101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB1310

 

Introduced , by Rep. Michael J. Madigan

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-4.1  from Ch. 23, par. 5-4.1

    Amends the Illinois Public Aid Code. Makes a technical change in a Section regarding Medicaid co-payments.


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A BILL FOR

 

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1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Public Aid Code is amended by
5changing Section 5-4.1 as follows:
 
6    (305 ILCS 5/5-4.1)  (from Ch. 23, par. 5-4.1)
7    Sec. 5-4.1. Co-payments. The The Department may by rule
8provide that recipients under any Article of this Code shall
9pay a fee as a co-payment for services. Co-payments shall be
10maximized to the extent permitted by federal law, except that
11the Department shall impose a co-pay of $2 on generic drugs.
12Provided, however, that any such rule must provide that no
13co-payment requirement can exist for renal dialysis, radiation
14therapy, cancer chemotherapy, or insulin, and other products
15necessary on a recurring basis, the absence of which would be
16life threatening, or where co-payment expenditures for
17required services and/or medications for chronic diseases that
18the Illinois Department shall by rule designate shall cause an
19extensive financial burden on the recipient, and provided no
20co-payment shall exist for emergency room encounters which are
21for medical emergencies. The Department shall seek approval of
22a State plan amendment that allows pharmacies to refuse to
23dispense drugs in circumstances where the recipient does not

 

 

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1pay the required co-payment. Co-payments may not exceed $10 for
2emergency room use for a non-emergency situation as defined by
3the Department by rule and subject to federal approval.
4(Source: P.A. 96-1501, eff. 1-25-11; 97-74, eff. 6-30-11;
597-689, eff. 6-14-12.)