93RD GENERAL ASSEMBLY
State of Illinois
2003 and 2004
HB6851


 
Introduced 02/09/04, by Elizabeth Coulson
 
SYNOPSIS AS INTRODUCED:
 		














305 ILCS 5/5-5.12a









    Amends the Public Aid Code. Provides that, in the event that the current pharmacy assistance program ceases to provide benefits and the federal government creates a Medicare prescription drug benefit, the Department shall develop a new supplemental coverage program to help cover out-of-pocket expenses of individuals enrolled in the Medicare prescription drug benefit program.  Provides guidelines for coverage under and eligibility for the program. Effective immediately.
















LRB093 18822 AMC 44557 b

















FISCAL NOTE ACT MAY APPLY
















 


 


A BILL FOR









 











HB6851

LRB093 18822 AMC 44557 b






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    AN ACT concerning public aid.

 
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    Be it enacted by the People of the State of Illinois,
 
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represented in the General Assembly:


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



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    (305 ILCS 5/5-5.12a)



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    Sec. 5-5.12a. Title XIX waiver; pharmacy assistance 
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program. The
Illinois Department may seek a waiver of otherwise 
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applicable requirements
of Title XIX of the federal Social 
10
Security Act in order to claim federal
financial participation 
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for a pharmacy assistance program for persons aged
65 and over 
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with income levels at or less than 250% of the federal poverty

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level.  The Illinois Department may provide by rule for all 
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other requirements
of the program, including cost sharing, as 
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permitted by an approved waiver and
without regard to any 
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provision of this Code to the contrary.  The benefits may
be no 
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more restrictive than the Pharmacy Assistance Program in effect 
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on May
31, 2001.  Benefits provided under the waiver are subject 
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to appropriation.

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    The Illinois Department may not implement the waiver until 
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cost neutrality is
demonstrated for the State relative to the 
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final Pharmacy Assistance Program
appropriation for the fiscal 
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year beginning July 1, 2001.  Implementation of
the waiver shall 
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terminate on June 30, 2007.

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    In the event that the program implemented under this 
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Section ceases to provide benefits and the federal government 
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creates a Medicare prescription drug benefit, the Department 
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shall develop a new supplemental coverage program to help cover 
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out-of-pocket expenses of individuals enrolled in the Medicare 
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prescription drug benefit program.  The coverage under this new 
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supplemental program shall include reimbursements for 
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out-of-pocket expenses, including premiums, deductibles, 
 


 






HB6851
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LRB093 18822 AMC 44557 b




1
co-payments, and any other payments required by enrollees.  The 
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coverage provided under this supplemental program may be capped 
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by the Department, provided that the cap implemented by the 
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Department is not less than the cost of Medicare prescription 
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drug coverage premiums paid by an enrollee or the amount of 
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$420 per person, whichever is greater.  In no case shall the 
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reimbursements under this supplemental program be higher than 
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the actual out-of-pocket expenses incurred by the enrollee.  
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Eligibility for the supplemental program shall be set by the 
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Department, but shall include at a minimum persons who would 
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have met income eligibility requirements for the program under 
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this Section as of January 1, 2004.  The Department shall adopt 
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any additional rules to implement this new supplemental 
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pharmacy assistance program.

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(Source: P.A. 92-10, eff. 6-11-01.)

 

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    Section 99. Effective date. This Act takes effect upon 
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becoming law.