Illinois SB2913

House Amendment 004

Requires the Department of Human Services (rather than the Department of Healthcare and Family Services) to: (i) use certain standards and distribution requirements for notification of missing supporting documents and information during all phases of the application process; and (ii) adopt policies and procedures to improve communication between long-term care benefits central office personnel, applicants and their representatives, and facilities in which the applicants reside. Provides that no Department of Human Services office (rather than no local Department of Human Services office) shall request submission of any document in hard copy. Removes language providing that if an applicant is determined ineligible for any public assistance, the notice shall include a list of all missing supporting documents and information and the date the documents were requested.

House Amendment 002

Replaces everything after the enacting clause. Reinserts the provisions of House Amendment No. 1, but with the following changes: Removes language requiring the Department of Healthcare Family Services to serve as the lead agency assuming primary responsibility for the full implementation of expedited long-term care eligibility determinations and enrollments. Instead provides that the establishment of the expedited long-term care eligibility determination and enrollment system shall be a joint venture of the Departments of Human Services and Healthcare and Family Services and the Department on Aging. Provides that the streamlined application and enrollment process shall be put in place on or before July 1, 2019 (rather than on or before January 1, 2019). Removes language requiring the Department of Healthcare and Family Services to establish policies and procedures to ensure prospective compliance with certain federal deadlines for Medicaid and Medicaid long-term care benefits eligibility determinations. Provides that the State (rather than the Department of Healthcare and Family Services) must expedite the eligibility process for applicants meeting specified guidelines, regardless of the age of the application. Subjects the specified guidelines to federal approval. Provides that the ex parte renewal process for Medicaid-eligible individuals residing in long-term care facilities must be fully operational on or before January 1, 2019 (rather than by January 1, 2019). Provides that no local Department of Human Services office shall request submission of any document in hard copy. In provisions concerning decisions on applications for medical assistance, provides that "application" also refers to requests for admission approval to facilities licensed under the Nursing Home Care Act or to supportive living facilities authorized under the Code. Effective immediately.

House Amendment 001

Replaces everything after the enacting clause. Amends the Illinois Public Aid Code. Requires long-term care providers to submit all changes in resident status, including, but not limited to, death, discharge, changes in patient credit, third party liability, and Medicare coverage to the Department of Healthcare and Family Services through the Medical Electronic Data Interchange System, the Recipient Eligibility Verification System, or the Electronic Data Interchange System under a specified schedule. Requires the Department to serve as the lead agency assuming primary responsibility for the full implementation of provisions concerning expedited long-term care eligibility determinations and enrollments, including the establishment and operation of the expedited long-term care system. Requires the Department to adopt, by rule, policies and procedures to ensure prospective compliance with the federal deadlines for Medicaid and Medicaid long-term care benefits eligibility determinations. Provides that on or before January 1, 2019, a streamlined application and enrollment process shall be put in place which must include, but need not be limited to, provide training and step-by-step written instructions for caseworkers, applicants, and providers. Requires the Department to expedite the eligibility processing system for applicants meeting specified guidelines, regardless of the age of the application. Provides that, subject to federal approval, the Department must implement an ex parte renewal process for Medicaid-eligible individuals residing in long-term care facilities. Provides that the ex parte renewal process shall be fully operational by January 1, 2019. Requires the Department to use certain standards and distribution requirements for notification of missing supporting documents and information during all phases of the application process. Requires the Department to adopt policies and procedures to improve communication between long-term care benefits central office personnel, applicants and their representatives, and facilities in which the applicants reside. Provides that if an applicant is determined ineligible for any public assistance, the notice shall include a list of all missing supporting documents and information and the date the documents were requested. Grants the Department rulemaking authority. Makes other changes. Effective immediately.

Senate Amendment 002

Replaces everything after the enacting clause. Amends the Illinois Public Aid Code. Requires long-term care providers to submit all changes in resident status, including, but not limited to, death, discharge, changes in patient credit, third party liability, and Medicare coverage to the Department of Healthcare and Family Services through the Medical Electronic Data Interchange System, the Recipient Eligibility Verification System, or the Electronic Data Interchange System under a specified schedule. Requires the Department of Healthcare and Family Services to serve as the lead agency assuming primary responsibility for the full implementation of provisions concerning expedited long-term care eligibility determinations, renewals, enrollments, and payments, including the establishment and operation of the expedited long-term care system. Provides that beginning on June 29, 2018, provisional eligibility must be issued to any applicant who has not received a final eligibility determination on his or her application for Medicaid or Medicaid long-term care benefits or a notice of an opportunity for a hearing within the federally prescribed deadlines for the processing of such applications. Requires the Department to maintain the applicant's provisional Medicaid enrollment status until a final eligibility determination is approved or the applicant's appeal has been adjudicated and eligibility is denied. Provides that the Department or the managed care organization, if applicable, must reimburse providers for all services rendered during an applicant's provisional eligibility period. Requires the Department to adopt, by rule, policies and procedures to ensure prospective compliance with the federal deadlines for Medicaid and Medicaid long-term care benefits eligibility determinations. Sets forth certain standards and principles the policies must address, including: (i) a streamlined application and enrollment process; (ii) protocols to expedite the eligibility processing system for applicants meeting certain guidelines, regardless of the age of the application; (iii) the review of applications for long-term care benefits when there exists credible evidence that an applicant has transferred assets with the intent of defrauding the State; and other matters. Contains provisions concerning: (1) the adoption of policies and procedures to improve communication between long-term care benefits central office personnel, applicants, and facilities in which the applicants reside; the establishment of policies and procedures to improve accountability and provide for the expedited payment of services rendered; (3) the Department's investigation of public-private partnerships in use in Ohio, Michigan, and Minnesota that are aimed at redeploying caseworkers to targeted high-Medicaid facilities for the purpose of expediting initial Medicaid and Medicaid long-term care benefits applications, renewals, and all other things related to enrollment, reimbursement, and application processing; (4) provider association meetings; (5) presumptive eligibility of benefits; (6) the prioritization of processing applications on a last-in, first-out basis; and other matters. Effective immediately.

Senate Amendment 001

Replaces everything after the enacting clause. Amends the Illinois Public Aid Code. Requires long-term care providers to submit all changes in resident status, including, but not limited to, death, discharge, changes in patient credit, third party liability, and Medicare coverage to the Department of Healthcare and Family Services through the Medical Electronic Data Interchange System, the Recipient Eligibility Verification System, or the Electronic Data Interchange System under a specified schedule. Effective immediately.

House Amendment 003

May 31, 2018: HFA0002 - Executive

May 31, 2018: HFA0002 - Concurrence

May 31, 2018: HFA0004 - Concurrence

May 31, 2018: HCA0001 - Executive

May 31, 2018: HFA0004 - Executive

May 31, 2018: HCA0001 - Concurrence

May 30, 2018: SB2913 - Third Reading

May 23, 2018: HFA0002 - Human Services

May 16, 2018: SB2913 - Human Services

May 2, 2018: SB2913 - Third Reading

April 24, 2018: SFA0002 - Public Health

March 13, 2018: SB2913 - Public Health

March 13, 2018: SCA0001 - Public Health