TITLE 89: SOCIAL SERVICES
SUBPART A: PURPOSE AND DEFINITIONS SUBPART B: RESPONSIBILITIES OF THE DEPARTMENT
SUBPART C: RESPONSIBILITIES OF THE PROGRAM ADMINISTRATOR
SUBPART D: FUNDING SUBPART E: DISCOUNTS |
AUTHORITY: Implementing, and authorized by Section 45 of, the Illinois Prescription Drug Discount Program Act [320 ILCS 55] and implementing and authorized by Section 12-13 of the Illinois Public Aid Code [305 ILCS 5/12-13].
SOURCE: Adopted at 11 Ill. Reg. 20978, effective December 15, 1987; amended at 13 Ill. Reg. 1589, effective January 18, 1989; amended at 17 Ill. Reg. 11566, effective July 8, 1993; amended at 22 Ill. Reg. 19929, effective October 28, 1998; amended at 24 Ill. Reg. 17562, effective November 16, 2000; emergency amendment at 25 Ill. Reg. 8449, effective July 1, 2001, for a maximum of 150 days; emergency amendment modified in response to JCAR objection at 25 Ill. Reg. 12913; emergency expired November 27, 2001; amended at 25 Ill. Reg. 16508, effective December 18, 2001; amended at 26 Ill. Reg. 8437, effective May 24, 2002; emergency amendment at 26 Ill. Reg. 11126, effective July 1, 2002, for a maximum of 150 days; amended at 26 Ill. Reg. 16981, effective November 7, 2002; amended at 27 Ill. Reg. 2699, effective January 31, 2003; amended at 28 Ill. Reg. 1133, effective January 2, 2004; 86 Ill. Adm. Code 530.101, 530.105, 530.110, 530.116, 530.125, 530.130, 530.135, 530.140, 530.145, 530.150, 530.155, 530.160 and 530.165(a), (d) and (e) transferred from the Department of Revenue (86 Ill. Adm. Code 530) to the Department of Public Aid (89 Ill. Adm. Code 126.101, 126.105, 126.110, 126.116, 126.125, 126.130, 126.135, 126.140, 126.145, 126.150, 126.155, 126.160 and 126.165(a), (b) and (c)) pursuant to Executive Order 2004-3 ; Subpart B transferred from the Department of Central Management Services to the Department of Healthcare and Family Services pursuant to Executive Order 2005-3 and P.A. 94-86 at 30 Ill. Reg. 219; emergency amendment at 30 Ill. Reg. 563, effective January 1, 2006, for a maximum of 150 days; repealed by emergency rulemaking at 30 Ill. Reg. 926, effective January 1, 2006, for a maximum of 150 days; old Part repealed at 30 Ill. Reg. 10357 and new Part adopted at 30 Ill. Reg. 10359, effective May 26, 2006.
SUBPART A: PURPOSE AND DEFINITIONS
Section 126.10 Purpose
This Part implements the Illinois Prescription Drug Discount Program, also known as the Illinois Rx Buying Club, to enable Illinois citizens to purchase prescription drugs at discounted prices.
Section 126.20 Definitions
The following terms have the following meanings:
"Act" means the Illinois Prescription Drug Discount Program Act [320 ILCS 55].
"Authorized Pharmacy" means any pharmacy registered in this State under the Pharmacy Practice Act of 1987 or approved by the Department of Financial and Professional Regulation and approved by the Department or its Program Administrator.
"AWP" or "Average Wholesale Price" means the amount determined from the latest publication of the Red Book, a universally subscribed pharmacist reference guide annually published by the Hearst Corporation. AWP may also be derived electronically from the drug pricing database synonymous with the latest publication of the Red Book and furnished in the National Drug Data File (NDDF) by First Data Bank (FDB), a service of the Hearst Corporation.
"Cardholder" means an eligible Illinois citizen who has enrolled in the program.
"Citizen" means a resident of the State of Illinois.
"Covered medication" means any medication included in the Illinois Prescription Drug Discount Program.
"Department" or "HFS" means the Department of Healthcare and Family Services.
"Director" means the Director of the Department of Healthcare and Family Services.
"Drug Manufacturer" means any entity that is located within or outside Illinois that is engaged in:
the production, preparation, propagation, compounding, conversion, or processing of prescription drug products covered under the program, either directly or indirectly by extraction from substances of natural origin, independently by means of chemical synthesis, or by a combination of extraction and chemical synthesis; or
the packaging, repackaging, leveling, labeling, or distribution of prescription drug products covered under the program and that elects to provide prescription drugs either directly or under contract with any entity providing prescription drug services on behalf of the State of Illinois.
Drug manufacturer, however, does not include a wholesale distributor of drugs or a retail pharmacy licensed under Illinois law.
"Eligible Enrollee" means an eligible Illinois resident, with a household income equal to or less than 300 percent of the Federal Poverty Level (FPL), and who has paid the enrollment fee.
"Federal Poverty Level" or "FPL" means the Federal Poverty Income Guidelines published annually in the Federal Register.
"Income" means household income equal to or less than 300 percent of the FPL.
"Participating Pharmacy" means any pharmacy that complies with the requirements of the Illinois Prescription Drug Discount Program.
"Prescription Drug" means any prescribed drug that may be legally dispensed by an authorized pharmacy.
"Program" means the Illinois Rx Buying Club created under the Illinois Prescription Drug Discount Program Act.
"Program Administrator" means the entity that is chosen by the Department to administer the program, consistent with the requirements of the Illinois Prescription Drug Discount Program and this Part 126.