Full Text of HB1567 97th General Assembly
HB1567 97TH GENERAL ASSEMBLY |
| | 97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012 HB1567 Introduced 2/15/2011, by Rep. Jim Watson 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 Medical Assistance Article of the Illinois Public Aid Code. Provides that nothwithstanding any provision to the contrary, medical assistance recipients utilizing emergency rooms for non-emergency services shall be required to pay the maximum co-payment permitted by federal law. Effective immediately.
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| | | FISCAL NOTE ACT MAY APPLY | |
| | A BILL FOR |
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| | | HB1567 | | LRB097 08682 KTG 48811 b |
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| 1 | | AN ACT concerning public aid.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Illinois Public Aid Code is amended by | 5 | | changing Section 5-4.1 as follows:
| 6 | | (305 ILCS 5/5-4.1) (from Ch. 23, par. 5-4.1)
| 7 | | Sec. 5-4.1. Co-payments. The Department may by rule provide | 8 | | that recipients
under any Article of this Code shall pay a fee | 9 | | as a co-payment for services.
Co-payments shall be maximized to | 10 | | the extent permitted by federal law. Provided, however, that | 11 | | any such rule must provide that no
co-payment requirement can | 12 | | exist
for renal dialysis, radiation therapy, cancer | 13 | | chemotherapy, or insulin, and
other products necessary on a | 14 | | recurring basis, the absence of which would
be life | 15 | | threatening, or where co-payment expenditures for required | 16 | | services
and/or medications for chronic diseases that the | 17 | | Illinois Department shall
by rule designate shall cause an | 18 | | extensive financial burden on the
recipient, and provided no | 19 | | co-payment shall exist for emergency room
encounters which are | 20 | | for medical emergencies. The Department shall seek approval of | 21 | | a State plan amendment that allows pharmacies to refuse to | 22 | | dispense drugs in circumstances where the recipient does not | 23 | | pay the required co-payment. In the event the State plan |
| | | HB1567 | - 2 - | LRB097 08682 KTG 48811 b |
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| 1 | | amendment is rejected, co-payments may not exceed $3 for brand | 2 | | name drugs, $1 for other pharmacy
services other than for | 3 | | generic drugs, and $2 for physician services, dental
services, | 4 | | optical services and supplies, chiropractic services, podiatry
| 5 | | services, and encounter rate clinic services. There shall be no | 6 | | co-payment for
generic drugs. Co-payments may not exceed $3 for | 7 | | hospital outpatient and clinic
services.
| 8 | | Nothwithstanding any provision in this Section to the | 9 | | contrary, recipients utilizing emergency rooms for | 10 | | non-emergency services shall be required to pay the maximum | 11 | | co-payment permitted by federal law. | 12 | | (Source: P.A. 96-1501, eff. 1-25-11.)
| 13 | | Section 99. Effective date. This Act takes effect upon | 14 | | becoming law.
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