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Bill > HB5210


IL HB5210

IL HB5210
CMS-MEDICARE AUDIT


summary

Introduced
02/05/2026
In Committee
02/10/2026
Crossed Over
Passed
Dead

Introduced Session

104th General Assembly

Bill Summary

Amends the Department of Central Management Services Law of the Civil Administrative Code of Illinois. Creates the Disability Benefits Maximization Program. Provides that, within 6 months after the effective date of the amendatory Act, the Department of Central Management Services, in conjunction with the 5 State-funded retirement systems, shall enter into a contract with an administrator to establish and conduct a Disability Benefits Maximization Program to identify individuals eligible for but not enrolled in Medicare, and to assist those individuals with enrolling in Social Security and Medicare. Provides that the Disability Benefits Maximization Program shall conduct an annual audit of the State health benefits program for everyone covered under the State Employees Group Insurance Program, the Teachers' Retirement Insurance Program, and the College Insurance Program for the purpose of identifying participants and their dependents who are eligible for Medicare under federal law and shall also ensure that those annuitants, retirees, benefit recipients, survivors, and dependents who are eligible for Medicare are enrolled in Medicare with Medicare as their primary health care benefits coverage and the State health benefits program being the secondary provider of their health care benefits coverage. Provides that the Disability Benefits Maximization Program shall assist annuitants, retirees, benefit recipients, and their survivors and dependents who become disabled and are not enrolled in Social Security Disability Insurance and Medicare with enrolling in and obtaining Social Security Disability Insurance and Medicare benefits. Provides that the administrator of the Disability Benefits Maximization Program shall provide the Department, the 5 State-funded retirement systems, and the General Assembly with an annual report. Effective January 1, 2027.

AI Summary

This bill establishes a Disability Benefits Maximization Program, requiring the Department of Central Management Services, in collaboration with five state-funded retirement systems, to contract with an administrator within six months of the bill's effective date of January 1, 2027. This program will identify and assist individuals receiving state benefits, including annuitants, retirees, and their survivors or dependents, who are eligible for but not yet enrolled in Medicare and Social Security. The program will conduct an annual audit of state health benefit programs, such as the State Employees Group Insurance Program, to ensure that eligible individuals are enrolled in Medicare, making it their primary health coverage with state programs acting as secondary. Furthermore, it will help individuals who become disabled and are not enrolled in Social Security Disability Insurance (SSDI) and Medicare to enroll in these federal programs, offering assistance with education, outreach, eligibility analysis, and claims representation. The administrator will then provide an annual report to the Department, the retirement systems, and the General Assembly detailing the number of individuals transitioned to SSDI and Medicare and the resulting cost savings for the state.

Sponsors (1)

Last Action

Referred to Rules Committee (on 02/10/2026)

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