HB 784 — SENIORS & DISABLD PERSONS-TECH

HB0784 EngrossedEnrolled LRB093 05320 DRJ 05410 b AN ACT concerning assistance to citizens.

The Senior Citizens and Disabled Persons Property Tax Relief and Pharmaceutical Assistance Act is amended by changing 3.15Section 4 as follows:

(320 ILCS 25/3.15)25/4) (from Ch.

403.15)404) Sec.

3.15.4.

__________P___________________._Amount "Coveredof prescriptionGrant. drug" means (1) any cardiovascular agent or drug;

(2)(a) anyIn insulingeneral. or other prescription drug used in the treatment of diabetes, including syringe and needles used to administer the insulin;

(3)Any individual 65 years or older or any prescriptionindividual drugwho usedwill inbecome 65 years old during the treatmentcalendar ofyear arthritis,in (4)which beginninga onclaim Januaryis 1,filed, 2001,and any prescriptionsurviving drugspouse usedof insuch a claimant, who at the treatmenttime of cancer,death (5)received beginningor onwas Januaryentitled 1,to 2001,receive anya prescriptiongrant drugpursuant usedto inthis theSection, treatmentwhich ofsurviving Alzheimer'sspouse disease,will (6)become beginning65 onyears Januaryof 1,age 2001,within anythe prescription24 drugmonths usedimmediately infollowing the treatmentdeath of Parkinson'ssuch disease,claimant (7)and beginningwhich onsurviving Januaryspouse 1,but 2001,for anyhis prescriptionor drugher usedage inis theotherwise treatmentqualified ofto glaucoma,receive (8)a beginninggrant onpursuant Januaryto 1,this 2001,Section, and any prescriptiondisabled drugperson usedwhose inannual household income is less than $14,000 for grant years before the treatment1998 ofgrant lungyear, diseaseless than $16,000 for the 1998 and smoking1999 relatedgrant illnesses,years, and (9)less beginningthan on(i) July$21,218 1,for 2001,a anyhousehold prescriptioncontaining drugone usedperson, in(ii) $28,480 for a household containing 2 persons, or (iii) $35,740 for a household containing 3 or more persons for the treatment2000 grant year and thereafter and whose household is liable for payment of osteoporosis.property taxes accrued or has paid rent constituting property taxes accrued and is domiciled in this State at the time he or she files his or her claim is entitled to claim a grant under this Act.

TheWith specificrespect agentsto orclaims productsfiled by individuals who will become 65 years old during the calendar year in which a claim is filed, the amount of any grant to bewhich includedthat underhousehold suchis categoriesentitled shall HB0784 Enrolled -2- LRB093 05320 DRJ 05410 b be listedan inamount aequal handbookto 1/12 of the amount to which the claimant would otherwise be preparedentitled andas distributedprovided in this Section, multiplied by the Department.number of months in which the claimant was 65 in the calendar year in which the claim is filed.

The(b) generalLimitation. types of covered prescription drugs shall be indicated by rule.

Except as otherwise provided in subsections (a) and (f) of this Section, the maximum amount of grant which a claimant is entitled to claim is the amount by which the property taxes accrued which were paid or payable during the last preceding tax year or rent constituting property taxes accrued upon the claimant's residence for the last preceding taxable year exceeds 3 1/2% of the claimant's household income for that year but in no event is the grant to exceed (i) $700 less 4.5% of household income for that year for those with a household income of $14,000 or less or (ii) $70 if household income for that year is more than $14,000.

(c) Public aid recipients.

If household income in one or more months during a year includes cash assistance in excess of $55 per month from the Department of Public Aid or the Department of Human Services (acting as successor to the Department of Public Aid under the Department of Human Services Act) which was determined under regulations of that Department on a measure of need that included an allowance for actual rent or property taxes paid by the recipient of that assistance, the amount of grant to which that household is entitled, except as otherwise provided in subsection (a), shall be the product of (1) the maximum amount computed as specified in subsection (b) of this Section and (2) the ratio of the number of months in which household income did not include such cash assistance over $55 to the number twelve.

If household income did not include such cash assistance over $55 for any months during the year, the amount of the grant to which the household is entitled shall be the maximum HB0784 Enrolled -3- LRB093 05320 DRJ 05410 b amount computed as specified in subsection (b) of this Section.

For purposes of this paragraph (c), "cash assistance" does not include any amount received under the federal Supplemental Security Income (SSI) program.

(d) Joint ownership.

If title to the residence is held jointly by the claimant with a person who is not a member of his or her household, the amount of property taxes accrued used in computing the amount of grant to which he or she is entitled shall be the same percentage of property taxes accrued as is the percentage of ownership held by the claimant in the residence.

(e) More than one residence.

If a claimant has occupied more than one residence in the taxable year, he or she may claim only one residence for any part of a month.

In the case of property taxes accrued, he or she shall prorate 1/12 of the total property taxes accrued on his or her residence to each month that he or she owned and occupied that residence;

and, in the case of rent constituting property taxes accrued, shall prorate each month's rent payments to the residence actually occupied during that month.

(f) There is hereby established a program of pharmaceutical assistance to the aged and disabled which shall be administered by the Department in accordance with this Act, to consist of payments to authorized pharmacies, on behalf of beneficiaries of the program, for the reasonable costs of covered prescription drugs.

Each beneficiary who pays $5 for an identification card shall pay no additional prescription costs.

Each beneficiary who pays $25 for an identification card shall pay $3 per prescription.

In addition, after a beneficiary receives $2,000 in benefits during a State fiscal year, that beneficiary shall also be charged 20% of the cost of each prescription for which payments are made by the program during the remainder of the fiscal year.

To become a beneficiary under this program a HB0784 Enrolled -4- LRB093 05320 DRJ 05410 b person must:

(1) be (i) 65 years of age or older, or (ii) the surviving spouse of such a claimant, who at the time of death received or was entitled to receive benefits pursuant to this subsection, which surviving spouse will become 65 years of age within the 24 months immediately following the death of such claimant and which surviving spouse but for his or her age is otherwise qualified to receive benefits pursuant to this subsection, or (iii) disabled, and (2) be domiciled in this State at the time he or she files his or her claim, and (3) have a maximum household income of less than $14,000 for grant years before the 1998 grant year, less than $16,000 for the 1998 and 1999 grant years, and less than (i) $21,218 for a household containing one person, (ii) $28,480 for a household containing 2 persons, or (iii) $35,740 for a household containing 3 more persons for the 2000 grant year and thereafter.

In addition, each eligible person must (1) obtain an identification card from the Department, (2) at the time the card is obtained, sign a statement assigning to the State of Illinois benefits which may be otherwise claimed under any private insurance plans, and (3) present the identification card to the dispensing pharmacist.

_h_____________________p______________________p_____________ _____r_____________________h______________________n_____________ _____d_____________________n_______________________c____________ _____d_____________________t______________________a_____________ _____h_____________________h______________________i_____________ _____f_____________________l______________________s_____________ _______p____________________p_____________________h_____________ _____o_____________________i______________________v_____________ _____f_____________________i______________________s_____________ _____a______________________t_____________________c_____________ _____r_____________________m_______________________r____________ _____d______________________b_____________________P_____________ _____m_____________________a______________________n_____________ HB0784 Enrolled -5- LRB093 05320 DRJ 05410 b _____2_____________________b______________ Whenever a generic equivalent for a covered prescription drug is available, the Department shall reimburse only for the reasonable costs of the generic equivalent, less the co-pay established in this Section, unless (i) the covered prescription drug contains one or more ingredients defined as a narrow therapeutic index drug at 21 CFR 320.33, (ii) the prescriber indicates on the face of the prescription "brand medically necessary", and (iii) the prescriber specifies that a substitution is not permitted.

When issuing an oral prescription for covered prescription medication described in item (i) of this paragraph, the prescriber shall stipulate "brand medically necessary" and that a substitution is not permitted.

If the covered prescription drug and its authorizing prescription do not meet the criteria listed above, the beneficiary may purchase the non-generic equivalent of the covered prescription drug by paying the difference between the generic cost and the non-generic cost plus the beneficiary co-pay.

Any person otherwise eligible for pharmaceutical assistance under this Act whose covered drugs are covered by any public program for assistance in purchasing any covered prescription drugs shall be ineligible for assistance under this Act to the extent such costs are covered by such other plan.

The fee to be charged by the Department for the identification card shall be equal to $5 per coverage year for persons below the official poverty line as defined by the United States Department of Health and Human Services and $25 per coverage year for all other persons.

In the event that 2 or more persons are eligible for any benefit under this Act, and are members of the same household, (1) each such person shall be entitled to participate in the pharmaceutical assistance program, HB0784 Enrolled -6- LRB093 05320 DRJ 05410 b provided that he or she meets all other requirements imposed by this subsection and (2) each participating household member contributes the fee required for that person by the preceding paragraph for the purpose of obtaining an identification card.

91-357, eff.

7-29-99;

92-10,92-131, eff.

6-11-01;7-23-01;

92-790,92-519, eff.

8-6-02.)1-1-02;