(305 ILCS 5/5-4.1)
(from Ch. 23, par. 5-4.1)
The Department may by rule provide that recipients
under any Article of this Code shall pay a fee as a co-payment for services.
Co-payments shall be maximized to the extent permitted by federal law, except that the Department shall impose a co-pay of $2 on generic drugs. Provided, however, that any such rule must provide that no
co-payment requirement can exist
for renal dialysis, radiation therapy, cancer chemotherapy, or insulin, and
other products necessary on a recurring basis, the absence of which would
be life threatening, or where co-payment expenditures for required services
and/or medications for chronic diseases that the Illinois Department shall
by rule designate shall cause an extensive financial burden on the
recipient, and provided no co-payment shall exist for emergency room
encounters which are for medical emergencies. The Department shall seek approval of a State plan amendment that allows pharmacies to refuse to dispense drugs in circumstances where the recipient does not pay the required co-payment. Co-payments may not exceed $10 for emergency room use for a non-emergency situation as defined by the Department by rule and subject to federal approval.
(Source: P.A. 96-1501, eff. 1-25-11; 97-74, eff. 6-30-11; 97-689, eff. 6-14-12.)