98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014
HB2537

 

Introduced , by Rep. Elgie R. Sims, Jr.

 

SYNOPSIS AS INTRODUCED:
 
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 total amount in co-payments a recipient shall be required to pay per month for his or her prescription medications shall not exceed $5. Effective immediately.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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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 total amount in co-payments a
22recipient shall be required to pay per month for his or her
23prescription medications shall not exceed $5. The Department

 

 

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1shall seek approval of a State plan amendment that allows
2pharmacies to refuse to dispense drugs in circumstances where
3the recipient does not pay the required co-payment. Co-payments
4may not exceed $10 for emergency room use for a non-emergency
5situation as defined by the Department by rule and subject to
6federal approval.
7(Source: P.A. 96-1501, eff. 1-25-11; 97-74, eff. 6-30-11;
897-689, eff. 6-14-12.)
 
9    Section 99. Effective date. This Act takes effect upon
10becoming law.