Full Text of HB0236 100th General Assembly
HB0236ham001 100TH GENERAL ASSEMBLY | Rep. La Shawn K. Ford Filed: 3/16/2017
| | 10000HB0236ham001 | | LRB100 04181 KTG 23676 a |
|
| 1 | | AMENDMENT TO HOUSE BILL 236
| 2 | | AMENDMENT NO. ______. Amend House Bill 236 by replacing | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 5. The Illinois Public Aid Code is amended by
| 5 | | changing Sections 5-2b and 5-4.1 as follows: | 6 | | (305 ILCS 5/5-2b) | 7 | | Sec. 5-2b. Medically fragile and technology dependent | 8 | | children eligibility and program. Notwithstanding any other | 9 | | provision of law, on and after September 1, 2012, subject to | 10 | | federal approval, medical assistance under this Article shall | 11 | | be available to children who qualify as persons with a | 12 | | disability, as defined under the federal Supplemental Security | 13 | | Income program and who are medically fragile and technology | 14 | | dependent. The program shall allow eligible children to receive | 15 | | the medical assistance provided under this Article in the | 16 | | community and must maximize, to the fullest extent permissible |
| | | 10000HB0236ham001 | - 2 - | LRB100 04181 KTG 23676 a |
|
| 1 | | under federal law, federal reimbursement and family | 2 | | cost-sharing, including co-pays for brand name prescription | 3 | | drugs , premiums, or any other family contributions, except that | 4 | | the Department shall be permitted to incentivize the | 5 | | utilization of selected services through the use of | 6 | | cost-sharing adjustments. The Department shall establish the | 7 | | policies, procedures, standards, services, and criteria for | 8 | | this program by rule.
| 9 | | (Source: P.A. 97-689, eff. 6-14-12; 98-104, eff. 7-22-13.)
| 10 | | (305 ILCS 5/5-4.1) (from Ch. 23, par. 5-4.1)
| 11 | | Sec. 5-4.1. Co-payments ; limitations . The Department may | 12 | | not require recipients of benefits under any Article of this | 13 | | Code to pay a fee as a co-payment for any service or generic | 14 | | drug or prescribed over-the-counter drug covered under the fee | 15 | | for service or managed care medical assistance programs. The | 16 | | Department may by rule provide that recipients
under any | 17 | | Article of this Code shall pay a fee as a co-payment for brand | 18 | | name prescription drugs. services.
Co-payments shall be | 19 | | maximized to the extent permitted by federal law, except that | 20 | | the Department shall impose a co-pay of $2 on generic drugs. | 21 | | Provided, however, that any such rule must provide that no
| 22 | | co-payment requirement can exist
for renal dialysis, radiation | 23 | | therapy, cancer chemotherapy, or insulin, and
other products | 24 | | necessary on a recurring basis, the absence of which would
be | 25 | | life threatening, or where co-payment expenditures for |
| | | 10000HB0236ham001 | - 3 - | LRB100 04181 KTG 23676 a |
|
| 1 | | required services
and/or medications for chronic diseases that | 2 | | the Illinois Department shall
by rule designate shall cause an | 3 | | extensive financial burden on the
recipient, and provided no | 4 | | co-payment shall exist for emergency room
encounters which are | 5 | | for medical emergencies. The Department shall seek approval of | 6 | | a State plan amendment that allows pharmacies to refuse to | 7 | | dispense brand name prescription drugs in circumstances where | 8 | | the recipient does not pay the required co-payment for a brand | 9 | | name prescription drug . Co-payments may not exceed $10 for | 10 | | emergency room use for a non-emergency situation as defined by | 11 | | the Department by rule and subject to federal approval.
| 12 | | (Source: P.A. 96-1501, eff. 1-25-11; 97-74, eff. 6-30-11; | 13 | | 97-689, eff. 6-14-12.)".
|
|