Emergengy Rules

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Emergengy Rules

  1. 1. ILLINOISREGISTERRULESOF GOVERNMENTALAGENCIESPUBLISHED BY JESSE WHITE • SECRETARY OF STATEIndex DepartmentAdministrative Code Division111 E. Monroe St.Springfield, IL 62756217-782-7017www.cyberdriveillinois.comPrinted on recycled paperVolume 37, Issue 15April 12, 2013Pages 4411-51302013Rules ofGovernmental AgenciesIndex DepartmentAdministrative Code Division111 E. Monroe St.Springfield, IL 62756217-782-7017Printed by authority of the State of Illinois. April — 90
  2. 2. iTABLE OF CONTENTSApril 12, 2013 Volume 37, Issue 15PROPOSED RULESCOMMERCE AND ECONOMIC OPPORTUNITY, DEPARTMENT OFEnterprise Zone and High Impact Business Programs14 Ill. Adm. Code 520........................................................................4411FINANCIAL AND PROFESSIONAL REGULATION, DEPARTMENT OFMassage Licensing Act68 Ill. Adm. Code 1284......................................................................4413HEALTHCARE AND FAMILY SERVICES, DEPARTMENT OFChildrens Health Insurance Program89 Ill. Adm. Code 125........................................................................4420Medical Payment89 Ill. Adm. Code 140........................................................................4429Hospital Services89 Ill. Adm. Code 148........................................................................4455PUBLIC HEALTH, DEPARTMENT OFIllinois Vital Records Code77 Ill. Adm. Code 500........................................................................4466Control of Communicable Diseases Code77 Ill. Adm. Code 690........................................................................4479STATE BOARD OF EDUCATIONStandards for Endorsements in Elementary Education23 Ill. Adm. Code 20..........................................................................4606Standards for Endorsements in the Middle Grades23 Ill. Adm. Code 21..........................................................................4633Certification23 Ill. Adm. Code 25..........................................................................4671Standards for Certification in Early Childhood Education andElementary Education23 Ill. Adm. Code 26..........................................................................4705Standards for Certification in Specific Teaching Fields23 Ill. Adm. Code 27..........................................................................4710Special Education23 Ill. Adm. Code 226........................................................................4735ADOPTED RULESCENTRAL MANAGEMENT SERVICES, DEPARTMENT OFPay Plan80 Ill. Adm. Code 310........................................................................4750FINANCIAL AND PROFESSIONAL REGULATION, DEPARTMENT OFDetection of Deception Examiners Act68 Ill. Adm. Code 1230......................................................................4832Funeral Directors and Embalmers Licensing Code
  3. 3. ii68 Ill. Adm. Code 1250......................................................................4838Orthotics, Prosthetics and Pedorthics Practice Act68 Ill. Adm. Code 1325.....................................................................4861GAMING BOARD, ILLINOISVideo Gaming (General)11 Ill. Adm. Code 1800.....................................................................4892HOUSING DEVELOPMENT AUTHORITY, ILLINOISState Housing Appeals Board47 Ill. Adm. Code 395.......................................................................4901LABOR, DEPARTMENT OFCarnival and Amusement Ride Safety Act56 Ill. Adm. Code 6000.....................................................................4935PUBLIC HEALTH, DEPARTMENT OFSkilled Nursing and Intermediate Care Facilities Code77 Ill. Adm. Code 300.......................................................................4954Sheltered Care Facilities Code77 Ill. Adm. Code 330.......................................................................4970Illinois Veterans Homes Code77 Ill. Adm. Code 340.......................................................................4983RACING BOARD, ILLINOISMedication11 Ill. Adm. Code 603.......................................................................4993EMERGENCY RULESCOMMERCE AND ECONOMIC OPPORTUNITY, DEPARTMENT OFEnterprise Zone and High Impact Business Programs14 Ill. Adm. Code 520.......................................................................5006HEALTHCARE AND FAMILY SERVICESChildrens Health Insurance Program (Effective Until June 30, 2013)89 Ill. Adm. Code 125.......................................................................5049Medical Payment (Effective Until June 30, 2013)89 Ill. Adm. Code 140.......................................................................5058Hospital Services (Effective Until June 30, 2013)89 Ill. Adm. Code 148.......................................................................5082JOINT COMMITTEE ON ADMINISTRATIVE RULES AGENDAJOINT COMMITTEE ON ADMINISTRATIVE RULESApril Agenda.............................................................................................5093SECOND NOTICES RECEIVEDJOINT COMMITTEE ON ADMINISTRATIVE RULESSecond Notices Received..........................................................................5100EXECUTIVE ORDERS AND PROCLAMATIONSEXECUTIVE ORDERSExecutive Order Eliminating and Consolidating Boards andCommissions2013-5................................................................................................5103PROCLAMATIONS
  4. 4. iiiBataan Day2013-118............................................................................................5111Genocide Awareness and Prevention Month2013-119...........................................................................................5111Illinois Museum Day2013-120...........................................................................................5112National Water Safety Month2013-121...........................................................................................5113Siblings Day2013-122...........................................................................................5114Sikh American Heritage Day2013-123...........................................................................................5115Voices For Illinois Children Day2013-124...........................................................................................5115Chicago Business Opportunity Days2013-125...........................................................................................5116Chicago Latino Film Festival Days2013-126...........................................................................................5117Money Smart Week2013-127...........................................................................................5118Blake Shelton Day2013-128...........................................................................................5119Food Allergy Awareness Week2013-129...........................................................................................5120International Red Hat Day2013-130...........................................................................................5121Starlight Week2013-131...........................................................................................5122Sleep Apnea Awareness Day2013-132...........................................................................................5123Autism Awareness Month and World Autism Awareness Day2013-133...........................................................................................5123Cesar Estrada Chavez Day2013-134...........................................................................................5124Earth Month2013-135...........................................................................................5126Marylee Freeman2013-136...........................................................................................5126Non-Violence, No Higher Calling Day2013-137...........................................................................................5127Missing Childrens Day2013-138...........................................................................................5128Municipal Clerks Week2013-139...........................................................................................5129
  5. 5. ivINTRODUCTIONThe Illinois Register is the official state document for publishing public notice of rulemaking activityinitiated by State governmental agencies. The table of contents is arranged categorically byrulemaking activity and alphabetically by agency within each category.Rulemaking activity consists of proposed or adopted new rules; amendments to or repealers ofexisting rules; and rules promulgated by emergency or peremptory action. Executive Orders andProclamations issued by the Governor; notices of public information required by State Statute; andactivities (meeting agendas; Statements of Objection or Recommendation, etc.) of the JointCommittee on Administrative Rules (JCAR), a legislative oversight committee which monitors therulemaking activities of State Agencies; is also published in the Register.The Register is a weekly update of the Illinois Administrative Code (a compilation of the rulesadopted by State agencies). The most recent edition of the Code, along with the Register, comprisethe most current accounting of State agencies’ rulemakings.The Illinois Register is the property of the State of Illinois, granted by the authority of the IllinoisAdministrative Procedure Act [5 ILCS 100/1-1, et seq.].ILLINOIS REGISTER PUBLICATION SCHEDULE FOR 2013Issue# Rules Due Date Date of Issue1 December 26, 2012 January 4, 20132 December 31, 2012 January 11, 20133 January 7, 2013 January 18, 20134 January 14, 2013 January 25, 20135 January 22, 2013 February 1, 20136 January 28, 2013 February 8, 20137 February 4, 2013 February 15, 20138 February 11, 2013 February 22, 20139 February 19, 2013 March 1, 201310 February 25, 2013 March 8, 201311 March 4, 2013 March 15, 201312 March 11, 2013 March 22, 201313 March 18, 2013 March 29, 201314 March 25, 2013 April 5, 201315 April 1, 2013 April 12, 201316 April 8, 2013 April 19, 201317 April 15, 2013 April 26, 201318 April 22, 2013 May 3, 201319 April 29, 2013 May 10, 201320 May 6, 2013 May 17, 201321 May 13, 2013 May 24, 201322 May 20, 2013 May 31, 201323 May 28, 2013 June 7, 2013
  6. 6. v24 June 3, 2013 June 14, 201325 June 10, 2013 June 21, 201326 June 17, 2013 June 28, 201327 June 24, 2013 July 5, 201328 July 1, 2013 July 12, 201329 July 8, 2013 July 19, 201330 July 15, 2013 July 26, 201331 July 22, 2013 August 2, 201332 July 29, 2013 August 9, 201333 August 5, 2013 August 16, 201334 August 12, 2013 August 23, 201335 August 19, 2013 August 30, 201336 August 26, 2013 September 6, 201337 September 3, 2013 September 13, 201338 September 9, 2013 September 20, 201339 September 16, 2013 September 27, 201340 September 23, 2013 October 4, 201341 September 30, 2013 October 11, 201342 October 7, 2013 October 18, 201343 October 15, 2013 October 25, 201344 October 21, 2013 November 1, 201345 October 28, 2013 November 8, 201346 November 4, 2013 November 15, 201347 November 12, 2013 November 22, 201348 November 18, 2013 December 2, 201349 November 25, 2013 December 6, 201350 December 2, 2013 December 13, 201351 December 9, 2013 December 20, 201352 December 16, 2013 December 27, 2013
  7. 7. ILLINOIS REGISTER 441113DEPARTMENT OF COMMERCE AND ECONOMIC OPPORTUNITYNOTICE OF PROPOSED AMENDMENTS1) Heading of the Part: Enterprise Zone and High Impact Business Programs2) Code Citation: 14 Ill. Adm. Code 5203) Section Numbers: Proposed Action:520.100 Amend520.200 Amend520.210 Amend520.220 Amend520.230 Amend520.240 Amend520.250 Amend520.300 Amend520.310 Amend520.315 Amend520.320 Amend520.420 Amend520.700 Amend520.900 Amend520.910 Amend520.1000 Amend520.1010 Amend520.1200 Amend520.1300 Amend520.1400 Amend4) Statutory Authority: Illinois Enterprise Zone Act [20ILCS 655]5) A Complete Description of the Subjects and Issues Involved: This rulemaking revisesrules concerning the Enterprise Zone and High Impact Business Program to conform withchanges to the Enterprise Zone Act made by PA 97-9056) Any published studies or reports that were used when composing this rulemaking: None7) Will this rulemaking replace any emergency rulemaking currently in effect? Yes8) Does this rulemaking contain an automatic repeal date? No9) Does this rulemaking contain incorporations by reference? No
  8. 8. ILLINOIS REGISTER 441213DEPARTMENT OF COMMERCE AND ECONOMIC OPPORTUNITYNOTICE OF PROPOSED AMENDMENTS10) Does this rulemaking contain any incorporations by reference? No11) Statement of Statewide Policy Objectives: The rulemaking does not create or expand aState Mandate as defined in Section 3(b) of the State Mandate Act (30 ILCS 805).12) Time, Place and Manner in which interested persons may comment on this proposedrulemaking:Jolene ClarkeRules AdministratorDepartment of Commerce and Economic Opportunity500 E. MonroeSpringfield, IL 62701217/557-1820217-524-3701jolene.clarke@illinois.gov13) Initial Regulatory Flexibility Analysis:A) Types of small businesses and small municipalities affected: Municipalities thatseek to amend or apply for an enterprise zone.B) Reporting, bookkeeping or other procedures required for compliance:Application must be completedC) Types of Professional skills necessary for compliance: None14) Regulatory Agenda on which this rulemaking was summarized: This rulemaking was notincluded on either of the two most recent Agendas because the Department did notanticipate the need for the rulemaking at the time the Agendas were published.The full text of the Proposed Rulemaking is identical to that of the text of the EmergencyRulemaking and begins on Page 5006:
  9. 9. ILLINOIS REGISTER 441313DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATIONNOTICE OF PROPOSED AMENDMENTS1) Heading of the Part: Massage Licensing Act2) Code Citation: 68 Ill. Adm. Code 12843) Section Numbers: Proposed Action:1284.20 Amendment1284.30 Amendment1284.40 Amendment4) Statutory Authority: Implementing the Massage Licensing Act [225 ILCS 57] andauthorized by Section 2105-15(7) of the Civil Administrative Code of Illinois [20 ILCS2105/2105-15(7)]5) A Complete Description of the Subjects and Issues Involved: The Department isinitiating these amendments in order to implement Public Act 97-514, which was thesunset reauthorization of the Massage Licensing Act, effective August 23, 2011. Section1284.20 will be amended to stipulate that an applicants massage therapy training must nowinclude 600 clock hours of supervised classroom and supervised hands-on instruction,instead of 500. This requirement will become effective on January 1, 2014.6) Any published studies or reports, along with the sources of underlying data, that were usedwhen comprising this rulemaking, in accordance with 1 Ill. Adm. Code 100.355: None7) Will this rulemaking replace any emergency rulemaking currently in effect? No8) Does this rulemaking contain an automatic repeal date? No9) Does this rulemaking contain incorporations by reference? No10) Are there any other proposed rulemakings pending on this Part? No11) Statement of Statewide Policy Objectives: This rulemaking will not require a localgovernment to establish, expand or modify its activities in such a way as to necessitateadditional expenditures from local revenues.12) Time, Place and Manner in which interested persons may comment on this proposedrulemaking: Persons who wish to comment on this proposed rulemaking may submitwritten comments no later than 45 days after the publication of this Notice to:
  10. 10. ILLINOIS REGISTER 441413DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATIONNOTICE OF PROPOSED AMENDMENTSDepartment of Financial and Professional RegulationAttention: Craig Cellini320 West Washington, 3rdFloorSpringfield, IL 62786217/785-0813Fax: 217/557-4451All written comments received within 45 days after this issue of the Illinois Register willbe considered.13) Initial Regulatory Flexibility Analysis:A) Types of small businesses, small municipalities and not for profit corporationsaffected: Those providing massage therapy servicesB) Reporting, bookkeeping or other procedures required for compliance: NoneC) Types of Professional skills necessary for compliance: Massage therapy trainingis necessary for licensure.14) Regulatory Agenda on which this rulemaking was summarized: January 2013The full text of the Proposed Amendments begins on the next page:
  11. 11. ILLINOIS REGISTER 441513DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATIONNOTICE OF PROPOSED AMENDMENTSTITLE 68: PROFESSIONS AND OCCUPATIONSCHAPTER VII: DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATIONSUBCHAPTER b: PROFESSIONS AND OCCUPATIONSPART 1284MASSAGE LICENSING ACTSection1284.10 Requirements for Licensure Under Section 20 of the Act (Grandfather)(Repealed)1284.20 Approved ProgramsMassage Therapy School1284.30 Application for Licensure1284.40 Endorsement1284.45 Display of License1284.50 Fees1284.60 Renewals1284.70 Inactive Status1284.80 Restoration1284.90 Continuing Education1284.110 Granting VariancesAUTHORITY: Implementing the Massage Licensing Act [225 ILCS 57] and authorized bySection 2105-15(7) of the Civil Administrative Code of Illinois [20 ILCS 2105/2105-15(7)].SOURCE: Adopted at 28 Ill. Reg. 13366, effective September 21, 2004; amended at 30 Ill. Reg.12114, effective June 29, 2006; amended at 35 Ill. Reg. 12885, effective July 20, 2011; amendedat 37 Ill. Reg. ______, effective ____________.Section 1284.20 Approved ProgramsMassage Therapy Schoola) Effective January 1, 2014,The Division shall review an applicants massagetherapy training must meetto determine if it meets the following minimumcriteria:.1) A minimum of 600500 clock hours of supervised classroom andsupervised hands-on instruction. Should an applicant not meet the requirednumber of classroom/hands-on hours, the Division may requirecompletion of additional coursework, as identified in subsection (a)(2),prior to licensure. For purposes of this subsection (a)(1), "supervised"
  12. 12. ILLINOIS REGISTER 441613DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATIONNOTICE OF PROPOSED AMENDMENTSmeans the supervisor is physically on-site, qualified and immediatelyavailable.2) The minimum required subject matter and activities are:A) Human anatomy, physiology, pathology and kinesiology.B) Massage therapy theory, technique and practice, which mayinclude but is not limited to: effleurage/gliding;petrissage/kneading; compression; friction tapotement/percussion;vibration; direct pressure; superficial warming techniques;pumping; stretching; jostling; shaking; rocking.C) Contraindications, benefits, universal precautions, bodymechanics, history, client data collection, documentation, ethics,business and legalities of massage, professional standardsincluding draping and modesty, therapeutic relationships andcommunications.3) Each student must maintain a minimum grade of 70% for all massagetherapy related course and clinical work as described in this Section.b) A massage therapy programschool must meet the following minimum criteria:1) Maintain a written program philosophy, objectives and plan oforganization;2) Have written plans of study, including prerequisite, requisite, and electivecourses;3) Maintain course outlines or syllabi for all massage therapy courses;4) Provide a student handbook;5) Have a faculty that consists of a sufficient number of full and part-timeinstructors to ensure that the educational obligations to the student arefulfilled. Lab/clinical/community course core (lead) faculty mustdemonstrate competence in their respective areas of teaching as evidencedby a minimum of 2 years or 2000 hours of experience in their field.
  13. 13. ILLINOIS REGISTER 441713DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATIONNOTICE OF PROPOSED AMENDMENTSHuman sciences course core (lead) faculty (anatomy, pathology,physiology) must demonstrate competence in their respective areas ofteaching as evidenced by a minimum of 2 years or 2000 hours experiencein their field and/or by appropriate degrees/certificates from approvedcolleges/schools/institutions/programs;6) If a programschool utilizes faculty assistants, it shall establish andmaintain policies that set forth qualifications, duties and procedures foruse of these personnel. Faculty assistants shall not be used as substitutesor replacements for regular faculty; shall not be responsible for the overallevaluation of any student; and shall work under the direct supervision ofapproved faculty;7) Maintain permanent student records that summarize the credentials foradmission, attendance, grades and other records of performance;8) The ratio of students to faculty in the lab/clinical/community area shall notexceed 20 students to 1 instructor with no more than 10 student therapistsand 10 serving as clients; and9) All hands-on practice must be done on a living human being.c) A massage therapy program from another jurisdiction must have substantiallysimilar criteria for an applicant to have his or her credentials accepted forlicensure by the Department.(Source: Amended at 37 Ill. Reg. ______, effective ____________)Section 1284.30 Application for Licensurea) Any applicant for a massage therapy license shall meet all of the followingrequirements:1) The applicant is at least 18 years of age and of good moral character;2) The applicant has successfully completed an approved massage therapyprogram in accordance with Section 1284.20 or a substantially similarmassage therapy program from another jurisdiction and passed theNational Certification Board for Therapeutic Massage & Bodyworks
  14. 14. ILLINOIS REGISTER 441813DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATIONNOTICE OF PROPOSED AMENDMENTS(NCBTMB) examination or the Massage & Bodywork LicensingExamination (MBLEx) administered by the Federation of State MassageTherapy Boards (FSMTB).3) Should an applicant not meet the required number of classroom/hands-onhours required for licensure, the Division may require completion ofadditional coursework prior to licensure.4)3) Either:A) Verification of electronic fingerprint processing from the IllinoisDepartment of State Police or one of the Illinois State Policeapproved vendors. Applicants shall contact one of the approvedvendors for fingerprint processing; orB) Out-of-state residents unable to utilize the Illinois State Policeelectronic fingerprint process may submit to one of the IllinoisState Police approved vendors one fingerprint card issued by theIllinois State Police, accompanied by the fee specified by thevendor; and5)4) Pay the required fee specified in Section 1284.50.b) When the accuracy of any submitted documentation or the relevance orsufficiency of the course work or experience is questioned by the Divisionbecause of lack of information, discrepancies or conflicts in information given, ora need for clarification, the applicant seeking licensure shall be requested to:1) Provide such information as may be necessary; and/or2) Appear for an interview before the Massage Licensing Board (Board) toexplain such relevance or sufficiency, clarify information or clear up anydiscrepancies or conflicts in information.(Source: Amended at 37 Ill. Reg. ______, effective ____________)Section 1284.40 Endorsement
  15. 15. ILLINOIS REGISTER 441913DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATIONNOTICE OF PROPOSED AMENDMENTSAn applicant who is currently licensed under the laws of another jurisdiction and who wishes tobe licensed as a massage therapist by endorsement shall file an application with the Division, onforms provided by the Division, that shall include:a) Certification, on forms provided by the Division, of successful completion of anapproved massage therapy program in accordance with Section 1284.20 or asubstantially similar massage therapy program from another jurisdiction. Shouldan applicant not meet the required number of classroom/hands-on hours, theDivision may require completion of additional coursework prior to licensure;b) Certification from the jurisdiction of original licensure and the state in which theapplicant is currently licensed and practicing, if other than the original, stating thetime during which the applicant was licensed in that state, whether the file on theapplicant contains records of any disciplinary actions taken or pending, and theapplicants license number;c) A report of the applicants examination record forwarded directly from NCBTMBor FSMTB;d) Either:1) Verification of electronic fingerprint processing from the IllinoisDepartment of State Police or one of the Illinois State Police approvedvendors. Applicants shall contact one of the approved vendors forfingerprint processing; or2) Out-of-state residents unable to utilize the Illinois State Police electronicfingerprint process may submit to one of the Illinois State Police approvedvendors one fingerprint card issued by the Illinois State Police,accompanied by the fee specified by the vendor; ande) The required fee specified in Section 1284.50.(Source: Amended at 37 Ill. Reg. ______, effective ____________)
  16. 16. ILLINOIS REGISTER 442013DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENTS1) Heading of the Part: Childrens Health Insurance Program2) Code Citation: 89 Ill. Adm. Code 1253) Section Numbers: Proposed Action:125.310 Amendment125.340 Amendment4) Statutory Authority: Section 12-13 of the Illinois Public Aid Code [305 ILCS 5/12-13]and PA 97-06895) Complete Description of the Subjects and Issues Involved: Part 125 is being amended tocomply with the reduction in FamilyCare eligibility mandated by PA 97-0689, theSMART Act. Effective July 1, 2012, FamilyCare eligibility will be limited to individualsin families with income at or below 133 percent of the federal poverty level asestablished in 89 Ill. Adm. Code 120.32. The rulemaking also makes name changes toavoid inadvertent establishment of provisions, necessary to implement SMART thatcould be construed as conflicting with other parts of Title 89. For example, KidCare ischanged to All Kids because the name KidCare is no longer used and Premium ischanged to Premium Level 1 to avoid confusion with the Premium LevelIn addition, this rulemaking includes changes necessary to bring the rule into compliancewith recent statutory changes made in PA 96-1501 regarding reinstatement of benefitsand PA 96-1272 regarding elimination of the three-month penalty period for reenrollmentin circumstances where past due premiums are paid in full.6) Published studies or reports, and sources of underlying data, used to compose thisrulemaking: None7) Will this rulemaking replace any emergency rulemaking currently in effect? Yes8) Does this rulemaking contain an automatic repeal date? No9) Does this rulemaking contain incorporations by reference? No10) Are there any other proposed rulemakings pending on this Part? YesSections Proposed Action Illinois Register Citation125.110 Amendment 37 Ill. Reg. 992; February 1, 2013125.200 Amendment 37 Ill. Reg. 992; February 1, 2013125.205 Amendment 37 Ill. Reg. 992; February 1, 2013
  17. 17. ILLINOIS REGISTER 442113DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENTS125.220 Amendment 37 Ill. Reg. 992; February 1, 2013125.225 Amendment 37 Ill. Reg. 992; February 1, 2013125.240 Amendment 37 Ill. Reg. 992; February 1, 2013125.245 Amendment 37 Ill. Reg. 992; February 1, 2013125.250 Amendment 37 Ill. Reg. 992; February 1, 2013125.260 Amendment 37 Ill. Reg. 992; February 1, 2013125.265 Repealed 37 Ill. Reg. 992; February 1, 2013125.300 Amendment 37 Ill. Reg. 992; February 1, 2013125.305 Amendment 37 Ill. Reg. 992; February 1, 2013125.320 Amendment 37 Ill. Reg. 992; February 1, 2013125.330 Amendment 37 Ill. Reg. 992; February 1, 2013125.340 Amendment 37 Ill. Reg. 992; February 1, 2013125.400 Amendment 37 Ill. Reg. 992; February 1, 2013125.420 Amendment 37 Ill. Reg. 992; February 1, 2013125.430 Amendment 37 Ill. Reg. 992; February 1, 2013125.440 Amendment 37 Ill. Reg. 992; February 1, 2013125.445 Amendment 37 Ill. Reg. 992; February 1, 201311) Statement of Statewide Policy Objectives: This rulemaking does not affect units of localgovernment.12) Time, Place, and Manner in which interested persons may comment on this ProposedRulemaking: Any interested parties may submit comments, data, views or argumentsconcerning this proposed rulemaking. All comments must be in writing and should beaddressed to:Jeanette BadrovGeneral CounselIllinois Department of Healthcare and Family Services201 South Grand Avenue E., 3rdFloorSpringfield IL 62763-0002217/782-1233HFS.Rules@illinois.govThe Department requests the submission of written comments within 45 days after thepublication of this Notice. The Department will consider all written comments it receivesduring the first notice period as required by Section 5-40 of the Illinois AdministrativeProcedure Act [5 ILCS 100/5-40].
  18. 18. ILLINOIS REGISTER 442213DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENTS13) Initial Regulatory Flexibility Analysis:A) Types of small businesses, small municipalities and not-for-profit corporationsaffected: NoneB) Reporting, bookkeeping or other procedures required for compliance: NoneC) Types of Professional skills necessary for compliance: None14) Regulatory Agenda on which this Rulemaking was Summarized: January 2013The full text of the Proposed Amendments begins on the next page:
  19. 19. ILLINOIS REGISTER 442313DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENTSTITLE 89: SOCIAL SERVICESCHAPTER I: DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESSUBCHAPTER b: ASSISTANCE PROGRAMSPART 125CHILDRENS HEALTH INSURANCE PROGRAMSUBPART A: GENERAL PROVISIONSSection125.100 General Description125.110 DefinitionsSUBPART B: GENERAL ELIGIBILITY AND ENROLLMENTSection125.200 Eligibility for Childrens Health Insurance Program and Family Care125.205 Eligibility Exclusions and Terminations125.220 Application Process125.225 Presumptive Eligibility for Children125.230 Determination of Monthly Countable Income125.240 Eligibility Determination and Enrollment Process125.245 Appeals125.250 Annual Renewals125.260 Adding Children to the Program and Changes in Participation125.265 Adding Eligible Adults to the Program and Changes in ParticipationSUBPART C: ALL KIDSKIDCARE/FAMILYCARE HEALTH PLANSection125.300 Covered Services125.305 Service Exclusions125.310 Copayments125.320 Premium Requirements125.330 Non-payment of Premium125.340 Provider ReimbursementSUBPART D: KIDCARE/FAMILYCARE REBATESection125.400 Minimum Coverage Requirements
  20. 20. ILLINOIS REGISTER 442413DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENTS125.420 Coverage Verification Process125.430 Provision of Policyholders Social Security Number125.440 KidCare/FamilyCare Insurance Rebate125.445 Rebate OverpaymentsAUTHORITY: Implementing and authorized by the Childrens Health Insurance Program Act[215 ILCS 106] and Section 12-13 of the Illinois Public Aid Code [305 ILCS 5/12-13].SOURCE: Adopted by emergency rulemaking at 22 Ill. Reg. 15706, effective August 12, 1998,for a maximum of 150 days; adopted at 23 Ill. Reg. 543, effective December 24, 1998;emergency amendment at 24 Ill. Reg. 4217, effective March 1, 2000, for a maximum of 150days; amended at 24 Ill. Reg. 11822, effective July 28, 2000; amended at 26 Ill. Reg. 12313,effective July 26, 2002; emergency amendment at 26 Ill. Reg. 15066, effective October 1, 2002,for a maximum of 150 days; amended at 27 Ill. Reg. 4723, effective February 25, 2003;emergency amendment at 27 Ill. Reg. 10807, effective July 1, 2003, for a maximum of 150 days;amended at 27 Ill. Reg. 18623, effective November 26, 2003; emergency amendment at 28 Ill.Reg. 7163, effective May 3, 2004, for a maximum of 150 days; amended at 28 Ill. Reg. 13632,effective September 28, 2004; emergency amendment at 30 Ill. Reg. 535, effective January 1,2006, for a maximum of 150 days; amended at 30 Ill. Reg. 10328, effective May 26, 2006;emergency amendment at 36 Ill. Reg. 10298, effective July 1, 2012 through June 30, 2013; ;emergency amendment at 37 Ill. Reg. 5049, effective April 1, 2013 through June 30, 2013;amended at 37 Ill. Reg. ______, effective ____________.SUBPART C: ALL KIDSKIDCARE/FAMILYCARE HEALTH PLANSection 125.310 Copaymentsa) Copayments may be charged to the family by a health care professional wheneverthe service is performed in an office or home setting, except for visits scheduledfor well-baby care, well-child care or age-appropriate immunizations.Copayments may also be charged to the family by hospitals, for inpatienthospitalizationonce per inpatient admission or outpatient encounter (including theemergency room). No copayment is permitted for visits to health careprofessionals or hospitals made solely for speech, occupational or physicaltherapy, audiology, radiology or laboratory services (including APL Group 2procedures). Families with an enrolled individual who is an American Indian orAlaska Native shall not be charged copayments.b) Effective July 1, 2013, copaymentCopayment requirements are as follows:
  21. 21. ILLINOIS REGISTER 442513DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENTS1) Practitioner office visit:A) All KidsKidCare/FamilyCare Share copayment: the nominalcopayment amount as defined at 42 CFR 447.54. Specificcopayment amounts are described and updated on the DepartmentsWeb site$2 per visit.B) All KidsKidCare/FamilyCare Premium Level 1 copayment: $5 pervisit.2) Home health care visit:A) KidCare/FamilyCare Share copayment: $2 per visit.B) KidCare/FamilyCare Premium copayment: $5 per visit.23) Inpatient hospitalization:A) All KidsKidCare/FamilyCare Share copayment: a daily copaymentamount as defined at 42 CFR 447.54 et seq. Specific copaymentamounts are described and updated annually on the DepartmentsWeb site$2 per admission.B) All KidsKidCare/FamilyCare Premium Level 1 copayment: $5 perdayadmission.34) Outpatient hospital encounter (including the emergency room):A) All KidsKidCare/FamilyCare Share copayment: the nominalcopayment amount as defined at 42 CFR 447.54. Specificcopayment amounts are described and updated annually on theDepartments Web site$2 per visit.B) All KidsKidCare/FamilyCare Premium Level 1 copayment: $5 pervisit.45) Prescription drugs:A) All KidsKidCare/FamilyCare Share copayment: $2 for a 1-day to30-day supply ofon both generic drugs, including over-the-counter
  22. 22. ILLINOIS REGISTER 442613DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENTSdrugs and the nominal copayment amount as defined at 42 CFR447.54 for a 1-day to 30-day supply of brand name drugs. Specificcopayment amounts are described and updated on the DepartmentsWeb site.B) All KidsKidCare/FamilyCare Premium Level 1copaymentcopayments: $3 for a 1-day to 30-day supply ofongeneric drugs or $5 for 1-day to 30-day supply ofon brand namedrugs.56) Nonemergency visit to an emergency room:A) All Kids Share copayment: $0 per visitKidCare/FamilyCare Sharecopayments: $2 per visit.B) All KidsKidCare/FamilyCare Premium Level 1 copayment: $25per visit.6) Emergency room visit:A) All Kids Share copayment: $0 per visit.B) All Kids Premium Level 1 copayment: $5 per visit.c) The maximum out-of-pocket expense a family will incur for copayments during a12-month eligibility period is $100.d) Once the family has satisfied the copayment cap, the family is responsible forsubmitting receipts, to the Department, documenting the payment of copayments.The Department may return partial documentation received on copayments to thefamily.e) Upon the Department determining that the copayment cap has been satisfied, thefollowing will occur:1) A notice stating that the copayment cap has been satisfied, and the datesatisfied, will be sent to the family.2) A message that the copayment cap has been satisfied, and the datesatisfied, will be available through the familys identification card.
  23. 23. ILLINOIS REGISTER 442713DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENTS23) REV will be updated to reflect that the copayment cap has been reached.f) Providers will be responsible for collecting copayments under the AllKidsKidCare/FamilyCare Health Plan.g) Providers may elect not to charge copayments. If copayments are charged, thecopayment must comply with the requirements in this Section.h) Providers shall be responsible for refunding to the family copayments they collectafter the family has reached the copayment cap.i) The Department will not require providers to deliver services when copaymentsproperly charged under the All KidsKidCare/FamilyCare Health Plan are notpaid.(Source: Amended at 37 Ill. Reg. ______, effective ____________)Section 125.340 Provider Reimbursementa) Providers under this Part shall be subject to approval by the Department toprovide health care under the Illinois Public Aid Code.b) Provider participation under this Part shall be voluntary.c) Providers under this Part shall be reimbursed in accordance with the establishedrates of the Department or other appropriate State agency.d) In addition to reimbursements received from the Department, providers mayretain copayments defined in Section 125.310.e) Providers under this Part shall be prohibited from billing families covered underthe All KidsKidCare/FamilyCare Health Plan any difference between the chargeamount and the amount paid by the Department, except for copayments asspecified in Section 125.310.f) Providers shall be responsible for refunding to the family copayments collected inexcess of the amounts permitted by this Part.g) In each instance in which a copayment is payable, the Department will reduce the
  24. 24. ILLINOIS REGISTER 442813DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENTSamount payable to the provider by the respective amount of the required payment.(Source: Amended at 37 Ill. Reg. ______, effective ____________)
  25. 25. ILLINOIS REGISTER 442913DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENT1) Heading of the Part: Medical Payment2) Code Citation: 89 Ill. Adm. Code 1403) Section Number: Proposed Action:140.402 Amendment4) Statutory Authority: Section 12-13 of the Illinois Public Aid Code [305 ILCS 5/12-13]5) Complete Description of the Subjects and Issues Involved: This rulemaking isauthorized by the SMART Act which mandates adjustments to co-pays and anyrate of reimbursement for services or other payments or alteration of anymethodologies authorized by the Public Aid Code to reduce any rate ofreimbursement for services or other payments.6) Published studies or reports, and sources of underlying data, used to compose thisrulemaking: None7) Will this rulemaking replace any emergency rulemaking currently in effect? Yes8) Does this rulemaking contain an automatic repeal date? No9) Does this rulemaking contain incorporations by reference? No10) Are there any other proposed rulemakings pending on this Part? YesSections Proposed Action Illinois Register Citation140.445 Amendment 36 Ill. Reg. 7757; May 25, 2012140.523 Amendment 36 Ill. Reg. 7757; May 25, 2012140.539 Amendment 36 Ill. Reg. 7757; May 25, 2012140.570 Amendment 36 Ill. Reg. 7757; May 25, 2012140.400 Amendment 36 Ill. Reg. 8594; June 15, 2012140.438 Amendment 36 Ill. Reg. 8594; June 15, 2012140.5 Amendment 36 Ill. Reg. 9650; July 6, 2012140.642 Amendment 36 Ill. Reg. 9650; July 6, 2012140.643 Amendment 36 Ill. Reg. 9650; July 6, 2012140.491 Amendment 36 Ill. Reg. 15425; December 28, 2012140.462 Amendment 37 Ill. Reg. 18; January 4, 2013140.2 Amendment 37 Ill. Reg. 1390; February 8, 2013
  26. 26. ILLINOIS REGISTER 443013DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENT140.3 Amendment 37 Ill. Reg. 1390; February 8, 2013140.5 Amendment 37 Ill. Reg. 1390; February 8, 2013140.11 Amendment 37 Ill. Reg. 1390; February 8, 2013140.12 Amendment 37 Ill. Reg. 1390; February 8, 2013140.13 Amendment 37 Ill. Reg. 1390; February 8, 2013140.14 Amendment 37 Ill. Reg. 1390; February 8, 2013140.15 Amendment 37 Ill. Reg. 1390; February 8, 2013140.16 Amendment 37 Ill. Reg. 1390; February 8, 2013140.18 Amendment 37 Ill. Reg. 1390; February 8, 2013140.19 Amendment 37 Ill. Reg. 1390; February 8, 2013140.20 Amendment 37 Ill. Reg. 1390; February 8, 2013140.30 Amendment 37 Ill. Reg. 1390; February 8, 2013140.32 Amendment 37 Ill. Reg. 1390; February 8, 2013140.44 Amendment 37 Ill. Reg. 1390; February 8, 2013140.45 Amendment 37 Ill. Reg. 1390; February 8, 2013140.80 Amendment 37 Ill. Reg. 1390; February 8, 2013140.405 Amendment 37 Ill. Reg. 1390; February 8, 2013140.413 Amendment 37 Ill. Reg. 1390; February 8, 2013140.414 Amendment 37 Ill. Reg. 1390; February 8, 2013140.417 Amendment 37 Ill. Reg. 1390; February 8, 2013140.420 Amendment 37 Ill. Reg. 1390; February 8, 2013140.425 Amendment 37 Ill. Reg. 1390; February 8, 2013140.428 Amendment 37 Ill. Reg. 1390; February 8, 2013140.440 Amendment 37 Ill. Reg. 1390; February 8, 2013140.441 Amendment 37 Ill. Reg. 1390; February 8, 2013140.442 Amendment 37 Ill. Reg. 1390; February 8, 2013140.443 Amendment 37 Ill. Reg. 1390; February 8, 2013140.445 Amendment 37 Ill. Reg. 1390; February 8, 2013140.449 Amendment 37 Ill. Reg. 1390; February 8, 2013140.457 Amendment 37 Ill. Reg. 1390; February 8, 2013140.458 Amendment 37 Ill. Reg. 1390; February 8, 2013140.469 Amendment 37 Ill. Reg. 1390; February 8, 2013140.470 Amendment 37 Ill. Reg. 1390; February 8, 2013140.471 Amendment 37 Ill. Reg. 1390; February 8, 2013140.472 Amendment 37 Ill. Reg. 1390; February 8, 2013140.473 Amendment 37 Ill. Reg. 1390; February 8, 2013140.474 Amendment 37 Ill. Reg. 1390; February 8, 2013140.477 Amendment 37 Ill. Reg. 1390; February 8, 2013140.498 Amendment 37 Ill. Reg. 1390; February 8, 2013
  27. 27. ILLINOIS REGISTER 443113DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENT140.523 Amendment 37 Ill. Reg. 1390; February 8, 2013140.Table D Amendment 37 Ill. Reg. 1390; February 8, 2013140.Table F Amendment 37 Ill. Reg. 1390; February 8, 201311) Statement of Statewide Policy Objectives: This rulemaking does affect units of localgovernment. It will have an impact on county government entities that own or operatenursing facilities enrolled in the Medical Assistance Program.12) Time, Place and Manner in Which Interested Persons May Comment on this ProposedRulemaking: Any interested parties may submit comments, data, views, or argumentsconcerning this proposed rulemaking. All comments must be in writing and should beaddressed to:Jeanette BadrovGeneral CounselIllinois Department of Healthcare and Family Services201 South Grand Avenue East, 3rdFloorSpringfield IL 62763-0002217/782-1233HFS.Rules@illinois.govThe Department requests the submission of written comments within 45 days after thepublication of this Notice. The Department will consider all written comments it receivesduring the first notice period as required by Section 5-40 of the Illinois AdministrativeProcedure Act [5 ILCS 100/5-40].13) Initial Regulatory Flexibility Analysis:A) Types of small businesses, small municipalities and not-for-profit corporationsaffected: Medicaid funded providersB) Reporting, bookkeeping or other procedures required for compliance:Preparation, documentation, and submission of facilitys cost report.C) Types of Professional skills necessary for compliance: None
  28. 28. ILLINOIS REGISTER 443213DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENT14) Regulatory Agenda on Which this Rulemaking Was Summarized: January 2013The full text of the Proposed Amendment begins on the next page:
  29. 29. ILLINOIS REGISTER 443313DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENTTITLE 89: SOCIAL SERVICESCHAPTER I: DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESSUBCHAPTER d: MEDICAL PROGRAMSPART 140MEDICAL PAYMENTSUBPART A: GENERAL PROVISIONSSection140.1 Incorporation By Reference140.2 Medical Assistance Programs140.3 Covered Services Under Medical Assistance Programs140.4 Covered Medical Services Under AFDC-MANG for non-pregnant persons whoare 18 years of age or older (Repealed)140.5 Covered Medical Services Under General Assistance140.6 Medical Services Not Covered140.7 Medical Assistance Provided to Individuals Under the Age of Eighteen Who DoNot Qualify for AFDC and Children Under Age Eight140.8 Medical Assistance For Qualified Severely Impaired Individuals140.9 Medical Assistance for a Pregnant Woman Who Would Not Be CategoricallyEligible for AFDC/AFDC-MANG if the Child Were Already Born Or Who DoNot Qualify As Mandatory Categorically Needy140.10 Medical Assistance Provided to Persons Confined or Detained by the CriminalJustice SystemSUBPART B: MEDICAL PROVIDER PARTICIPATIONSection140.11 Enrollment Conditions for Medical Providers140.12 Participation Requirements for Medical Providers140.13 Definitions140.14 Denial of Application to Participate in the Medical Assistance Program140.15 Recovery of Money140.16 Termination or Suspension of a Vendors Eligibility to Participate in the MedicalAssistance Program140.17 Suspension of a Vendors Eligibility to Participate in the Medical AssistanceProgram140.18 Effect of Termination or Revocation on Persons Associated with Vendor
  30. 30. ILLINOIS REGISTER 443413DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENT140.19 Application to Participate or for Reinstatement Subsequent to Termination,Suspension or Barring140.20 Submittal of Claims140.21 Reimbursement for QMB Eligible Medical Assistance Recipients and QMBEligible Only Recipients and Individuals Who Are Entitled to Medicare Part A orPart B and Are Eligible for Some Form of Medicaid Benefits140.22 Magnetic Tape Billings (Repealed)140.23 Payment of Claims140.24 Payment Procedures140.25 Overpayment or Underpayment of Claims140.26 Payment to Factors Prohibited140.27 Assignment of Vendor Payments140.28 Record Requirements for Medical Providers140.30 Audits140.31 Emergency Services Audits140.32 Prohibition on Participation, and Special Permission for Participation140.33 Publication of List of Sanctioned Entities140.35 False Reporting and Other Fraudulent Activities140.40 Prior Approval for Medical Services or Items140.41 Prior Approval in Cases of Emergency140.42 Limitation on Prior Approval140.43 Post Approval for Items or Services When Prior Approval Cannot Be Obtained140.44 Withholding of Payments Due to Fraud or Misrepresentation140.55 Recipient Eligibility Verification (REV) System140.71 Reimbursement for Medical Services Through the Use of a C-13 Invoice VoucherAdvance Payment and Expedited Payments140.72 Drug Manual (Recodified)140.73 Drug Manual Updates (Recodified)SUBPART C: PROVIDER ASSESSMENTSSection140.80 Hospital Provider Fund140.82 Developmentally Disabled Care Provider Fund140.84 Long Term Care Provider Fund140.94 Medicaid Developmentally Disabled Provider Participation Fee TrustFund/Medicaid Long Term Care Provider Participation Fee Trust Fund140.95 Hospital Services Trust Fund140.96 General Requirements (Recodified)
  31. 31. ILLINOIS REGISTER 443513DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENT140.97 Special Requirements (Recodified)140.98 Covered Hospital Services (Recodified)140.99 Hospital Services Not Covered (Recodified)140.100 Limitation On Hospital Services (Recodified)140.101 Transplants (Recodified)140.102 Heart Transplants (Recodified)140.103 Liver Transplants (Recodified)140.104 Bone Marrow Transplants (Recodified)140.110 Disproportionate Share Hospital Adjustments (Recodified)140.116 Payment for Inpatient Services for GA (Recodified)140.117 Hospital Outpatient and Clinic Services (Recodified)140.200 Payment for Hospital Services During Fiscal Year 1982 (Recodified)140.201 Payment for Hospital Services After June 30, 1982 (Repealed)140.202 Payment for Hospital Services During Fiscal Year 1983 (Recodified)140.203 Limits on Length of Stay by Diagnosis (Recodified)140.300 Payment for Pre-operative Days and Services Which Can Be Performed in anOutpatient Setting (Recodified)140.350 Copayments (Recodified)140.360 Payment Methodology (Recodified)140.361 Non-Participating Hospitals (Recodified)140.362 Pre July 1, 1989 Services (Recodified)140.363 Post June 30, 1989 Services (Recodified)140.364 Prepayment Review (Recodified)140.365 Base Year Costs (Recodified)140.366 Restructuring Adjustment (Recodified)140.367 Inflation Adjustment (Recodified)140.368 Volume Adjustment (Repealed)140.369 Groupings (Recodified)140.370 Rate Calculation (Recodified)140.371 Payment (Recodified)140.372 Review Procedure (Recodified)140.373 Utilization (Repealed)140.374 Alternatives (Recodified)140.375 Exemptions (Recodified)140.376 Utilization, Case-Mix and Discretionary Funds (Repealed)140.390 Subacute Alcoholism and Substance Abuse Services (Recodified)140.391 Definitions (Recodified)140.392 Types of Subacute Alcoholism and Substance Abuse Services (Recodified)140.394 Payment for Subacute Alcoholism and Substance Abuse Services (Recodified)
  32. 32. ILLINOIS REGISTER 443613DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENT140.396 Rate Appeals for Subacute Alcoholism and Substance Abuse Services(Recodified)140.398 Hearings (Recodified)SUBPART D: PAYMENT FOR NON-INSTITUTIONAL SERVICESSection140.400 Payment to Practitioners140.402 Copayments for Noninstitutional Medical Services140.403 Telehealth Services140.405 SeniorCare Pharmaceutical Benefit (Repealed)140.410 Physicians Services140.411 Covered Services By Physicians140.412 Services Not Covered By Physicians140.413 Limitation on Physician Services140.414 Requirements for Prescriptions and Dispensing of Pharmacy Items – Prescribers140.416 Optometric Services and Materials140.417 Limitations on Optometric Services140.418 Department of Corrections Laboratory140.420 Dental Services140.421 Limitations on Dental Services140.422 Requirements for Prescriptions and Dispensing Items of Pharmacy Items –Dentists (Repealed)140.425 Podiatry Services140.426 Limitations on Podiatry Services140.427 Requirement for Prescriptions and Dispensing of Pharmacy Items – Podiatry(Repealed)140.428 Chiropractic Services140.429 Limitations on Chiropractic Services (Repealed)140.430 Independent Clinical Laboratory Services140.431 Services Not Covered by Independent Clinical Laboratories140.432 Limitations on Independent Clinical Laboratory Services140.433 Payment for Clinical Laboratory Services140.434 Record Requirements for Independent Clinical Laboratories140.435 Advanced Practice Nurse Services140.436 Limitations on Advanced Practice Nurse Services140.438 Diagnostic Imaging Services140.440 Pharmacy Services140.441 Pharmacy Services Not Covered
  33. 33. ILLINOIS REGISTER 443713DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENT140.442 Prior Approval of Prescriptions140.443 Filling of Prescriptions140.444 Compounded Prescriptions140.445 Legend Prescription Items (Not Compounded)140.446 Over-the-Counter Items140.447 Reimbursement140.448 Returned Pharmacy Items140.449 Payment of Pharmacy Items140.450 Record Requirements for Pharmacies140.451 Prospective Drug Review and Patient Counseling140.452 Mental Health Services140.453 Definitions140.454 Types of Mental Health Services140.455 Payment for Mental Health Services140.456 Hearings140.457 Therapy Services140.458 Prior Approval for Therapy Services140.459 Payment for Therapy Services140.460 Clinic Services140.461 Clinic Participation, Data and Certification Requirements140.462 Covered Services in Clinics140.463 Clinic Service Payment140.464 Hospital-Based and Encounter Rate Clinic Payments140.465 Speech and Hearing Clinics (Repealed)140.466 Rural Health Clinics (Repealed)140.467 Independent Clinics140.469 Hospice140.470 Eligible Home Health Providers140.471 Description of Home Health Services140.472 Types of Home Health Services140.473 Prior Approval for Home Health Services140.474 Payment for Home Health Services140.475 Medical Equipment, Supplies, Prosthetic Devices and Orthotic Devices140.476 Medical Equipment, Supplies, Prosthetic Devices and Orthotic Devices for WhichPayment Will Not Be Made140.477 Limitations on Equipment, Prosthetic Devices and Orthotic Devices140.478 Prior Approval for Medical Equipment, Supplies, Prosthetic Devices and OrthoticDevices140.479 Limitations, Medical Supplies
  34. 34. ILLINOIS REGISTER 443813DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENT140.480 Equipment Rental Limitations140.481 Payment for Medical Equipment, Supplies, Prosthetic Devices and Hearing Aids140.482 Family Planning Services140.483 Limitations on Family Planning Services140.484 Payment for Family Planning Services140.485 Healthy Kids Program140.486 Illinois Healthy Women140.487 Healthy Kids Program Timeliness Standards140.488 Periodicity Schedules, Immunizations and Diagnostic Laboratory Procedures140.490 Medical Transportation140.491 Limitations on Medical Transportation140.492 Payment for Medical Transportation140.493 Payment for Helicopter Transportation140.494 Record Requirements for Medical Transportation Services140.495 Psychological Services140.496 Payment for Psychological Services140.497 Hearing Aids140.498 Fingerprint-Based Criminal Background ChecksSUBPART E: GROUP CARESection140.500 Long Term Care Services140.502 Cessation of Payment at Federal Direction140.503 Cessation of Payment for Improper Level of Care140.504 Cessation of Payment Because of Termination of Facility140.505 Informal Hearing Process for Denial of Payment for New ICF/MR140.506 Provider Voluntary Withdrawal140.507 Continuation of Provider Agreement140.510 Determination of Need for Group Care140.511 Long Term Care Services Covered By Department Payment140.512 Utilization Control140.513 Notification of Change in Resident Status140.514 Certifications and Recertifications of Care (Repealed)140.515 Management of Recipient Funds – Personal Allowance Funds140.516 Recipient Management of Funds140.517 Correspondent Management of Funds140.518 Facility Management of Funds140.519 Use or Accumulation of Funds
  35. 35. ILLINOIS REGISTER 443913DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENT140.520 Management of Recipient Funds – Local Office Responsibility140.521 Room and Board Accounts140.522 Reconciliation of Recipient Funds140.523 Bed Reserves140.524 Cessation of Payment Due to Loss of License140.525 Quality Incentive Program (QUIP) Payment Levels140.526 County Contribution to Medicaid Reimbursement (Repealed)140.527 Quality Incentive Survey (Repealed)140.528 Payment of Quality Incentive (Repealed)140.529 Reviews (Repealed)140.530 Basis of Payment for Long Term Care Services140.531 General Service Costs140.532 Health Care Costs140.533 General Administration Costs140.534 Ownership Costs140.535 Costs for Interest, Taxes and Rent140.536 Organization and Pre-Operating Costs140.537 Payments to Related Organizations140.538 Special Costs140.539 Reimbursement for Basic Nursing Assistant, Developmental Disabilities Aide,Basic Child Care Aide and Habilitation Aide Training and Nursing AssistantCompetency Evaluation140.540 Costs Associated With Nursing Home Care Reform Act and ImplementingRegulations140.541 Salaries Paid to Owners or Related Parties140.542 Cost Reports – Filing Requirements140.543 Time Standards for Filing Cost Reports140.544 Access to Cost Reports (Repealed)140.545 Penalty for Failure to File Cost Reports140.550 Update of Operating Costs140.551 General Service Costs Updates140.552 Nursing and Program Costs140.553 General Administrative Costs Updates140.554 Component Inflation Index (Repealed)140.555 Minimum Wage140.560 Components of the Base Rate Determination140.561 Support Costs Components140.562 Nursing Costs140.563 Capital Costs
  36. 36. ILLINOIS REGISTER 444013DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENT140.565 Kosher Kitchen Reimbursement140.566 Out-of-State Placement140.567 Level II Incentive Payments (Repealed)140.568 Duration of Incentive Payments (Repealed)140.569 Clients With Exceptional Care Needs140.570 Capital Rate Component Determination140.571 Capital Rate Calculation140.572 Total Capital Rate140.573 Other Capital Provisions140.574 Capital Rates for Rented Facilities140.575 Newly Constructed Facilities (Repealed)140.576 Renovations (Repealed)140.577 Capital Costs for Rented Facilities (Renumbered)140.578 Property Taxes140.579 Specialized Living Centers140.580 Mandated Capital Improvements (Repealed)140.581 Qualifying as Mandated Capital Improvement (Repealed)140.582 Cost Adjustments140.583 Campus Facilities140.584 Illinois Municipal Retirement Fund (IMRF)140.590 Audit and Record Requirements140.642 Screening Assessment for Nursing Facility and Alternative Residential Settingsand Services140.643 In-Home Care Program140.645 Home and Community Based Services Waivers for Medically Fragile,Technology Dependent, Disabled Persons Under Age 21 (Repealed)140.646 Reimbursement for Developmental Training (DT) Services for Individuals WithDevelopmental Disabilities Who Reside in Long Term Care (ICF and SNF) andResidential (ICF/MR) Facilities140.647 Description of Developmental Training (DT) Services140.648 Determination of the Amount of Reimbursement for Developmental Training(DT) Programs140.649 Effective Dates of Reimbursement for Developmental Training (DT) Programs140.650 Certification of Developmental Training (DT) Programs140.651 Decertification of Day Programs140.652 Terms of Assurances and Contracts140.680 Effective Date Of Payment Rate140.700 Discharge of Long Term Care Residents140.830 Appeals of Rate Determinations
  37. 37. ILLINOIS REGISTER 444113DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENT140.835 Determination of Cap on Payments for Long Term Care (Repealed)SUBPART F: FEDERAL CLAIMING FOR STATE ANDLOCAL GOVERNMENTAL ENTITIESSection140.850 Reimbursement of Administrative Expenditures140.855 Administrative Claim Review and Reconsideration Procedure140.860 County Owned or Operated Nursing Facilities140.865 Sponsor Qualifications (Repealed)140.870 Sponsor Responsibilities (Repealed)140.875 Department Responsibilities (Repealed)140.880 Provider Qualifications (Repealed)140.885 Provider Responsibilities (Repealed)140.890 Payment Methodology (Repealed)140.895 Contract Monitoring (Repealed)140.896 Reimbursement For Program Costs (Active Treatment) For Clients in Long TermCare Facilities For the Developmentally Disabled (Recodified)140.900 Reimbursement For Nursing Costs For Geriatric Residents in Group CareFacilities (Recodified)140.901 Functional Areas of Needs (Recodified)140.902 Service Needs (Recodified)140.903 Definitions (Recodified)140.904 Times and Staff Levels (Repealed)140.905 Statewide Rates (Repealed)140.906 Reconsiderations (Recodified)140.907 Midnight Census Report (Recodified)140.908 Times and Staff Levels (Recodified)140.909 Statewide Rates (Recodified)140.910 Referrals (Recodified)140.911 Basic Rehabilitation Aide Training Program (Recodified)140.912 Interim Nursing Rates (Recodified)SUBPART G: MATERNAL AND CHILD HEALTH PROGRAMSection140.920 General Description140.922 Covered Services140.924 Maternal and Child Health Provider Participation Requirements
  38. 38. ILLINOIS REGISTER 444213DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENT140.926 Client Eligibility (Repealed)140.928 Client Enrollment and Program Components (Repealed)140.930 Reimbursement140.932 Payment Authorization for Referrals (Repealed)SUBPART H: ILLINOIS COMPETITIVE ACCESS ANDREIMBURSEMENT EQUITY (ICARE) PROGRAMSection140.940 Illinois Competitive Access and Reimbursement Equity (ICARE) Program(Recodified)140.942 Definition of Terms (Recodified)140.944 Notification of Negotiations (Recodified)140.946 Hospital Participation in ICARE Program Negotiations (Recodified)140.948 Negotiation Procedures (Recodified)140.950 Factors Considered in Awarding ICARE Contracts (Recodified)140.952 Closing an ICARE Area (Recodified)140.954 Administrative Review (Recodified)140.956 Payments to Contracting Hospitals (Recodified)140.958 Admitting and Clinical Privileges (Recodified)140.960 Inpatient Hospital Care or Services by Non-Contracting Hospitals Eligible forPayment (Recodified)140.962 Payment to Hospitals for Inpatient Services or Care not Provided under theICARE Program (Recodified)140.964 Contract Monitoring (Recodified)140.966 Transfer of Recipients (Recodified)140.968 Validity of Contracts (Recodified)140.970 Termination of ICARE Contracts (Recodified)140.972 Hospital Services Procurement Advisory Board (Recodified)140.980 Elimination Of Aid To The Medically Indigent (AMI) Program (EmergencyExpired)140.982 Elimination Of Hospital Services For Persons Age Eighteen (18) And Older AndPersons Married And Living With Spouse, Regardless Of Age (EmergencyExpired)SUBPART I: PRIMARY CARE CASE MANAGEMENT PROGRAMSection140.990 Primary Care Case Management Program
  39. 39. ILLINOIS REGISTER 444313DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENT140.991 Primary Care Provider Participation Requirements140.992 Populations Eligible to Participate in the Primary Care Case ManagementProgram140.993 Care Management Fees140.994 Panel Size and Affiliated Providers140.995 Mandatory Enrollment140.996 Access to Health Care Services140.997 Payment for ServicesSUBPART J: ALTERNATE PAYEE PARTICIPATIONSection140.1001 Registration Conditions for Alternate Payees140.1002 Participation Requirements for Alternate Payees140.1003 Recovery of Money for Alternate Payees140.1004 Conditional Registration for Alternate Payees140.1005 Revocation of an Alternate PayeeSUBPART K: MANDATORY MCO ENROLLMENT140.1010 Mandatory Enrollment in MCOsSUBPART L: UNAUTHORIZED USE OF MEDICAL ASSISTANCESection140.1300 Definitions140.1310 Recovery of Money140.1320 Penalties140.1330 Enforcement140.TABLE A Criteria for Non-Emergency Ambulance Transportation140.TABLE B Geographic Areas140.TABLE C Capital Cost Areas140.TABLE D Schedule of Dental Procedures140.TABLE E Time Limits for Processing of Prior Approval Requests140.TABLE F Podiatry Service Schedule140.TABLE G Travel Distance Standards140.TABLE H Areas of Major Life Activity140.TABLE I Staff Time and Allocation for Training Programs (Recodified)
  40. 40. ILLINOIS REGISTER 444413DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENT140.TABLE J HSA Grouping (Repealed)140.TABLE K Services Qualifying for 10% Add-On (Repealed)140.TABLE L Services Qualifying for 10% Add-On to Surgical Incentive Add-On(Repealed)140.TABLE M Enhanced Rates for Maternal and Child Health Provider ServicesAUTHORITY: Implementing and authorized by Articles III, IV, V, VI and Section 12-13 of theIllinois Public Aid Code [305 ILCS 5/Arts. III, IV, V, VI and 12-13].SOURCE: Adopted at 3 Ill. Reg. 24, p. 166, effective June 10, 1979; rule repealed and new ruleadopted at 6 Ill. Reg. 8374, effective July 6, 1982; emergency amendment at 6 Ill. Reg. 8508,effective July 6, 1982, for a maximum of 150 days; amended at 7 Ill. Reg. 681, effectiveDecember 30, 1982; amended at 7 Ill. Reg. 7956, effective July 1, 1983; amended at 7 Ill. Reg.8308, effective July 1, 1983; amended at 7 Ill. Reg. 8271, effective July 5, 1983; emergencyamendment at 7 Ill. Reg. 8354, effective July 5, 1983, for a maximum of 150 days; amended at 7Ill. Reg. 8540, effective July 15, 1983; amended at 7 Ill. Reg. 9382, effective July 22, 1983;amended at 7 Ill. Reg. 12868, effective September 20, 1983; peremptory amendment at 7 Ill.Reg. 15047, effective October 31, 1983; amended at 7 Ill. Reg. 17358, effective December 21,1983; amended at 8 Ill. Reg. 254, effective December 21, 1983; emergency amendment at 8 Ill.Reg. 580, effective January 1, 1984, for a maximum of 150 days; codified at 8 Ill. Reg. 2483;amended at 8 Ill. Reg. 3012, effective February 22, 1984; amended at 8 Ill. Reg. 5262, effectiveApril 9, 1984; amended at 8 Ill. Reg. 6785, effective April 27, 1984; amended at 8 Ill. Reg. 6983,effective May 9, 1984; amended at 8 Ill. Reg. 7258, effective May 16, 1984; emergencyamendment at 8 Ill. Reg. 7910, effective May 22, 1984, for a maximum of 150 days; amended at8 Ill. Reg. 7910, effective June 1, 1984; amended at 8 Ill. Reg. 10032, effective June 18, 1984;emergency amendment at 8 Ill. Reg. 10062, effective June 20, 1984, for a maximum of 150 days;amended at 8 Ill. Reg. 13343, effective July 17, 1984; amended at 8 Ill. Reg. 13779, effectiveJuly 24, 1984; Sections 140.72 and 140.73 recodified to 89 Ill. Adm. Code 141 at 8 Ill. Reg.16354; amended (by adding sections being codified with no substantive change) at 8 Ill. Reg.17899; peremptory amendment at 8 Ill. Reg. 18151, effective September 18, 1984; amended at 8Ill. Reg. 21629, effective October 19, 1984; peremptory amendment at 8 Ill. Reg. 21677,effective October 24, 1984; amended at 8 Ill. Reg. 22097, effective October 24, 1984;peremptory amendment at 8 Ill. Reg. 22155, effective October 29, 1984; amended at 8 Ill. Reg.23218, effective November 20, 1984; emergency amendment at 8 Ill. Reg. 23721, effectiveNovember 21, 1984, for a maximum of 150 days; amended at 8 Ill. Reg. 25067, effectiveDecember 19, 1984; emergency amendment at 9 Ill. Reg. 407, effective January 1, 1985, for amaximum of 150 days; amended at 9 Ill. Reg. 2697, effective February 22, 1985; amended at 9Ill. Reg. 6235, effective April 19, 1985; amended at 9 Ill. Reg. 8677, effective May 28, 1985;amended at 9 Ill. Reg. 9564, effective June 5, 1985; amended at 9 Ill. Reg. 10025, effective June
  41. 41. ILLINOIS REGISTER 444513DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENT26, 1985; emergency amendment at 9 Ill. Reg. 11403, effective June 27, 1985, for a maximum of150 days; amended at 9 Ill. Reg. 11357, effective June 28, 1985; amended at 9 Ill. Reg. 12000,effective July 24, 1985; amended at 9 Ill. Reg. 12306, effective August 5, 1985; amended at 9 Ill.Reg. 13998, effective September 3, 1985; amended at 9 Ill. Reg. 14684, effective September 13,1985; amended at 9 Ill. Reg. 15503, effective October 4, 1985; amended at 9 Ill. Reg. 16312,effective October 11, 1985; amended at 9 Ill. Reg. 19138, effective December 2, 1985; amendedat 9 Ill. Reg. 19737, effective December 9, 1985; amended at 10 Ill. Reg. 238, effectiveDecember 27, 1985; emergency amendment at 10 Ill. Reg. 798, effective January 1, 1986, for amaximum of 150 days; amended at 10 Ill. Reg. 672, effective January 6, 1986; amended at 10 Ill.Reg. 1206, effective January 13, 1986; amended at 10 Ill. Reg. 3041, effective January 24, 1986;amended at 10 Ill. Reg. 6981, effective April 16, 1986; amended at 10 Ill. Reg. 7825, effectiveApril 30, 1986; amended at 10 Ill. Reg. 8128, effective May 7, 1986; emergency amendment at10 Ill. Reg. 8912, effective May 13, 1986, for a maximum of 150 days; amended at 10 Ill. Reg.11440, effective June 20, 1986; amended at 10 Ill. Reg. 14714, effective August 27, 1986;amended at 10 Ill. Reg. 15211, effective September 12, 1986; emergency amendment at 10 Ill.Reg. 16729, effective September 18, 1986, for a maximum of 150 days; amended at 10 Ill. Reg.18808, effective October 24, 1986; amended at 10 Ill. Reg. 19742, effective November 12, 1986;amended at 10 Ill. Reg. 21784, effective December 15, 1986; amended at 11 Ill. Reg. 698,effective December 19, 1986; amended at 11 Ill. Reg. 1418, effective December 31, 1986;amended at 11 Ill. Reg. 2323, effective January 16, 1987; amended at 11 Ill. Reg. 4002, effectiveFebruary 25, 1987; Section 140.71 recodified to 89 Ill. Adm. Code 141 at 11 Ill. Reg. 4302;amended at 11 Ill. Reg. 4303, effective March 6, 1987; amended at 11 Ill. Reg.7664, effectiveApril 15, 1987; emergency amendment at 11 Ill. Reg. 9342, effective April 20, 1987, for amaximum of 150 days; amended at 11 Ill. Reg. 9169, effective April 28, 1987; amended at 11 Ill.Reg. 10903, effective June 1, 1987; amended at 11 Ill. Reg. 11528, effective June 22, 1987;amended at 11 Ill. Reg. 12011, effective June 30, 1987; amended at 11 Ill. Reg. 12290, effectiveJuly 6, 1987; amended at 11 Ill. Reg. 14048, effective August 14, 1987; amended at 11 Ill. Reg.14771, effective August 25, 1987; amended at 11 Ill. Reg. 16758, effective September 28, 1987;amended at 11 Ill. Reg. 17295, effective September 30, 1987; amended at 11 Ill. Reg. 18696,effective October 27, 1987; amended at 11 Ill. Reg. 20909, effective December 14, 1987;amended at 12 Ill. Reg. 916, effective January 1, 1988; emergency amendment at 12 Ill. Reg.1960, effective January 1, 1988, for a maximum of 150 days; amended at 12 Ill. Reg. 5427,effective March 15, 1988; amended at 12 Ill. Reg. 6246, effective March 16, 1988; amended at12 Ill. Reg. 6728, effective March 22, 1988; Sections 140.900 thru 140.912 and 140.Table H and140.Table I recodified to 89 Ill. Adm. Code 147.5 thru 147.205 and 147.Table A and 147.TableB at 12 Ill. Reg. 6956; amended at 12 Ill. Reg. 6927, effective April 5, 1988; Sections 140.940thru 140.972 recodified to 89 Ill. Adm. Code 149.5 thru 149.325 at 12 Ill. Reg. 7401; amended at12 Ill. Reg. 7695, effective April 21, 1988; amended at 12 Ill. Reg. 10497, effective June 3,1988; amended at 12 Ill. Reg. 10717, effective June 14, 1988; emergency amendment at 12 Ill.
  42. 42. ILLINOIS REGISTER 444613DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENTReg. 11868, effective July 1, 1988, for a maximum of 150 days; amended at 12 Ill. Reg. 12509,effective July 15, 1988; amended at 12 Ill. Reg. 14271, effective August 29, 1988; emergencyamendment at 12 Ill. Reg. 16921, effective September 28, 1988, for a maximum of 150 days;amended at 12 Ill. Reg. 16738, effective October 5, 1988; amended at 12 Ill. Reg. 17879,effective October 24, 1988; amended at 12 Ill. Reg. 18198, effective November 4, 1988;amended at 12 Ill. Reg. 19396, effective November 6, 1988; amended at 12 Ill. Reg. 19734,effective November 15, 1988; amended at 13 Ill. Reg. 125, effective January 1, 1989; amendedat 13 Ill. Reg. 2475, effective February 14, 1989; amended at 13 Ill. Reg. 3069, effectiveFebruary 28, 1989; amended at 13 Ill. Reg. 3351, effective March 6, 1989; amended at 13 Ill.Reg. 3917, effective March 17, 1989; amended at 13 Ill. Reg. 5115, effective April 3, 1989;amended at 13 Ill. Reg. 5718, effective April 10, 1989; amended at 13 Ill. Reg. 7025, effectiveApril 24, 1989; Sections 140.850 thru 140.896 recodified to 89 Ill. Adm. Code 146.5 thru146.225 at 13 Ill. Reg. 7040; amended at 13 Ill. Reg. 7786, effective May 20, 1989; Sections140.94 thru 140.398 recodified to 89 Ill. Adm. Code 148.10 thru 148.390 at 13 Ill. Reg. 9572;emergency amendment at 13 Ill. Reg. 10977, effective July 1, 1989, for a maximum of 150 days;emergency expired November 28, 1989; amended at 13 Ill. Reg. 11516, effective July 3, 1989;amended at 13 Ill. Reg. 12119, effective July 7, 1989; Section 140.110 recodified to 89 Ill. Adm.Code 148.120 at 13 Ill. Reg. 12118; amended at 13 Ill. Reg. 12562, effective July 17, 1989;amended at 13 Ill. Reg. 14391, effective August 31, 1989; emergency amendment at 13 Ill. Reg.15473, effective September 12, 1989, for a maximum of 150 days; amended at 13 Ill. Reg.16992, effective October 16, 1989; amended at 14 Ill. Reg. 190, effective December 21, 1989;amended at 14 Ill. Reg. 2564, effective February 9, 1990; emergency amendment at 14 Ill. Reg.3241, effective February 14, 1990, for a maximum of 150 days; emergency expired July 14,1990; amended at 14 Ill. Reg. 4543, effective March 12, 1990; emergency amendment at 14 Ill.Reg. 4577, effective March 6, 1990, for a maximum of 150 days; emergency expired August 3,1990; emergency amendment at 14 Ill. Reg. 5575, effective April 1, 1990, for a maximum of 150days; emergency expired August 29, 1990; emergency amendment at 14 Ill. Reg. 5865, effectiveApril 3, 1990, for a maximum of 150 days; amended at 14 Ill. Reg. 7141, effective April 27,1990; emergency amendment at 14 Ill. Reg. 7249, effective April 27, 1990, for a maximum of150 days; amended at 14 Ill. Reg. 10062, effective June 12, 1990; amended at 14 Ill. Reg. 10409,effective June 19, 1990; emergency amendment at 14 Ill. Reg. 12082, effective July 5, 1990, fora maximum of 150 days; amended at 14 Ill. Reg. 13262, effective August 6, 1990; emergencyamendment at 14 Ill. Reg. 14184, effective August 16, 1990, for a maximum of 150 days;emergency amendment at 14 Ill. Reg. 14570, effective August 22, 1990, for a maximum of 150days; amended at 14 Ill. Reg. 14826, effective August 31, 1990; amended at 14 Ill. Reg. 15366,effective September 12, 1990; amended at 14 Ill. Reg. 15981, effective September 21, 1990;amended at 14 Ill. Reg. 17279, effective October 12, 1990; amended at 14 Ill. Reg. 18057,effective October 22, 1990; amended at 14 Ill. Reg. 18508, effective October 30, 1990; amendedat 14 Ill. Reg. 18813, effective November 6, 1990; Notice of Corrections to Adopted
  43. 43. ILLINOIS REGISTER 444713DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENTAmendment at 15 Ill. Reg. 1174; amended at 14 Ill. Reg. 20478, effective December 7, 1990;amended at 14 Ill. Reg. 20729, effective December 12, 1990; amended at 15 Ill. Reg. 298,effective December 28, 1990; emergency amendment at 15 Ill. Reg. 592, effective January 1,1991, for a maximum of 150 days; amended at 15 Ill. Reg. 1051, effective January 18, 1991;amended at 15 Ill. Reg. 6220, effective April 18, 1991; amended at 15 Ill. Reg. 6534, effectiveApril 30, 1991; amended at 15 Ill. Reg. 8264, effective May 23, 1991; amended at 15 Ill. Reg.8972, effective June 17, 1991; amended at 15 Ill. Reg. 10114, effective June 21, 1991; amendedat 15 Ill. Reg. 10468, effective July 1, 1991; amended at 15 Ill. Reg. 11176, effective August 1,1991; emergency amendment at 15 Ill. Reg. 11515, effective July 25, 1991, for a maximum of150 days; emergency expired December 22, 1991; emergency amendment at 15 Ill. Reg. 12919,effective August 15, 1991, for a maximum of 150 days; emergency expired January 12, 1992;emergency amendment at 15 Ill. Reg. 16366, effective October 22, 1991, for a maximum of 150days; amended at 15 Ill. Reg. 17318, effective November 18, 1991; amended at 15 Ill. Reg.17733, effective November 22, 1991; emergency amendment at 16 Ill. Reg. 300, effectiveDecember 20, 1991, for a maximum of 150 days; amended at 16 Ill. Reg. 174, effectiveDecember 24, 1991; amended at 16 Ill. Reg. 1877, effective January 24, 1992; amended at 16 Ill.Reg. 3552, effective February 28, 1992; amended at 16 Ill. Reg. 4006, effective March 6, 1992;amended at 16 Ill. Reg. 6408, effective March 20, 1992; expedited correction at 16 Ill. Reg.11348, effective March 20, 1992; amended at 16 Ill. Reg. 6849, effective April 7, 1992; amendedat 16 Ill. Reg. 7017, effective April 17, 1992; amended at 16 Ill. Reg. 10050, effective June 5,1992; amended at 16 Ill. Reg. 11174, effective June 26, 1992; emergency amendment at 16 Ill.Reg. 11947, effective July 10, 1992, for a maximum of 150 days; amended at 16 Ill. Reg. 12186,effective July 24, 1992; emergency amendment at 16 Ill. Reg. 13337, effective August 14, 1992,for a maximum of 150 days; emergency amendment at 16 Ill. Reg. 15109, effective September21, 1992, for a maximum of 150 days; amended at 16 Ill. Reg. 15561, effective September 30,1992; amended at 16 Ill. Reg. 17302, effective November 2, 1992; emergency amendment at 16Ill. Reg. 18097, effective November 17, 1992, for a maximum of 150 days; amended at 16 Ill.Reg. 19146, effective December 1, 1992; expedited correction at 17 Ill. Reg. 7078, effectiveDecember 1, 1992; amended at 16 Ill. Reg. 19879, effective December 7, 1992; amended at 17Ill. Reg. 837, effective January 11, 1993; amended at 17 Ill. Reg. 1112, effective January 15,1993; amended at 17 Ill. Reg. 2290, effective February 15, 1993; amended at 17 Ill. Reg. 2951,effective February 17, 1993; amended at 17 Ill. Reg. 3421, effective February 19, 1993; amendedat 17 Ill. Reg. 6196, effective April 5, 1993; amended at 17 Ill. Reg. 6839, effective April 21,1993; amended at 17 Ill. Reg. 7004, effective May 17, 1993; emergency amendment at 17 Ill.Reg. 11201, effective July 1, 1993, for a maximum of 150 days; emergency amendment at 17 Ill.Reg. 15162, effective September 2, 1993, for a maximum of 150 days; emergency amendmentsuspended at 17 Ill. Reg. 18902, effective October 12, 1993; emergency amendment at 17 Ill.Reg. 18152, effective October 1, 1993, for a maximum of 150 days; amended at 17 Ill. Reg.18571, effective October 8, 1993; emergency amendment at 17 Ill. Reg. 18611, effective October
  44. 44. ILLINOIS REGISTER 444813DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENT1, 1993, for a maximum of 150 days; amended at 17 Ill. Reg. 20999, effective November 24,1993; emergency amendment repealed at 17 Ill. Reg. 22583, effective December 20, 1993;amended at 18 Ill. Reg. 3620, effective February 28, 1994; amended at 18 Ill. Reg. 4250,effective March 4, 1994; amended at 18 Ill. Reg. 5951, effective April 1, 1994; emergencyamendment at 18 Ill. Reg. 10922, effective July 1, 1994, for a maximum of 150 days; emergencyamendment suspended at 18 Ill. Reg. 17286, effective November 15, 1994; emergencyamendment repealed at 19 Ill. Reg. 5839, effective April 4, 1995; amended at 18 Ill. Reg. 11244,effective July 1, 1994; amended at 18 Ill. Reg. 14126, effective August 29, 1994; amended at 18Ill. Reg. 16675, effective November 1, 1994; amended at 18 Ill. Reg. 18059, effective December19, 1994; amended at 19 Ill. Reg. 1082, effective January 20, 1995; amended at 19 Ill. Reg.2933, effective March 1, 1995; emergency amendment at 19 Ill. Reg. 3529, effective March 1,1995, for a maximum of 150 days; amended at 19 Ill. Reg. 5663, effective April 1, 1995;amended at 19 Ill. Reg. 7919, effective June 5, 1995; emergency amendment at 19 Ill. Reg. 8455,effective June 9, 1995, for a maximum of 150 days; emergency amendment at 19 Ill. Reg. 9297,effective July 1, 1995, for a maximum of 150 days; emergency amendment at 19 Ill. Reg. 10252,effective July 1, 1995, for a maximum of 150 days; amended at 19 Ill. Reg. 13019, effectiveSeptember 5, 1995; amended at 19 Ill. Reg. 14440, effective September 29, 1995; emergencyamendment at 19 Ill. Reg. 14833, effective October 6, 1995, for a maximum of 150 days;amended at 19 Ill. Reg. 15441, effective October 26, 1995; amended at 19 Ill. Reg. 15692,effective November 6, 1995; amended at 19 Ill. Reg. 16677, effective November 28, 1995;amended at 20 Ill. Reg. 1210, effective December 29, 1995; amended at 20 Ill. Reg. 4345,effective March 4, 1996; amended at 20 Ill. Reg. 5858, effective April 5, 1996; amended at 20Ill. Reg. 6929, effective May 6, 1996; amended at 20 Ill. Reg. 7922, effective May 31, 1996;amended at 20 Ill. Reg. 9081, effective June 28, 1996; emergency amendment at 20 Ill. Reg.9312, effective July 1, 1996, for a maximum of 150 days; amended at 20 Ill. Reg. 11332,effective August 1, 1996; amended at 20 Ill. Reg. 14845, effective October 31, 1996; emergencyamendment at 21 Ill. Reg. 705, effective December 31, 1996, for a maximum of 150 days;emergency amendment at 21 Ill. Reg. 3734, effective March 5, 1997, for a maximum of 150days; amended at 21 Ill. Reg. 4777, effective April 2, 1997; amended at 21 Ill. Reg. 6899,effective May 23, 1997; amended at 21 Ill. Reg. 9763, effective July 15, 1997; amended at 21 Ill.Reg. 11569, effective August 1, 1997; emergency amendment at 21 Ill. Reg. 13857, effectiveOctober 1, 1997, for a maximum of 150 days; amended at 22 Ill. Reg. 1416, effective December29, 1997; amended at 22 Ill. Reg. 4412, effective February 27, 1998; amended at 22 Ill. Reg.7024, effective April 1, 1998; amended at 22 Ill. Reg. 10606, effective June 1, 1998; emergencyamendment at 22 Ill. Reg. 13117, effective July 1, 1998, for a maximum of 150 days; amended at22 Ill. Reg. 16302, effective August 28, 1998; amended at 22 Ill. Reg. 18979, effectiveSeptember 30, 1998; amended at 22 Ill. Reg. 19898, effective October 30, 1998; emergencyamendment at 22 Ill. Reg. 22108, effective December 1, 1998, for a maximum of 150 days;emergency expired April 29, 1999; amended at 23 Ill. Reg. 5796, effective April 30, 1999;
  45. 45. ILLINOIS REGISTER 444913DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENTamended at 23 Ill. Reg. 7122, effective June 1, 1999; emergency amendment at 23 Ill. Reg. 8236,effective July 1, 1999, for a maximum of 150 days; amended at 23 Ill. Reg. 9874, effectiveAugust 3, 1999; amended at 23 Ill. Reg. 12697, effective October 1, 1999; amended at 23 Ill.Reg. 13646, effective November 1, 1999; amended at 23 Ill. Reg. 14567, effective December 1,1999; amended at 24 Ill. Reg. 661, effective January 3, 2000; amended at 24 Ill. Reg. 10277,effective July 1, 2000; emergency amendment at 24 Ill. Reg. 10436, effective July 1, 2000, for amaximum of 150 days; amended at 24 Ill. Reg. 15086, effective October 1, 2000; amended at 24Ill. Reg. 18320, effective December 1, 2000; emergency amendment at 24 Ill. Reg. 19344,effective December 15, 2000, for a maximum of 150 days; amended at 25 Ill. Reg. 3897,effective March 1, 2001; amended at 25 Ill. Reg. 6665, effective May 11, 2001; amended at 25Ill. Reg. 8793, effective July 1, 2001; emergency amendment at 25 Ill. Reg. 8850, effective July1, 2001, for a maximum of 150 days; amended at 25 Ill. Reg. 11880, effective September 1,2001; amended at 25 Ill. Reg. 12820, effective October 8, 2001; amended at 25 Ill. Reg. 14957,effective November 1, 2001; emergency amendment at 25 Ill. Reg. 16127, effective November28, 2001, for a maximum of 150 days; emergency amendment at 25 Ill. Reg. 16292, effectiveDecember 3, 2001, for a maximum of 150 days; emergency amendment at 26 Ill. Reg. 514,effective January 1, 2002, for a maximum of 150 days; amended at 26 Ill. Reg. 663, effectiveJanuary 7, 2002; amended at 26 Ill. Reg. 4781, effective March 15, 2002; emergency amendmentat 26 Ill. Reg. 5984, effective April 15, 2002, for a maximum of 150 days; amended at 26 Ill.Reg. 7285, effective April 29, 2002; emergency amendment at 26 Ill. Reg. 8594, effective June1, 2002, for a maximum of 150 days; emergency amendment at 26 Ill. Reg. 11259, effective July1, 2002, for a maximum of 150 days; emergency amendment at 26 Ill. Reg. 12461, effective July29, 2002, for a maximum of 150 days; emergency amendment repealed at 26 Ill. Reg. 16593,effective October 22, 2002; emergency amendment at 26 Ill. Reg. 12772, effective August 12,2002, for a maximum of 150 days; amended at 26 Ill. Reg. 13641, effective September 3, 2002;amended at 26 Ill. Reg. 14789, effective September 26, 2002; emergency amendment at 26 Ill.Reg. 15076, effective October 1, 2002, for a maximum of 150 days; amended at 26 Ill. Reg.16303, effective October 25, 2002; amended at 26 Ill. Reg. 17751, effective November 27, 2002;amended at 27 Ill. Reg. 768, effective January 3, 2003; amended at 27 Ill. Reg. 3041, effectiveFebruary 10, 2003; amended at 27 Ill. Reg. 4364, effective February 24, 2003; amended at 27 Ill.Reg. 7823, effective May 1, 2003; amended at 27 Ill. Reg. 9157, effective June 2, 2003;emergency amendment at 27 Ill. Reg. 10813, effective July 1, 2003, for a maximum of 150 days;amended at 27 Ill. Reg. 13784, effective August 1, 2003; amended at 27 Ill. Reg. 14799,effective September 5, 2003; emergency amendment at 27 Ill. Reg. 15584, effective September20, 2003, for a maximum of 150 days; emergency amendment at 27 Ill. Reg. 16161, effectiveOctober 1, 2003, for a maximum of 150 days; amended at 27 Ill. Reg. 18629, effectiveNovember 26, 2003; amended at 28 Ill. Reg. 2744, effective February 1, 2004; amended at 28 Ill.Reg. 4958, effective March 3, 2004; emergency amendment at 28 Ill. Reg. 6622, effective April19, 2004, for a maximum of 150 days; amended at 28 Ill. Reg. 7081, effective May 3, 2004;
  46. 46. ILLINOIS REGISTER 445013DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENTemergency amendment at 28 Ill. Reg. 8108, effective June 1, 2004, for a maximum of 150 days;amended at 28 Ill. Reg. 9640, effective July 1, 2004; emergency amendment at 28 Ill. Reg.10135, effective July 1, 2004, for a maximum of 150 days; amended at 28 Ill. Reg. 11161,effective August 1, 2004; emergency amendment at 28 Ill. Reg. 12198, effective August 11,2004, for a maximum of 150 days; amended at 28 Ill. Reg. 13775, effective October 1, 2004;amended at 28 Ill. Reg. 14804, effective October 27, 2004; amended at 28 Ill. Reg. 15513,effective November 24, 2004; amended at 29 Ill. Reg. 831, effective January 1, 2005; amendedat 29 Ill. Reg. 6945, effective May 1, 2005; emergency amendment at 29 Ill. Reg. 8509, effectiveJune 1, 2005, for a maximum of 150 days; emergency amendment at 29 Ill. Reg. 12534, effectiveAugust 1, 2005, for a maximum of 150 days; amended at 29 Ill. Reg. 14957, effective September30, 2005; emergency amendment at 29 Ill. Reg. 15064, effective October 1, 2005, for amaximum of 150 days; emergency amendment repealed by emergency rulemaking at 29 Ill. Reg.15985, effective October 5, 2005, for the remainder of the maximum 150 days; emergencyamendment at 29 Ill. Reg. 15610, effective October 1, 2005, for a maximum of 150 days;emergency amendment at 29 Ill. Reg. 16515, effective October 5, 2005, for a maximum of 150days; amended at 30 Ill. Reg. 349, effective December 28, 2005; emergency amendment at 30 Ill.Reg. 573, effective January 1, 2006, for a maximum of 150 days; amended at 30 Ill. Reg. 796,effective January 1, 2006; amended at 30 Ill. Reg. 2802, effective February 24, 2006; amended at30 Ill. Reg. 10370, effective May 26, 2006; emergency amendment at 30 Ill. Reg. 12376,effective July 1, 2006, for a maximum of 150 days; emergency amendment at 30 Ill. Reg. 13909,effective August 2, 2006, for a maximum of 150 days; amended at 30 Ill. Reg. 14280, effectiveAugust 18, 2006; expedited correction at 31 Ill. Reg. 1745, effective August 18, 2006;emergency amendment at 30 Ill. Reg. 17970, effective November 1, 2006, for a maximum of 150days; amended at 30 Ill. Reg. 18648, effective November 27, 2006; emergency amendment at 30Ill. Reg. 19400, effective December 1, 2006, for a maximum of 150 days; amended at 31 Ill.Reg. 388, effective December 29, 2006; emergency amendment at 31 Ill. Reg. 1580, effectiveJanuary 1, 2007, for a maximum of 150 days; amended at 31 Ill. Reg. 2413, effective January 19,2007; amended at 31 Ill. Reg. 5561, effective March 30, 2007; amended at 31 Ill. Reg. 6930,effective April 29, 2007; amended at 31 Ill. Reg. 8485, effective May 30, 2007; emergencyamendment at 31 Ill. Reg. 10115, effective June 30, 2007, for a maximum of 150 days; amendedat 31 Ill. Reg. 14749, effective October 22, 2007; emergency amendment at 32 Ill. Reg. 383,effective January 1, 2008, for a maximum of 150 days; peremptory amendment at 32 Ill. Reg.6743, effective April 1, 2008; peremptory amendment suspended at 32 Ill. Reg. 8449, effectiveMay 21, 2008; suspension withdrawn by the Joint Committee on Administrative Rules at 32 Ill.Reg. 18323, effective November 12, 2008; peremptory amendment repealed by emergencyrulemaking at 32 Ill. Reg. 18422, effective November 12, 2008, for a maximum of 150 days;emergency expired April 10, 2009; peremptory amendment repealed at 33 Ill. Reg. 6667,effective April 29, 2009; amended at 32 Ill. Reg. 7727, effective May 5, 2008; emergencyamendment at 32 Ill. Reg. 10480, effective July 1, 2008, for a maximum of 150 days; emergency
  47. 47. ILLINOIS REGISTER 445113DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENTexpired November 27, 2008; amended at 32 Ill. Reg. 17133, effective October 15, 2008;amended at 33 Ill. Reg. 209, effective December 29, 2008; amended at 33 Ill. Reg. 9048,effective June 15, 2009; emergency amendment at 33 Ill. Reg. 10800, effective June 30, 2009,for a maximum of 150 days; amended at 33 Ill. Reg. 11287, effective July 14, 2009; amended at33 Ill. Reg. 11938, effective August 17, 2009; amended at 33 Ill. Reg. 12227, effective October1, 2009; emergency amendment at 33 Ill. Reg. 14324, effective October 1, 2009, for a maximumof 150 days; emergency expired February 27, 2010; amended at 33 Ill. Reg. 16573, effectiveNovember 16, 2009; amended at 34 Ill. Reg. 516, effective January 1, 2010; amended at 34 Ill.Reg. 903, effective January 29, 2010; amended at 34 Ill. Reg. 3761, effective March 14, 2010;amended at 34 Ill. Reg. 5215, effective March 25, 2010; amended at 34 Ill. Reg. 19517, effectiveDecember 6, 2010; amended at 35 Ill. Reg. 394, effective December 27, 2010; amended at 35 Ill.Reg. 7648, effective May 1, 2011; amended at 35 Ill. Reg. 7962, effective May 1, 2011;amended at 35 Ill. Reg. 10000, effective June 15, 2011; amended at 35 Ill. Reg. 12909, effectiveJuly 25, 2011; amended at 36 Ill. Reg. 2271, effective February 1, 2012; amended at 36 Ill. Reg.7010, effective April 27, 2012; amended at 36 Ill. Reg. 7545, effective May 7, 2012; amended at36 Ill. Reg. 9113, effective June 11, 2012; emergency amendment at 36 Ill. Reg. 11329, effectiveJuly 1, 2012 through June 30, 2013; emergency amendment to Section 140.442(e)(4) suspendedat 36 Ill. Reg. 13736, effective August 15, 2012; suspension withdrawn from Section140.442(e)(4) at 36 Ill. Reg. 14529, September 11, 2012; emergency amendment in response toJoint Committee on Administrative Rules action on Section 140.442(e)(4) at 36 Ill. Reg. 14820,effective September 21, 2012 through June 30, 2013; emergency amendment to Section 140.491suspended at 36 Ill. Reg. 13738, effective August 15, 2012; suspension withdrawn by the JointCommittee on Administrative Rules from Section 140.491 at 37 Ill. Reg. 890, January 8, 2013;emergency amendment in response to Joint Committee on Administrative Rules action onSection 140.491 at 37 Ill. Reg. 1330, effective January 15, 2013 through June 30, 2013; amendedat 36 Ill. Reg. 15361, effective October 15, 2012; emergency amendment at 37 Ill. Reg. 253,effective January 1, 2013 through June 30, 2013; emergency amendment at 37 Ill. Reg. 846,effective January 9, 2013 through June 30, 2013; emergency amendment at 37 Ill. Reg. 1774,effective January 28, 2013 through June 30, 2013; emergency amendment at 37 Ill. Reg. 2348,effective February 1, 2013 through June 30, 2013; amended at 37 Ill. Reg. 3831, effective March13, 2013; emergency amendment at 37 Ill. Reg. 5058, effective April 1, 2013 through June 30,2013; amended at 37 Ill. Reg. ______, effective ____________.SUBPART D: PAYMENT FOR NON-INSTITUTIONAL SERVICESSection 140.402 Copayments for Noninstitutional Medical ServicesThe following implements cost sharing in compliance with 42 USC 1396o (section 1916 of theSocial Security Act):
  48. 48. ILLINOIS REGISTER 445213DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENTa) Effective July 1, 20132003, each recipient, with the exception of those classes ofrecipients identified in subsection (d) of this Section, may be required to pay acopayment of $2.00 for generic legend drugs and over-the-counter drugs billed tothe Department, and for other services, with the exception of those servicesidentified in subsection (e), the nominal copayment amount as defined at 42 CFR447.54. Specific copayment amounts are described and updated on theDepartments Web site for the following specified copayment for noninstitutionalmedical services:1) Practitioner office visits. Each office visit to a chiropractor, podiatrist,optometrist, or a physician licensed to practice medicine in all its branchesbilled to the Department, with the exception of those office visits forservices identified in subsection (e) of this Section, may require acopayment of $2.00.2) Each brand name legend drug billed to the Department, with the exceptionof drugs identified in subsection (e) of this Section, may require acopayment of $3.00.3) Each encounter billed to the Department by an Encounter Rate Clinic(ERC), Federally Qualified Health Center (FQHC) or Rural Health Clinic(RHC).b) In each instance where a copayment is payable, the Department will reduce theamount payable to the affected provider by the respective amount of the requiredcopayment.c) No provider of services listed in subsection (a) of this Section may deny service toan individual who is eligible for service on account of the individuals inability topay the cost of a copayment.d) The following individuals receiving medical assistance are exempt from thecopayment requirement set forth in subsection (a) of this Section:1) Pregnant women, including a postpartum period of 60 days.2) Children under 19 years of age.
  49. 49. ILLINOIS REGISTER 445313DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENT3) All noninstitutionalized individuals whose care is subsidized by theDepartment of Children and Family Services or the Department ofCorrections.4) Hospice patients.5) Individuals residing in hospitals, nursing facilities, and intermediate carefacilities for the developmentally disabled who, as a condition of receivingservices, are required to pay all of their income, except an authorizedprotected amount for personal use, for the cost of their care. For thepurpose of this subsection (d)(5), the protected amount shall be no greaterthan the protected amount authorized for personal use under 89 Ill. Adm.Code 146.225(c).mentally retarded.6) Residents of a State-certified, State-licensed, or State-contractedresidential care program where residents, as a condition of receiving carein that program, are required to pay all of their income, except anauthorized protected amount for personal use, for the cost of theirresidential care program. For the purpose of this subsection (d)(6), theprotected amount shall be no greater than the protected amount authorizedfor personal use under 89 Ill. Adm. Code 146.225(c).7) Individuals enrolled in the "Health Benefits for Person with Breast orCervical Cancer" program under 89 Ill. Adm. Code 120.500.8) American Indians or Alaskan Natives.e) The following medical services are exempt from any copayments:1) Renal dialysis treatment.2) Radiation therapy.3) Cancer chemotherapy.4) InsulinUse of insulin.5) Services for which Medicare is the primary payer.
  50. 50. ILLINOIS REGISTER 445413DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENT6) Over-the-counter drugs.6)7) Emergency services as defined at 42 USC 1396u-2(b)(2) (section1932(b)(2) of the Social Security Act) and 42 CFR 438.114(a)42 CFR447.53(b)(4).7)8) Any pharmacy compounded drugs.8)9) Any prescription (legend drug) dispensed or administered by a hospital,clinic or physician.9)10) Family planning services and supplies described in 42 USC1396d(a)(4)(C) (section 1905(a)(4)(C) of the Social Security Act),including contraceptives and other pharmaceuticals for which the Stateclaims or could claim federal match at the enhanced rate under 42 USC1396b(a)(5) (section 1903(a)(5) of the Social Security Act) for familyplanning services and supplies.10)11) Other therapeutic drug classes as specified by the Department.(Source: Amended at 37 Ill. Reg. ______, effective ____________)
  51. 51. ILLINOIS REGISTER 445513DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESNOTICE OF PROPOSED AMENDMENT1) Heading of the Part: Hospital Services2) Code Citation: 89 Ill. Adm. Code 1483) Section Number: Proposed Action:148.190 Amendment4) Statutory Authority: Section 12-13 of the Illinois Public Aid Code [305 ILCS 5/12-13]5) Complete Description of the Subjects and Issues Involved: These administrativerules are authorized by the SMART Act which mandates adjustments to co-paysand any rate of reimbursement for services or other payments or alteration of anymethodologies authorized by the Public Aid Code to reduce any rate ofreimbursement for services or other payments.6) Published studies or reports, and sources of underlying data, used to compose thisrulemaking: None7) Will this rulemaking replace any emergency rulemaking currently in effect? Yes8) Does this rulemaking contain an automatic repeal date? No9) Does this rulemaking contain incorporations by reference? No10) Are there any other proposed rulemakings pending on this Part? YesSections Proposed Action Illinois Register Citation148.70 Amendment 36 Ill. Reg. 8117; June 1, 2012148.70 Amendment 37 Ill. Reg. 1018; February 1, 2013148.117 Amendment 37 Ill. Reg. 1018; February 1, 2013148.126 Amendment 37 Ill. Reg. 1018; February 1, 2013148.140 Amendment 37 Ill. Reg. 1018; February 1, 2013148.240 Amendment 37 Ill. Reg. 1018; February 1, 2013148.285 Repealed 37 Ill. Reg. 1018; February 1, 2013148.295 Amendment 37 Ill. Reg. 1018; February 1, 2013148.458 Amendment 37 Ill. Reg. 1018; February 1, 2013148.510 Amendment 37 Ill. Reg. 1018; February 1, 201311) Statement of Statewide Policy Objectives: This rulemaking does not affect units of localgovernment.

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