Full Text of SB3486 97th General Assembly
SB3486 97TH GENERAL ASSEMBLY |
| | 97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012 SB3486 Introduced 2/7/2012, by Sen. William Delgado SYNOPSIS AS INTRODUCED: |
| 305 ILCS 5/5-5 | from Ch. 23, par. 5-5 |
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Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that a dental desensitization program that aims to allay the fears and anxieties of dental patients, age 5 through 21, who have a developmental disability or mental illness by familiarizing such patients with the surroundings, tools, and procedures of the dental office or clinic during a comprehensive patient walk-through shall be covered under the State's medical assistance program for persons who are otherwise eligible for medical assistance under the Code. Effective immediately.
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| | | FISCAL NOTE ACT MAY APPLY | |
| | 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,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Illinois Public Aid Code is amended by | 5 | | changing Section 5-5 as follows: | 6 | | (305 ILCS 5/5-5) (from Ch. 23, par. 5-5)
| 7 | | Sec. 5-5. Medical services. The Illinois Department, by | 8 | | rule, shall
determine the quantity and quality of and the rate | 9 | | of reimbursement for the
medical assistance for which
payment | 10 | | will be authorized, and the medical services to be provided,
| 11 | | which may include all or part of the following: (1) inpatient | 12 | | hospital
services; (2) outpatient hospital services; (3) other | 13 | | laboratory and
X-ray services; (4) skilled nursing home | 14 | | services; (5) physicians'
services whether furnished in the | 15 | | office, the patient's home, a
hospital, a skilled nursing home, | 16 | | or elsewhere; (6) medical care, or any
other type of remedial | 17 | | care furnished by licensed practitioners; (7)
home health care | 18 | | services; (8) private duty nursing service; (9) clinic
| 19 | | services; (10) dental services, including prevention and | 20 | | treatment of periodontal disease and dental caries disease for | 21 | | pregnant women, provided by an individual licensed to practice | 22 | | dentistry or dental surgery; for purposes of this item (10), | 23 | | "dental services" means diagnostic, preventive, or corrective |
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| 1 | | procedures provided by or under the supervision of a dentist in | 2 | | the practice of his or her profession; (11) physical therapy | 3 | | and related
services; (12) prescribed drugs, dentures, and | 4 | | prosthetic devices; and
eyeglasses prescribed by a physician | 5 | | skilled in the diseases of the eye,
or by an optometrist, | 6 | | whichever the person may select; (13) other
diagnostic, | 7 | | screening, preventive, and rehabilitative services, for | 8 | | children and adults; (14)
transportation and such other | 9 | | expenses as may be necessary; (15) medical
treatment of sexual | 10 | | assault survivors, as defined in
Section 1a of the Sexual | 11 | | Assault Survivors Emergency Treatment Act, for
injuries | 12 | | sustained as a result of the sexual assault, including
| 13 | | examinations and laboratory tests to discover evidence which | 14 | | may be used in
criminal proceedings arising from the sexual | 15 | | assault; (16) the
diagnosis and treatment of sickle cell | 16 | | anemia; and (17)
any other medical care, and any other type of | 17 | | remedial care recognized
under the laws of this State, but not | 18 | | including abortions, or induced
miscarriages or premature | 19 | | births, unless, in the opinion of a physician,
such procedures | 20 | | are necessary for the preservation of the life of the
woman | 21 | | seeking such treatment, or except an induced premature birth
| 22 | | intended to produce a live viable child and such procedure is | 23 | | necessary
for the health of the mother or her unborn child. The | 24 | | Illinois Department,
by rule, shall prohibit any physician from | 25 | | providing medical assistance
to anyone eligible therefor under | 26 | | this Code where such physician has been
found guilty of |
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| 1 | | performing an abortion procedure in a wilful and wanton
manner | 2 | | upon a woman who was not pregnant at the time such abortion
| 3 | | procedure was performed. The term "any other type of remedial | 4 | | care" shall
include nursing care and nursing home service for | 5 | | persons who rely on
treatment by spiritual means alone through | 6 | | prayer for healing.
| 7 | | Notwithstanding any other provision of this Section, a | 8 | | comprehensive
tobacco use cessation program that includes | 9 | | purchasing prescription drugs or
prescription medical devices | 10 | | approved by the Food and Drug Administration shall
be covered | 11 | | under the medical assistance
program under this Article for | 12 | | persons who are otherwise eligible for
assistance under this | 13 | | Article.
| 14 | | Notwithstanding any other provision of this Code, the | 15 | | Illinois
Department may not require, as a condition of payment | 16 | | for any laboratory
test authorized under this Article, that a | 17 | | physician's handwritten signature
appear on the laboratory | 18 | | test order form. The Illinois Department may,
however, impose | 19 | | other appropriate requirements regarding laboratory test
order | 20 | | documentation.
| 21 | | The Department of Healthcare and Family Services shall | 22 | | provide the following services to
persons
eligible for | 23 | | assistance under this Article who are participating in
| 24 | | education, training or employment programs operated by the | 25 | | Department of Human
Services as successor to the Department of | 26 | | Public Aid:
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| 1 | | (1) dental services provided by or under the | 2 | | supervision of a dentist; and
| 3 | | (2) eyeglasses prescribed by a physician skilled in the | 4 | | diseases of the
eye, or by an optometrist, whichever the | 5 | | person may select.
| 6 | | Notwithstanding any other provision of this Code and | 7 | | subject to federal approval, the Department may adopt rules to | 8 | | allow a dentist who is volunteering his or her service at no | 9 | | cost to render dental services through an enrolled | 10 | | not-for-profit health clinic without the dentist personally | 11 | | enrolling as a participating provider in the medical assistance | 12 | | program. A not-for-profit health clinic shall include a public | 13 | | health clinic or Federally Qualified Health Center or other | 14 | | enrolled provider, as determined by the Department, through | 15 | | which dental services covered under this Section are performed. | 16 | | The Department shall establish a process for payment of claims | 17 | | for reimbursement for covered dental services rendered under | 18 | | this provision. | 19 | | Notwithstanding any other provision of this Section, a | 20 | | dental desensitization program that aims to allay the fears and | 21 | | anxieties of dental patients, age 5 through 21, who have a | 22 | | developmental disability or mental illness by familiarizing | 23 | | such patients with the surroundings, tools, and procedures of | 24 | | the dental office or clinic during a comprehensive patient | 25 | | walk-through shall be covered under the medical assistance | 26 | | program under this Article for persons who are otherwise |
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| 1 | | eligible for medical assistance under this Article. | 2 | | The Illinois Department, by rule, may distinguish and | 3 | | classify the
medical services to be provided only in accordance | 4 | | with the classes of
persons designated in Section 5-2.
| 5 | | The Department of Healthcare and Family Services must | 6 | | provide coverage and reimbursement for amino acid-based | 7 | | elemental formulas, regardless of delivery method, for the | 8 | | diagnosis and treatment of (i) eosinophilic disorders and (ii) | 9 | | short bowel syndrome when the prescribing physician has issued | 10 | | a written order stating that the amino acid-based elemental | 11 | | formula is medically necessary.
| 12 | | The Illinois Department shall authorize the provision of, | 13 | | and shall
authorize payment for, screening by low-dose | 14 | | mammography for the presence of
occult breast cancer for women | 15 | | 35 years of age or older who are eligible
for medical | 16 | | assistance under this Article, as follows: | 17 | | (A) A baseline
mammogram for women 35 to 39 years of | 18 | | age.
| 19 | | (B) An annual mammogram for women 40 years of age or | 20 | | older. | 21 | | (C) A mammogram at the age and intervals considered | 22 | | medically necessary by the woman's health care provider for | 23 | | women under 40 years of age and having a family history of | 24 | | breast cancer, prior personal history of breast cancer, | 25 | | positive genetic testing, or other risk factors. | 26 | | (D) A comprehensive ultrasound screening of an entire |
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| 1 | | breast or breasts if a mammogram demonstrates | 2 | | heterogeneous or dense breast tissue, when medically | 3 | | necessary as determined by a physician licensed to practice | 4 | | medicine in all of its branches. | 5 | | All screenings
shall
include a physical breast exam, | 6 | | instruction on self-examination and
information regarding the | 7 | | frequency of self-examination and its value as a
preventative | 8 | | tool. For purposes of this Section, "low-dose mammography" | 9 | | means
the x-ray examination of the breast using equipment | 10 | | dedicated specifically
for mammography, including the x-ray | 11 | | tube, filter, compression device,
and image receptor, with an | 12 | | average radiation exposure delivery
of less than one rad per | 13 | | breast for 2 views of an average size breast.
The term also | 14 | | includes digital mammography.
| 15 | | On and after January 1, 2012, providers participating in a | 16 | | quality improvement program approved by the Department shall be | 17 | | reimbursed for screening and diagnostic mammography at the same | 18 | | rate as the Medicare program's rates, including the increased | 19 | | reimbursement for digital mammography. | 20 | | The Department shall convene an expert panel including | 21 | | representatives of hospitals, free-standing mammography | 22 | | facilities, and doctors, including radiologists, to establish | 23 | | quality standards. | 24 | | Subject to federal approval, the Department shall | 25 | | establish a rate methodology for mammography at federally | 26 | | qualified health centers and other encounter-rate clinics. |
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| 1 | | These clinics or centers may also collaborate with other | 2 | | hospital-based mammography facilities. | 3 | | The Department shall establish a methodology to remind | 4 | | women who are age-appropriate for screening mammography, but | 5 | | who have not received a mammogram within the previous 18 | 6 | | months, of the importance and benefit of screening mammography. | 7 | | The Department shall establish a performance goal for | 8 | | primary care providers with respect to their female patients | 9 | | over age 40 receiving an annual mammogram. This performance | 10 | | goal shall be used to provide additional reimbursement in the | 11 | | form of a quality performance bonus to primary care providers | 12 | | who meet that goal. | 13 | | The Department shall devise a means of case-managing or | 14 | | patient navigation for beneficiaries diagnosed with breast | 15 | | cancer. This program shall initially operate as a pilot program | 16 | | in areas of the State with the highest incidence of mortality | 17 | | related to breast cancer. At least one pilot program site shall | 18 | | be in the metropolitan Chicago area and at least one site shall | 19 | | be outside the metropolitan Chicago area. An evaluation of the | 20 | | pilot program shall be carried out measuring health outcomes | 21 | | and cost of care for those served by the pilot program compared | 22 | | to similarly situated patients who are not served by the pilot | 23 | | program. | 24 | | Any medical or health care provider shall immediately | 25 | | recommend, to
any pregnant woman who is being provided prenatal | 26 | | services and is suspected
of drug abuse or is addicted as |
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| 1 | | defined in the Alcoholism and Other Drug Abuse
and Dependency | 2 | | Act, referral to a local substance abuse treatment provider
| 3 | | licensed by the Department of Human Services or to a licensed
| 4 | | hospital which provides substance abuse treatment services. | 5 | | The Department of Healthcare and Family Services
shall assure | 6 | | coverage for the cost of treatment of the drug abuse or
| 7 | | addiction for pregnant recipients in accordance with the | 8 | | Illinois Medicaid
Program in conjunction with the Department of | 9 | | Human Services.
| 10 | | All medical providers providing medical assistance to | 11 | | pregnant women
under this Code shall receive information from | 12 | | the Department on the
availability of services under the Drug | 13 | | Free Families with a Future or any
comparable program providing | 14 | | case management services for addicted women,
including | 15 | | information on appropriate referrals for other social services
| 16 | | that may be needed by addicted women in addition to treatment | 17 | | for addiction.
| 18 | | The Illinois Department, in cooperation with the | 19 | | Departments of Human
Services (as successor to the Department | 20 | | of Alcoholism and Substance
Abuse) and Public Health, through a | 21 | | public awareness campaign, may
provide information concerning | 22 | | treatment for alcoholism and drug abuse and
addiction, prenatal | 23 | | health care, and other pertinent programs directed at
reducing | 24 | | the number of drug-affected infants born to recipients of | 25 | | medical
assistance.
| 26 | | Neither the Department of Healthcare and Family Services |
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| 1 | | nor the Department of Human
Services shall sanction the | 2 | | recipient solely on the basis of
her substance abuse.
| 3 | | The Illinois Department shall establish such regulations | 4 | | governing
the dispensing of health services under this Article | 5 | | as it shall deem
appropriate. The Department
should
seek the | 6 | | advice of formal professional advisory committees appointed by
| 7 | | the Director of the Illinois Department for the purpose of | 8 | | providing regular
advice on policy and administrative matters, | 9 | | information dissemination and
educational activities for | 10 | | medical and health care providers, and
consistency in | 11 | | procedures to the Illinois Department.
| 12 | | Notwithstanding any other provision of law, a health care | 13 | | provider under the medical assistance program may elect, in | 14 | | lieu of receiving direct payment for services provided under | 15 | | that program, to participate in the State Employees Deferred | 16 | | Compensation Plan adopted under Article 24 of the Illinois | 17 | | Pension Code. A health care provider who elects to participate | 18 | | in the plan does not have a cause of action against the State | 19 | | for any damages allegedly suffered by the provider as a result | 20 | | of any delay by the State in crediting the amount of any | 21 | | contribution to the provider's plan account. | 22 | | The Illinois Department may develop and contract with | 23 | | Partnerships of
medical providers to arrange medical services | 24 | | for persons eligible under
Section 5-2 of this Code. | 25 | | Implementation of this Section may be by
demonstration projects | 26 | | in certain geographic areas. The Partnership shall
be |
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| 1 | | represented by a sponsor organization. The Department, by rule, | 2 | | shall
develop qualifications for sponsors of Partnerships. | 3 | | Nothing in this
Section shall be construed to require that the | 4 | | sponsor organization be a
medical organization.
| 5 | | The sponsor must negotiate formal written contracts with | 6 | | medical
providers for physician services, inpatient and | 7 | | outpatient hospital care,
home health services, treatment for | 8 | | alcoholism and substance abuse, and
other services determined | 9 | | necessary by the Illinois Department by rule for
delivery by | 10 | | Partnerships. Physician services must include prenatal and
| 11 | | obstetrical care. The Illinois Department shall reimburse | 12 | | medical services
delivered by Partnership providers to clients | 13 | | in target areas according to
provisions of this Article and the | 14 | | Illinois Health Finance Reform Act,
except that:
| 15 | | (1) Physicians participating in a Partnership and | 16 | | providing certain
services, which shall be determined by | 17 | | the Illinois Department, to persons
in areas covered by the | 18 | | Partnership may receive an additional surcharge
for such | 19 | | services.
| 20 | | (2) The Department may elect to consider and negotiate | 21 | | financial
incentives to encourage the development of | 22 | | Partnerships and the efficient
delivery of medical care.
| 23 | | (3) Persons receiving medical services through | 24 | | Partnerships may receive
medical and case management | 25 | | services above the level usually offered
through the | 26 | | medical assistance program.
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| 1 | | Medical providers shall be required to meet certain | 2 | | qualifications to
participate in Partnerships to ensure the | 3 | | delivery of high quality medical
services. These | 4 | | qualifications shall be determined by rule of the Illinois
| 5 | | Department and may be higher than qualifications for | 6 | | participation in the
medical assistance program. Partnership | 7 | | sponsors may prescribe reasonable
additional qualifications | 8 | | for participation by medical providers, only with
the prior | 9 | | written approval of the Illinois Department.
| 10 | | Nothing in this Section shall limit the free choice of | 11 | | practitioners,
hospitals, and other providers of medical | 12 | | services by clients.
In order to ensure patient freedom of | 13 | | choice, the Illinois Department shall
immediately promulgate | 14 | | all rules and take all other necessary actions so that
provided | 15 | | services may be accessed from therapeutically certified | 16 | | optometrists
to the full extent of the Illinois Optometric | 17 | | Practice Act of 1987 without
discriminating between service | 18 | | providers.
| 19 | | The Department shall apply for a waiver from the United | 20 | | States Health
Care Financing Administration to allow for the | 21 | | implementation of
Partnerships under this Section.
| 22 | | The Illinois Department shall require health care | 23 | | providers to maintain
records that document the medical care | 24 | | and services provided to recipients
of Medical Assistance under | 25 | | this Article. Such records must be retained for a period of not | 26 | | less than 6 years from the date of service or as provided by |
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| 1 | | applicable State law, whichever period is longer, except that | 2 | | if an audit is initiated within the required retention period | 3 | | then the records must be retained until the audit is completed | 4 | | and every exception is resolved. The Illinois Department shall
| 5 | | require health care providers to make available, when | 6 | | authorized by the
patient, in writing, the medical records in a | 7 | | timely fashion to other
health care providers who are treating | 8 | | or serving persons eligible for
Medical Assistance under this | 9 | | Article. All dispensers of medical services
shall be required | 10 | | to maintain and retain business and professional records
| 11 | | sufficient to fully and accurately document the nature, scope, | 12 | | details and
receipt of the health care provided to persons | 13 | | eligible for medical
assistance under this Code, in accordance | 14 | | with regulations promulgated by
the Illinois Department. The | 15 | | rules and regulations shall require that proof
of the receipt | 16 | | of prescription drugs, dentures, prosthetic devices and
| 17 | | eyeglasses by eligible persons under this Section accompany | 18 | | each claim
for reimbursement submitted by the dispenser of such | 19 | | medical services.
No such claims for reimbursement shall be | 20 | | approved for payment by the Illinois
Department without such | 21 | | proof of receipt, unless the Illinois Department
shall have put | 22 | | into effect and shall be operating a system of post-payment
| 23 | | audit and review which shall, on a sampling basis, be deemed | 24 | | adequate by
the Illinois Department to assure that such drugs, | 25 | | dentures, prosthetic
devices and eyeglasses for which payment | 26 | | is being made are actually being
received by eligible |
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| 1 | | recipients. Within 90 days after the effective date of
this | 2 | | amendatory Act of 1984, the Illinois Department shall establish | 3 | | a
current list of acquisition costs for all prosthetic devices | 4 | | and any
other items recognized as medical equipment and | 5 | | supplies reimbursable under
this Article and shall update such | 6 | | list on a quarterly basis, except that
the acquisition costs of | 7 | | all prescription drugs shall be updated no
less frequently than | 8 | | every 30 days as required by Section 5-5.12.
| 9 | | The rules and regulations of the Illinois Department shall | 10 | | require
that a written statement including the required opinion | 11 | | of a physician
shall accompany any claim for reimbursement for | 12 | | abortions, or induced
miscarriages or premature births. This | 13 | | statement shall indicate what
procedures were used in providing | 14 | | such medical services.
| 15 | | The Illinois Department shall require all dispensers of | 16 | | medical
services, other than an individual practitioner or | 17 | | group of practitioners,
desiring to participate in the Medical | 18 | | Assistance program
established under this Article to disclose | 19 | | all financial, beneficial,
ownership, equity, surety or other | 20 | | interests in any and all firms,
corporations, partnerships, | 21 | | associations, business enterprises, joint
ventures, agencies, | 22 | | institutions or other legal entities providing any
form of | 23 | | health care services in this State under this Article.
| 24 | | The Illinois Department may require that all dispensers of | 25 | | medical
services desiring to participate in the medical | 26 | | assistance program
established under this Article disclose, |
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| 1 | | under such terms and conditions as
the Illinois Department may | 2 | | by rule establish, all inquiries from clients
and attorneys | 3 | | regarding medical bills paid by the Illinois Department, which
| 4 | | inquiries could indicate potential existence of claims or liens | 5 | | for the
Illinois Department.
| 6 | | Enrollment of a vendor that provides non-emergency medical | 7 | | transportation,
defined by the Department by rule,
shall be
| 8 | | conditional for 180 days. During that time, the Department of | 9 | | Healthcare and Family Services may
terminate the vendor's | 10 | | eligibility to participate in the medical assistance
program | 11 | | without cause. That termination of eligibility is not subject | 12 | | to the
Department's hearing process.
| 13 | | The Illinois Department shall establish policies, | 14 | | procedures,
standards and criteria by rule for the acquisition, | 15 | | repair and replacement
of orthotic and prosthetic devices and | 16 | | durable medical equipment. Such
rules shall provide, but not be | 17 | | limited to, the following services: (1)
immediate repair or | 18 | | replacement of such devices by recipients without
medical | 19 | | authorization; and (2) rental, lease, purchase or | 20 | | lease-purchase of
durable medical equipment in a | 21 | | cost-effective manner, taking into
consideration the | 22 | | recipient's medical prognosis, the extent of the
recipient's | 23 | | needs, and the requirements and costs for maintaining such
| 24 | | equipment. Such rules shall enable a recipient to temporarily | 25 | | acquire and
use alternative or substitute devices or equipment | 26 | | pending repairs or
replacements of any device or equipment |
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| 1 | | previously authorized for such
recipient by the Department.
| 2 | | The Department shall execute, relative to the nursing home | 3 | | prescreening
project, written inter-agency agreements with the | 4 | | Department of Human
Services and the Department on Aging, to | 5 | | effect the following: (i) intake
procedures and common | 6 | | eligibility criteria for those persons who are receiving
| 7 | | non-institutional services; and (ii) the establishment and | 8 | | development of
non-institutional services in areas of the State | 9 | | where they are not currently
available or are undeveloped.
| 10 | | The Illinois Department shall develop and operate, in | 11 | | cooperation
with other State Departments and agencies and in | 12 | | compliance with
applicable federal laws and regulations, | 13 | | appropriate and effective
systems of health care evaluation and | 14 | | programs for monitoring of
utilization of health care services | 15 | | and facilities, as it affects
persons eligible for medical | 16 | | assistance under this Code.
| 17 | | The Illinois Department shall report annually to the | 18 | | General Assembly,
no later than the second Friday in April of | 19 | | 1979 and each year
thereafter, in regard to:
| 20 | | (a) actual statistics and trends in utilization of | 21 | | medical services by
public aid recipients;
| 22 | | (b) actual statistics and trends in the provision of | 23 | | the various medical
services by medical vendors;
| 24 | | (c) current rate structures and proposed changes in | 25 | | those rate structures
for the various medical vendors; and
| 26 | | (d) efforts at utilization review and control by the |
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| 1 | | Illinois Department.
| 2 | | The period covered by each report shall be the 3 years | 3 | | ending on the June
30 prior to the report. The report shall | 4 | | include suggested legislation
for consideration by the General | 5 | | Assembly. The filing of one copy of the
report with the | 6 | | Speaker, one copy with the Minority Leader and one copy
with | 7 | | the Clerk of the House of Representatives, one copy with the | 8 | | President,
one copy with the Minority Leader and one copy with | 9 | | the Secretary of the
Senate, one copy with the Legislative | 10 | | Research Unit, and such additional
copies
with the State | 11 | | Government Report Distribution Center for the General
Assembly | 12 | | as is required under paragraph (t) of Section 7 of the State
| 13 | | Library Act shall be deemed sufficient to comply with this | 14 | | Section.
| 15 | | Rulemaking authority to implement Public Act 95-1045, if | 16 | | any, is conditioned on the rules being adopted in accordance | 17 | | with all provisions of the Illinois Administrative Procedure | 18 | | Act and all rules and procedures of the Joint Committee on | 19 | | Administrative Rules; any purported rule not so adopted, for | 20 | | whatever reason, is unauthorized. | 21 | | (Source: P.A. 96-156, eff. 1-1-10; 96-806, eff. 7-1-10; 96-926, | 22 | | eff. 1-1-11; 96-1000, eff. 7-2-10; 97-48, eff. 6-28-11; 97-638, | 23 | | eff. 1-1-12.)
| 24 | | Section 99. Effective date. This Act takes effect upon | 25 | | becoming law.
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