Current through Register Vol. 48, No. 38, September 20, 2024
The provisions of this Section are effective October 1,
2013.
a) An application is:
1) a signed request for medical assistance in
a form approved by the Department of Healthcare and Family Services
("Department") thathas been completed to the best of the client's knowledge and
belief;
2) an electronic
transmission received from the Social Security Administration on behalf of an
applicant for enrollment in the Medicare Savings Program (MSP) and Low-Income
Subsidy (LIS) Program pursuant to
42 USC
1320 b - 14(c). Such a transmission shall be
treated as the initiation of an application for MSP benefits as if the
application was submitted directly by the applicant;
3) a signed electronically transmitted
request for medical assistance in a form approved by the Department, complying
with the security requirements of subsection (b)(4), that has been completed to
the best of the applicant's knowledge and belief;
4) a signed request for medical assistance
submitted by telephone in a form approved by the Department, complying with the
security requirements of subsection (b)(4), that has been completed to the best
of the applicant's knowledge and belief.
b) The application must comply with the
following:
1) Contain the applicant's name and
address.
A) A person who is homeless, may use
the address of a friend or relative, supervised shelter, church, halfway house,
or similar facility.
B) A person
who is homeless and does not have a permanent address may use the address of
the local Department of Human Services office where he or she applied or where
his or her case is currently active.
2) Contain a signature or signatures
satisfying one of the following conditions:
A) an original signature or signatures on an
application submitted under subsection (a)(1);
B) an electronic signature from the Social
Security Administration on an application received under subsection
(a)(2);
C) an electronic signature
meeting the security requirements of subsection (b)(4) on an application
submitted under subsection (a)(3); or
D) a voice recording constituting a
telephonic signature meeting the security requirements of subsection (b)(4) on
an application submitted under subsection (a)(4).
3) If the application does not contain a name
or address, it will not be processed. If it does not contain a signature or
signatures, the Department shall:
A) return
an application submitted pursuant to subsection (a)(1) to the applicant to
obtain the missing signature;
B)
not accept an application submitted pursuant to subsection (a)(2), (a)(3) or
(a)(4).
4) Applications
submitted pursuant to subsection (a)(3) or (a)(4) of this Section shall:
A) in accordance with Section 25-101(c) of
the Electronic Commerce Security Act [5 ILCS 175 ], meet the security
requirements of 14 Ill. Adm. Code
105.210;
B) be captured in a secure format and placed
into a secure, auditable database that tracks the user when the application is
modified to ensure the integrity, security and confidentiality of the
electronic signature; and
C) be
made in accordance with the instructions given for completing any form approved
by the Department.
c) The application must be signed by the
applicant with the following exceptions:
1)
When a guardian has been appointed for the applicant, the guardian must sign
the application. For purposes of this Section, "guardian" means a
representative of a minor or a representative of a person under legal
disability as defined in Section 1-2.08 of the Probate Act of 1975 [755 ILCS 5
] and a representative as defined in Section 1-2.15 of that Act. The term
"guardian" includes a conservator.
2) When the applicant is physically or
mentally unable to sign the application, the application may be signed by
someone acting responsibly in behalf of the applicant, including, as allowed by
Section 11-4.1 of the Public Aide Code [305 ILCS 5 ], a representative of a
facility licensed under the Nursing Home Care Act [210 ILCS 45 ] or the ID/DD
Community Care Act [210 ILCS 47 ] or certified under the Public Aid
Code.
3) When application is made
for a non-emancipated child under the age of 18, the application must be signed
by one of the following:
A) the child's
caretaker relative with whom the child lives;
B) an individual with whom the child lives
who intends to claim the child as a tax dependent; or
C) if neither subsection (c)(3)(A) or
(c)(3)(B) applies, the child.
4) When the applicant has appointed an
authorized representative with the Department. (An authorized representative is
a person authorized by the applicant to act in his or her behalf. The term
"approved representative" has the same meaning as the term "authorized
representative".)
5) When an
electronic application is received from the Social Security Administration as
described in subsection (a)(2).
6)
When the applicant is a member of a household, as determined pursuant to 89
Ill. Adm. Code
120.64,
and another adult member of the household submits application for the
applicant.
d)
Application for medical assistance may be made in behalf of a deceased person.
In order for payment to be made by the Department for the funeral and burial
expenses of the decedent, the completed application must be received in the
local office not more than 30 calendar days after the individual's death,
excluding the day on which death occurred, unless delay in receipt of the form
occurred through no fault of the individual applying.
e) The applicant may be assisted by the
Department and by individuals of the applicant's choice in completing the
application.
f) The date of
application shall be the business day an application with a name, address and
proper signature or signatures is received by the Department, with one
exception: for applications completed by pregnant women and children under age
18 at a disproportionate share hospital or federally qualified health center,
the date the application is properly signed shall be the date of
application.
g) If the Department
does not process or does not accept an application for any reason set forth in
subsection (b)(3), the Department shall use reasonable efforts to identify the
individual who initiated or submitted the application; and inform that
individual of:
1) the reason that the
Department did not process or did not accept the application; and
2) the action or actions required for an
application to be processed or accepted by the Department.
