Bill Text: IL SB0660 | 2017-2018 | 100th General Assembly | Introduced

---

Bill Title: Amends the Veterans' Health Insurance Program Act of 2008. Changes the short title of the Act to the Veterans' Supplemental Health Insurance Program Act of 2008. Makes conforming changes in the Illinois Public Aid Code and State Finance Act. Changes references in the Act from "Veterans' Health Insurance Program" to "Veterans' Supplemental Health Insurance Program". Provides that enrollment in the Program is limited to individuals at or below 200% of the federal poverty level (currently, enrollment is based on the availability of funds and may be capped based on the availability of funds appropriated for the Program). Makes conforming changes in eligibility provisions concerning household income requirements. Provides that the Department of Healthcare and Family Services shall adopt rules concerning covered services that must include dental preventative and restorative services. Removes a provision providing that the spouse of a veteran is ineligible for coverage under the Program for a minimum period of 3 months if the required monthly premium is not paid. Removes a provision stating that the Program is not an entitlement. Makes changes to provisions concerning legislative intent.

Spectrum: Partisan Bill (Democrat 9-0)

Status: (Failed) 2019-01-09 - Session Sine Die [SB0660 Detail]

Download: Illinois-2017-SB0660-Introduced.html

---

100TH GENERAL ASSEMBLY State of Illinois 2017 and 2018 SB0660 Introduced 1/25/2017, by Sen. Michael E. Hastings SYNOPSIS AS INTRODUCED:
30 ILCS 105/6z-52
305 ILCS 5/11-22 from Ch. 23, par. 11-22
305 ILCS 5/11-22a from Ch. 23, par. 11-22a
305 ILCS 5/11-22b from Ch. 23, par. 11-22b
305 ILCS 5/11-22c from Ch. 23, par. 11-22c
330 ILCS 126/1
330 ILCS 126/3
330 ILCS 126/5
330 ILCS 126/10
330 ILCS 126/15
Amends the Veterans' Health Insurance Program Act of 2008. Changes the short title of the Act to the Veterans' Supplemental Health Insurance Program Act of 2008. Makes conforming changes in the Illinois Public Aid Code and State Finance Act. Changes references in the Act from "Veterans' Health Insurance Program" to "Veterans' Supplemental Health Insurance Program". Provides that enrollment in the Program is limited to individuals at or below 200% of the federal poverty level (currently, enrollment is based on the availability of funds and may be capped based on the availability of funds appropriated for the Program). Makes conforming changes in eligibility provisions concerning household income requirements. Provides that the Department of Healthcare and Family Services shall adopt rules concerning covered services that must include dental preventative and restorative services. Removes a provision providing that the spouse of a veteran is ineligible for coverage under the Program for a minimum period of 3 months if the required monthly premium is not paid. Removes a provision stating that the Program is not an entitlement. Makes changes to provisions concerning legislative intent.
LRB100 05667 MJP 15684 b
A BILL FOR
SB0660 LRB100 05667 MJP 15684 b
AN ACT concerning military service.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The State Finance Act is amended by changing
Section 6z-52 as follows:
(30 ILCS 105/6z-52)
Sec. 6z-52. Drug Rebate Fund.
(a) There is created in the State Treasury a special fund
to be known as the Drug Rebate Fund.
(b) The Fund is created for the purpose of receiving and
disbursing moneys in accordance with this Section.
Disbursements from the Fund shall be made, subject to
appropriation, only as follows:
(1) For payments for reimbursement or coverage for
prescription drugs and other pharmacy products provided to
a recipient of medical assistance under the Illinois Public
Aid Code, the Children's Health Insurance Program Act, the
Covering ALL KIDS Health Insurance Act, and the Veterans'
Supplemental Health Insurance Program Act of 2008.
(2) For reimbursement of moneys collected by the
Department of Healthcare and Family Services (formerly
Illinois Department of Public Aid) through error or
mistake.

SB0660 - 2 - LRB100 05667 MJP 15684 b
(3) For payments of any amounts that are reimbursable
to the federal government resulting from a payment into
this Fund.
(4) For payments of operational and administrative
expenses related to providing and managing coverage for
prescription drugs and other pharmacy products provided to
a recipient of medical assistance under the Illinois Public
Aid Code, the Children's Health Insurance Program Act, the
Covering ALL KIDS Health Insurance Act, the Veterans'
Supplemental Health Insurance Program Act of 2008, and the
Senior Citizens and Disabled Persons Property Tax Relief
and Pharmaceutical Assistance Act.
(c) The Fund shall consist of the following:
(1) Upon notification from the Director of Healthcare
and Family Services, the Comptroller shall direct and the
Treasurer shall transfer the net State share (disregarding
the reduction in net State share attributable to the
American Recovery and Reinvestment Act of 2009 or any other
federal economic stimulus program) of all moneys received
by the Department of Healthcare and Family Services
(formerly Illinois Department of Public Aid) from drug
rebate agreements with pharmaceutical manufacturers
pursuant to Title XIX of the federal Social Security Act,
including any portion of the balance in the Public Aid
Recoveries Trust Fund on July 1, 2001 that is attributable
to such receipts.

SB0660 - 3 - LRB100 05667 MJP 15684 b
(2) All federal matching funds received by the Illinois
Department as a result of expenditures made by the
Department that are attributable to moneys deposited in the
Fund.
(3) Any premium collected by the Illinois Department
from participants under a waiver approved by the federal
government relating to provision of pharmaceutical
services.
(4) All other moneys received for the Fund from any
other source, including interest earned thereon.
(Source: P.A. 96-8, eff. 4-28-09; 96-1100, eff. 1-1-11; 97-689,
eff. 7-1-12.)
Section 10. The Illinois Public Aid Code is amended by
changing Sections 11-22, 11-22a, 11-22b, and 11-22c as follows:
(305 ILCS 5/11-22) (from Ch. 23, par. 11-22)
Sec. 11-22. Charge upon claims and causes of action for
injuries. The Illinois Department shall have a charge upon all
claims, demands and causes of action for injuries to an
applicant for or recipient of (i) financial aid under Articles
III, IV, and V, (ii) health care benefits provided under the
Covering ALL KIDS Health Insurance Act, or (iii) health care
benefits provided under the Veterans' Health Insurance Program
Act or the Veterans' Supplemental Health Insurance Program Act
of 2008 for the total amount of medical assistance provided the

SB0660 - 4 - LRB100 05667 MJP 15684 b
recipient from the time of injury to the date of recovery upon
such claim, demand or cause of action. In addition, if the
applicant or recipient was employable, as defined by the
Department, at the time of the injury, the Department shall
also have a charge upon any such claims, demands and causes of
action for the total amount of aid provided to the recipient
and his dependents, including all cash assistance and medical
assistance only to the extent includable in the claimant's
action, from the time of injury to the date of recovery upon
such claim, demand or cause of action. Any definition of
"employable" adopted by the Department shall apply only to
persons above the age of compulsory school attendance.
If the injured person was employable at the time of the
injury and is provided aid under Articles III, IV, or V and any
dependent or member of his family is provided aid under Article
VI, or vice versa, both the Illinois Department and the local
governmental unit shall have a charge upon such claims, demands
and causes of action for the aid provided to the injured person
and any dependent member of his family, including all cash
assistance, medical assistance and food stamps, from the time
of the injury to the date of recovery.
"Recipient", as used herein, means (i) in the case of
financial aid provided under this Code, the grantee of record
and any persons whose needs are included in the financial aid
provided to the grantee of record or otherwise met by grants
under the appropriate Article of this Code for which such

SB0660 - 5 - LRB100 05667 MJP 15684 b
person is eligible, (ii) in the case of health care benefits
provided under the Covering ALL KIDS Health Insurance Act, the
child to whom those benefits are provided, and (iii) in the
case of health care benefits provided under the Veterans'
Health Insurance Program Act or the Veterans' Supplemental
Health Insurance Program Act of 2008, the veteran to whom
benefits are provided.
In each case, the notice shall be served by certified mail
or registered mail, or by facsimile or electronic messaging
when requested by the party or parties against whom the
applicant or recipient has a claim, demand, or cause of action,
upon the party or parties against whom the applicant or
recipient has a claim, demand or cause of action. The notice
shall claim the charge and describe the interest the Illinois
Department, the local governmental unit, or the county, has in
the claim, demand, or cause of action. The charge shall attach
to any verdict or judgment entered and to any money or property
which may be recovered on account of such claim, demand, cause
of action or suit from and after the time of the service of the
notice.
On petition filed by the Illinois Department, or by the
local governmental unit or county if either is claiming a
charge, or by the recipient, or by the defendant, the court, on
written notice to all interested parties, may adjudicate the
rights of the parties and enforce the charge. The court may
approve the settlement of any claim, demand or cause of action

SB0660 - 6 - LRB100 05667 MJP 15684 b
either before or after a verdict, and nothing in this Section
shall be construed as requiring the actual trial or final
adjudication of any claim, demand or cause of action upon which
the Illinois Department, the local governmental unit or county
has charge. The court may determine what portion of the
recovery shall be paid to the injured person and what portion
shall be paid to the Illinois Department, the local
governmental unit or county having a charge against the
recovery. In making this determination, the court shall conduct
an evidentiary hearing and shall consider competent evidence
pertaining to the following matters:
(1) the amount of the charge sought to be enforced
against the recovery when expressed as a percentage of the
gross amount of the recovery; the amount of the charge
sought to be enforced against the recovery when expressed
as a percentage of the amount obtained by subtracting from
the gross amount of the recovery the total attorney's fees
and other costs incurred by the recipient incident to the
recovery; and whether the Department, unit of local
government or county seeking to enforce the charge against
the recovery should as a matter of fairness and equity bear
its proportionate share of the fees and costs incurred to
generate the recovery from which the charge is sought to be
satisfied;
(2) the amount, if any, of the attorney's fees and
other costs incurred by the recipient incident to the

SB0660 - 7 - LRB100 05667 MJP 15684 b
recovery and paid by the recipient up to the time of
recovery, and the amount of such fees and costs remaining
unpaid at the time of recovery;
(3) the total hospital, doctor and other medical
expenses incurred for care and treatment of the injury to
the date of recovery therefor, the portion of such expenses
theretofore paid by the recipient, by insurance provided by
the recipient, and by the Department, unit of local
government and county seeking to enforce a charge against
the recovery, and the amount of such previously incurred
expenses which remain unpaid at the time of recovery and by
whom such incurred, unpaid expenses are to be paid;
(4) whether the recovery represents less than
substantially full recompense for the injury and the
hospital, doctor and other medical expenses incurred to the
date of recovery for the care and treatment of the injury,
so that reduction of the charge sought to be enforced
against the recovery would not likely result in a double
recovery or unjust enrichment to the recipient;
(5) the age of the recipient and of persons dependent
for support upon the recipient, the nature and permanency
of the recipient's injuries as they affect not only the
future employability and education of the recipient but
also the reasonably necessary and foreseeable future
material, maintenance, medical, rehabilitative and
training needs of the recipient, the cost of such

SB0660 - 8 - LRB100 05667 MJP 15684 b
reasonably necessary and foreseeable future needs, and the
resources available to meet such needs and pay such costs;
(6) the realistic ability of the recipient to repay in
whole or in part the charge sought to be enforced against
the recovery when judged in light of the factors enumerated
above.
The burden of producing evidence sufficient to support the
exercise by the court of its discretion to reduce the amount of
a proven charge sought to be enforced against the recovery
shall rest with the party seeking such reduction.
The court may reduce and apportion the Illinois
Department's lien proportionate to the recovery of the
claimant. The court may consider the nature and extent of the
injury, economic and noneconomic loss, settlement offers,
comparative negligence as it applies to the case at hand,
hospital costs, physician costs, and all other appropriate
costs. The Illinois Department shall pay its pro rata share of
the attorney fees based on the Illinois Department's lien as it
compares to the total settlement agreed upon. This Section
shall not affect the priority of an attorney's lien under the
Attorneys Lien Act. The charges of the Illinois Department
described in this Section, however, shall take priority over
all other liens and charges existing under the laws of the
State of Illinois with the exception of the attorney's lien
under said statute.
Whenever the Department or any unit of local government has

SB0660 - 9 - LRB100 05667 MJP 15684 b
a statutory charge under this Section against a recovery for
damages incurred by a recipient because of its advancement of
any assistance, such charge shall not be satisfied out of any
recovery until the attorney's claim for fees is satisfied,
irrespective of whether or not an action based on recipient's
claim has been filed in court.
This Section shall be inapplicable to any claim, demand or
cause of action arising under (a) the Workers' Compensation Act
or the predecessor Workers' Compensation Act of June 28, 1913,
(b) the Workers' Occupational Diseases Act or the predecessor
Workers' Occupational Diseases Act of March 16, 1936; and (c)
the Wrongful Death Act.
(Source: P.A. 98-73, eff. 7-15-13.)
(305 ILCS 5/11-22a) (from Ch. 23, par. 11-22a)
Sec. 11-22a. Right of Subrogation. To the extent of the
amount of (i) medical assistance provided by the Department to
or on behalf of a recipient under Article V or VI, (ii) health
care benefits provided for a child under the Covering ALL KIDS
Health Insurance Act, or (iii) health care benefits provided to
a veteran under the Veterans' Health Insurance Program Act or
the Veterans' Supplemental Health Insurance Program Act of
2008, the Department shall be subrogated to any right of
recovery such recipient may have under the terms of any private
or public health care coverage or casualty coverage, including
coverage under the "Workers' Compensation Act", approved July

SB0660 - 10 - LRB100 05667 MJP 15684 b
9, 1951, as amended, or the "Workers' Occupational Diseases
Act", approved July 9, 1951, as amended, without the necessity
of assignment of claim or other authorization to secure the
right of recovery to the Department. To enforce its subrogation
right, the Department may (i) intervene or join in an action or
proceeding brought by the recipient, his or her guardian,
personal representative, estate, dependents, or survivors
against any person or public or private entity that may be
liable; (ii) institute and prosecute legal proceedings against
any person or public or private entity that may be liable for
the cost of such services; or (iii) institute and prosecute
legal proceedings, to the extent necessary to reimburse the
Illinois Department for its costs, against any noncustodial
parent who (A) is required by court or administrative order to
provide insurance or other coverage of the cost of health care
services for a child eligible for medical assistance under this
Code and (B) has received payment from a third party for the
costs of those services but has not used the payments to
reimburse either the other parent or the guardian of the child
or the provider of the services.
(Source: P.A. 94-693, eff. 7-1-06; 94-816, eff. 5-30-06;
95-755, eff. 7-25-08.)
(305 ILCS 5/11-22b) (from Ch. 23, par. 11-22b)
Sec. 11-22b. Recoveries.
(a) As used in this Section:

SB0660 - 11 - LRB100 05667 MJP 15684 b
(1) "Carrier" means any insurer, including any private
company, corporation, mutual association, trust fund,
reciprocal or interinsurance exchange authorized under the
laws of this State to insure persons against liability or
injuries caused to another and any insurer providing
benefits under a policy of bodily injury liability
insurance covering liability arising out of the ownership,
maintenance or use of a motor vehicle which provides
uninsured motorist endorsement or coverage.
(2) "Beneficiary" means any person or their dependents
who has received benefits or will be provided benefits
under this Code, under the Covering ALL KIDS Health
Insurance Act, or under the Veterans' Health Insurance
Program Act or the Veterans' Supplemental Health Insurance
Program Act of 2008 because of an injury for which another
person may be liable. It includes such beneficiary's
guardian, conservator or other personal representative,
his estate or survivors.
(b)(1) When benefits are provided or will be provided to a
beneficiary under this Code, under the Covering ALL KIDS Health
Insurance Act, or under the Veterans' Health Insurance Program
Act or the Veterans' Supplemental Health Insurance Program Act
of 2008 because of an injury for which another person is
liable, or for which a carrier is liable in accordance with the
provisions of any policy of insurance issued pursuant to the
Illinois Insurance Code, the Illinois Department shall have a

SB0660 - 12 - LRB100 05667 MJP 15684 b
right to recover from such person or carrier the reasonable
value of benefits so provided. The Attorney General may, to
enforce such right, institute and prosecute legal proceedings
against the third person or carrier who may be liable for the
injury in an appropriate court, either in the name of the
Illinois Department or in the name of the injured person, his
guardian, personal representative, estate, or survivors.
(2) The Department may:
(A) compromise or settle and release any such claim for
benefits provided under this Code, or
(B) waive any such claims for benefits provided under
this Code, in whole or in part, for the convenience of the
Department or if the Department determines that collection
would result in undue hardship upon the person who suffered
the injury or, in a wrongful death action, upon the heirs
of the deceased.
(3) No action taken on behalf of the Department pursuant to
this Section or any judgment rendered in such action shall be a
bar to any action upon the claim or cause of action of the
beneficiary, his guardian, conservator, personal
representative, estate, dependents or survivors against the
third person who may be liable for the injury, or shall operate
to deny to the beneficiary the recovery for that portion of any
damages not covered hereunder.
(c)(1) When an action is brought by the Department pursuant
to subsection (b), it shall be commenced within the period

SB0660 - 13 - LRB100 05667 MJP 15684 b
prescribed by Article XIII of the Code of Civil Procedure.
However, the Department may not commence the action prior
to 5 months before the end of the applicable period prescribed
by Article XIII of the Code of Civil Procedure. Thirty days
prior to commencing an action, the Department shall notify the
beneficiary of the Department's intent to commence such an
action.
(2) The death of the beneficiary does not abate any right
of action established by subsection (b).
(3) When an action or claim is brought by persons entitled
to bring such actions or assert such claims against a third
person who may be liable for causing the death of a
beneficiary, any settlement, judgment or award obtained is
subject to the Department's claim for reimbursement of the
benefits provided to the beneficiary under this Code, under the
Covering ALL KIDS Health Insurance Act, or under the Veterans'
Health Insurance Program Act or the Veterans' Supplemental
Health Insurance Program Act of 2008.
(4) When the action or claim is brought by the beneficiary
alone and the beneficiary incurs a personal liability to pay
attorney's fees and costs of litigation, the Department's claim
for reimbursement of the benefits provided to the beneficiary
shall be the full amount of benefits paid on behalf of the
beneficiary under this Code, under the Covering ALL KIDS Health
Insurance Act, or under the Veterans' Health Insurance Program
Act or the Veterans' Supplemental Health Insurance Program Act

SB0660 - 14 - LRB100 05667 MJP 15684 b
of 2008 less a pro rata share which represents the Department's
reasonable share of attorney's fees paid by the beneficiary and
that portion of the cost of litigation expenses determined by
multiplying by the ratio of the full amount of the expenditures
of the full amount of the judgment, award or settlement.
(d)(1) If either the beneficiary or the Department brings
an action or claim against such third party or carrier, the
beneficiary or the Department shall within 30 days of filing
the action give to the other written notice by personal service
or registered mail of the action or claim and of the name of
the court in which the action or claim is brought. Proof of
such notice shall be filed in such action or claim. If an
action or claim is brought by either the Department or the
beneficiary, the other may, at any time before trial on the
facts, become a party to such action or claim or shall
consolidate his action or claim with the other if brought
independently.
(2) If an action or claim is brought by the Department
pursuant to subsection (b)(1), written notice to the
beneficiary, guardian, personal representative, estate or
survivor given pursuant to this Section shall advise him of his
right to intervene in the proceeding, his right to obtain a
private attorney of his choice and the Department's right to
recover the reasonable value of the benefits provided.
(e) In the event of judgment or award in a suit or claim
against such third person or carrier:

SB0660 - 15 - LRB100 05667 MJP 15684 b
(1) If the action or claim is prosecuted by the
beneficiary alone, the court shall first order paid from
any judgment or award the reasonable litigation expenses
incurred in preparation and prosecution of such action or
claim, together with reasonable attorney's fees, when an
attorney has been retained. After payment of such expenses
and attorney's fees the court shall, on the application of
the Department, allow as a first lien against the amount of
such judgment or award the amount of the Department's
expenditures for the benefit of the beneficiary under this
Code, under the Covering ALL KIDS Health Insurance Act, or
under the Veterans' Health Insurance Program Act or the
Veterans' Supplemental Health Insurance Program Act of
2008, as provided in subsection (c)(4).
(2) If the action or claim is prosecuted both by the
beneficiary and the Department, the court shall first order
paid from any judgment or award the reasonable litigation
expenses incurred in preparation and prosecution of such
action or claim, together with reasonable attorney's fees
for plaintiffs attorneys based solely on the services
rendered for the benefit of the beneficiary. After payment
of such expenses and attorney's fees, the court shall apply
out of the balance of such judgment or award an amount
sufficient to reimburse the Department the full amount of
benefits paid on behalf of the beneficiary under this Code,
under the Covering ALL KIDS Health Insurance Act, or under

SB0660 - 16 - LRB100 05667 MJP 15684 b
the Veterans' Health Insurance Program Act or the Veterans'
Supplemental Health Insurance Program Act of 2008.
(f) The court shall, upon further application at any time
before the judgment or award is satisfied, allow as a further
lien the amount of any expenditures of the Department in
payment of additional benefits arising out of the same cause of
action or claim provided on behalf of the beneficiary under
this Code, under the Covering ALL KIDS Health Insurance Act, or
under the Veterans' Health Insurance Program Act or the
Veterans' Supplemental Health Insurance Program Act of 2008,
when such benefits were provided or became payable subsequent
to the original order.
(g) No judgment, award, or settlement in any action or
claim by a beneficiary to recover damages for injuries, when
the Department has an interest, shall be satisfied without
first giving the Department notice and a reasonable opportunity
to perfect and satisfy its lien.
(h) When the Department has perfected a lien upon a
judgment or award in favor of a beneficiary against any third
party for an injury for which the beneficiary has received
benefits under this Code, under the Covering ALL KIDS Health
Insurance Act, or under the Veterans' Health Insurance Program
Act or the Veterans' Supplemental Health Insurance Program Act
of 2008, the Department shall be entitled to a writ of
execution as lien claimant to enforce payment of said lien
against such third party with interest and other accruing costs

SB0660 - 17 - LRB100 05667 MJP 15684 b
as in the case of other executions. In the event the amount of
such judgment or award so recovered has been paid to the
beneficiary, the Department shall be entitled to a writ of
execution against such beneficiary to the extent of the
Department's lien, with interest and other accruing costs as in
the case of other executions.
(i) Except as otherwise provided in this Section,
notwithstanding any other provision of law, the entire amount
of any settlement of the injured beneficiary's action or claim,
with or without suit, is subject to the Department's claim for
reimbursement of the benefits provided and any lien filed
pursuant thereto to the same extent and subject to the same
limitations as in Section 11-22 of this Code.
(Source: P.A. 94-693, eff. 7-1-06; 94-816, eff. 5-30-06;
95-755, eff. 7-25-08.)
(305 ILCS 5/11-22c) (from Ch. 23, par. 11-22c)
Sec. 11-22c. Recovery of back wages.
(a) As used in this Section, "recipient" means any person
receiving financial assistance under Article IV or Article VI
of this Code, receiving health care benefits under the Covering
ALL KIDS Health Insurance Act, or receiving health care
benefits under the Veterans' Health Insurance Program Act or
the Veterans' Supplemental Health Insurance Program Act of
2008.
(b) If a recipient maintains any suit, charge or other

SB0660 - 18 - LRB100 05667 MJP 15684 b
court or administrative action against an employer seeking back
pay for a period during which the recipient received financial
assistance under Article IV or Article VI of this Code, health
care benefits under the Covering ALL KIDS Health Insurance Act,
or health care benefits under the Veterans' Health Insurance
Program Act or the Veterans' Supplemental Health Insurance
Program Act of 2008, the recipient shall report such fact to
the Department. To the extent of the amount of assistance
provided to or on behalf of the recipient under Article IV or
Article VI, health care benefits provided under the Covering
ALL KIDS Health Insurance Act, or health care benefits provided
under the Veterans' Health Insurance Program Act or the
Veterans' Supplemental Health Insurance Program Act of 2008,
the Department may by intervention or otherwise without the
necessity of assignment of claim, attach a lien on the recovery
of back wages equal to the amount of assistance provided by the
Department to the recipient under Article IV or Article VI,
under the Covering ALL KIDS Health Insurance Act, or under the
Veterans' Health Insurance Program Act or the Veterans'
Supplemental Health Insurance Program Act of 2008.
(Source: P.A. 94-693, eff. 7-1-06; 94-816, eff. 5-30-06;
95-755, eff. 7-25-08.)
Section 15. The Veterans' Health Insurance Program Act of
2008 is amended by changing Sections 1, 3, 5, 10, and 15 as
follows:

SB0660 - 19 - LRB100 05667 MJP 15684 b
(330 ILCS 126/1)
Sec. 1. Short title. This Act may be cited as the Veterans'
Supplemental Health Insurance Program Act of 2008.
(Source: P.A. 95-755, eff. 7-25-08.)
(330 ILCS 126/3)
Sec. 3. Legislative intent. The General Assembly finds that
those who have served their country honorably in military
service and who are residing in this State deserve access to
affordable, comprehensive health insurance. Many veterans are
uninsured and unable to afford healthcare. This lack of
healthcare, including medical and dental preventative care,
often exacerbates health conditions. The effects of lack of
insurance negatively impact those residents of the State who
are insured because the cost of paying for care to the
uninsured is often shifted to those who have insurance in the
form of higher health insurance premiums. It is, therefore, the
intent of this legislation to provide access to affordable
health and dental insurance for veterans and their spouses
residing in Illinois who are unable to afford such coverage.
However, the State has only a limited amount of resources, and
the General Assembly therefore declares that while it intends
to cover as many such veterans and spouses as possible, the
State may not be able to cover every eligible person who
qualifies for this Program as a matter of entitlement due to

SB0660 - 20 - LRB100 05667 MJP 15684 b
limited funding.
(Source: P.A. 95-755, eff. 7-25-08; 96-45, eff. 7-15-09.)
(330 ILCS 126/5)
Sec. 5. Definitions. The following words have the following
meanings:
"Department" means the Department of Healthcare and Family
Services, or any successor agency.
"Director" means the Director of Healthcare and Family
Services, or any successor agency.
"Medical assistance" means health care benefits provided
under Article V of the Illinois Public Aid Code.
"Program" means the Veterans' Supplemental Health
Insurance Program.
"Resident" means an individual who has an Illinois
residence, as provided in Section 5-3 of the Illinois Public
Aid Code.
"Spouse" means the person who is the person who, under the
laws of the State of Illinois, is married to an eligible
veteran at the time of application and subsequent
re-determinations for the Program and includes enrolled
spouses surviving the death of veteran spouses.
"Veteran" means any person who has served in a branch of
the United States military for greater than 180 days after
initial training.
"Veterans Affairs" or "VA" means the United States

SB0660 - 21 - LRB100 05667 MJP 15684 b
Department of Veterans Affairs.
(Source: P.A. 95-755, eff. 7-25-08; 96-45, eff. 7-15-09;
96-1000, eff. 7-2-10.)
(330 ILCS 126/10)
Sec. 10. Operation of the Program.
(a) The Veterans' Supplemental Health Insurance Program is
created. This Program is not an entitlement. Enrollment is
limited to individuals at or below 200% of the federal poverty
level based on the availability of funds, and enrollment may be
capped based on funds appropriated for the Program. As soon as
practical after the effective date of this Act, coverage for
this Program shall begin. The Program shall be administered by
the Department of Healthcare and Family Services in
collaboration with the Department of Veterans' Affairs. The
Department shall have the same powers and authority to
administer the Program as are provided to the Department in
connection with the Department's administration of the
Illinois Public Aid Code. The Department shall coordinate the
Program with other health programs operated by the Department
and other State and federal agencies.
(b) The Department shall operate the Program in a manner so
that the estimated cost of the Program during the fiscal year
will not exceed the total appropriation for the Program. The
Department may take any appropriate action to limit spending or
enrollment into the Program, including, but not limited to,

SB0660 - 22 - LRB100 05667 MJP 15684 b
ceasing to accept or process applications, reviewing
eligibility more frequently than annually, adjusting
cost-sharing, or reducing the income threshold for eligibility
as necessary to control expenditures for the Program.
(c) Notwithstanding subsections (a) and (b) and with the
mutual agreement of the Department of Veterans' Affairs and the
Department of Healthcare and Family Services, the operation of
the Program may be changed to simplify its administration and
to take advantage of health insurance coverage that may be
available to veterans under the Patient Protection and
Affordable Care Act.
(Source: P.A. 98-104, eff. 7-22-13.)
(330 ILCS 126/15)
Sec. 15. Eligibility.
(a) To be eligible for the Program, a person must:
(1) be a veteran who is not on active duty and who has
not been dishonorably discharged from service or the spouse
of such a veteran;
(2) be a resident of the State of Illinois;
(3) be at least 19 years of age and no older than 64
years of age;
(4) be uninsured, as defined by the Department by rule,
for a period of time established by the Department by rule,
which shall be no less than 3 months;
(5) not be eligible for medical assistance under the

SB0660 - 23 - LRB100 05667 MJP 15684 b
Illinois Public Aid Code or healthcare benefits under the
Children's Health Insurance Program Act or the Covering ALL
KIDS Health Insurance Act;
(6) not be eligible for medical benefits through the
Veterans Health Administration; and
(7) have a household income no greater than 200% the
sum of (i) an amount equal to 25% of the federal poverty
level plus (ii) an amount equal to the Veterans
Administration means test income threshold at the
initiation of the Program; depending on the availability of
funds, this level may be increased to an amount equal to
the sum of (iii) an amount equal to 50% of the federal
poverty level plus (iv) an amount equal to the Veterans
Administration means test income threshold. This means
test income threshold is subject to alteration by the
Department as set forth in subsection (b) of Section 10.
(b) A veteran or spouse who is determined eligible for the
Program shall remain eligible for 12 months, provided the
veteran or spouse remains a resident of the State and is not
excluded under subsection (c) of this Section and provided the
Department has not limited the enrollment period as set forth
in subsection (b) of Section 10.
(c) A veteran or spouse is not eligible for coverage under
the Program if:
(1) the premium required under Section 35 of this Act
has not been timely paid; if the required premiums are not

SB0660 - 24 - LRB100 05667 MJP 15684 b
paid, the liability of the Program shall be limited to
benefits incurred under the Program for the time period for
which premiums have been paid and for grace periods as
established under subsection (d); if the required monthly
premium is not paid, the veteran or spouse is ineligible
for re-enrollment for a minimum period of 3 months; or
(2) the veteran or spouse is a resident of a nursing
facility or an inmate of a public institution, as defined
by 42 CFR 435.1009.
(d) The Department shall adopt rules for the Program,
including, but not limited to, rules relating to eligibility,
re-enrollment, grace periods, notice requirements, hearing
procedures, cost-sharing, covered services, and provider
requirements. For purposes of this Section, "covered services"
must include dental preventative and restorative services.
(Source: P.A. 95-755, eff. 7-25-08; 96-45, eff. 7-15-09.)