SB2148 102ND GENERAL ASSEMBLY

  
  

 


 
102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
SB2148

 

Introduced 2/26/2021, by Sen. Chapin Rose

 

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

    Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services shall (rather than may) provide by rule that any recipient of medical assistance, with the exception of those classes of recipients identified in a specified provision of the Illinois Administrative Code, shall pay a fee as a co-payment for services. Provides that co-payments shall be maximized to the extent permitted by federal law, except that the Department shall impose a co-pay of $2 on generic drugs and a nominal co-pay of at least $3.90 for each physician or clinic visit, each emergency room visit in a non-emergency, each day of an inpatient hospital visit, and for each brand name prescription.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

SB2148LRB102 04392 KTG 15138 b

1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Public Aid Code is amended by
5changing 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. The Department shall may by rule
8provide that recipients under any Article of this Code, with
9the exception of those classes of recipients identified in 89
10Ill. Adm. Code 140.402(d), shall pay a federally approved fee
11as a co-payment for services. Co-payments shall be maximized
12to the extent permitted by federal law, except that the
13Department shall impose a co-pay of $2 on generic drugs and a
14nominal co-pay of at least $3.90 for each physician or clinic
15visit, each emergency room visit in a non-emergency, each day
16of an inpatient hospital visit, and for each brand name
17prescription. However, any such rule must provide that no No
18co-payment requirement can exist for renal dialysis, radiation
19therapy, cancer chemotherapy, or insulin, and other products
20necessary on a recurring basis, the absence of which would be
21life threatening, or where co-payment expenditures for
22required services and/or medications for chronic diseases that
23the Illinois Department shall by rule designate shall cause an

 

 

SB2148- 2 -LRB102 04392 KTG 15138 b

1extensive financial burden on the recipient, and provided no
2co-payment shall exist for emergency room encounters which are
3for medical emergencies. The Department shall seek approval of
4a State plan amendment that allows pharmacies to refuse to
5dispense drugs in circumstances where the recipient does not
6pay the required co-payment. Co-payments may not exceed $10
7for emergency room use for a non-emergency situation as
8defined by the Department by rule and subject to federal
9approval.
10(Source: P.A. 101-209, eff. 8-5-19.)