State of Illinois
2017 and 2018


Introduced , by Rep. Camille Y. Lilly


305 ILCS 5/5-4.1  from Ch. 23, par. 5-4.1

    Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services shall not require any person committed to the custody of the Department of Corrections who is eligible for medical assistance to pay a fee as a co-payment for services.

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HB5308LRB100 18911 KTG 34156 b

1    AN ACT concerning public aid.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Illinois Public Aid Code is amended by
5changing Section 5-4.1 as follows:
6    (305 ILCS 5/5-4.1)  (from Ch. 23, par. 5-4.1)
7    Sec. 5-4.1. Co-payments. The Department may by rule provide
8that recipients under any Article of this Code shall pay a fee
9as a co-payment for services. Co-payments shall be maximized to
10the extent permitted by federal law, except that the Department
11shall impose a co-pay of $2 on generic drugs. Provided,
12however, that any such rule must provide that no co-payment
13requirement can exist for renal dialysis, radiation therapy,
14cancer chemotherapy, or insulin, and other products necessary
15on a recurring basis, the absence of which would be life
16threatening, or where co-payment expenditures for required
17services and/or medications for chronic diseases that the
18Illinois Department shall by rule designate shall cause an
19extensive financial burden on the recipient, and provided no
20co-payment shall exist for emergency room encounters which are
21for medical emergencies. The Department shall seek approval of
22a State plan amendment that allows pharmacies to refuse to
23dispense drugs in circumstances where the recipient does not



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1pay the required co-payment. Co-payments may not exceed $10 for
2emergency room use for a non-emergency situation as defined by
3the Department by rule and subject to federal approval.
4    Notwithstanding the provisions of this Section or any other
5law, the Department shall not require any person committed to
6the custody of the Department of Corrections who is eligible
7for medical assistance under this Article to pay a fee as a
8co-payment for services.
9(Source: P.A. 96-1501, eff. 1-25-11; 97-74, eff. 6-30-11;
1097-689, eff. 6-14-12.)