SB 2008

  • Illinois Senate Bill
  • 102nd Regular Session
  • Introduced in Senate
  • Senate
  • House
  • Governor

Ins-Pharmacy Benefit Managers

Abstract

Amends the Illinois Insurance Code. Provides that if a generic equivalent for a brand name drug is approved by the federal Food and Drug Administration, plans that provide coverage for prescription drugs through the use of a drug formulary that are amended, delivered, issued, or renewed in the State on or after January 1, 2022 shall comply with specified requirements. Provides that the Department of Insurance may adopt rules to implement provisions concerning notice of change of drug formulary. In provisions concerning a contract between a health insurer and a pharmacy benefit manager, provides that a pharmacy benefit manager must update and publish maximum allowable cost pricing information according to specified requirements, must provide a reasonable administrative appeal procedure to allow pharmacies to challenge maximum allowable costs, and must comply with specified requirements if an appeal is denied. Sets forth provisions concerning pharmacy benefit manager contracts; specified requirements that a pharmacy benefit manager shall comply with; specified requirements that an auditing entity shall comply with when conducting a pharmacy audit; and specified requirements concerning pharmacy network access standards. Provides that a violation of specified provisions is an unfair method of competition and unfair and deceptive act or practice in the business of insurance. Sets forth provisions concerning applicability of the Pharmacy Benefit Managers Article of the Illinois Insurance Code, and provisions concerning fiduciary responsibility of a pharmacy benefit manager. Defines terms. Makes other changes. Amends the Illinois Public Aid Code. Sets forth provisions concerning reimbursement of professional dispensing fees and acquisition costs for pharmacy providers. Senate Committee Amendment No. 1 Adds reference to: 215 ILCS 5/513b7 new 215 ILCS 5/513b8 new 215 ILCS 124/35 new Replaces everything after the enacting clause with the provisions of the introduced bill with the following changes. Provides that a pharmacy may not be subject to a chargeback or recoupment for a clerical or recordkeeping error in a required document or record unless the pharmacy benefit manager can provide proof of intent to commit fraud or such error results in actual financial harm to the pharmacy benefit manager, a health plan managed by the pharmacy benefit manager, or a consumer. Removes various provisions concerning pharmacy benefit manager contracts. Defines "spread pricing". Removes various definitions. Amends the Network Adequacy and Transparency Act. In provisions concerning pharmacy payments under the Medical Assistance Article of the Illinois Public Aid Code, provides that the Department of Healthcare and Family Services may reimburse a pharmacy owned by an entity participating in the federal Drug Pricing Program under the federal Public Health Service Act, for drugs purchased under the Program, an amount equal to or greater than the ceiling price calculated under the federal Act. Provides that all Medicaid managed care organizations must reimburse a pharmacy participating in the federal Drug Pricing Program, for drugs purchased under the Program, an amount equal to or greater than the current national average drug acquisition cost listing for the pharmaceutical product. Provides that the Department, a Medicaid managed care organization, and a pharmacy benefit manager under contract with a Medicaid managed care provider to reimburse pharmacy providers shall not prohibit any entity or pharmacy participating in the federal Drug Pricing Program from using drugs purchased under the federal Act when submitting claims for pharmaceutical reimbursement. Makes other changes.

Bill Sponsors (18)

Votes


No votes to display

Actions


Feb 10, 2022

Senate

Senate Committee Amendment No. 3 Rule 3-9(a) / Re-referred to Assignments

Senate

Rule 3-9(a) / Re-referred to Assignments

Feb 08, 2022

Senate

Senate Committee Amendment No. 3 Assignments Refers to Insurance

Feb 01, 2022

Senate

Senate Committee Amendment No. 3 Referred to Assignments

Senate

Senate Committee Amendment No. 3 Filed with Secretary by Sen. David Koehler

Jan 12, 2022

Senate

Postponed - Insurance

Jan 05, 2022

Senate

Re-assigned to Insurance

May 21, 2021

Senate

Rule 3-9(a) / Re-referred to Assignments

May 12, 2021

Senate

Sponsor Removed Sen. Chapin Rose

May 10, 2021

Senate

Rule 2-10 Committee/3rd Reading Deadline Established As May 21, 2021

Senate

Re-assigned to Insurance

May 07, 2021

Senate

Rule 3-9(a) / Re-referred to Assignments

Senate

Senate Committee Amendment No. 2 Rule 3-9(a) / Re-referred to Assignments

Apr 30, 2021

Senate

Rule 2-10 Committee/3rd Reading Deadline Established As May 7, 2021

Apr 29, 2021

Senate

Added as Co-Sponsor Sen. Terri Bryant

Apr 23, 2021

Senate

Rule 2-10 Committee/3rd Reading Deadline Established As April 30, 2021

Apr 21, 2021

Senate

Postponed - Insurance

Senate

Senate Committee Amendment No. 1 Adopted

Apr 20, 2021

Senate

Senate Committee Amendment No. 2 Assignments Refers to Insurance

Apr 16, 2021

Senate

Senate Committee Amendment No. 2 Referred to Assignments

Senate

Senate Committee Amendment No. 2 Filed with Secretary by Sen. David Koehler

Senate

Rule 2-10 Committee Deadline Established As April 23, 2021

Apr 15, 2021

Senate

Postponed - Insurance

Senate

Added as Co-Sponsor Sen. Steven M. Landek

Apr 14, 2021

Senate

Added as Co-Sponsor Sen. Julie A. Morrison

Senate

Senate Committee Amendment No. 1 Postponed - Insurance

Senate

Senate Committee Amendment No. 1 Assignments Refers to Insurance

Senate

Sponsor Removed Sen. Antonio Muñoz

Apr 13, 2021

Senate

Added as Co-Sponsor Sen. Melinda Bush

Senate

Added as Chief Co-Sponsor Sen. Michael E. Hastings

Apr 12, 2021

Senate

Senate Committee Amendment No. 1 Referred to Assignments

Senate

Senate Committee Amendment No. 1 Filed with Secretary by Sen. David Koehler

Apr 07, 2021

Senate

Added as Co-Sponsor Sen. Chapin Rose

Mar 25, 2021

Senate

Added as Co-Sponsor Sen. Laura Fine

Mar 24, 2021

Senate

Postponed - Insurance

Mar 23, 2021

Senate

Added as Co-Sponsor Sen. Darren Bailey

Mar 18, 2021

Senate

Added as Co-Sponsor Sen. Doris Turner

Senate

Added as Chief Co-Sponsor Sen. Napoleon Harris, III

Mar 17, 2021

Senate

Added as Co-Sponsor Sen. Dale Fowler

Mar 16, 2021

Senate

Assigned to Insurance

Senate

Added as Co-Sponsor Sen. Sally J. Turner

Senate

Added as Co-Sponsor Sen. Steve McClure

Mar 09, 2021

Senate

Added as Co-Sponsor Sen. Antonio Muñoz

Senate

Added as Co-Sponsor Sen. Mattie Hunter

Senate

Added as Co-Sponsor Sen. Cristina Castro

Mar 05, 2021

Senate

Added as Chief Co-Sponsor Sen. Linda Holmes

Senate

Added as Chief Co-Sponsor Sen. Laura M. Murphy

Senate

Added as Co-Sponsor Sen. Sara Feigenholtz

Feb 26, 2021

Senate

Filed with Secretary by Sen. David Koehler

Senate

First Reading

Senate

Referred to Assignments

Bill Text

Bill Text Versions Format
Introduced HTML PDF
Senate Amendment 001 HTML PDF
Senate Amendment 002 HTML PDF
Senate Amendment 003 HTML PDF

Related Documents

Document Format
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Sources

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