SB 3290 — DHFS-MED DENTAL REIMBURSE FUND

SB3290 EngrossedEnrolled LRB096 20040 KTG 35543 b AN ACT concerning public aid.

(3) Municipalities with a population greater than SB3290 EngrossedEnrolled - 2 - LRB096 20040 KTG 35543 b 50,000 not located in the areas described in item (i) of subsection (a) and paragraphs (1) and (2) of item (ii) of subsection (a);

SB3290 EngrossedEnrolled - 3 - LRB096 20040 KTG 35543 b No more than one children's respite care model owned and operated by a licensed skilled pediatric facility shall be located in each of the areas designated in this subsection (a-10).

SB3290 EngrossedEnrolled - 4 - LRB096 20040 KTG 35543 b (3) Three in rural areas, one of which shall be owned or operated by a hospital and one of which shall be owned or operated by a federally qualified health center.

If, after obtaining its initial certificate of need, an alternative health care delivery model that is a SB3290 EngrossedEnrolled - 5 - LRB096 20040 KTG 35543 b community based residential rehabilitation center seeks to increase the bed capacity of that center, it must obtain a certificate of need from the Health Facilities and Services Review Board before increasing the bed capacity.

(2) If the postsurgical recovery care center obtains a Certificate of Need permit to operate as a hospital, it SB3290 EngrossedEnrolled - 6 - LRB096 20040 KTG 35543 b shall apply for licensure as a hospital under the Hospital Licensing Act and shall meet all statutory and regulatory requirements of a hospital.

The Department shall advise the licensee of the conditions under which the provisional license is issued, including the manner in which the alternative health care model fails to comply with the provisions of this Act and rules, and the time within which the changes and corrections necessary for the alternative health care model to SB3290 EngrossedEnrolled - 7 - LRB096 20040 KTG 35543 b substantially comply with this Act and rules shall be completed.

revised 11-4-09.) SB3290 EngrossedEnrolled - 8 - LRB096 20040 KTG 35543 b Section 10.

(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 SB3290 EngrossedEnrolled - 9 - LRB096 20040 KTG 35543 b either of the following requirements:

(b) All persons who, excluding any eligibility requirements that are inconsistent with any federal SB3290 EngrossedEnrolled - 10 - LRB096 20040 KTG 35543 b law or federal regulation, as interpreted by the U.S.

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 SB3290 EngrossedEnrolled - 11 - LRB096 20040 KTG 35543 b 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.

Persons who are under 21 years of age and would qualify as disabled as defined under the Federal SB3290 EngrossedEnrolled - 12 - LRB096 20040 KTG 35543 b Supplemental Security Income Program, provided medical service for such persons would be eligible for Federal Financial Participation, and provided the Illinois Department determines that:

and SB3290 EngrossedEnrolled - 13 - LRB096 20040 KTG 35543 b (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:

Assistance shall be provided to such persons to the maximum extent SB3290 EngrossedEnrolled - 14 - LRB096 20040 KTG 35543 b permitted under Title XIX of the Federal Social Security Act.

and SB3290 EngrossedEnrolled - 15 - LRB096 20040 KTG 35543 b (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.

The Department must request federal approval of the SB3290 EngrossedEnrolled - 16 - LRB096 20040 KTG 35543 b coverage under this paragraph 12 within 30 days after the effective date of this amendatory Act of the 92nd General Assembly.

If an individual has an appeal pending regarding an application for asylum before the Department SB3290 EngrossedEnrolled - 17 - LRB096 20040 KTG 35543 b of Homeland Security, eligibility under this paragraph 14 may be extended until a final decision is rendered on the appeal.

(g) Failure to pay the full monthly premium by the last day of the grace period shall result in SB3290 EngrossedEnrolled - 18 - LRB096 20040 KTG 35543 b termination of coverage.

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 SB3290 EngrossedEnrolled - 19 - LRB096 20040 KTG 35543 b U.S.C.

A person shall be considered SB3290 EngrossedEnrolled - 20 - LRB096 20040 KTG 35543 b 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.

Department of Health and Human Services, unless the SB3290 EngrossedEnrolled - 21 - LRB096 20040 KTG 35543 b Department is provided with express statutory authority.

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 SB3290 EngrossedEnrolled - 22 - LRB096 20040 KTG 35543 b members of the person's family have actual control over the donations or benefits or the disbursement of the donations or benefits.

Surveys or assessments of resident needs under this Section shall include a review by the facility of the results of such assessments and a discussion of issues in dispute with SB3290 EngrossedEnrolled - 23 - LRB096 20040 KTG 35543 b authorized survey staff, unless the facility elects not to participate in such a review process.

SB3290 EngrossedEnrolled - 24 - LRB096 20040 KTG 35543 b (E) A statement on the methodology's effect on the quality of care given to residents in the sample nursing facilities;

(b) In developing a prospective method for determining SB3290 EngrossedEnrolled - 25 - LRB096 20040 KTG 35543 b payment rates for skilled nursing and intermediate care services in nursing facilities, the Department of Healthcare and Family Services shall consider the following cost elements:

For purposes of the Illinois Administrative Procedure Act, the adoption of rules to implement the amendatory changes to this Section made by this amendatory Act SB3290 EngrossedEnrolled - 26 - LRB096 20040 KTG 35543 b of 1991 shall be deemed an emergency and necessary for the public interest, safety and welfare.

(2) The deposit of any interest accrued by the revolving fund, which interest shall be available to pay for dental services provided by enrolled dental service SB3290 EngrossedEnrolled - 27 - LRB096 20040 KTG 35543 b providers for services to participants in the medical programs administered by the Department.