IL SB3294

Medicaid recipients receiving institutional or home and community-based services would be presumed eligible for continued coverage during any redetermination process, with payments continuing unless a material change in financial circumstances occurs.

Recipients, caregivers, or responsible parties must notify the Department of Healthcare and Family Services if a material change in financial circumstances results in loss of eligibility.

The Department must provide written notice before starting any redetermination and upon its conclusion, including results and effective dates of eligibility changes.

By October 1, 2026, the Department must seek federal authorization to exempt persons with disabilities from annual Medicaid eligibility redeterminations, requiring full redetermination only once every 5 years.

Amends the Illinois Public Aid Code (305 ILCS 5/5-2.03) and adds new Section 5-2.03a; takes effect immediately upon becoming law.