Illinois HB 1256: EDUCATION-TECH

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 Full Text of HB1256

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104TH GENERAL ASSEMBLY 
State of Illinois 
2025 and 2026
HB1256

Introduced 1/28/2025, by Rep. Dan Ugaste 

SYNOPSIS AS INTRODUCED:

820 ILCS 305/8.2

 Amends the Workers' Compensation Act in relation to custom compound medications. Sets forth conditions for approval of payment. Provides that charges shall be based upon the specific amount of each component drug and its original manufacturer's National Drug Code number and also upon specified criteria. Provides that a provider may prescribe a one-time 7-day supply unless a prescription for more than 7 days is preauthorized by the employer. Effective immediately.

LRB104 06147 SPS 16181 b

A BILL FOR

HB1256LRB104 06147 SPS 16181 b

1 AN ACT concerning employment.

2 Be it enacted by the People of the State of Illinois, 

3represented in the General Assembly:

4 Section 5. The Workers' Compensation Act is amended by 

5changing Section 8.2 as follows:

6 (820 ILCS 305/8.2)

7 Sec. 8.2. Fee schedule. 

8 (a) Except as provided for in subsection (c), for 

9procedures, treatments, or services covered under this Act and 

10rendered or to be rendered on and after February 1, 2006, the 

11maximum allowable payment shall be 90% of the 80th percentile 

12of charges and fees as determined by the Commission utilizing 

13information provided by employers' and insurers' national 

14databases, with a minimum of 12,000,000 Illinois line item 

15charges and fees comprised of health care provider and 

16hospital charges and fees as of August 1, 2004 but not earlier 

17than August 1, 2002. These charges and fees are provider 

18billed amounts and shall not include discounted charges. The 

1980th percentile is the point on an ordered data set from low to 

20high such that 80% of the cases