State of Illinois
90th General Assembly
Legislation

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90_HB2501

      20 ILCS 1305/10-30 new
      30 ILCS 105/5.480 new
          Amends the Department of Human Services Act and the State
      Finance Act.  Requires the Department to establish a  program
      to  pay for drugs prescribed exclusively for the treatment of
      cancer. Creates the Cancer Treatment Drug Fund as  a  special
      fund  in  the  State  treasury,  from which payments shall be
      made.  Effective January 1, 1999.
                                                     LRB9008696JMmb
                                               LRB9008696JMmb
 1        AN ACT concerning the Department of Human Services.
 2        Be it enacted by the People of  the  State  of  Illinois,
 3    represented in the General Assembly:
 4        Section  5.  The  Department  of  Human  Services  Act is
 5    amended by adding Section 10-30 as follows:
 6        (20 ILCS 1305/10-30 new)
 7        Sec. 10-30.  Payments for cancer treatment drugs.
 8        (a)  The Department  shall  establish  and  administer  a
 9    program  to  pay  recipients  for  costs  of drugs prescribed
10    exclusively for the treatment of cancer when those costs  are
11    not  otherwise  reimbursed.   The  Department shall establish
12    eligibility standards and an application process by rule.
13        (b)  Participation in the program  shall  be  limited  to
14    persons  whose  household  income is not greater than 200% of
15    the federal poverty  level  as  established  by  the  federal
16    Office of Management and Budget.
17        The  program shall be available only to eligible Illinois
18    residents who have  resided  in  Illinois  for  at  least  12
19    months.
20        (c)  The Department shall pay a maximum amount per cancer
21    patient based on the following:
22             (1)  Available moneys.
23             (2)  The   terms   of   any   contract  between  the
24        Department and the provider.
25             (3)  The reimbursement rates shall be  the  same  as
26        the  Medicaid  reimbursement rate for the drug, minus the
27        copayment.
28        (d)  Payment shall be made under the  program  to  or  on
29    behalf  of  a  program  eligible recipient only for costs not
30    reimbursed or eligible for reimbursement by any  other  third
31    party  or governmental entity (including, without limitation,
                            -2-                LRB9008696JMmb
 1    private  or  group  insurance,  Medicaid,  Medicare,  or  the
 2    Veterans Administration).  The Secretary may, however,  waive
 3    this  requirement  in  individually  considered  cases if the
 4    Secretary determines that its enforcement will deny  services
 5    to a class of cancer patients because of conflicting State or
 6    federal laws or regulations.  The Department of Public Health
 7    shall  make  rules  to  ensure  that  all  third  parties and
 8    governmental entities (including, without limitation, private
 9    or group  insurance,  Medicaid,  Medicare,  or  the  Veterans
10    Administration) make all required benefit payments.
11        (e)  The    Secretary    may   restrict   or   categorize
12    reimbursements to meet budgetary limitations.
13        (f)  The Secretary shall maintain a cancer drug formulary
14    that shall include all drugs eligible  for  reimbursement  by
15    the  program.   The  Secretary  shall  establish  an internal
16    review procedure for updating the  formulary;  the  procedure
17    shall  allow  the addition and deletion of allowable drugs to
18    the formulary.  The  internal  review  procedure  shall  take
19    place at least quarterly during a fiscal year.
20        (g)  Payments  made  under  the program established under
21    this Section shall be made, subject to  appropriations,  from
22    the Cancer Treatment Drug Fund, a special fund that is hereby
23    established  in  the  State treasury.  The following shall be
24    deposited into the Fund:  (1)  amounts  appropriated  to  the
25    Department  for  that  purpose  and  (ii)  gifts, grants, and
26    donations for that purpose from public and  private  sources.
27    Interest  accruing  on moneys in the Fund shall remain in the
28    Fund.  Moneys in the Fund may be used only by the  Department
29    to   make   payments  for  cancer  drugs  under  the  program
30    established under this Section.
31        (h)  Moneys remaining in the Cancer Drug Fund at the  end
32    of the fiscal year may be used in the following fiscal year.
33        Section  10.  The  State Finance Act is amended by adding
                            -3-                LRB9008696JMmb
 1    Section 5.480 as follows:
 2        (30 ILCS 105/5.480 new)
 3        Sec. 5.480.  The Cancer Treatment Drug Fund.
 4        Section  99.  Effective  date.   This  Act  takes  effect
 5    January 1, 1999.

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