Bill Text: IL HB1567 | 2011-2012 | 97th General Assembly | Introduced
Bill Title: Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that notwithstanding 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.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2011-03-17 - Tabled By Sponsor Rep. Jim Watson [HB1567 Detail]
Download: Illinois-2011-HB1567-Introduced.html
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1 | AN ACT concerning public aid.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Illinois Public Aid Code is amended by | ||||||||||||||||||||||||
5 | changing Section 5-4.1 as follows:
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6 | (305 ILCS 5/5-4.1) (from Ch. 23, par. 5-4.1)
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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 |
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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
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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.
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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.)
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13 | Section 99. Effective date. This Act takes effect upon | ||||||
14 | becoming law.
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