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90_HB1319eng
20 ILCS 1305/10-30 new
30 ILCS 105/5.449 new
Amends the Department of Human Services Act and the State
Finance Act. Requires the Department to establish a program
to pay for drugs prescribed exclusively for the treatment of
Alzheimer's disease. Creates the Alzheimer's Disease
Treatment Drug Fund as a special fund in the State treasury,
from which payments shall be made. Effective July 1, 1998.
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1 AN ACT concerning the Department of Human Services.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 5. The Department of Human Services Act is
5 amended by adding Section 10-30 as follows:
6 (20 ILCS 1305/10-30 new)
7 Sec. 10-30. Payments for Alzheimer's disease treatment
8 drugs.
9 (a) The Department shall establish and administer a
10 program to pay recipients for costs of drugs prescribed
11 exclusively for the treatment of Alzheimer's disease when
12 those costs are not otherwise reimbursed. The Department
13 shall establish eligibility standards and an application
14 process by rule.
15 (b) Participation in the program shall be limited to
16 persons whose household income is not greater than 200% of
17 the federal poverty level as established by the federal
18 Office of Management and Budget.
19 The program shall be available only to eligible Illinois
20 residents who have resided in Illinois for at least 12
21 months.
22 (c) The Department shall pay a maximum amount per
23 Alzheimer's disease patient based on the following:
24 (1) Available moneys.
25 (2) The terms of any contract between the
26 Department and the provider.
27 (3) The reimbursement rates shall be the same as
28 the Medicaid reimbursement rate for the drug, minus the
29 copayment.
30 (d) Payment shall be made under the program to or on
31 behalf of a program eligible recipient only for costs not
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1 reimbursed or eligible for reimbursement by any other third
2 party or governmental entity (including, without limitation,
3 private or group insurance, Medicaid, Medicare, or the
4 Veterans Administration). The Secretary may, however, waive
5 this requirement in individually considered cases if the
6 Secretary determines that its enforcement will deny services
7 to a class of Alzheimer's disease patients because of
8 conflicting State or federal laws or regulations. The
9 Department of Public Health shall make rules to ensure that
10 all third parties and governmental entities (including,
11 without limitation, private or group insurance, Medicaid,
12 Medicare, or the Veterans Administration) make all required
13 benefit payments.
14 (e) The Secretary may restrict or categorize
15 reimbursements to meet budgetary limitations.
16 (f) The Secretary shall maintain an Alzheimer's disease
17 drug formulary that shall include all drugs eligible for
18 reimbursement by the program. The Secretary shall establish
19 an internal review procedure for updating the formulary; the
20 procedure shall allow the addition and deletion of allowable
21 drugs to the formulary. The internal review procedure shall
22 take place at least quarterly during a fiscal year.
23 (g) Payments made under the program established under
24 this Section shall be made, subject to appropriations, from
25 the Alzheimer's Disease Treatment Drug Fund, a special fund
26 that is hereby established in the State treasury. The
27 following shall be deposited into the Fund: (1) amounts
28 appropriated to the Department for that purpose and (ii)
29 gifts, grants, and donations for that purpose from public and
30 private sources. Interest accruing on moneys in the Fund
31 shall remain in the Fund. Moneys in the Fund may be used
32 only by the Department to make payments for Alzheimer's
33 disease drugs under the program established under this
34 Section.
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1 (h) Moneys remaining in the Alzheimer's Disease Drug
2 Fund at the end of the fiscal year may be used in the
3 following fiscal year.
4 Section 10. The State Finance Act is amended by adding
5 Section 5.449 as follows:
6 (30 ILCS 105/5.449 new)
7 Sec. 5.449. The Alzheimer's Disease Treatment Drug Fund.
8 Section 99. Effective date. This Act takes effect July
9 1, 1998.