Christ Hospital v. Illinois Comprehensive Health Insurance Plan
Annotate this Case
1-97-1154
SECOND DIVISION
APRIL 14, 1998
CHRIST HOSPITAL AND MEDICAL CENTER, ) APPEAL FROM
) THE CIRCUIT COURT
Plaintiff-Appellant and ) COOK COUNTY.
Cross-Appellee, )
)
) Nos. 93 CH 5193
) 93 CH 5194
) 93 CH 5195
) (Cons.)
v. )
)
ILLINOIS COMPREHENSIVE HEALTH ) THE HONORABLE
INSURANCE PLAN, ) AARON JAFFE,
) JUDGE PRESIDING.
Defendant-Appellee and )
Cross-Appellant. )
JUSTICE COUSINS delivered the opinion of the court:
This is an appeal and cross-appeal from consolidated
declaratory judgment actions filed by the plaintiff-appellant,
Christ Hospital & Medical Center (Christ Hospital), against
defendant-appellee, the Illinois Comprehensive Health Insurance
Plan (ICHIP). ICHIP contended that Christ Hospital should have
refunded $431,899.56 that ICHIP had paid for services rendered to
a patient, Brian Noti, whom ICHIP considered no longer eligible
for ICHIP coverage under the Illinois Comprehensive Health
Insurance Plan Act (215 ILCS 105/1 et seq. (West 1996) (formerly
Ill. Rev. Stat. 1989, ch. 73, par. 1301 et seq.)) (the Act).
ICHIP argued that Brian Noti was no longer eligible for ICHIP
coverage because section 7(e)(2) of the Act (Ill. Rev. Stat. ch.
1989, ch. 73, par. 1307(e)(2) et seq., provided that a person was
ineligible for ICHIP coverage if that person was a recipient of
medical assistance. ICHIP contended that Brian Noti was a
recipient of medical assistance from the Illinois Department of
Public Aid (the Department). When Christ Hospital denied that
any refund was due, ICHIP deducted the disputed amount from
amounts due the hospital for services rendered to other patients
who were covered by ICHIP. Christ Hospital then attempted to
recover $239,743.34 of the amount set off by ICHIP.
Christ Hospital now appeals from a February 21, 1997, order
in which the trial court granted ICHIP's motion for summary
judgment and, inter alia, ordered ICHIP to pay Christ Hospital
$239,753.34, the amount owed for services rendered to other
patients but also ordered Christ Hospital to pay ICHIP
$167,269.54, the amount to be refunded to ICHIP for services
rendered to Brian Noti. ICHIP cross-appeals from a December 2,
1994, order in which the trial court granted Christ Hospital's
motion for summary judgment and held that "receipt of medical
assistance" as used in section 7(e)(2) of the Act (Ill. Rev.
Stat. 1989, ch. 73, par. 1307(e)(2) means payment of medical
assistance benefits.
BACKGROUND
Jerome Noti's son, Brian, suffered from severe medical
problems. Jerome insured Brian as a dependent under a group
health insurance plan issued by Central Life Insurance Company
(Central Life) to his employer. The Central Life policy
contained a lifetime maximum benefit for any one insured
individual of $1 million. Brian was born on June 7, 1988, and
developed congestive heart failure shortly after birth. He was
hospitalized at Christ Hospital for most of his life. He reached
the lifetime maximum benefit under the Central Life policy on or
about October 1, 1989.
In anticipation of Brian reaching his lifetime maximum
benefit under the Central Life policy, Jerome applied for
insurance coverage for Brian from ICHIP on June 1, 1989. ICHIP
issued a policy on June 28, 1989, that provided Brian with health
insurance with a lifetime maximum benefit of $500,000.
Christ Hospital provided medical services to Brian from
October 1, 1989, to May 28, 1990. Christ Hospital billed the
Notis $563,671.34 for these services. ICHIP paid Christ Hospital
$441,889.56 for services rendered from October 1, 1989, to
February 11, 1990. Central Life paid $111,261.78 of the bill.
On January 23, 1990, Jerome applied to the Department for
medical assistance for Brian. The Department application queried
whether the applicant had received any medical services during
the three months prior to the date of the application. Jerome
checked "yes" and listed the months of October, November and
December 1989. The Department application queried whether the
applicant wanted the Department to evaluate eligibility for these
bills. Jerome checked "yes" and again listed the months of
October, November and December 1989. The Department approved
Brian for medical assistance on March 8, 1990, but made his
approval retroactive to October 1, 1989.
Thereafter, ICHIP determined that, under the eligibility
provision of the Act, section 7(e)(2) (Ill. Rev. Stat. 1989, ch.
73, par. 1307(e)(2)), Brian's eligibility for medical assistance
from the Department disqualified him from ICHIP coverage.
Section 7(e)(2) provides that a person shall not be eligible for
coverage under ICHIP if he or she is a recipient of medical
assistance. ICHIP further contended that Brian's policy
terminated on October 1, 1989, the date upon which Brian was
eligible for medical assistance with the Department. ICHIP
sought a refund from Christ Hospital for the $441,899.56 that it
had paid the hospital for services rendered to Brian after
October 1, 1989, and instructed Christ Hospital to bill the
Department for any services provided to Brian after October 1,
1989. Christ Hospital billed the Department for services
rendered to Brian from March 1, 1990, to May 28, 1990, and the
Department made payments to the hospital for those services.
When Christ Hospital did not bill the Department for the services
rendered to Brian from October 1989 to March 1990, ICHIP refused
to pay Christ Hospital for services rendered to three other ICHIP
insureds, Steven McCawley, Gene McPherson and Roger Safranek.
On June 8, 1993, Christ Hospital filed three actions for
declaratory and other relief against ICHIP. The hospital sought
to recover the sums owed by ICHIP for services provided to Steven
McCawley, Gene McPherson and Roger Safranek and alleged that
ICHIP withheld these sums in order to offset what ICHIP claimed
was an overpayment for services rendered to Brian Noti. The
trial court granted a motion by Christ Hospital to consolidate
the actions. The circuit court also granted a motion by Christ
Hospital to nonsuit the complaint seeking recovery from ICHIP for
services provided to Roger Safranek.
On August 23, 1994, Christ Hospital filed a motion for
summary judgment on a major issue and argued that Brian Noti's
eligibility for medical assistance did not disqualify him from
ICHIP coverage under section 7(e)(2) of the Act in effect at the
time in 1989, because the Act predicated eligibility upon actual
receipt of medical assistance benefits. In response, ICHIP
argued that Brian's eligibility for ICHIP coverage ended when he
became eligible for medical assistance on October 1, 1989. On
December 2, 1994, the trial court granted Christ Hospital's
motion and held that "receipt of medical assistance" as used in
the Act means payment of medical assistance.
Thereafter, Christ Hospital and ICHIP filed cross-motions
for summary judgment concerning the appropriate amount due under
the trial court's December 2, 1994, ruling. Christ Hospital
contended that ICHIP owed the hospital $191,949.44 for services
rendered to Steven McCawley and $47,804.90 for services rendered
to Gene McPherson. ICHIP argued that Christ Hospital owed a
refund of $167,269.54 for the amount it paid Christ Hospital for
services rendered to Brian from December 30, 1989, to February
11, 1990. ICHIP attached to its motion a payment ledger which
showed that the Department made payments for services rendered to
Brian as early as December 30, 1989. Therefore, ICHIP argued
that Brian became ineligible for ICHIP coverage on December 30,
1989, because medical assistance payments were made by the
Department on Brian's behalf for services rendered that day. In
reply, Christ Hospital argued that Brian Noti was not in receipt
of medical assistance benefits on December 30, 1989, because the
Department did not pay for those services until January 10, 1991.
Christ Hospital further argued that Brian retained his
eligibility for ICHIP coverage after December 30, 1989, and until
his $500,000 policy limit was exhausted.
On February 21, 1997, the trial court granted ICHIP's motion
for summary judgment and ruled that Brian Noti became ineligible
for ICHIP coverage on December 30, 1989, because the Department
paid for services he received on that day. In addition, the
trial court ordered ICHIP to pay Christ Hospital $239,753.34, the
amount claimed by Christ Hospital for services rendered to Steven
McCawley and Gene McPherson. The trial court also ordered Christ
Hospital to pay ICHIP $167,269.54, the amount that ICHIP had paid
the hospital for services rendered to Brian Noti between December
30, 1989, and February 11, 1990.
Christ Hospital now appeals from the trial court's order of
February 21, 1997. ICHIP cross-appeals from the trial court's
order of December 2, 1994.
We affirm both of the trial court's orders.
OPINION
We first address ICHIP's contention that Brian Noti became
ineligible for ICHIP coverage on October 1, 1989, because his
eligibility for medical assistance from the Department began on
that date. We disagree with ICHIP's contention.
The primary rule of statutory construction is to ascertain
and give effect to the intention of the legislature and that
inquiry appropriately begins with the language of the statute.
Illinois Power Company v. Mahin, 72 Ill. 2d 189, 194, 381 N.E.2d 222 (1978). When interpreting a statutory provision and
attempting to determine the legislature's intent, a court must
give the legislative language its plain and ordinary meaning;
legislative intent is clear when the language of the provision is
plain and unambiguous and it will be given effect as written
without resorting to other aids for construction. Cella v.
Sanitary District Employees' & Trustees' Annuity & Benefit Fund,
266 Ill. App. 3d 558, 564, 639 N.E.2d 1335 (1994); see also
Solich v. George & Anna Portes Cancer Prevention Center of
Chicago, Inc., 158 Ill. 2d 76, 83, 630 N.E.2d 820 (1994).
Under ICHIP's analysis of section 7(e)(2) of the Act, Brian
Noti was a recipient of medical assistance on October 1, 1989,
the date that the Department determined that he was entitled to
receive medical benefits retroactively. However, we disagree.
The record reflects that services provided to Brian Noti on
December 30, 1989, were paid for on January 10, 1991. Because of
this payment and our analysis of section 7(e)(2) of the Act, we
conclude that he was a recipient of medical assistance on
December 30, 1989.
Section 7(e)(2) of the Act provided that a person shall not
be eligible for coverage under the plan if:
(2) He or she is a recipient of medical assistance.
* * * Coverage under the plan shall automatically terminate
as of the effective date of receipt of medical assistance if
a person becomes eligible to receive medical assistance."
Ill. Rev. Stat. 1989 ch. 73, par. 1307(e)(2).
"Medical assistance" is defined in section 2(n) of the Act, which
provides:
"1302. Definitions
* * *
n. 'Medical assistance' means health care benefits
provided under Articles V (Medical Assistance) VI
(General Assistance), or VII (Aid to the Medically
Indigent) of The Illinois Public Aid Code."
(Emphasis added.) Ill. Rev. Stat. 1989, ch. 73,
par. 1302(n).
Our conclusion that receipt of medical assistance under
section 7(e)(2) of the Act means payment of medical assistance
comports with the use of the term "medical assistance" as it is
defined in another Illinois statute. Section 3-1 of the Illinois
Health Finance Reform Act (20 ILCS 2215/3-1(k) (West 1997),
formerly Ill. Rev. Stat., 1989, ch. 1111/2 par. 6503(1)(k)),
defines medical assistance as "payments made by the Illinois
Department of Public Aid for health care services rendered to
persons eligible for medical assistance" under Illinois Public
Aid. In interpreting statutory language, legislative intent may
be discerned from the history of the legislation or from the use
of terms in other sections of the same or other Illinois
statutes. Koenig v. McCarthy Construction Co., 344 Ill. App. 93,
97, 100 N.E.2d 338 (1951). We recognize the limitations in
importing definitions from other statutes since the context in
which a term is used bears on its intended meaning. See Navlyt
v. Kalinich, 125 Ill. App. 2d 290, 295, 260 N.E.2d 855 (1970).
However, we may presume that the legislature, when drafting the
language of section 7(e)(2), was aware of the construction and
use of the term in the Illinois Health Finance Reform Act (Ill.
Rev. Stat. 1989, ch. 1111/2 par. 6503(1)(k). See generally
People v. Wicks, 283 Ill. App. 3d 337, 342, 669 N.E.2d 722
(1996)(appellate court may presume legislature was aware of
judicial construction given to term used in a statute other than
the statute at issue and that the language used was intended to
have the same meaning).
Additionally, it is our view that Brian Noti was not a
recipient of medical assistance from the Department on October 1,
1989. Rather, it was later determined, pursuant to the
Department's own internal policies, that he was eligible for the
Department coverage and that such coverage would take effect
retroactively to October 1, 1989. As a result, the Department
paid for services that Brian Noti received on December 30, 1989.
ICHIP further argues that a later amendment to section
7(e)(2) of the Act clarifies that persons who are approved for
medical assistance are ineligible for ICHIP coverage. However,
this argument is unpersuasive.
A statutory amendment gives rise to the presumption that the
new legislation was intended to effect a change in the law as it
formerly existed. People v. Hare, 119 Ill. 2d 441, 451, 519 N.E.2d 879 (1988). Whether a legislative modification of a statute
is held to indicate an intent to change the law as it previously
existed or only to clarify the terms of the law depends upon the
circumstances involved. Hare, 119 Ill. 2d at 451. However,
when the meaning of the original statutory language is clear,
courts have declined to view an amendment as clarifying the
legislature's original intention. Hare, 119 Ill. 2d at 451.
The General Assembly amended section 7(e)(2) by passing
Public Act 87-560, which became effective on September 17, 1991.
Pub. Act 87-560, 1 (eff. September 17, 1991). As a result,
section 7(e)(2) now states that a person is ineligible for ICHIP
coverage if he or she "is a recipient of or approved to receive
medical assistance." 215 ILCS 105/7(e)(2) (West 1996). We see no
reason to construe this amendment as a clarification. The
meaning of the original statutory language is clear that a person
would be ineligible for insurance coverage under ICHIP if he or
she received medical assistance benefits that were provided. The
Act made no reference to eligibility as a bar to coverage.
Therefore, we conclude that the 1991 amendment was intended to
effect a change in the law as it formerly existed.
Accordingly, we hold that the summary judgment was properly
granted in favor of Christ Hospital on December 2, 1994, because
receipt of medical assistance under section 7(e)(2) of the Act
means payment of medical assistance. The record reflects that
the Department paid for services that were provided to Brian Noti
on December 30, 1989, to February 11, 1990. Therefore, we
further hold that summary judgment was properly granted in favor
of ICHIP. The trial court's order of February 21, 1997, which
ordered ICHIP to pay Christ Hospital $239,753.34, for services
rendered to Steven McCawley and Gene McPherson and ordered Christ
Hospital to refund $167,269.54 to ICHIP for overpayment of
payments to the hospital on behalf of Brian Noti, is affirmed.
For the foregoing reasons, the judgments of the circuit
court are affirmed.
Affirmed.
McNULTY, P.J., and TULLY, J., concur.
SECOND DIVISION
APRIL 14, 1998
CHRIST HOSPITAL AND MEDICAL CENTER, ) APPEAL FROM
) THE CIRCUIT COURT
Plaintiff-Appellant and ) COOK COUNTY.
Cross-Appellee, )
)
) Nos. 93 CH 5193
) 93 CH 5194
) 93 CH 5195
) (Cons.)
v. )
)
ILLINOIS COMPREHENSIVE HEALTH ) THE HONORABLE
INSURANCE PLAN, ) AARON JAFFE,
) JUDGE PRESIDING.
Defendant-Appellee and )
Cross-Appellant. )
JUSTICE COUSINS delivered the opinion of the court:
This is an appeal and cross-appeal from consolidated
declaratory judgment actions filed by the plaintiff-appellant,
Christ Hospital & Medical Center (Christ Hospital), against
defendant-appellee, the Illinois Comprehensive Health Insurance
Plan (ICHIP). ICHIP contended that Christ Hospital should have
refunded $431,899.56 that ICHIP had paid for services rendered to
a patient, Brian Noti, whom ICHIP considered no longer eligible
for ICHIP coverage under the Illinois Comprehensive Health
Insurance Plan Act (215 ILCS 105/1 et seq. (West 1996) (formerly
Ill. Rev. Stat. 1989, ch. 73, par. 1301 et seq.)) (the Act).
ICHIP argued that Brian Noti was no longer eligible for ICHIP
coverage because section 7(e)(2) of the Act (Ill. Rev. Stat. ch.
1989, ch. 73, par. 1307(e)(2) et seq., provided that a person was
ineligible for ICHIP coverage if that person was a recipient of
medical assistance. ICHIP contended that Brian Noti was a
recipient of medical assistance from the Illinois Department of
Public Aid (the Department). When Christ Hospital denied that
any refund was due, ICHIP deducted the disputed amount from
amounts due the hospital for services rendered to other patients
who were covered by ICHIP. Christ Hospital then attempted to
recover $239,743.34 of the amount set off by ICHIP.
Christ Hospital now appeals from a February 21, 1997, order
in which the trial court granted ICHIP's motion for summary
judgment and, inter alia, ordered ICHIP to pay Christ Hospital
$239,753.34, the amount owed for services rendered to other
patients but also ordered Christ Hospital to pay ICHIP
$167,269.54, the amount to be refunded to ICHIP for services
rendered to Brian Noti. ICHIP cross-appeals from a December 2,
1994, order in which the trial court granted Christ Hospital's
motion for summary judgment and held that "receipt of medical
assistance" as used in section 7(e)(2) of the Act (Ill. Rev.
Stat. 1989, ch. 73, par. 1307(e)(2) means payment of medical
assistance benefits.
BACKGROUND
Jerome Noti's son, Brian, suffered from severe medical
problems. Jerome insured Brian as a dependent under a group
health insurance plan issued by Central Life Insurance Company
(Central Life) to his employer. The Central Life policy
contained a lifetime maximum benefit for any one insured
individual of $1 million. Brian was born on June 7, 1988, and
developed congestive heart failure shortly after birth. He was
hospitalized at Christ Hospital for most of his life. He reached
the lifetime maximum benefit under the Central Life policy on or
about October 1, 1989.
In anticipation of Brian reaching his lifetime maximum
benefit under the Central Life policy, Jerome applied for
insurance coverage for Brian from ICHIP on June 1, 1989. ICHIP
issued a policy on June 28, 1989, that provided Brian with health
insurance with a lifetime maximum benefit of $500,000.
Christ Hospital provided medical services to Brian from
October 1, 1989, to May 28, 1990. Christ Hospital billed the
Notis $563,671.34 for these services. ICHIP paid Christ Hospital
$441,889.56 for services rendered from October 1, 1989, to
February 11, 1990. Central Life paid $111,261.78 of the bill.
On January 23, 1990, Jerome applied to the Department for
medical assistance for Brian. The Department application queried
whether the applicant had received any medical services during
the three months prior to the date of the application. Jerome
checked "yes" and listed the months of October, November and
December 1989. The Department application queried whether the
applicant wanted the Department to evaluate eligibility for these
bills. Jerome checked "yes" and again listed the months of
October, November and December 1989. The Department approved
Brian for medical assistance on March 8, 1990, but made his
approval retroactive to October 1, 1989.
Thereafter, ICHIP determined that, under the eligibility
provision of the Act, section 7(e)(2) (Ill. Rev. Stat. 1989, ch.
73, par. 1307(e)(2)), Brian's eligibility for medical assistance
from the Department disqualified him from ICHIP coverage.
Section 7(e)(2) provides that a person shall not be eligible for
coverage under ICHIP if he or she is a recipient of medical
assistance. ICHIP further contended that Brian's policy
terminated on October 1, 1989, the date upon which Brian was
eligible for medical assistance with the Department. ICHIP
sought a refund from Christ Hospital for the $441,899.56 that it
had paid the hospital for services rendered to Brian after
October 1, 1989, and instructed Christ Hospital to bill the
Department for any services provided to Brian after October 1,
1989. Christ Hospital billed the Department for services
rendered to Brian from March 1, 1990, to May 28, 1990, and the
Department made payments to the hospital for those services.
When Christ Hospital did not bill the Department for the services
rendered to Brian from October 1989 to March 1990, ICHIP refused
to pay Christ Hospital for services rendered to three other ICHIP
insureds, Steven McCawley, Gene McPherson and Roger Safranek.
On June 8, 1993, Christ Hospital filed three actions for
declaratory and other relief against ICHIP. The hospital sought
to recover the sums owed by ICHIP for services provided to Steven
McCawley, Gene McPherson and Roger Safranek and alleged that
ICHIP withheld these sums in order to offset what ICHIP claimed
was an overpayment for services rendered to Brian Noti. The
trial court granted a motion by Christ Hospital to consolidate
the actions. The circuit court also granted a motion by Christ
Hospital to nonsuit the complaint seeking recovery from ICHIP for
services provided to Roger Safranek.
On August 23, 1994, Christ Hospital filed a motion for
summary judgment on a major issue and argued that Brian Noti's
eligibility for medical assistance did not disqualify him from
ICHIP coverage under section 7(e)(2) of the Act in effect at the
time in 1989, because the Act predicated eligibility upon actual
receipt of medical assistance benefits. In response, ICHIP
argued that Brian's eligibility for ICHIP coverage ended when he
became eligible for medical assistance on October 1, 1989. On
December 2, 1994, the trial court granted Christ Hospital's
motion and held that "receipt of medical assistance" as used in
the Act means payment of medical assistance.
Thereafter, Christ Hospital and ICHIP filed cross-motions
for summary judgment concerning the appropriate amount due under
the trial court's December 2, 1994, ruling. Christ Hospital
contended that ICHIP owed the hospital $191,949.44 for services
rendered to Steven McCawley and $47,804.90 for services rendered
to Gene McPherson. ICHIP argued that Christ Hospital owed a
refund of $167,269.54 for the amount it paid Christ Hospital for
services rendered to Brian from December 30, 1989, to February
11, 1990. ICHIP attached to its motion a payment ledger which
showed that the Department made payments for services rendered to
Brian as early as December 30, 1989. Therefore, ICHIP argued
that Brian became ineligible for ICHIP coverage on December 30,
1989, because medical assistance payments were made by the
Department on Brian's behalf for services rendered that day. In
reply, Christ Hospital argued that Brian Noti was not in receipt
of medical assistance benefits on December 30, 1989, because the
Department did not pay for those services until January 10, 1991.
Christ Hospital further argued that Brian retained his
eligibility for ICHIP coverage after December 30, 1989, and until
his $500,000 policy limit was exhausted.
On February 21, 1997, the trial court granted ICHIP's motion
for summary judgment and ruled that Brian Noti became ineligible
for ICHIP coverage on December 30, 1989, because the Department
paid for services he received on that day. In addition, the
trial court ordered ICHIP to pay Christ Hospital $239,753.34, the
amount claimed by Christ Hospital for services rendered to Steven
McCawley and Gene McPherson. The trial court also ordered Christ
Hospital to pay ICHIP $167,269.54, the amount that ICHIP had paid
the hospital for services rendered to Brian Noti between December
30, 1989, and February 11, 1990.
Christ Hospital now appeals from the trial court's order of
February 21, 1997. ICHIP cross-appeals from the trial court's
order of December 2, 1994.
We affirm both of the trial court's orders.
OPINION
We first address ICHIP's contention that Brian Noti became
ineligible for ICHIP coverage on October 1, 1989, because his
eligibility for medical assistance from the Department began on
that date. We disagree with ICHIP's contention.
The primary rule of statutory construction is to ascertain
and give effect to the intention of the legislature and that
inquiry appropriately begins with the language of the statute.
Illinois Power Company v. Mahin, 72 Ill. 2d 189, 194, 381 N.E.2d 222 (1978). When interpreting a statutory provision and
attempting to determine the legislature's intent, a court must
give the legislative language its plain and ordinary meaning;
legislative intent is clear when the language of the provision is
plain and unambiguous and it will be given effect as written
without resorting to other aids for construction. Cella v.
Sanitary District Employees' & Trustees' Annuity & Benefit Fund,
266 Ill. App. 3d 558, 564, 639 N.E.2d 1335 (1994); see also
Solich v. George & Anna Portes Cancer Prevention Center of
Chicago, Inc., 158 Ill. 2d 76, 83, 630 N.E.2d 820 (1994).
Under ICHIP's analysis of section 7(e)(2) of the Act, Brian
Noti was a recipient of medical assistance on October 1, 1989,
the date that the Department determined that he was entitled to
receive medical benefits retroactively. However, we disagree.
The record reflects that services provided to Brian Noti on
December 30, 1989, were paid for on January 10, 1991. Because of
this payment and our analysis of section 7(e)(2) of the Act, we
conclude that he was a recipient of medical assistance on
December 30, 1989.
Section 7(e)(2) of the Act provided that a person shall not
be eligible for coverage under the plan if:
(2) He or she is a recipient of medical assistance.
* * * Coverage under the plan shall automatically terminate
as of the effective date of receipt of medical assistance if
a person becomes eligible to receive medical assistance."
Ill. Rev. Stat. 1989 ch. 73, par. 1307(e)(2).
"Medical assistance" is defined in section 2(n) of the Act, which
provides:
"1302. Definitions
* * *
n. 'Medical assistance' means health care benefits
provided under Articles V (Medical Assistance) VI
(General Assistance), or VII (Aid to the Medically
Indigent) of The Illinois Public Aid Code."
(Emphasis added.) Ill. Rev. Stat. 1989, ch. 73,
par. 1302(n).
Our conclusion that receipt of medical assistance under
section 7(e)(2) of the Act means payment of medical assistance
comports with the use of the term "medical assistance" as it is
defined in another Illinois statute. Section 3-1 of the Illinois
Health Finance Reform Act (20 ILCS 2215/3-1(k) (West 1997),
formerly Ill. Rev. Stat., 1989, ch. 1111/2 par. 6503(1)(k)),
defines medical assistance as "payments made by the Illinois
Department of Public Aid for health care services rendered to
persons eligible for medical assistance" under Illinois Public
Aid. In interpreting statutory language, legislative intent may
be discerned from the history of the legislation or from the use
of terms in other sections of the same or other Illinois
statutes. Koenig v. McCarthy Construction Co., 344 Ill. App. 93,
97, 100 N.E.2d 338 (1951). We recognize the limitations in
importing definitions from other statutes since the context in
which a term is used bears on its intended meaning. See Navlyt
v. Kalinich, 125 Ill. App. 2d 290, 295, 260 N.E.2d 855 (1970).
However, we may presume that the legislature, when drafting the
language of section 7(e)(2), was aware of the construction and
use of the term in the Illinois Health Finance Reform Act (Ill.
Rev. Stat. 1989, ch. 1111/2 par. 6503(1)(k). See generally
People v. Wicks, 283 Ill. App. 3d 337, 342, 669 N.E.2d 722
(1996)(appellate court may presume legislature was aware of
judicial construction given to term used in a statute other than
the statute at issue and that the language used was intended to
have the same meaning).
Additionally, it is our view that Brian Noti was not a
recipient of medical assistance from the Department on October 1,
1989. Rather, it was later determined, pursuant to the
Department's own internal policies, that he was eligible for the
Department coverage and that such coverage would take effect
retroactively to October 1, 1989. As a result, the Department
paid for services that Brian Noti received on December 30, 1989.
ICHIP further argues that a later amendment to section
7(e)(2) of the Act clarifies that persons who are approved for
medical assistance are ineligible for ICHIP coverage. However,
this argument is unpersuasive.
A statutory amendment gives rise to the presumption that the
new legislation was intended to effect a change in the law as it
formerly existed. People v. Hare, 119 Ill. 2d 441, 451, 519 N.E.2d 879 (1988). Whether a legislative modification of a statute
is held to indicate an intent to change the law as it previously
existed or only to clarify the terms of the law depends upon the
circumstances involved. Hare, 119 Ill. 2d at 451. However,
when the meaning of the original statutory language is clear,
courts have declined to view an amendment as clarifying the
legislature's original intention. Hare, 119 Ill. 2d at 451.
The General Assembly amended section 7(e)(2) by passing
Public Act 87-560, which became effective on September 17, 1991.
Pub. Act 87-560, 1 (eff. September 17, 1991). As a result,
section 7(e)(2) now states that a person is ineligible for ICHIP
coverage if he or she "is a recipient of or approved to receive
medical assistance." 215 ILCS 105/7(e)(2) (West 1996). We see no
reason to construe this amendment as a clarification. The
meaning of the original statutory language is clear that a person
would be ineligible for insurance coverage under ICHIP if he or
she received medical assistance benefits that were provided. The
Act made no reference to eligibility as a bar to coverage.
Therefore, we conclude that the 1991 amendment was intended to
effect a change in the law as it formerly existed.
Accordingly, we hold that the summary judgment was properly
granted in favor of Christ Hospital on December 2, 1994, because
receipt of medical assistance under section 7(e)(2) of the Act
means payment of medical assistance. The record reflects that
the Department paid for services that were provided to Brian Noti
on December 30, 1989, to February 11, 1990. Therefore, we
further hold that summary judgment was properly granted in favor
of ICHIP. The trial court's order of February 21, 1997, which
ordered ICHIP to pay Christ Hospital $239,753.34, for services
rendered to Steven McCawley and Gene McPherson and ordered Christ
Hospital to refund $167,269.54 to ICHIP for overpayment of
payments to the hospital on behalf of Brian Noti, is affirmed.
For the foregoing reasons, the judgments of the circuit
court are affirmed.
Affirmed.
McNULTY, P.J., and TULLY, J., concur.
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