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92_SB1815
LRB9215671DJgc
1 AN ACT in relation to public aid.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 5. The Medicaid Revenue Act is amended by adding
5 Section 6-4.5 as follows:
6 (305 ILCS 35/6-4.5 new)
7 Sec. 6-4.5. Quarterly report to General Assembly.
8 (a) In this Section, "Medicaid" means the program of
9 medical assistance under Article V of the Illinois Public Aid
10 Code.
11 (b) In order to aid in developing long-term strategies
12 for controlling rising health care costs, the Department of
13 Public Aid shall report the following information to the
14 General Assembly within 30 days after the end of each
15 calendar quarter:
16 (1) The average expenditures per patient for each
17 authorized service provided to any patient under Medicaid
18 during that quarter.
19 (2) The average number of prescriptions filled or
20 refilled per patient under Medicaid during that quarter.
21 (3) The average cost of a prescription filled or
22 refilled for a patient under Medicaid during that
23 quarter.
24 (4) The number of patients who received authorized
25 services or for whom prescriptions were filled or
26 refilled under Medicaid and with respect to whom the
27 expenditures for the authorized services or prescriptions
28 or the number of prescriptions filled or refilled
29 exceeded the appropriate average by 10% or more during
30 that quarter.
31 (5) The number of patients who received authorized
-2- LRB9215671DJgc
1 services or for whom prescriptions were filled or
2 refilled under Medicaid and with respect to whom the
3 expenditures for the authorized services or prescriptions
4 or the number of prescriptions filled or refilled
5 exceeded the appropriate average by 50% or more during
6 that quarter.
7 (6) The number of patients who received authorized
8 services or for whom prescriptions were filled or
9 refilled under Medicaid and with respect to whom the
10 expenditures for the authorized services or prescriptions
11 or the number of prescriptions filled or refilled
12 exceeded the appropriate average by 75% or more during
13 that quarter.
14 (7) The name and address of each provider of
15 pharmacy or other authorized services under Medicaid with
16 respect to whom the expenditures for authorized services
17 or prescriptions under Medicaid for more than 10% of the
18 provider's Medicaid patients during that quarter exceeded
19 25% of the average cost.
20 (8) The reasons that expenditures for authorized
21 services or prescriptions or the number of prescriptions
22 filled or refilled under Medicaid during that quarter
23 exceeded the appropriate average.
24 (9) The steps being taken by the Department to
25 control costs under Medicaid.
26 Section 99. Effective date. This Act takes effect upon
27 becoming law.