HB6726 95TH GENERAL ASSEMBLY

LRB095 22752 DRJ 53175 b

95TH GENERAL ASSEMBLY
State of Illinois
2007 and 2008
HB6726

Introduced , by Rep. Robert F. Flider

SYNOPSIS AS INTRODUCED:

30 ILCS 540/8 new
305 ILCS 5/5-5.12b new

Amends the State Prompt Payment Act and the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to reimburse qualified providers of prescription drugs to persons presumed eligible for medical assistance under an expanded program of medical assistance that was the subject of an injunction issued by the Circuit Court of Cook County. Requires the Department to give priority in processing claims for reimbursement from those qualified providers. Effective immediately.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning public aid.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The State Prompt Payment Act is amended by adding Section 8 as follows:

(30 ILCS 540/8 new)

Sec. 8. Qualified providers of prescription drugs under the Illinois Public Aid Code; priority of payment.

(a) In this Section, "qualified provider" means a pharmacy qualified under the Illinois Public Aid Code to provide prescription drugs to recipients of medical assistance under Article V of that Code who is entitled to reimbursement for prescription drugs provided to persons under Section 5-5.12b of that Code.

(b) Except as provided in subsection (c), if a qualified provider provides prescription drugs to a person presumed eligible for medical assistance under the expanded program of medical assistance described in Section 5-5.12b of the Illinois Public Aid Code and submits to the Department of Healthcare and Family Services a bill or invoice for those prescription drugs, then the Department must give priority to processing that bill or invoice for payment. Any bill or invoice meeting these criteria that is submitted to the Department must be processed and forwarded for payment before any other bill or invoice is processed or forwarded for payment.

(c) A properly prepared voucher request to the Office of the Comptroller for payment to a qualified provider, as defined in this Section, shall be given priority by the Comptroller for processing and warrant issuance after debt service obligations and payroll obligations of the State have been met unless the Comptroller deems that other obligations of the State must be satisfied prior to these categories of payment. If at any time the Comptroller determines that there are insufficient funds available to process priority payments as required under this Section, then vouchers shall be processed and paid out in a first-in, first-out manner as corresponding funds become available.

Section 10. The Illinois Public Aid Code is amended by adding Section 5-5.12b as follows:

(305 ILCS 5/5-5.12b new)

Sec. 5-5.12b. Prescription drugs provided under expanded medical assistance program; reimbursement. A pharmacy that provided prescription drugs to a person who was presumed eligible for medical assistance under the expanded program of medical assistance under this Article that was the subject of a preliminary injunction issued by the Circuit Court of Cook County in the case of Caro v. Blagojevich et al., Case No. 07 CH 34353, affirmed by the Illinois Appellate Court for the First District, Fifth Division, No. 1-08-1061, on September 26, 2008, is entitled to reimbursement for those prescription drugs from the Department of Healthcare and Family Services. The Department shall provide the reimbursement at the rates otherwise applicable in the case of recipients of medical assistance under this Article. The Department shall give priority to processing claims for reimbursement for those prescription drugs as required under Section 8 of the State Prompt Payment Act.

Section 99. Effective date. This Act takes effect upon becoming law.