State of Illinois
91st General Assembly

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 1        AN  ACT  to  amend the Illinois Public Aid Code by adding
 2    Section 5-5.12a.

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

 5        Section  5.  The  Illinois  Public Aid Code is amended by
 6    adding Section 5-5.12a as follows:

 7        (305 ILCS 5/5-5.12a new)
 8        Sec. 5-5.12a. Pharmacies; prescription rates for Medicare
 9    beneficiaries.
10        (a)  A pharmacy  must  comply  with  this  Section  as  a
11    condition  of  the  pharmacy's  participation  in the medical
12    assistance program under this Article.
13        (b)  When a Medicare beneficiary or someone on a Medicare
14    beneficiary's  behalf  presents  a  valid  prescription   for
15    medication  for  the  Medicare  beneficiary to a pharmacy and
16    also presents the Medicare beneficiary's Medicare  card,  the
17    pharmacy   must  charge  for  the  prescribed  medication  as
18    follows:
19             (1)  The pharmacy may not charge  a  price  for  the
20        medication  that  exceeds  the reimbursement rate for the
21        medication that is otherwise paid to the pharmacy by  the
22        Illinois Department under this Article.
23             (2)  The  pharmacy  may charge an additional amount,
24        as  set  by  the  Illinois  Department  by  rule,  as   a
25        dispensing  fee.   This fee may not exceed the dispensing
26        fee charged to recipients  of  medical  assistance  under
27        this Article for the same medication.
28        The  prescription  medication price limitations set forth
29    in  this  subsection  do  not   apply   to   over-the-counter
30    medications or to compounded prescriptions.
31        (c)  The  Illinois  Department  shall monitor pharmacies'
                            -2-                LRB9112793DJcs
 1    compliance with this Section and  report  its  findings  each
 2    year  to  the General Assembly.  The report must include, but
 3    need not be limited  to,  information  concerning  pharmacies
 4    that  discontinue  participation  in  the  medical assistance
 5    program under this Article and the  reasons  given  by  those
 6    pharmacies for discontinuing their participation.
 7             (d)  This Section is repealed on January 1, 2003.

 8        Section  99.  Effective date.  This Act takes effect upon
 9    becoming law.

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