Illinois General Assembly - Illinois Compiled Statutes

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215 ILCS 5/512-9

(215 ILCS 5/512-9) (from Ch. 73, par. 1065.59-9)

Sec. 512-9.

Denial of Payment.

(a) No administrator shall deny payment
to any pharmacy for covered pharmaceutical services or prescription drug
products rendered as a result of the misuse, fraudulent or illegal use of
an identification card unless such identification card had expired, been
noticeably altered, or the pharmacy was notified of the cancellation of
such card.  In lieu of notifying pharmacies which have a common ownership,
the administrator may notify a party designated by the pharmacy to receive
such notice, in which case, notification shall not become effective until
5 calendar days after the designee receives notification.

(b) No program administrator may withhold any payment to any pharmacy
for covered pharmaceutical services or prescription drug products beyond
the time period specified in the payment schedule provisions of the agreement,
except for individual claims for payment which have been returned to the pharmacy
as incomplete or illegible.  Such returned claims shall be paid if resubmitted
by the pharmacy to the program administrator with the appropriate corrections made.

(Source: P.A. 82-1005.)