HB3933 96TH GENERAL ASSEMBLY

LRB096 09812 DRJ 22356 b

96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010
HB3933

Introduced 2/26/2009, by Rep. Karen May

SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-5.12

from Ch. 23, par. 5-5.12

Amends the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services shall permit a pharmacy participating in the medical assistance program to fill a single prescription or multiple prescriptions so that the pharmacy may dispense a 3-month supply of a prescription drug to a medical assistance recipient in a single purchase, provided that the amount dispensed must be sufficient to last the patient until the date that occurs 3 months from the date of purchase. Provides that the Department shall permit a pharmacy to refill such a 3-month supply of a prescription drug at least 3 times per year as medically indicated, provided that the total of the amount dispensed at the time of the initial purchase plus the amounts dispensed at the times of the 3 subsequent purchases must be sufficient to last the patient until the date that occurs one year from the date of the initial purchase.

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 Illinois Public Aid Code is amended by changing Section 5-5.12 as follows:

(305 ILCS 5/5-5.12) (from Ch. 23, par. 5-5.12)

Sec. 5-5.12. Pharmacy payments.

(a) Every request submitted by a pharmacy for reimbursement under this Article for prescription drugs provided to a recipient of aid under this Article shall include the name of the prescriber or an acceptable identification number as established by the Department.

(b) Pharmacies providing prescription drugs under this Article shall be reimbursed at a rate which shall include a professional dispensing fee as determined by the Illinois Department, plus the current acquisition cost of the prescription drug dispensed. The Illinois Department shall update its information on the acquisition costs of all prescription drugs no less frequently than every 30 days. However, the Illinois Department may set the rate of reimbursement for the acquisition cost, by rule, at a percentage of the current average wholesale acquisition cost.

(c) (Blank).

(d) The Department shall not impose requirements for prior approval based on a preferred drug list for anti-retroviral, anti-hemophilic factor concentrates, or any atypical antipsychotics, conventional antipsychotics, or anticonvulsants used for the treatment of serious mental illnesses until 30 days after it has conducted a study of the impact of such requirements on patient care and submitted a report to the Speaker of the House of Representatives and the President of the Senate.

(e) The Department shall permit a pharmacy participating in the medical assistance program to fill a single prescription or multiple prescriptions so that the pharmacy may dispense a 3-month supply of a prescription drug to a medical assistance recipient in a single purchase, provided that the amount dispensed must be sufficient to last the patient until the date that occurs 3 months from the date of purchase. The Department shall permit a pharmacy to refill such a 3-month supply of a prescription drug at least 3 times per year as medically indicated, provided that the total of the amount dispensed at the time of the initial purchase plus the amounts dispensed at the times of the 3 subsequent purchases must be sufficient to last the patient until the date that occurs one year from the date of the initial purchase.

(Source: P.A. 93-106, eff. 7-8-03; 94-48, eff. 7-1-05.)