093_HB0789eng

 
HB0789 Engrossed                     LRB093 05314 DRJ 05404 b

 1        AN ACT in relation to aging.

 2        Be it enacted by the People of  the  State  of  Illinois,
 3    represented in the General Assembly:

 4        Section  5.  The  Senior  Citizens  and  Disabled Persons
 5    Property Tax Relief  and  Pharmaceutical  Assistance  Act  is
 6    amended by changing Section 6 as follows:

 7        (320 ILCS 25/6) (from Ch. 67 1/2, par. 406)
 8        Sec. 6.  Administration.
 9        (a)  In  general.   Upon receipt of a timely filed claim,
10    the Department shall determine  whether  the  claimant  is  a
11    person  entitled  to a grant under this Act and the amount of
12    grant to which he or she is  entitled  under  this  Act.  The
13    Department  may  require  the  claimant to furnish reasonable
14    proof of the statements of domicile, household  income,  rent
15    paid,  property  taxes  accrued  and  other  matters on which
16    entitlement is based, and may withhold  payment  of  a  grant
17    until such additional proof is furnished.
18        (b)  Rental  determination.  If the Department finds that
19    the gross rent used in the computation by a claimant of  rent
20    constituting  property  taxes accrued exceeds the fair rental
21    value for the right to occupy that residence, the  Department
22    may  determine  the  fair rental value for that residence and
23    recompute   rent   constituting   property   taxes    accrued
24    accordingly.
25        (c)  Fraudulent claims.  The Department shall deny claims
26    which  have  been fraudulently prepared or when it finds that
27    the claimant has acquired title to his residence or has  paid
28    rent for his residence primarily for the purpose of receiving
29    a grant under this Act.
30        (d)  Pharmaceutical   Assistance.  The  Department  shall
31    allow all pharmacies licensed under the Pharmacy Practice Act
 
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 1    of 1987 to participate as authorized pharmacies  unless  they
 2    have  been removed from that status for cause pursuant to the
 3    terms of this Section.   The Director of the  Department  may
 4    enter   into  a  written  contract  with  any  State  agency,
 5    instrumentality  or  political  subdivision,  or   a   fiscal
 6    intermediary for the purpose of making payments to authorized
 7    pharmacies  for  covered  prescription drugs and coordinating
 8    the program of pharmaceutical assistance established by  this
 9    Act  with  other  programs  that  provide payment for covered
10    prescription   drugs.    Such   agreement   shall   establish
11    procedures for properly contracting  for  pharmacy  services,
12    validating  reimbursement  claims,  validating  compliance of
13    dispensing pharmacists with the contracts  for  participation
14    required  under this Section, validating the reasonable costs
15    of covered prescription drugs, and  otherwise  providing  for
16    the effective administration of this Act.
17        The  Department shall promulgate rules and regulations to
18    implement  and  administer  the  program  of   pharmaceutical
19    assistance  required  by  this  Act,  which shall include the
20    following:
21             (1)  Execution  of  contracts  with  pharmacies   to
22        dispense covered prescription drugs. Such contracts shall
23        stipulate  terms and conditions for authorized pharmacies
24        participation and the rights of the  State  to  terminate
25        such  participation  for  breach  of such contract or for
26        violation of this Act or related rules and regulations of
27        the Department;
28             (2)  Establishment of maximum limits on the size  of
29        prescriptions, new or refilled, which shall be in amounts
30        sufficient  for 34 days, except as otherwise specified by
31        rule for medical or utilization control reasons;
32             (3)  Establishment of liens upon any and all  causes
33        of  action  which  accrue to a beneficiary as a result of
34        injuries  for  which  covered  prescription   drugs   are
 
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 1        directly   or  indirectly  required  and  for  which  the
 2        Director made payment or became  liable  for  under  this
 3        Act;
 4             (4)  Charge  or  collection  of  payments from third
 5        parties or private plans of  assistance,  or  from  other
 6        programs  of  public  assistance  for  any  claim that is
 7        properly chargeable  under  the  assignment  of  benefits
 8        executed by beneficiaries as a requirement of eligibility
 9        for  the  pharmaceutical  assistance  identification card
10        under this Act;
11             (5)  Inspection of appropriate records and audit  of
12        participating  authorized  pharmacies  to ensure contract
13        compliance, and to determine any fraudulent  transactions
14        or practices under this Act;
15             (6)  Annual determination of the reasonable costs of
16        covered  prescription  drugs  for which payments are made
17        under this Act, as provided in Section 3.16;
18             (7)  Payment  to  pharmacies  under  this   Act   in
19        accordance with the State Prompt Payment Act.
20        The  Department shall annually report to the Governor and
21    the General Assembly  by  March  1st  of  each  year  on  the
22    administration  of  pharmaceutical assistance under this Act.
23    By the effective  date  of  this  Act  the  Department  shall
24    determine  the reasonable costs of covered prescription drugs
25    in accordance with Section 3.16 of this Act.
26    (Source: P.A. 91-357, eff. 7-29-99; 92-651, eff. 7-11-02.)