State of Illinois
91st General Assembly

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HB1307 Engrossed                               LRB9101990PTpk

 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 Alzheimer's  disease  treatment
 8    drugs.
 9        (a)  The  Department  shall  establish  and  administer a
10    program to pay  recipients  for  costs  of  drugs  prescribed
11    exclusively  for  the  treatment  of Alzheimer's disease when
12    those costs are not  otherwise  reimbursed.   The  Department
13    shall  establish  eligibility  standards  and  an application
14    process by rule.
15        (b)  Participation in the program  shall  be  limited  to
16    persons  whose  household  income is not greater than 200% of
17    the federal poverty  level  as  established  by  the  federal
18    Office of Management and Budget.
19        The  program shall be available only to eligible Illinois
20    residents who have  resided  in  Illinois  for  at  least  12
21    months.
22        (c)  The  Department  shall  pay  a  maximum  amount  per
23    Alzheimer's disease patient based on the following:
24             (1)  Available moneys.
25             (2)  The   terms   of   any   contract  between  the
26        Department and the provider.
27             (3)  The reimbursement rates shall be  the  same  as
28        the  Medicaid  reimbursement rate for the drug, minus the
29        copayment.
30        (d)  Payment shall be made under the  program  to  or  on
31    behalf  of  a  program  eligible recipient only for costs not
HB1307 Engrossed            -2-                LRB9101990PTpk
 1    reimbursed or eligible for reimbursement by any  other  third
 2    party  or governmental entity (including, without limitation,
 3    private  or  group  insurance,  Medicaid,  Medicare,  or  the
 4    Veterans Administration).  The Secretary may, however,  waive
 5    this  requirement  in  individually  considered  cases if the
 6    Secretary determines that its enforcement will deny  services
 7    to  a  class  of  Alzheimer's  disease  patients  because  of
 8    conflicting  State  or  federal  laws  or  regulations.   The
 9    Department  of  Public Health shall make rules to ensure that
10    all  third  parties  and  governmental  entities  (including,
11    without limitation, private  or  group  insurance,  Medicaid,
12    Medicare,  or  the Veterans Administration) make all required
13    benefit payments.
14        (e)  The   Secretary   may   restrict    or    categorize
15    reimbursements to meet budgetary limitations.
16        (f)  The  Secretary shall maintain an Alzheimer's disease
17    drug formulary that shall  include  all  drugs  eligible  for
18    reimbursement  by the program.  The Secretary shall establish
19    an internal review procedure for updating the formulary;  the
20    procedure  shall allow the addition and deletion of allowable
21    drugs to the formulary.  The internal review procedure  shall
22    take place at least quarterly during a fiscal year.
23        (g)  Payments  made  under  the program established under
24    this Section shall be made, subject to  appropriations,  from
25    the  Alzheimer's  Disease Treatment Drug Fund, a special fund
26    that is hereby  established  in  the  State  treasury.    The
27    following  shall  be  deposited  into  the  Fund: (1) amounts
28    appropriated to the Department  for  that  purpose  and  (ii)
29    gifts, grants, and donations for that purpose from public and
30    private  sources.   Interest  accruing  on moneys in the Fund
31    shall remain in the Fund.  Moneys in the  Fund  may  be  used
32    only  by  the  Department  to  make  payments for Alzheimer's
33    disease  drugs  under  the  program  established  under  this
34    Section.
HB1307 Engrossed            -3-                LRB9101990PTpk
 1        (h)  Moneys remaining in  the  Alzheimer's  Disease  Drug
 2    Fund  at  the  end  of  the  fiscal  year  may be used in the
 3    following fiscal year.

 4        Section 10.  The State Finance Act is amended  by  adding
 5    Section 5.490 as follows:

 6        (30 ILCS 105/5.490 new)
 7        Sec. 5.490.  The Alzheimer's Disease Treatment Drug Fund.

 9        Section  99.  Effective date.  This Act takes effect July
10    1, 2000.

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