Bill Text: IL HB4840 | 2011-2012 | 97th General Assembly | Introduced
Bill Title: Amends the Illinois Public Aid Code. Makes a technical change in a Section regarding Medicaid co-payments.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Failed) 2013-01-08 - Session Sine Die [HB4840 Detail]
Download: Illinois-2011-HB4840-Introduced.html
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1 | AN ACT concerning public aid.
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2 | Be it enacted by the People of the State of Illinois, | |||||||||||||||||||
3 | represented in the General Assembly:
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4 | Section 5. The Illinois Public Aid Code is amended by | |||||||||||||||||||
5 | changing Section 5-4.1 as follows:
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6 | (305 ILCS 5/5-4.1) (from Ch. 23, par. 5-4.1)
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7 | Sec. 5-4.1. Co-payments. The The Department may by rule | |||||||||||||||||||
8 | provide that recipients
under any Article of this Code shall | |||||||||||||||||||
9 | pay a fee as a co-payment for services.
Co-payments shall be | |||||||||||||||||||
10 | maximized to the extent permitted by federal law. Provided, | |||||||||||||||||||
11 | however, that any such rule must provide that no
co-payment | |||||||||||||||||||
12 | requirement can exist
for renal dialysis, radiation therapy, | |||||||||||||||||||
13 | cancer chemotherapy, or insulin, and
other products necessary | |||||||||||||||||||
14 | on a recurring basis, the absence of which would
be life | |||||||||||||||||||
15 | threatening, or where co-payment expenditures for required | |||||||||||||||||||
16 | services
and/or medications for chronic diseases that the | |||||||||||||||||||
17 | Illinois Department shall
by rule designate shall cause an | |||||||||||||||||||
18 | extensive financial burden on the
recipient, and provided no | |||||||||||||||||||
19 | co-payment shall exist for emergency room
encounters which are | |||||||||||||||||||
20 | for medical emergencies. The Department shall seek approval of | |||||||||||||||||||
21 | a State plan amendment that allows pharmacies to refuse to | |||||||||||||||||||
22 | dispense drugs in circumstances where the recipient does not | |||||||||||||||||||
23 | pay the required co-payment. In the event the State plan |
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1 | amendment is rejected, co-payments may not exceed $3 for brand | ||||||
2 | name drugs, $1 for other pharmacy
services other than for | ||||||
3 | generic drugs, and $2 for physician services, dental
services, | ||||||
4 | optical services and supplies, chiropractic services, podiatry
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5 | services, and encounter rate clinic services. There shall be no | ||||||
6 | co-payment for
generic drugs. Co-payments may not exceed $10 | ||||||
7 | for emergency room use for a non-emergency situation as defined | ||||||
8 | by the Department by rule and subject to federal approval.
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9 | (Source: P.A. 96-1501, eff. 1-25-11; 97-74, eff. 6-30-11.)
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