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91_HB1307eng HB1307 Engrossed LRB9101990PTpk 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 Alzheimer's disease treatment 8 drugs. 9 (a) The Department shall establish and administer a 10 program to pay recipients for costs of drugs prescribed 11 exclusively for the treatment of Alzheimer's disease when 12 those costs are not otherwise reimbursed. The Department 13 shall establish eligibility standards and an application 14 process by rule. 15 (b) Participation in the program shall be limited to 16 persons whose household income is not greater than 200% of 17 the federal poverty level as established by the federal 18 Office of Management and Budget. 19 The program shall be available only to eligible Illinois 20 residents who have resided in Illinois for at least 12 21 months. 22 (c) The Department shall pay a maximum amount per 23 Alzheimer's disease patient based on the following: 24 (1) Available moneys. 25 (2) The terms of any contract between the 26 Department and the provider. 27 (3) The reimbursement rates shall be the same as 28 the Medicaid reimbursement rate for the drug, minus the 29 copayment. 30 (d) Payment shall be made under the program to or on 31 behalf of a program eligible recipient only for costs not HB1307 Engrossed -2- LRB9101990PTpk 1 reimbursed or eligible for reimbursement by any other third 2 party or governmental entity (including, without limitation, 3 private or group insurance, Medicaid, Medicare, or the 4 Veterans Administration). The Secretary may, however, waive 5 this requirement in individually considered cases if the 6 Secretary determines that its enforcement will deny services 7 to a class of Alzheimer's disease patients because of 8 conflicting State or federal laws or regulations. The 9 Department of Public Health shall make rules to ensure that 10 all third parties and governmental entities (including, 11 without limitation, private or group insurance, Medicaid, 12 Medicare, or the Veterans Administration) make all required 13 benefit payments. 14 (e) The Secretary may restrict or categorize 15 reimbursements to meet budgetary limitations. 16 (f) The Secretary shall maintain an Alzheimer's disease 17 drug formulary that shall include all drugs eligible for 18 reimbursement by the program. The Secretary shall establish 19 an internal review procedure for updating the formulary; the 20 procedure shall allow the addition and deletion of allowable 21 drugs to the formulary. The internal review procedure shall 22 take place at least quarterly during a fiscal year. 23 (g) Payments made under the program established under 24 this Section shall be made, subject to appropriations, from 25 the Alzheimer's Disease Treatment Drug Fund, a special fund 26 that is hereby established in the State treasury. The 27 following shall be deposited into the Fund: (1) amounts 28 appropriated to the Department for that purpose and (ii) 29 gifts, grants, and donations for that purpose from public and 30 private sources. Interest accruing on moneys in the Fund 31 shall remain in the Fund. Moneys in the Fund may be used 32 only by the Department to make payments for Alzheimer's 33 disease drugs under the program established under this 34 Section. HB1307 Engrossed -3- LRB9101990PTpk 1 (h) Moneys remaining in the Alzheimer's Disease Drug 2 Fund at the end of the fiscal year may be used in the 3 following fiscal year. 4 Section 10. The State Finance Act is amended by adding 5 Section 5.490 as follows: 6 (30 ILCS 105/5.490 new) 7 Sec. 5.490. The Alzheimer's Disease Treatment Drug Fund. 8 9 Section 99. Effective date. This Act takes effect July 10 1, 2000.