Override HB 685

Governor Blagojevich vetoed HB685 on July 30, 2003. Both chambers

of the General Assembly unanimously supported HB685. The bill

comprises two components: Medicaid pre-payment spend down and mental health service invoices used to meet spend down.

Medicaid Pre-Pay Spend down

HB685 would allow persons who have been found potentially eligible for Medicaid--because they are elderly, blind, have a disability, are pregnant, or in a family–to qualify for monthly Medicaid by paying their monthly spend down amount as a monthly premium.

Under the bill, DPA and DHS will set up an alternative method for Medicaid applicants to satisfy their monthly spend down amounts. People could qualify by prepaying their spend down amount directly to IDHS, much the way that insurance premiums are paid. Spend down premiums would be paid to a central office (just as Kid Care and Health Benefits for Working Disabled monthly premiums are now paid) under rules established by the Illinois Department of Public Aid. The spend down prepayment program will not in any way expand Medicaid eligibility rules.

Mental Health Service Invoices Used to Meet Spend down

Both the Illinois Department of Public Aid (DPA) and Illinois Department of Human Services (DHS) have made clear in memoranda, policy manual updates, and during seminars attended by mental health care providers that the total cost of mental health services paid out of state grant money could be used to satisfy a patient’s Medicaid spend down obligation. This has allowed Illinois to use Medicaid funds to help cover the costs of mental health coverage.

HB685 would solidify the following:


Consistency within Medicaid statute set forth in the state’s current practice and approved by the federal government: that current practice allows usual and customary charges from community mental health centers to be used to meet Medicaid spend down obligations for patients.

Continued federal participation within Illinois Medicaid Program for community mental health services.

Continued access to the Illinois Medicaid Program for mentally ill clients. 

 

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