SB1171sam001 103RD GENERAL ASSEMBLY

Sen. Neil Anderson

Filed: 10/25/2023

10300SB1171sam001 LRB103 05612 AWJ 64958 a

AMENDMENT TO SENATE BILL 1171

AMENDMENT NO. ______. Amend Senate Bill 1171 by replacing everything after the enacting clause with the following:

"Section 5. The Department of Central Management Services Law of the Civil Administrative Code of Illinois is amended by adding Section 405-545 as follows:

(20 ILCS 405/405-545 new)

Sec. 405-545. State Retiree Medicare Primacy Coordination Audit and Assistance Program.

(a) Within 6 months after the effective date of this amendatory Act of the 103rd General Assembly, the Department of Central Management Services, in conjunction with the State Employees Retirement System, shall enter into a contract with a qualified and experienced administrator to establish and conduct a State Retiree Medicare Primacy Coordination Audit and Assistance Program to identify retirees who are eligible for Medicare, but not enrolled in Medicare, and to assist those retirees in enrolling in Social Security and Medicare.

(b) The Program shall conduct an annual audit of the State Health Benefits Program for State of Illinois retirees for the purpose of identifying participants and their dependents who are eligible for Medicare under federal law. The Program shall also ensure that those retirees or their dependents who are eligible for Medicare are enrolled in Medicare with Medicare as their primary health care benefits coverage and the State Health Benefits Program being the secondary provider of their health care benefits coverage.

(c) The Program shall assist any retiree or dependent who becomes disabled and is not enrolled in Social Security Disability Insurance and Medicare with enrolling in and obtaining Social Security Disability Insurance and Medicare benefits. This assistance shall include, but not be limited to: (i) developing communication materials to educate retirees about Social Security Disability Insurance benefits; (ii) performing multiple outreaches to targeted populations; (iii) analyzing responses to determine Social Security Disability Insurance eligibility; and (iv) representing qualified individuals on their claim for Social Security Disability Insurance and Medicare.

(d) The administrator shall provide the Department, the State Employees Retirement System, and the General Assembly with an annual report showing the number of retirees and dependents who are transitioned to Social Security Disability Insurance and Medicare and the amount of savings realized by the State of Illinois.

Section 10. The Department of Healthcare and Family Services Law of the Civil Administrative Code of Illinois is amended by adding Section 2205-45 as follows:

(20 ILCS 2205/2205-45 new)

Sec. 2205-45. Medicare Primacy Coordination Audit and Assistance Program.

(a) Within 6 months after the effective date of this amendatory Act of the 103rd General Assembly, the Department of Healthcare and Family Services shall enter into a contract with a qualified and experienced administrator to establish and conduct a Medicare Primacy Coordination Audit and Assistance Program to identify Medicaid recipients who could benefit from Social Security Disability Insurance representation that could provide them with income and ultimately Medicare benefits.

(b) The Program shall conduct an ongoing claims analysis of adults receiving Medicaid for the purpose of identifying high cost participants who may be eligible for Social Security Disability Insurance.

(c) The Program shall assist any adult who claims disability and Social Security eligibility to apply for and be awarded Social Security Disability Insurance benefits and subsequently Medicare. This assistance shall include, but not be limited to: (i) developing communication materials to educate Medicaid recipients about Social Security Disability Insurance benefits; (ii) performing multiple outreaches to populations targeted by claims analysis; (iii) analyzing responses to determine Social Security Disability Insurance eligibility; and (iv) representing qualified individuals on their claim for Social Security Disability Insurance and Medicare.

(d) The administrator shall provide the Department of Healthcare and Family Services and the General Assembly with an annual report showing the number of Medicaid recipients who have transitioned to Social Security Disability Insurance and Medicare and the amount of savings realized by the State of Illinois.

Section 99. Effective date. This Act takes effect January 1, 2024.".