Medicaid assistance is available in Illinois for persons with very low income and specific categories of people who are unable to pay for medical care. In Illinois, the Department of Human Services is responsible for determining a person's Medicaid eligibility, and the Department of Healthcare and Family Services is responsible for administering Medicaid benefits to eligible persons. Because Medicaid is a joint effort between the state and federal government, both federal and state laws govern Medicaid in Illinois.
Federal Law
The Medicaid program was established in 1965 by Congress with the enactment of the Social Security Act and is found in the statutes starting at 42 U.S. Code section 1396 called the Grants to States for Medical Assistance Programs. A state's participation in the program is voluntary, but all Medicaid state programs must adhere to the requirements of the federal statute. The US Department of Health & Human Services maintains a website called Center for Medicare & Medicaid Eligibility, which provides information on Medicaid eligibility and the minimum requirements that must be followed by each state's Medicaid program, including Illinois.
State Law
Illinois' participation in the Medicaid program is set forth in the Illinois Public Aid Code, which authorizes medical assistance to persons unable to meet their basic medical needs due to inadequate resources. Throughout the Illinois Public Code, the definitions used to describe the medical assistance available and the requirements for eligibility specifically state that Illinois law is to comply with federal law. With this primary law as the basis for providing Medicaid benefits, the Illinois Department of Healthcare and Family Services administers a number of programs to meet the medical needs of specified groups, such as All Kids for children and Mom and Babies for pregnant women.
State Administrative Code
In addition to the general provisions set forth in the Illinois Public Aid Code, more specific provisions regarding Illinois Medicaid law is set forth in the Illinois Administrative Code. This body of law is composed of rules the legislature made for the Department of Healthcare and Family Services to follow when administering the Medicaid program. The rules govern all aspects of the program, from determining a person's eligibility benefits to paying a medical provider for services rendered.
Policy Manuals
In order to facilitate carrying out the requirements of Illinois Medicaid law, a policy manual has been developed and is used by the employees at the Department of Healthcare and Family Services and Department of Human Services. The purpose of the manual is to give specific guidance regarding how government employees are to implement and adhere to the various federal and state laws governing the Illinois Medicaid program. The policy manual also includes guidance regarding other public benefits, such as cash and food programs, and how a person's eligibility under other programs affects eligibility for Medicaid benefits.
Tags: Medicaid program, Department Healthcare, Department Healthcare Family, Family Services, Healthcare Family
