Ill. Admin. Code tit. 89, § 127.20 – Scope of Department Responsibility | Midpage
§ 127.20
Ill. Admin. Code tit. 89, § 127.20
Scope of Department Responsibility
AUTHORITY: Implementing and authorized by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (PL 108-173) and Section 12-13 of the Illinois Public Aid Code [305 ILCS 5/12-13].DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
a) The federal Centers for Medicare and Medicaid Services (CMS) have overall responsibility for implementing Medicare Part D. Under Medicare Part D, the federal Social Security Administration (SSA) has responsibility for eligibility determinations and redeterminations for the LIS, and for appeals of those eligibility determinations and redeterminations.
b) As described at 42 CFR 423, Subpart S, the State has certain responsibilities related to Medicare Part D. As the agency responsible for administering Medicaid in Illinois, the Department shall make eligibility determinations and redeterminations for the LIS, and hear appeals of eligibility determinations and redeterminations, only for individuals who specifically request a State determination (see 89 Ill. Adm. Code 110.10). The Department is also required to notify CMS of LIS eligibility determinations.