those rules necessary,
including emergency rules. Nothing in Public Act 96-20 permits
the Department to adopt rules or issue a decision that expands
eligibility for the FamilyCare Program to a person whose income
exceeds 185% of the Federal Poverty Level as determined from
time to time by the U.S. Department of Health and Human
Services, unless the Department is provided with express
statutory authority.
    The Illinois Department and the Governor shall provide a
plan for coverage of the persons eligible under paragraph 7 as
soon as possible after July 1, 1984.
    The eligibility of any such person for medical assistance
under this Article is not affected by the payment of any grant
under the Senior Citizens and Disabled Persons Property Tax
Relief and Pharmaceutical Assistance Act 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. The Department shall by rule establish the
amounts of assets to be disregarded in determining eligibility
for medical assistance, which shall at a minimum equal the
amounts to be disregarded under the Federal Supplemental
Security Income Program. The amount of assets of a single
person to be disregarded shall not be less than $2,000, and the
amount of assets of a married couple to be disregarded shall
not be less than $3,000.
    To the extent permitted under federal law, any person found
guilty of a second violation of Article VIIIA shall be
ineligible for medical assistance under this Article, as
provided in Section 8A-8.
    The eligibility of any person for medical assistance under
this Article shall not be affected by the receipt by the person
of donations or benefits from fundraisers held for the person
in cases of serious illness, as long as neither the person nor
members of the person's family have actual control over the
donations or benefits or the disbursement of the donations or
benefits.
    Notwithstanding any other provision of this Code, if the
United States Supreme Court holds Title II, Subtitle A, Section
2001(a) of Public Law 111-148 to be unconstitutional, or if a
holding of Public Law 111-148 makes Medicaid eligibility
allowed under Section 2001(a) inoperable, the State or a unit
of local government shall be prohibited from enrolling
individuals in the Medical Assistance Program as the result of
federal approval of a State Medicaid waiver on or after the
effective date of this amendatory Act of the 97th General
Assembly, and any individuals enrolled in the Medical
Assistance Program pursuant to eligibility permitted as a
result of such a State Medicaid waiver shall become immediately
ineligible.
    Notwithstanding any other provision of this Code, if an Act
of Congress that becomes a Public Law eliminates Section
2001(a) of Public Law 111-148, the State or a unit of local
government shall be prohibited from enrolling individuals in
the Medical Assistance Program as the result of federal
approval of a State Medicaid waiver on or after the effective
date of this amendatory Act of the 97th General Assembly, and
any individuals enrolled in the Medical Assistance Program
pursuant to eligibility permitted as a result of such a State
Medicaid waiver shall become immediately ineligible.
(Source: P.A. 96-20, eff. 6-30-09; 96-181, eff. 8-10-09;
96-328, eff. 8-11-09; 96-567, eff. 1-1-10; 96-1000, eff.
7-2-10; 96-1123, eff. 1-1-11; 96-1270, eff. 7-26-10; 97-48,
eff. 6-28-11; 97-74, eff. 6-30-11; 97-333, eff. 8-12-11;
revised 10-4-11.)
 
    (305 ILCS 5/5-2.03)
    Sec. 5-2.03. Presumptive eligibility. Beginning on the
effective date of this amendatory Act of the 96th General
Assembly and except where federal law requires presumptive
eligibility, no adult may be presumed eligible for medical
assistance under this Code and the Department may not cover any
service rendered to an adult unless the adult has completed an
application for benefits, all required verifications have been
received, and the Department or its designee has found the
adult eligible for the date on which that service was provided.
Nothing in this Section shall apply to pregnant women or to
persons enrolled under the medical assistance program due to
expansions approved by the federal government that are financed
entirely by units of local government and federal matching
funds.
(Source: P.A. 96-1501, eff. 1-25-11.)
 
    (305 ILCS 5/15-1)  (from Ch. 23, par. 15-1)
    Sec. 15-1. Definitions. As used in this Article, unless the
context requires otherwise:
    (a) (Blank). "Base amount" means $108,800,000 multiplied
by a fraction, the numerator of which is the number of days
represented by the payments in question and the denominator of
which is 365.
    (a-5) "County provider" means a health care provider that
is, or is operated by, a county with a population greater than
3,000,000.
    (b) "Fund" means the County Provider Trust Fund.
    (c) "Hospital" or "County hospital" means a hospital, as
defined in Section 14-1 of this Code, which is a county
hospital located in a county of over 3,000,000 population.
(Source: P.A. 87-13; 88-85; 88-554, eff. 7-26-94.)
 
    (305 ILCS 5/15-2)  (from Ch. 23, par. 15-2)
    Sec. 15-2. County Provider Trust Fund.
    (a) There is created in the State Treasury the County
Provider Trust Fund. Interest earned by the Fund shall be
credited to the Fund. The Fund shall not be used to replace any
funds appropriated to the Medicaid program by the General
Assembly.
    (b) The Fund is created solely for the purposes of
receiving, investing, and distributing monies in accordance
with this Article XV. The Fund shall consist of:
        (1) All monies collected or received by the Illinois
    Department under Section 15-3 of this Code;
        (2) All federal financial participation monies
    received by the Illinois Department pursuant to Title XIX
    of the Social Security Act, 42 U.S.C. 1396b, attributable
    to eligible expenditures made by the Illinois Department
    pursuant to Section 15-5 of this Code;
        (3) All federal moneys received by the Illinois
    Department pursuant to Title XXI of the Social Security Act
    attributable to eligible expenditures made by the Illinois
    Department pursuant to Section 15-5 of this Code; and
        (4) All other monies received by the Fund from any
    source, including interest thereon.
    (c) Disbursements from the Fund shall be by warrants drawn
by the State Comptroller upon receipt of vouchers duly executed
and certified by the Illinois Department and shall be made
only:
        (1) For hospital inpatient care, hospital outpatient
    care, care provided by other outpatient facilities
    operated by a county, and disproportionate share hospital
    adjustment payments made under Title XIX of the Social
    Security Act and Article V of this Code as required by
    Section 15-5 of this Code;
        (1.5) For services provided or purchased by county
    providers pursuant to Section 5-11 of this Code;
        (2) For the reimbursement of administrative expenses
    incurred by county providers on behalf of the Illinois
    Department as permitted by Section 15-4 of this Code;
        (3) For the reimbursement of monies received by the
    Fund through error or mistake;
        (4) For the payment of administrative expenses
    necessarily incurred by the Illinois Department or its
    agent in performing the activities required by this Article
    XV;
        (5) For the payment of any amounts that are
    reimbursable to the federal government, attributable
    solely to the Fund, and required to be paid by State
    warrant; and
        (6) For hospital inpatient care, hospital outpatient
    care, care provided by other outpatient facilities
    operated by a county, and disproportionate share hospital
    adjustment payments made under Title XXI of the Social
    Security Act, pursuant to Section 15-5 of this Code; and .
        (7) For medical care and related services provided
    pursuant to a contract with a county.
(Source: P.A. 95-859, eff. 8-19-08.)
 
    (305 ILCS 5/15-5)  (from Ch. 23, par. 15-5)
    Sec. 15-5. Disbursements from the Fund.
    (a) The monies in the Fund shall be disbursed only as
provided in Section 15-2 of this Code and as follows:
        (1) To the extent that such costs are reimbursable
    under federal law, to pay the county hospitals' inpatient
    reimbursement rates based on actual costs incurred,
    trended forward annually by an inflation index.
        (2) To the extent that such costs are reimbursable
    under federal law, to pay county hospitals and county
    operated outpatient facilities for outpatient services
    based on a federally approved methodology to cover the
    maximum allowable costs.
        (3) To pay the county hospitals disproportionate share
    hospital adjustment payments as may be specified in the
    Illinois Title XIX State plan.
        (3.5) To pay county providers for services provided or
    purchased pursuant to Section 5-11 of this Code.
        (4) To reimburse the county providers for expenses
    contractually assumed pursuant to Section 15-4 of this
    Code.
        (5) To pay the Illinois Department its necessary
    administrative expenses relative to the Fund and other
    amounts agreed to, if any, by the county providers in the
    agreement provided for in subsection (c).
        (6) To pay the county providers any other amount due
    according to a federally approved State plan, including but
    not limited to payments made under the provisions of
    Section 701(d)(3)(B) of the federal Medicare, Medicaid,
    and SCHIP Benefits Improvement and Protection Act of 2000.
    Intergovernmental transfers supporting payments under this
    paragraph (6) shall not be subject to the computation
    described in subsection (a) of Section 15-3 of this Code,
    but shall be computed as the difference between the total
    of such payments made by the Illinois Department to county
    providers less any amount of federal financial
    participation due the Illinois Department under Titles XIX
    and XXI of the Social Security Act as a result of such
    payments to county providers.
    (b) The Illinois Department shall promptly seek all
appropriate amendments to the Illinois Title XIX State Plan to
maximize reimbursement, including disproportionate share
hospital adjustment payments, to the county providers.
    (c) (Blank).
    (d) The payments provided for herein are intended to cover
services rendered on and after July 1, 1991, and any agreement
executed between a qualifying county and the Illinois
Department pursuant to this Section may relate back to that
date, provided the Illinois Department obtains federal
approval. Any changes in payment rates resulting from the
provisions of Article 3 of this amendatory Act of 1992 are
intended to apply to services rendered on or after October 1,
1992, and any agreement executed between a qualifying county
and the Illinois Department pursuant to this Section may be
effective as of that date.
    (e) If one or more hospitals file suit in any court
challenging any part of this Article XV, payments to hospitals
from the Fund under this Article XV shall be made only to the
extent that sufficient monies are available in the Fund and
only to the extent that any monies in the Fund are not
prohibited from disbursement and may be disbursed under any
order of the court.
    (f) All payments under this Section are contingent upon
federal approval of changes to the Title XIX State plan, if
that approval is required.
(Source: P.A. 95-859, eff. 8-19-08.)
 
    (305 ILCS 5/15-11)
    Sec. 15-11. Uses of State funds.
    (a) At any point, if State revenues referenced in
subsection (b) or (c) of Section 15-10 or additional State
grants are disbursed to the Cook County Health and Hospitals
System, all funds may be used only for the following:
        (1) medical services provided at hospitals or clinics
    owned and operated by the Cook County Health and Hospitals
    System Bureau of Health Services; or
        (2) information technology to enhance billing
    capabilities for medical claiming and reimbursement; or .
        (3) services purchased by county providers pursuant to
    Section 5-11 of this Code.
    (b) State funds may not be used for the following:
        (1) non-clinical services, except services that may be
    required by accreditation bodies or State or federal
    regulatory or licensing authorities;
        (2) non-clinical support staff, except as pursuant to
    paragraph (1) of this subsection; or
        (3) capital improvements, other than investments in
    medical technology, except for capital improvements that
    may be required by accreditation bodies or State or federal
    regulatory or licensing authorities.
(Source: P.A. 95-859, eff. 8-19-08.)
 
    Section 99. Effective date. This Act takes effect upon
becoming law; however, no part of this Act takes effect until
both Senate Bill 2840, AS AMENDED, of the 97th General Assembly
and Senate Bill 3397, AS AMENDED, of the 97th General Assembly
have become law.

Effective Date: 06/14/2012