HB 4343

Abstract

Amends the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to waive estate recovery under specified provisions of the Code where recovery would not be cost-effective, would work an undue hardship, or for any other just reason. Provides that when an estate is not valued at a minimum of $25,000, it is not cost-effective to pursue recovery. Requires the Department to pursue a State Plan amendment to establish a cost-effectiveness threshold of $25,000. Sets forth the circumstances under which an estate may apply for an undue hardship waiver. Requires the Department to make information about estate recovery and hardship waivers easily accessible. Requires the Department to maintain on its website information on how to request a hardship waiver in English, Spanish, and the next 4 most commonly used languages. In a provision concerning eligibility verification for medical assistance, requires the Department to include seniors and persons with disabilities in ex parte renewals. Requires the Department to use its asset verification system, accept the data provided about an individual's assets, and automatically renew the individual's coverage for medical assistance. Requires the Department to pursue a State Plan amendment, if required, by July 1, 2022 to implement ex parte renewals. In order to achieve efficiencies in the Medicare Savings Program's enrollment process, requires the Department to investigate how to align the eligibility criteria under the Medicare Savings Program with the criteria used by the Medicare Part D Low-Income Subsidy (LIS) program. Requires the Department to issue a report, by July 1, 2022, with its recommendations on alignment and outreach. Provides that by October 31, 2022, the Department shall change the Medicare Savings Program's eligibility criteria to facilitate the use of LIS leads data to automate or streamline enrollment into Medicare Savings Program benefits. Repeals several provisions concerning the State's authority to place a lien on a recipient's real property interests in order to recover payments made by the State on the recipient's behalf under the Aid to the Aged, Blind or Disabled program or the Medical Assistance program. Effective immediately. House Committee Amendment No. 1 Adds reference to: 305 ILCS 5/5-1.6 new Replaces everything after the enacting clause. Reinserts the provisions of the introduced bill with the following changes: Requires the Department of Healthcare and Family Services to seek a State Plan amendment or any federal waivers necessary to implement 12 months of continuous eligibility for adults participating in the medical assistance program. Requires the Department to secure federal financial participation in accordance with the amendatory Act for expenditures made in State Fiscal Year 2023 and every State fiscal year thereafter. Requires the Department to seek a State Plan amendment or any federal waivers or approvals necessary to implement an ex parte redetermination process for persons experiencing homelessness or who are without income at the time of application or redetermination. Requires the Department and the Department of Human Services to make necessary technical and rule changes to implement the ex parte redetermination process. Requires the Department to report on a monthly basis on its website the percentage of medical assistance recipients whose eligibility is renewed through the ex parte redetermination process. Requires the Department to share the data with the Medicaid Advisory Committee and the Medicaid Advisory Committee Public Education Subcommittee. Effective immediately. House Floor Amendment No. 3 Replaces everything after the enacting clause. Amends the Illinois Public Aid Code. Provides that by July 1, 2022, the Department of Healthcare and Family Services shall seek a State Plan amendment or any federal waivers necessary to make changes to the medical assistance program. Requires the Department to apply for federal approval to implement 12 months of continuous eligibility for adults participating in the medical assistance program. Requires the Department to secure federal financial participation for expenditures made by the Department in State Fiscal Year 2023 and every State fiscal year thereafter. Provides that by July 1, 2022, the Department shall seek a State Plan amendment or any federal waivers or approvals necessary to make changes to the medical assistance redetermination process for people without any income at the time of redetermination. Provides that within 60 days after federal approval or guidance, the Department and the Department of Human Services shall make necessary technical and rule changes to implement changes to the redetermination process. Requires the Department to publish on its website monthly reports on the percentage of medical assistance recipients whose eligibility is renewed through the ex parte redetermination process. Requires the Department to waive any claim against the first $25,000 of any estate to prevent substantial and unreasonable hardship. Requires the Department to make information about estate recovery and hardship waivers easily accessible. Provides that it is the determination of the General Assembly that the Department must (i) include seniors and persons with disabilities in ex parte renewals and (ii) use its asset verification system to assist in the determination of whether an individual's coverage can be renewed using the ex parte process. Requires the Department to pursue a State Plan amendment by July 1, 2022, if necessary. Repeals several provisions concerning the State's authority to place a lien on a recipient's real property interests in order to recover payments made by the State on the recipient's behalf under the Aid to the Aged, Blind or Disabled program or the Medical Assistance program. Effective immediately. Senate Floor Amendment No. 1 Adds reference to: New Act 305 ILCS 5/14-12 305 ILCS 5/5-18.5 305 ILCS 5/5-4 from Ch. 23, par. 5-4 305 ILCS 5/5-5.05d new 305 ILCS 5/5-5.05e new 305 ILCS 5/5-5.05f new 305 ILCS 5/5-5.05g new 305 ILCS 5/5-5.06c new 305 ILCS 5/5-5.06d new 305 ILCS 5/5-5.06e new 305 ILCS 5/5-5 from Ch. 23, par. 5-5 20 ILCS 2310/2310-434 new 210 ILCS 9/77 new 210 ILCS 45/3-613 new 210 ILCS 46/3-613 new 210 ILCS 47/3-613 new 305 ILCS 5/5-5.01b new 5 ILCS 100/5-45.21 new 5 ILCS 100/5-45.22 new 305 ILCS 5/5-1.6 new 305 ILCS 5/5-13.1 new 305 ILCS 5/11-5.1 305 ILCS 5/11-5.5 new 305 ILCS 5/3-10 rep. 305 ILCS 5/3-10.1 rep. 305 ILCS 5/3-10.2 rep. 305 ILCS 5/3-10.3 rep. 305 ILCS 5/3-10.4 rep. 305 ILCS 5/3-10.5 rep. 305 ILCS 5/3-10.6 rep. 305 ILCS 5/3-10.7 rep. 305 ILCS 5/3-10.8 rep. 305 ILCS 5/3-10.9 rep. 305 ILCS 5/3-10.10 rep. 305 ILCS 5/5-13.5 rep. 305 ILCS 5/5-5.07 305 ILCS 5/5-4.2 305 ILCS 5/5-30d new Replaces everything after the enacting clause. Reinserts the provisions of the engrossed bill with the following changes: Creates the Wellness Checks in Schools Program Act. Provides that subject to appropriation, the Department of Healthcare and Family Services shall establish the Wellness Checks in Schools Collaborative for school districts that wish to implement wellness checks to identify students in grades 7 through 12 who are at risk of mental health conditions, including depression or other mental health issues. Requires the Department to work with school districts that have a high percentage of students enrolled in Medicaid and a high number of referrals to the State's Crisis and Referral Entry Services (CARES) hotline. Provides that subject to appropriation, the Department shall establish and implement a program to provide wellness checks in public schools in accordance with the Act. Amends the Illinois Public Aid Code. In the Hospital Services Trust Fund Article, provides that beginning with dates of service on and after January 1, 2023, any general acute care hospital with more than 500 outpatient psychiatric Medicaid services to persons under 19 years of age in any calendar year shall be paid the outpatient add-on payment of no less than $113. In the Medical Assistance Article, provides that beginning January 1, 2023, licensed certified professional midwife services shall be covered under the medical assistance program, subject to appropriation, for persons who are otherwise eligible for medical assistance. Requires the Department of Healthcare and Family Services to consult with midwives on reimbursement rates for midwifery services. Provides that subject to federal approval, beginning January 1, 2023, the community spouse resource allowance shall be established and maintained at a base amount of $109,560 plus an additional amount of $2,784 added to the base amount each year for a period of 10 years commencing with calendar year 2024 through calendar year 2034. Requires yearly increases up to the maximum resource allowance permitted under the Social Security Act. Provides that subject to federal approval, beginning January 1, 2034 the community spouse resource allowance shall be established and maintained at the maximum amount permitted under the Social Security Act, or an amount set after a fair hearing. Provides that subject to federal approval, beginning January 1, 2023 the monthly maintenance allowance for the community spouse shall be established and maintained at the maximum amount higher of $2,739 per month or the minimum level permitted under the Social Security Act. Contains provisions requiring the Department of Human Services to develop a program designed to provide behavioral health providers with academic detailing and clinical consultation over the phone on how to best care for patients with severe mental illness or a developmental disability. Contains provisions requiring the Department of Human Services to track the availability of beds for withdrawal management services that are licensed by the Department and are available to medical assistance beneficiaries. Contains provisions concerning coverage for peer recovery support services under the medical assistance program; the alignment of substance use prevention and recovery and mental health policy; increased rates for prenatal and postpartum care; the external cephalic version rate; increased funding for dental services; and coverage for acupuncture services under the medical assistance program. Amends the Department of Public Health Powers and Duties Law. Requires the Department of Public Health to establish or approve a Certified Nursing Assistant Intern Program to address the increasing need for trained health care workers and provide additional pathways for individuals to become certified nursing assistants. Amends the Assisted Living and Shared Housing Act, the Nursing Home Care Act, the MC/DD Act, and the ID/DD Community Care Act to establish certain employment requirements for certified nursing assistant interns and establishments that employ certified nursing assistant interns. Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to establish or approve a Certified Nursing Assistant Intern Program to address the increasing need for trained health care workers for the supporting living facilities program. Sets forth classroom and on-the-job training requirements for certified nursing assistant interns. Provides that the Certified Nursing Assistant Intern Program shall end upon the termination of the Secretary of Health and Human Services' public health emergency declaration for COVID-19 or 3 years after the date that the Program becomes operational, whichever occurs later. Grants the Departments of Public Health and Healthcare and Family Services emergency rulemaking authority. Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that by July 1, 2022, the Department of Healthcare and Family Services shall seek a State Plan amendment or any federal waivers or approvals necessary to make changes to the medical assistance redetermination process by allowing all people without income to be considered for ex parte redetermination. Requires the Department of Healthcare and Family Services to waive estate recovery under the medical assistance program where recovery would not be cost-effective, would work an undue hardship, or for any other just reason. Requires the Department of Human Services to compile on a monthly basis data on the percentage of medical assistance beneficiaries whose eligibility is renewed through ex parte redeterminations. Requires the Department of Healthcare and Family Services to seek a State Plan amendment by July 1, 2022 that permits the use of its asset verification system to assist in determining whether the ex parte process can be used to renew the medical assistance coverage of a senior or a person with a disability. Contains provisions concerning streamlining enrollment into the Medicare Savings Program. Repeals provisions under the Aid to the Aged, Blind or Disabled Article of the Illinois Public Aid Code concerning liens on recipients real property interests. In a provision requiring the Department of Healthcare and Family Services to pay the DCFS per diem rate for inpatient psychiatric stays at free-standing psychiatric hospitals or hospitals with a pediatric or adolescent inpatient psychiatric unit, removes language making the provision operative only through July 1, 2023. Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions concerning ground ambulance services, provides that, within 90 days after the effective date of the amendatory Act, the Department of Healthcare and Family Services shall file rules to allow for the approval of ground ambulance services when the sole purpose of the transport is for the navigation of stairs or the assisting or lifting of a patient at a medical facility or during a medical appointment in instances where the Department or a contracted Medicaid managed care organization or their transportation broker is unable to secure transportation through any other transportation provider. Provides that beginning no later than January 1, 2023 and subject to federal approval, the amount allocated to fund rates for medi-car, service car, and attendant services provided to adults and children under the medical assistance program shall be increased by an approximate amount of $24,000,000. Effective immediately. Senate Floor Amendment No. 2 Adds reference to: New Act 305 ILCS 5/14-12 305 ILCS 5/5-18.5 305 ILCS 5/5-4 from Ch. 23, par. 5-4 305 ILCS 5/5-5.05d new 305 ILCS 5/5-5.05e new 305 ILCS 5/5-5.05f new 305 ILCS 5/5-5.05g new 305 ILCS 5/5-5.06c new 305 ILCS 5/5-5.06d new 305 ILCS 5/5-5.06e new 305 ILCS 5/5-5 from Ch. 23, par. 5-5 20 ILCS 2310/2310-434 new 210 ILCS 9/77 new 210 ILCS 45/3-613 new 210 ILCS 46/3-613 new 210 ILCS 47/3-613 new 305 ILCS 5/5-5.01b new 5 ILCS 100/5-45.21 new 5 ILCS 100/5-45.22 new 305 ILCS 5/5-1.6 new 305 ILCS 5/5-13.1 new 305 ILCS 5/11-5.1 305 ILCS 5/11-5.5 new 305 ILCS 5/3-10 rep. 305 ILCS 5/3-10.1 rep. 305 ILCS 5/3-10.2 rep. 305 ILCS 5/3-10.3 rep. 305 ILCS 5/3-10.4 rep. 305 ILCS 5/3-10.5 rep. 305 ILCS 5/3-10.6 rep. 305 ILCS 5/3-10.7 rep. 305 ILCS 5/3-10.8 rep. 305 ILCS 5/3-10.9 rep. 305 ILCS 5/3-10.10 rep. 305 ILCS 5/5-13.5 rep. 305 ILCS 5/5-5.07 305 ILCS 5/5-4.2 305 ILCS 5/5-30d new 5 ILCS 100/5-45.23 new 305 ILCS 5/12-4.35 Replaces everything after the enacting clause. Reinserts the provisions of the engrossed bill with the following changes: Creates the Wellness Checks in Schools Program Act. Provides that subject to appropriation, the Department of Healthcare and Family Services shall establish the Wellness Checks in Schools Collaborative for school districts that wish to implement wellness checks to identify students in grades 7 through 12 who are at risk of mental health conditions, including depression or other mental health issues. Requires the Department to work with school districts that have a high percentage of students enrolled in Medicaid and a high number of referrals to the State's Crisis and Referral Entry Services (CARES) hotline. Provides that subject to appropriation, the Department shall establish and implement a program to provide wellness checks in public schools in accordance with the Act. Amends the Illinois Public Aid Code. In the Hospital Services Trust Fund Article, provides that beginning with dates of service on and after January 1, 2023, any general acute care hospital with more than 500 outpatient psychiatric Medicaid services to persons under 19 years of age in any calendar year shall be paid the outpatient add-on payment of no less than $113. In the Medical Assistance Article, provides that beginning January 1, 2023, licensed certified professional midwife services shall be covered under the medical assistance program, subject to appropriation, for persons who are otherwise eligible for medical assistance. Requires the Department of Healthcare and Family Services to consult with midwives on reimbursement rates for midwifery services. Provides that subject to federal approval, beginning January 1, 2023, the community spouse resource allowance shall be established and maintained at a base amount of $109,560 plus an additional amount of $2,784 added to the base amount each year for a period of 10 years commencing with calendar year 2024 through calendar year 2034. Requires yearly increases up to the maximum resource allowance permitted under the Social Security Act. Provides that subject to federal approval, beginning January 1, 2034 the community spouse resource allowance shall be established and maintained at the maximum amount permitted under the Social Security Act, or an amount set after a fair hearing. Provides that subject to federal approval, beginning January 1, 2023 the monthly maintenance allowance for the community spouse shall be established and maintained at the maximum amount higher of $2,739 per month or the minimum level permitted under the Social Security Act. Contains provisions requiring the Department of Human Services to develop a program designed to provide behavioral health providers with academic detailing and clinical consultation over the phone on how to best care for patients with severe mental illness or a developmental disability. Contains provisions requiring the Department of Human Services to track the availability of beds for withdrawal management services that are licensed by the Department and are available to medical assistance beneficiaries. Contains provisions concerning coverage for peer recovery support services under the medical assistance program; the alignment of substance use prevention and recovery and mental health policy; increased rates for prenatal and postpartum care; the external cephalic version rate; increased funding for dental services; and coverage for acupuncture services under the medical assistance program. Amends the Department of Public Health Powers and Duties Law. Requires the Department of Public Health to establish or approve a Certified Nursing Assistant Intern Program to address the increasing need for trained health care workers and provide additional pathways for individuals to become certified nursing assistants. Amends the Assisted Living and Shared Housing Act, the Nursing Home Care Act, the MC/DD Act, and the ID/DD Community Care Act to establish certain employment requirements for certified nursing assistant interns and establishments that employ certified nursing assistant interns. Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to establish or approve a Certified Nursing Assistant Intern Program to address the increasing need for trained health care workers for the supporting living facilities program. Sets forth classroom and on-the-job training requirements for certified nursing assistant interns. Provides that the Certified Nursing Assistant Intern Program shall end upon the termination of the Secretary of Health and Human Services' public health emergency declaration for COVID-19 or 3 years after the date that the Program becomes operational, whichever occurs later. Grants the Departments of Public Health and Healthcare and Family Services emergency rulemaking authority. Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that by July 1, 2022, the Department of Healthcare and Family Services shall seek a State Plan amendment or any federal waivers or approvals necessary to make changes to the medical assistance redetermination process by allowing all people without income to be considered for ex parte redetermination. Requires the Department of Healthcare and Family Services to waive estate recovery under the medical assistance program where recovery would not be cost-effective, would work an undue hardship, or for any other just reason. Requires the Department of Human Services to compile on a monthly basis data on the percentage of medical assistance beneficiaries whose eligibility is renewed through ex parte redeterminations. Requires the Department of Healthcare and Family Services to seek a State Plan amendment by July 1, 2022 that permits the use of its asset verification system to assist in determining whether the ex parte process can be used to renew the medical assistance coverage of a senior or a person with a disability. Contains provisions concerning streamlining enrollment into the Medicare Savings Program. Repeals provisions under the Aid to the Aged, Blind or Disabled Article of the Illinois Public Aid Code concerning liens on recipients real property interests. In a provision requiring the Department of Healthcare and Family Services to pay the DCFS per diem rate for inpatient psychiatric stays at free-standing psychiatric hospitals or hospitals with a pediatric or adolescent inpatient psychiatric unit, removes language making the provision operative only through July 1, 2023. Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions concerning ground ambulance services, provides that, within 90 days after the effective date of the amendatory Act, the Department of Healthcare and Family Services shall file rules to allow for the approval of ground ambulance services when the sole purpose of the transport is for the navigation of stairs or the assisting or lifting of a patient at a medical facility or during a medical appointment in instances where the Department or a contracted Medicaid managed care organization or their transportation broker is unable to secure transportation through any other transportation provider. Provides that beginning no later than January 1, 2023 and subject to federal approval, the amount allocated to fund rates for medi-car, service car, and attendant services provided to adults and children under the medical assistance program shall be increased by an approximate amount of $24,000,000. Amends the Illinois Public Aid Code. Provides that by May 1, 2023, the Department of Healthcare and Family Services may provide medical services to noncitizens 42 years of age through 54 years of age who (i) are not eligible for medical assistance under Article V of the Code due to their not meeting the otherwise applicable provisions of the Code concerning citizenship and (ii) have income at or below 133% of the federal poverty level plus 5% for the applicable family size as determined under applicable federal law and regulations. Amends the Illinois Administrative Procedure Act. Grants the Department of Healthcare and Family Services emergency rulemaking authority to provide medical services to noncitizens 42 years of age through 54 years of age. Effective immediately. Senate Floor Amendment No. 3 Further amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions permitting the Department of Healthcare and Family Services to provide medical services to noncitizens 42 years of age through 54 years of age, permits the Department to provide such medical services by July 1, 2022 (rather than May 1, 2023).