97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB4840

 

Introduced 2/3/2012, by Rep. Tom Cross

 

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.


LRB097 17346 KTG 62547 b

 

 

A BILL FOR

 

HB4840LRB097 17346 KTG 62547 b

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. Provided,
11however, that any such rule must provide that no co-payment
12requirement can exist for renal dialysis, radiation therapy,
13cancer chemotherapy, or insulin, and other products necessary
14on a recurring basis, the absence of which would be life
15threatening, or where co-payment expenditures for required
16services and/or medications for chronic diseases that the
17Illinois Department shall by rule designate shall cause an
18extensive financial burden on the recipient, and provided no
19co-payment shall exist for emergency room encounters which are
20for medical emergencies. The Department shall seek approval of
21a State plan amendment that allows pharmacies to refuse to
22dispense drugs in circumstances where the recipient does not
23pay the required co-payment. In the event the State plan

 

 

HB4840- 2 -LRB097 17346 KTG 62547 b

1amendment is rejected, co-payments may not exceed $3 for brand
2name drugs, $1 for other pharmacy services other than for
3generic drugs, and $2 for physician services, dental services,
4optical services and supplies, chiropractic services, podiatry
5services, and encounter rate clinic services. There shall be no
6co-payment for generic drugs. Co-payments may not exceed $10
7for emergency room use for a non-emergency situation as defined
8by the Department by rule and subject to federal approval.
9(Source: P.A. 96-1501, eff. 1-25-11; 97-74, eff. 6-30-11.)