093_HB0703sam001











                                     LRB093 05492 DRJ 15122 a

 1                     AMENDMENT TO HOUSE BILL 703

 2        AMENDMENT NO.     .  Amend House Bill  703  by  replacing
 3    everything after the enacting clause with the following:

 4        "Section  5.  The  Illinois Public Aid Code is amended by
 5    changing Section 5-5.12 as follows:

 6        (305 ILCS 5/5-5.12) (from Ch. 23, par. 5-5.12)
 7        Sec. 5-5.12.  Pharmacy payments.
 8        (a)  Every  request   submitted   by   a   pharmacy   for
 9    reimbursement  under  this  Article  for  prescription  drugs
10    provided  to  a  recipient  of  aid  under this Article shall
11    include  the  name  of  the  prescriber  or   an   acceptable
12    identification number as established by the Department.
13        (b)  Pharmacies  providing  prescription drugs under this
14    Article shall be reimbursed at a rate which shall  include  a
15    professional  dispensing  fee  as  determined by the Illinois
16    Department,  plus  the  current  acquisition  cost   of   the
17    prescription  drug  dispensed.  The Illinois Department shall
18    update its  information  on  the  acquisition  costs  of  all
19    prescription  drugs  no  less  frequently than every 30 days.
20    However,  the  Illinois  Department  may  set  the  rate   of
21    reimbursement  for  the  acquisition  cost,  by  rule,  at  a
22    percentage of the current average wholesale acquisition cost.
 
                            -2-      LRB093 05492 DRJ 15122 a
 1        (c)  Reimbursement  under  this  Article for prescription
 2    drugs shall be limited  to  reimbursement  for  4  brand-name
 3    prescription  drugs  per  patient per month.  This subsection
 4    applies only if (i) the brand-name drug  was  not  prescribed
 5    for  an  acute  or urgent condition, (ii) the brand-name drug
 6    was  not  prescribed  for  Alzheimer's  disease,   arthritis,
 7    diabetes, HIV/AIDS, a mental health condition, or respiratory
 8    disease,  and  (iii)  a  therapeutically  equivalent  generic
 9    medication  has  been  approved  by the federal Food and Drug
10    Administration.
11        (d)  The Department shall  not  impose  requirements  for
12    prior   approval   based   on   a  preferred  drug  list  for
13    anti-retroviral, anti-hemophilic factor concentrates, or  any
14    atypical   antipsychotics,  conventional  antipsychotics,  or
15    anticonvulsants used for  the  treatment  of  serious  mental
16    illnesses until 30 days after it has conducted a study of the
17    impact  of  such requirements on patient care and submitted a
18    report to the Speaker of the House of Representatives and the
19    President of the Senate.
20    (Source: P.A. 92-597, eff.  6-28-02;  92-825,  eff.  8-21-02;
21    revised 9-19-02.)

22        Section  99.  Effective date.  This Act takes effect upon
23    becoming law.".