Public Act 097-0687 Public Act 0687 97TH GENERAL ASSEMBLY |
Public Act 097-0687 | HB5007 Enrolled | LRB097 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
|