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93RD GENERAL ASSEMBLY
State of Illinois
2003 and 2004
SB3206
Introduced 2/6/2004, by Christine Radogno SYNOPSIS AS INTRODUCED:
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305 ILCS 5/5-4.1 |
from Ch. 23, par. 5-4.1 |
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Amends the Illinois Public Aid Code. Increases the maximum allowable co-payment for dental, optical services and supplies, chiropractic services, podiatry services and encounter rate clinic services from $2 to $3. Establishes a maximum allowable co-payment of $2 for emergency room services that are not defined in 42CFR447.53(b)(4). Requires the Department of Public Aid to seek a waiver from the U.S. Secretary of Health and Human Services under Title XIX, Section 1916(a)(3) of the Social Security Act.
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A BILL FOR
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SB3206 |
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SRS093 00174 GLC 40044 b |
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| AN ACT concerning public aid.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Section 5. The Illinois Public Aid Code is amended by |
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| changing Section 5-4.1 as follows:
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| (305 ILCS 5/5-4.1) (from Ch. 23, par. 5-4.1)
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| Sec. 5-4.1. Co-payments.
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| (a) The Department may by rule provide that recipients
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| under any Article of this Code shall pay a fee as a co-payment |
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| for services.
Co-payments may not exceed $3 for brand name |
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| drugs, $1 for other pharmacy
services other than for generic |
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| drugs, and $2 for physicians services, $3 for dental
services, |
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| optical services and supplies, chiropractic services, podiatry
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| services, and encounter rate clinic services , and $2 for |
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| emergency room services not defined in 42CFR447.53(b)(4). |
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| There shall be no co-payment for
generic drugs. Co-payments may |
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| not exceed $3 for hospital outpatient and clinic
services. |
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| Provided, however, that any such rule must provide that no
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| co-payment requirement can exist
for renal dialysis, radiation |
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| therapy, cancer chemotherapy, or insulin, and
other products |
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| necessary on a recurring basis, the absence of which would
be |
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| life threatening, or where co-payment expenditures for |
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| required services
and/or medications for chronic diseases that |
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| the Illinois Department shall
by rule designate shall cause an |
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| extensive financial burden on the
recipient, and provided no |
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| co-payment shall exist for emergency room
encounters which are |
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| for medical emergencies.
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| (b) The Department shall submit a waiver to the U.S. |
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| Secretary of Health and Human Services under Title XIX Section |
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| 1916(a)(3) of the Social Security Act to impose a copayment of |
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| up to double the "nominal" copayment amounts determined under |
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| 42CFR447.54(a)(3).
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