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90_HB2501
20 ILCS 1305/10-30 new
30 ILCS 105/5.480 new
Amends the Department of Human Services Act and the State
Finance Act. Requires the Department to establish a program
to pay for drugs prescribed exclusively for the treatment of
cancer. Creates the Cancer Treatment Drug Fund as a special
fund in the State treasury, from which payments shall be
made. Effective January 1, 1999.
LRB9008696JMmb
LRB9008696JMmb
1 AN ACT concerning the Department of Human Services.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 5. The Department of Human Services Act is
5 amended by adding Section 10-30 as follows:
6 (20 ILCS 1305/10-30 new)
7 Sec. 10-30. Payments for cancer treatment drugs.
8 (a) The Department shall establish and administer a
9 program to pay recipients for costs of drugs prescribed
10 exclusively for the treatment of cancer when those costs are
11 not otherwise reimbursed. The Department shall establish
12 eligibility standards and an application process by rule.
13 (b) Participation in the program shall be limited to
14 persons whose household income is not greater than 200% of
15 the federal poverty level as established by the federal
16 Office of Management and Budget.
17 The program shall be available only to eligible Illinois
18 residents who have resided in Illinois for at least 12
19 months.
20 (c) The Department shall pay a maximum amount per cancer
21 patient based on the following:
22 (1) Available moneys.
23 (2) The terms of any contract between the
24 Department and the provider.
25 (3) The reimbursement rates shall be the same as
26 the Medicaid reimbursement rate for the drug, minus the
27 copayment.
28 (d) Payment shall be made under the program to or on
29 behalf of a program eligible recipient only for costs not
30 reimbursed or eligible for reimbursement by any other third
31 party or governmental entity (including, without limitation,
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1 private or group insurance, Medicaid, Medicare, or the
2 Veterans Administration). The Secretary may, however, waive
3 this requirement in individually considered cases if the
4 Secretary determines that its enforcement will deny services
5 to a class of cancer patients because of conflicting State or
6 federal laws or regulations. The Department of Public Health
7 shall make rules to ensure that all third parties and
8 governmental entities (including, without limitation, private
9 or group insurance, Medicaid, Medicare, or the Veterans
10 Administration) make all required benefit payments.
11 (e) The Secretary may restrict or categorize
12 reimbursements to meet budgetary limitations.
13 (f) The Secretary shall maintain a cancer drug formulary
14 that shall include all drugs eligible for reimbursement by
15 the program. The Secretary shall establish an internal
16 review procedure for updating the formulary; the procedure
17 shall allow the addition and deletion of allowable drugs to
18 the formulary. The internal review procedure shall take
19 place at least quarterly during a fiscal year.
20 (g) Payments made under the program established under
21 this Section shall be made, subject to appropriations, from
22 the Cancer Treatment Drug Fund, a special fund that is hereby
23 established in the State treasury. The following shall be
24 deposited into the Fund: (1) amounts appropriated to the
25 Department for that purpose and (ii) gifts, grants, and
26 donations for that purpose from public and private sources.
27 Interest accruing on moneys in the Fund shall remain in the
28 Fund. Moneys in the Fund may be used only by the Department
29 to make payments for cancer drugs under the program
30 established under this Section.
31 (h) Moneys remaining in the Cancer Drug Fund at the end
32 of the fiscal year may be used in the following fiscal year.
33 Section 10. The State Finance Act is amended by adding
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1 Section 5.480 as follows:
2 (30 ILCS 105/5.480 new)
3 Sec. 5.480. The Cancer Treatment Drug Fund.
4 Section 99. Effective date. This Act takes effect
5 January 1, 1999.