94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006
SB0441

 

Introduced 2/16/2005, by Sen. Dale A. Righter

 

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

    Amends the Illinois Public Aid Code. Increases the maximum allowable co-payment for dental, optical services and supplies, chiropractic services, podiatry services and encounter rate clinic services from $2 to $3. Establishes a maximum allowable co-payment of $2 for emergency room services that are not defined in 42 CFR 447.53(b)(4). Requires the Department of Public Aid to seek a waiver from the U.S. Secretary of Health and Human Services under Title XIX, Section 1916(a)(3) of the Social Security Act. Effective immediately.


LRB094 10562 DRJ 40858 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

SB0441 LRB094 10562 DRJ 40858 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 5-4.1 as follows:
 
6     (305 ILCS 5/5-4.1)  (from Ch. 23, par. 5-4.1)
7     Sec. 5-4.1. Co-payments.
8     (a) The Department may by rule provide that recipients
9 under any Article of this Code shall pay a fee as a co-payment
10 for services. Co-payments may not exceed $3 for brand name
11 drugs, $1 for other pharmacy services other than for generic
12 drugs, and $2 for physicians services, $3 for dental services,
13 optical services and supplies, chiropractic services, podiatry
14 services, and encounter rate clinic services, and $2 for
15 emergency room services not defined in 42 CFR 447.53(b)(4).
16 There shall be no co-payment for generic drugs. Co-payments may
17 not exceed $3 for hospital outpatient and clinic services.
18 Provided, however, that any such rule must provide that no
19 co-payment requirement can exist for renal dialysis, radiation
20 therapy, cancer chemotherapy, or insulin, and other products
21 necessary on a recurring basis, the absence of which would be
22 life threatening, or where co-payment expenditures for
23 required services and/or medications for chronic diseases that
24 the Illinois Department shall by rule designate shall cause an
25 extensive financial burden on the recipient, and provided no
26 co-payment shall exist for emergency room encounters which are
27 for medical emergencies.
28     (b) The Department shall submit a waiver to the U.S.
29 Secretary of Health and Human Services under Title XIX Section
30 1916(a)(3) of the Social Security Act to impose a copayment of
31 up to double the "nominal" copayment amounts determined under
32 42 CFR 447.54(a)(3).

 

 

SB0441 - 2 - LRB094 10562 DRJ 40858 b

1 (Source: P.A. 92-597, eff. 6-28-02; 93-593, eff. 8-25-03.)
 
2     Section 99. Effective date. This Act takes effect upon
3 becoming law.