94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006
HB1297

 

Introduced 02/09/05, by Rep. Constance A. Howard

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-5.12   from Ch. 23, par. 5-5.12

    Amends the Illinois Public Aid Code. Provides that the Department of Public Aid may not impose any requirement for prior approval or any other restriction on any single-source or multi-source drug that is prescribed for the treatment of HIV/AIDS. Effective immediately.


LRB094 09843 DRJ 40099 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB1297 LRB094 09843 DRJ 40099 b

1     AN ACT concerning public aid.
 
2     Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
 
4     Section 5. The Illinois Public Aid Code is amended by
5 changing Section 5-5.12 as follows:
 
6     (305 ILCS 5/5-5.12)  (from Ch. 23, par. 5-5.12)
7     Sec. 5-5.12. Pharmacy payments.
8     (a) Every request submitted by a pharmacy for reimbursement
9 under this Article for prescription drugs provided to a
10 recipient of aid under this Article shall include the name of
11 the prescriber or an acceptable identification number as
12 established by the Department.
13     (b) Pharmacies providing prescription drugs under this
14 Article shall be reimbursed at a rate which shall include a
15 professional dispensing fee as determined by the Illinois
16 Department, plus the current acquisition cost of the
17 prescription drug dispensed. The Illinois Department shall
18 update its information on the acquisition costs of all
19 prescription drugs no less frequently than every 30 days.
20 However, the Illinois Department may set the rate of
21 reimbursement for the acquisition cost, by rule, at a
22 percentage of the current average wholesale acquisition cost.
23     (c) Reimbursement under this Article for prescription
24 drugs shall be limited to reimbursement for 4 brand-name
25 prescription drugs per patient per month. This subsection
26 applies only if (i) the brand-name drug was not prescribed for
27 an acute or urgent condition, (ii) the brand-name drug was not
28 prescribed for Alzheimer's disease, arthritis, diabetes,
29 HIV/AIDS, a mental health condition, or respiratory disease,
30 and (iii) a therapeutically equivalent generic medication has
31 been approved by the federal Food and Drug Administration. This
32 subsection does not apply to any drug that is subject to

 

 

HB1297 - 2 - LRB094 09843 DRJ 40099 b

1 subsection (e).
2     (d) The Department shall not impose requirements for prior
3 approval based on a preferred drug list for anti-retroviral,
4 anti-hemophilic factor concentrates, or any atypical
5 antipsychotics, conventional antipsychotics, or
6 anticonvulsants used for the treatment of serious mental
7 illnesses until 30 days after it has conducted a study of the
8 impact of such requirements on patient care and submitted a
9 report to the Speaker of the House of Representatives and the
10 President of the Senate.
11     (e) The Department of Public Aid may not impose any
12 requirement for prior approval or any other restriction on any
13 single-source or multi-source drug that is prescribed for the
14 treatment of HIV/AIDS.
15 (Source: P.A. 92-597, eff. 6-28-02; 92-825, eff. 8-21-02;
16 93-106, eff. 7-8-03.)
 
17     Section 99. Effective date. This Act takes effect upon
18 becoming law.