State of Illinois
92nd General Assembly
Legislation

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[ Introduced ][ Engrossed ][ Senate Amendment 004 ]


92_HB3495sam002

 










                                          SRS92HB3495DLspam02

 1                    AMENDMENT TO HOUSE BILL 3495

 2        AMENDMENT NO.     .  Amend House Bill 3495  by  replacing
 3    everything after the enacting clause with the following:

 4        "Section  5.  The  Illinois Public Aid Code is amended by
 5    changing Sections 5-4.1, 5-5.4, and 5-5b as follows:

 6        (305 ILCS 5/5-4.1) (from Ch. 23, par. 5-4.1)
 7        Sec. 5-4.1.  Co-payments.  The  Department  may  by  rule
 8    provide that recipients under any Article of this Code (other
 9    than  group  care recipients) shall pay a fee as a co-payment
10    for services to the extent permitted by the Secretary of  the
11    United  States  Department  of  Health  and  Human  Services.
12    Co-payments  may not exceed one dollar for pharmacy services,
13    physicians services, dental services,  optical  services  and
14    supplies,   chiropractic  services,  podiatry  services,  and
15    encounter rate clinic services.  Co-payments may  not  exceed
16    three  dollars  for  hospital outpatient and clinic services.
17    Provided, however, that any such rule must  provide  that  no
18    co-payment   requirement   can   exist  for  renal  dialysis,
19    radiation therapy, cancer chemotherapy, or insulin, and other
20    products necessary on a recurring basis, the absence of which
21    would be life threatening, or where  co-payment  expenditures
22    for required services and/or medications for chronic diseases
 
                            -2-           SRS92HB3495DLspam02
 1    that  the  Illinois  Department shall by rule designate shall
 2    cause an extensive financial burden  on  the  recipient,  and
 3    provided   no  co-payment  shall  exist  for  emergency  room
 4    encounters which are for medical emergencies.
 5    (Source: P.A. 82-664.)

 6        (305 ILCS 5/5-5b) (from Ch. 23, par. 5-5b)
 7        Sec. 5-5b.  Payment Reductions.
 8        (a)  Notwithstanding  any  other  Section  in  this  Code
 9    establishing a methodology for determining payment  rates  or
10    dispensing fees for non-institutional services provided under
11    this  Code,  the  Illinois Department is authorized to reduce
12    those payment rates or dispensing fees with  due  regard  for
13    and  subject to budgetary limitations to the extent permitted
14    by federal law.
15        (a-5)  Notwithstanding any other  Section  in  this  Code
16    establishing  a  methodology for determining payment rates or
17    dispensing fees for services specified in subsection  (1)  of
18    Section  5-5.4  and  subsection  (a)  of Section 14-8 of this
19    Code, the Illinois Department may, by  emergency  rule  filed
20    before   April   1,  2002,  adjust  those  payment  rates  or
21    dispensing fees to a level not more than 5% below  the  rates
22    and  fees  in effect on July 1, 2001, with due regard for and
23    subject to budgeting limitations to the extent  permitted  by
24    federal law.
25        (b)  The  Illinois  Department may implement this Section
26    as added by this amendatory Act of 1991 through  the  use  of
27    emergency  rules in accordance with the provisions of Section
28    5.02  of  the  Illinois  Administrative  Procedure  Act.  For
29    purposes of the Illinois Administrative  Procedure  Act,  the
30    adoption  of rules to implement this Section as added by this
31    amendatory Act of 1991  shall  be  deemed  an  emergency  and
32    necessary for the public interest, safety and welfare.
33    (Source: P.A. 87-14.)
 
                            -3-           SRS92HB3495DLspam02
 1        Section  99.  Effective date.  This Act takes effect upon
 2    becoming law.".

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