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1 | AN ACT concerning public benefits.
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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 Senior Citizens and Disabled Persons | ||||||||||||||||||||||||||||
5 | Property Tax Relief and
Pharmaceutical Assistance Act is | ||||||||||||||||||||||||||||
6 | amended by changing Section 4 and by
adding Sections 3.18 and | ||||||||||||||||||||||||||||
7 | 3.19 as follows:
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8 | (320 ILCS 25/3.18 new)
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9 | Sec. 3.18. Drug used in the treatment of. "Drug used in | ||||||||||||||||||||||||||||
10 | the treatment of"
means (i) a drug used to treat a specified | ||||||||||||||||||||||||||||
11 | disease or illness or secondary
conditions caused by the | ||||||||||||||||||||||||||||
12 | disease or illness and (ii) a drug used to treat side
effects | ||||||||||||||||||||||||||||
13 | resulting from the use of a drug used to treat the disease or
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14 | illness.
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15 | (320 ILCS 25/3.19 new)
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16 | Sec. 3.19. Disease. "Disease" means a chronic and possibly | ||||||||||||||||||||||||||||
17 | recurrent
illness of long duration, as distinguished from an | ||||||||||||||||||||||||||||
18 | acute illness that is of
short duration with recovery due to | ||||||||||||||||||||||||||||
19 | limited medical treatment. "Disease" also
includes pneumonia, | ||||||||||||||||||||||||||||
20 | bronchitis, or other similar illnesses.
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21 | (320 ILCS 25/4) (from Ch. 67 1/2, par. 404)
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22 | Sec. 4. Amount of Grant.
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23 | (a) In general. Any individual 65 years or older or any | ||||||||||||||||||||||||||||
24 | individual who will
become 65 years old during the calendar | ||||||||||||||||||||||||||||
25 | year in which a claim is filed, and any
surviving spouse of | ||||||||||||||||||||||||||||
26 | such a claimant, who at the time of death received or was
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27 | entitled to receive a grant pursuant to this Section, which | ||||||||||||||||||||||||||||
28 | surviving spouse
will become 65 years of age within the 24 | ||||||||||||||||||||||||||||
29 | months immediately following the
death of such claimant and | ||||||||||||||||||||||||||||
30 | which surviving spouse but for his or her age is
otherwise |
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1 | qualified to receive a grant pursuant to this Section, and any
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2 | disabled person whose annual household income is less than | ||||||
3 | $14,000 for grant
years before the 1998 grant year, less than | ||||||
4 | $16,000 for the 1998 and 1999
grant years, and less than (i) | ||||||
5 | $21,218 for a household containing one person,
(ii) $28,480 for | ||||||
6 | a household containing 2 persons, or (iii) $35,740 for a
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7 | household containing 3 or more persons for the 2000 through | ||||||
8 | 2003 grant years, and less than (i) 28,000 for a household | ||||||
9 | containing
one person, (ii)
$35,000 for a household containing | ||||||
10 | 2 persons, or (iii) $42,000 for a household
containing 3 or | ||||||
11 | more persons for the 2004 grant year and thereafter
and whose | ||||||
12 | household is liable for payment of property taxes accrued or | ||||||
13 | has
paid rent constituting property taxes accrued and is | ||||||
14 | domiciled in this State
at the time he or she files his or her | ||||||
15 | claim is entitled to claim a
grant under this Act.
With respect | ||||||
16 | to claims filed by individuals who will become 65 years old
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17 | during the calendar year in which a claim is filed, the amount | ||||||
18 | of any grant
to which that household is entitled shall be an | ||||||
19 | amount equal to 1/12 of the
amount to which the claimant would | ||||||
20 | otherwise be entitled as provided in
this Section, multiplied | ||||||
21 | by the number of months in which the claimant was
65 in the | ||||||
22 | calendar year in which the claim is filed.
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23 | (b) Limitation. Except as otherwise provided in | ||||||
24 | subsections (a) and (f)
of this Section, the maximum amount of | ||||||
25 | grant which a claimant is
entitled to claim is the amount by | ||||||
26 | which the property taxes accrued which
were paid or payable | ||||||
27 | during the last preceding tax year or rent
constituting | ||||||
28 | property taxes accrued upon the claimant's residence for the
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29 | last preceding taxable year exceeds 3 1/2% of the claimant's | ||||||
30 | household
income for that year but in no event is the grant to | ||||||
31 | exceed (i) $700 less
4.5% of household income for that year for | ||||||
32 | those with a household income of
$14,000 or less or (ii) $70 if | ||||||
33 | household income for that year is more than
$14,000.
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34 | (c) Public aid recipients. If household income in one or | ||||||
35 | more
months during a year includes cash assistance in excess of | ||||||
36 | $55 per month
from the Department of Public Aid or the |
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1 | Department of Human Services (acting
as successor to the | ||||||
2 | Department of Public Aid under the Department of Human
Services | ||||||
3 | Act) which was determined under regulations of
that Department | ||||||
4 | on a measure of need that included an allowance for actual
rent | ||||||
5 | or property taxes paid by the recipient of that assistance, the | ||||||
6 | amount
of grant to which that household is entitled, except as | ||||||
7 | otherwise provided in
subsection (a), shall be the product of | ||||||
8 | (1) the maximum amount computed as
specified in subsection (b) | ||||||
9 | of this Section and (2) the ratio of the number of
months in | ||||||
10 | which household income did not include such cash assistance | ||||||
11 | over $55
to the number twelve. If household income did not | ||||||
12 | include such cash assistance
over $55 for any months during the | ||||||
13 | year, the amount of the grant to which the
household is | ||||||
14 | entitled shall be the maximum amount computed as specified in
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15 | subsection (b) of this Section. For purposes of this paragraph | ||||||
16 | (c), "cash
assistance" does not include any amount received | ||||||
17 | under the federal Supplemental
Security Income (SSI) program.
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18 | (d) Joint ownership. If title to the residence is held | ||||||
19 | jointly by
the claimant with a person who is not a member of | ||||||
20 | his or her household,
the amount of property taxes accrued used | ||||||
21 | in computing the amount of grant
to which he or she is entitled | ||||||
22 | shall be the same percentage of property
taxes accrued as is | ||||||
23 | the percentage of ownership held by the claimant in the
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24 | residence.
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25 | (e) More than one residence. If a claimant has occupied | ||||||
26 | more than
one residence in the taxable year, he or she may | ||||||
27 | claim only one residence
for any part of a month. In the case | ||||||
28 | of property taxes accrued, he or she
shall prorate 1/12 of the | ||||||
29 | total property taxes accrued on
his or her residence to each | ||||||
30 | month that he or she owned and occupied
that residence; and, in | ||||||
31 | the case of rent constituting property taxes accrued,
shall | ||||||
32 | prorate each month's rent payments to the residence
actually | ||||||
33 | occupied during that month.
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34 | (f) There is hereby established a program of pharmaceutical | ||||||
35 | assistance
to the aged and disabled which shall be administered | ||||||
36 | by the Department in
accordance with this Act, to consist of |
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1 | payments to authorized pharmacies, on
behalf of beneficiaries | ||||||
2 | of the program, for the reasonable costs of covered
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3 | prescription drugs. Each beneficiary who pays $5 for an | ||||||
4 | identification card
shall pay no additional prescription | ||||||
5 | costs. Each beneficiary who pays $25 for
an identification card | ||||||
6 | shall pay $3 per prescription. In addition, after a
beneficiary | ||||||
7 | receives $2,000 in benefits during a State fiscal year through | ||||||
8 | December 31, 2004 and, on and after January 1, 2005, after a
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9 | beneficiary receives $2,000 in benefits during a calendar year , | ||||||
10 | that
beneficiary shall also be charged 20% of the cost of each | ||||||
11 | prescription for
which payments are made by the program during | ||||||
12 | the remainder of the fiscal
year through December 31, 2004 and, | ||||||
13 | on and after January 1, 2005, during the
remainder of the | ||||||
14 | calendar year . To become a beneficiary under this program a | ||||||
15 | person must: (1)
be (i) 65 years of age or older, or (ii) the | ||||||
16 | surviving spouse of such
a claimant, who at the time of death | ||||||
17 | received or was entitled to receive
benefits pursuant to this | ||||||
18 | subsection, which surviving spouse will become 65
years of age | ||||||
19 | within the 24 months immediately following the death of such
| ||||||
20 | claimant and which surviving spouse but for his or her age is | ||||||
21 | otherwise
qualified to receive benefits pursuant to this | ||||||
22 | subsection, or (iii) disabled,
and (2) be domiciled in this | ||||||
23 | State at the time he or she files
his or her claim, and (3) have | ||||||
24 | a maximum household income of less
than $14,000 for grant years | ||||||
25 | before the 1998 grant year, less than $16,000
for the 1998 and | ||||||
26 | 1999 grant years, and less than (i) $21,218 for a household
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27 | containing one person, (ii) $28,480 for a household containing | ||||||
28 | 2 persons, or
(iii) $35,740 for a household containing 3 more | ||||||
29 | persons for the 2000 through 2003 grant
years, and less than | ||||||
30 | (i) 28,000 for a household containing one person, (ii)
$35,000 | ||||||
31 | for a household containing 2 persons, or (iii) $42,000 for a | ||||||
32 | household
containing 3 or more persons for the 2004 grant year
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33 | and thereafter. In addition, each eligible person must (1) | ||||||
34 | obtain an
identification card from the Department, (2) at the | ||||||
35 | time the card is obtained,
sign a statement assigning to the | ||||||
36 | State of Illinois benefits which may be
otherwise claimed under |
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1 | any private insurance plans, and (3) present the
identification | ||||||
2 | card to the dispensing pharmacist.
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3 | The Department may adopt rules specifying
participation
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4 | requirements for the pharmaceutical assistance program, | ||||||
5 | including copayment
amounts,
identification card fees, | ||||||
6 | expenditure limits, and the benefit threshold after
which a 20% | ||||||
7 | charge is imposed on the cost of each prescription, to be in
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8 | effect on and
after July 1, 2004.
Notwithstanding any other | ||||||
9 | provision of this paragraph, however, the Department
may not
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10 | increase the identification card fee above the amount in effect | ||||||
11 | on May 1, 2003
without
the express consent of the General | ||||||
12 | Assembly.
To the extent practicable, those requirements shall | ||||||
13 | be
commensurate
with the requirements provided in rules adopted | ||||||
14 | by the Department of Public Aid
to
implement the pharmacy | ||||||
15 | assistance program under Section 5-5.12a of the Illinois
Public
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16 | Aid Code.
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17 | Whenever a generic equivalent for a covered prescription | ||||||
18 | drug is available,
the Department shall reimburse only for the | ||||||
19 | reasonable costs of the generic
equivalent, less the co-pay | ||||||
20 | established in this Section, unless (i) the covered
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21 | prescription drug contains one or more ingredients defined as a | ||||||
22 | narrow
therapeutic index drug at 21 CFR 320.33, (ii) the | ||||||
23 | prescriber indicates on the
face of the prescription "brand | ||||||
24 | medically necessary", and (iii) the prescriber
specifies that a | ||||||
25 | substitution is not permitted. When issuing an oral
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26 | prescription for covered prescription medication described in | ||||||
27 | item (i) of this
paragraph, the prescriber shall stipulate | ||||||
28 | "brand medically necessary" and
that a substitution is not | ||||||
29 | permitted. If the covered prescription drug and its
authorizing | ||||||
30 | prescription do not meet the criteria listed above, the | ||||||
31 | beneficiary
may purchase the non-generic equivalent of the | ||||||
32 | covered prescription drug by
paying the difference between the | ||||||
33 | generic cost and the non-generic cost plus
the beneficiary | ||||||
34 | co-pay.
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35 | Any person otherwise eligible for pharmaceutical | ||||||
36 | assistance under this
Act whose covered drugs are covered by |
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1 | any public program for assistance in
purchasing any covered | ||||||
2 | prescription drugs shall be ineligible for assistance
under | ||||||
3 | this Act to the extent such costs are covered by such other | ||||||
4 | plan.
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5 | The fee to be charged by the Department for the | ||||||
6 | identification card shall
be equal to $5 per coverage year for | ||||||
7 | persons below the official poverty line
as defined by the | ||||||
8 | United States Department of Health and Human Services and
$25 | ||||||
9 | per coverage year for all other persons. On and before December | ||||||
10 | 31, 2004, coverage under this pharmaceutical
assistance | ||||||
11 | program shall begin on the date of application approval and be | ||||||
12 | in
effect for 12 months. On and after January 1, 2005, coverage | ||||||
13 | under this
pharmaceutical assistance program shall be in effect | ||||||
14 | on a calendar year
basis.
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15 | In the event that 2 or more persons are eligible for any | ||||||
16 | benefit under
this Act, and are members of the same household, | ||||||
17 | (1) each such person shall
be entitled to participate in the | ||||||
18 | pharmaceutical assistance program, provided
that he or she | ||||||
19 | meets all other requirements imposed by this subsection
and (2) | ||||||
20 | each participating household member contributes the fee | ||||||
21 | required
for that person by the preceding paragraph for the | ||||||
22 | purpose
of obtaining an identification card.
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23 | (Source: P.A. 92-131, eff.
7-23-01; 92-519, eff. 1-1-02; | ||||||
24 | 92-651, eff. 7-11-02; 93-130, eff. 7-10-03.)
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25 | Section 99. Effective date. This Act takes effect upon | ||||||
26 | becoming law. |