Bill Sponsors: IL HB0465 | 2019-2020 | 101st General Assembly

Bill Title: Reinserts the provisions of House Amendment No. 1, but with the following changes: Further amends the Illinois Insurance Code. In a provision concerning contracts between health insurers and pharmacy benefit managers, provides that such contracts must require pharmacy benefit managers to: (1) update maximum allowable cost pricing information at least every 7 calendar days; (2) provide access to its maximum allowable cost list to each pharmacy or pharmacy services administrative organization, as defined, subject to the maximum allowable cost list; (4) provide a process by which a contracted pharmacy can appeal the provider's reimbursement for a drug subject to maximum allowable cost pricing; and other matters. Regarding a drug on the maximum allowable cost list, requires pharmacy benefits managers to ensure that: (i) if a drug is a generically equivalent drug, it is listed as therapeutically equivalent and pharmaceutically equivalent to certain rating standards; (ii) the drug is available for purchase by each pharmacy in the State from national or regional wholesalers operating in Illinois; and (ii) the drug is not obsolete (rather than requiring a drug to have at least 3 or more nationally available, therapeutically equivalent, multiple source generic drugs with a significant cost difference and be available for purchase without limitations by all pharmacies in the State from national or regional wholesalers). Permits the Director of Insurance to examine a pharmacy benefit manager's designee, representative, or other specified persons (rather than any individual) about the business of the pharmacy benefit manager. Contains provisions concerning the denial of a pharmacy benefits manager's registration application or the suspension or revocation of a pharmacy benefits manager's registration. Defines terms. Further amends the Managed Care Reform and Patient Rights Act. Makes changes to the definition of "emergency medical condition". Removes changes made to a provision concerning the denial of coverage and payment for emergency services provided without prior authorization or an approved plan. Further amends the Illinois Public Aid Code. Makes changes to certain reporting requirements imposed on the Director of Healthcare and Family Services. Requires a pharmacy benefit manager to make certain disclosures to the Department of Healthcare and Family Services upon request. Requires a pharmacy benefit manager to make certain written disclosures to a pharmacy provider or pharmacy services administrative organization. Defines "pharmacy services administrative organization." Requires the Department to adopt rules establishing reasonable dispensing fees for fee-for-service payments in accordance with guidance or guidelines from the federal Centers for Medicare and Medicaid Services.

Spectrum: Slight Partisan Bill (Democrat 34-17)

Status: (Passed) 2019-08-23 - Public Act . . . . . . . . . 101-0452 [HB0465 Detail]

Text: Latest bill text (Chaptered) [HTML]

Sponsors

NameTypeSponsorshipDistrictFinancialEncyclopediaBiography
Representative Gregory Harris [D]PrimarySponsored BillsHD-013FollowTheMoneyBallotpediaVoteSmart
Representative Christopher Davidsmeyer [R]CosponsorSponsored BillsHD-100FollowTheMoneyBallotpediaVoteSmart
Representative Anna Moeller [D]CosponsorSponsored BillsHD-043FollowTheMoneyBallotpediaVoteSmart
Representative Elizabeth Hernandez [D]CosponsorSponsored BillsHD-024FollowTheMoneyBallotpediaVoteSmart
Representative Darren Bailey [R]CosponsorSponsored BillsHD-109FollowTheMoneyBallotpediaVoteSmart
Representative Monica Bristow [D]CosponsorSponsored BillsHD-111FollowTheMoneyBallotpediaVoteSmart
Representative Mark Walker [D]CosponsorSponsored BillsHD-053FollowTheMoneyBallotpediaVoteSmart
Representative Michael Zalewski [D]CosponsorSponsored BillsHD-023FollowTheMoneyBallotpediaVoteSmart
Representative Ann Williams [D]CosponsorSponsored BillsHD-011FollowTheMoneyBallotpediaVoteSmart
Representative Martin Moylan [D]CosponsorSponsored BillsHD-055FollowTheMoneyBallotpediaVoteSmart
Representative Will Guzzardi [D]CosponsorSponsored BillsHD-039FollowTheMoneyBallotpediaVoteSmart
Representative Robyn Gabel [D]CosponsorSponsored BillsHD-018FollowTheMoneyBallotpediaVoteSmart
Senator Robert Martwick [D]CosponsorSponsored BillsSD-010FollowTheMoneyBallotpediaVoteSmart
Representative Michael Halpin [D]CosponsorSponsored BillsHD-072FollowTheMoneyBallotpediaVoteSmart
Representative Jaime Andrade [D]CosponsorSponsored BillsHD-040FollowTheMoneyBallotpediaVoteSmart
Representative Jerry Costello [D]CosponsorSponsored BillsHD-116FollowTheMoneyBallotpediaVoteSmart
Representative Emanuel Welch [D]CosponsorSponsored BillsHD-007FollowTheMoneyBallotpediaVoteSmart
Representative Dan Caulkins [R]CosponsorSponsored BillsHD-101FollowTheMoneyBallotpediaVoteSmart
Representative Mike Murphy [R]CosponsorSponsored BillsHD-099FollowTheMoneyBallotpediaVoteSmart
Representative Grant Wehrli [R]CosponsorSponsored BillsHD-041FollowTheMoneyBallotpediaVoteSmart
Senator Sara Feigenholtz [D]CosponsorSponsored BillsSD-006FollowTheMoneyBallotpediaVoteSmart
Representative Dave Severin [R]CosponsorSponsored BillsHD-117FollowTheMoneyBallotpediaVoteSmart
Representative Brad Halbrook [R]CosponsorSponsored BillsHD-110FollowTheMoneyBallotpediaVoteSmart
Representative Kelly Burke [D]CosponsorSponsored BillsHD-036FollowTheMoneyBallotpediaVoteSmart
Representative Thomas Bennett [R]CosponsorSponsored BillsHD-106FollowTheMoneyBallotpediaVoteSmart
Representative Yehiel Kalish [D]CosponsorSponsored BillsHD-016FollowTheMoneyBallotpediaVoteSmart
Representative Keith Sommer [R]CosponsorSponsored BillsHD-088FollowTheMoneyBallotpediaVoteSmart
Representative Carol Ammons [D]CosponsorSponsored BillsHD-103FollowTheMoneyBallotpediaVoteSmart
Senator Celina Villanueva [D]CosponsorSponsored BillsSD-011FollowTheMoneyBallotpediaVoteSmart
Representative Delia Ramirez [D]CosponsorSponsored BillsHD-004FollowTheMoneyBallotpediaVoteSmart
Representative Kelly Cassidy [D]CosponsorSponsored BillsHD-014FollowTheMoneyBallotpediaVoteSmart
Representative Anne Stava-Murray [D]CosponsorSponsored BillsHD-081FollowTheMoneyBallotpediaVoteSmart
Representative Jennifer Gong-Gershowitz [D]CosponsorSponsored BillsHD-017FollowTheMoneyBallotpediaVoteSmart
Representative Lamont Robinson [D]CosponsorSponsored BillsHD-005FollowTheMoneyBallotpediaVoteSmart
Representative Maurice West [D]CosponsorSponsored BillsHD-067FollowTheMoneyBallotpediaVoteSmart
Representative Joyce Mason [D]CosponsorSponsored BillsHD-061FollowTheMoneyBallotpediaVoteSmart
Representative Aaron Ortiz [D]CosponsorSponsored BillsHD-001FollowTheMoneyBallotpediaVoteSmart
Representative Timothy Butler [R]CosponsorSponsored BillsHD-087FollowTheMoneyBallotpediaVoteSmart
Senator Andy Manar [D]PrimarySponsored BillsSD-048FollowTheMoneyBallotpediaVoteSmart
Senator Linda Holmes [D]CosponsorSponsored BillsSD-042FollowTheMoneyBallotpediaVoteSmart
Senator Dale Fowler [R]CosponsorSponsored BillsSD-059FollowTheMoneyBallotpediaVoteSmart
Senator Laura Murphy [D]CosponsorSponsored BillsSD-028FollowTheMoneyBallotpediaVoteSmart
Senator Melinda Bush [D]CosponsorSponsored BillsSD-031FollowTheMoneyBallotpediaVoteSmart
Senator Dan McConchie [R]CosponsorSponsored BillsSD-026FollowTheMoneyBallotpediaVoteSmart
Senator Jennifer Bertino-Tarrant [D]CosponsorSponsored BillsSD-049FollowTheMoneyBallotpediaVoteSmart
Senator Susan Rezin [R]CosponsorSponsored BillsSD-038FollowTheMoneyBallotpediaVoteSmart
Senator Steve McClure [R]CosponsorSponsored BillsSD-050FollowTheMoneyBallotpediaVoteSmart
Senator Paul Schimpf [R]CosponsorSponsored BillsSD-058FollowTheMoneyBallotpediaVoteSmart
Senator Chuck Weaver [R]CosponsorSponsored BillsSD-037FollowTheMoneyBallotpediaVoteSmart
Senator Chapin Rose [R]CosponsorSponsored BillsSD-051FollowTheMoneyBallotpediaVoteSmart
Senator Napoleon Harris [D]CosponsorSponsored BillsSD-015FollowTheMoneyBallotpediaVoteSmart

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