103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB4504

 

Introduced 1/31/2024, by Rep. Laura Faver Dias

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 5/356z.71 new

    Amends the Illinois Insurance Code. Provides that a health plan shall limit the total amount that a covered person is required to pay for a covered prescription inhaler at an amount not to exceed $25 per 30-day supply and shall limit the total amount that a covered person is required to pay for all covered prescription inhalers at an amount not to exceed $50 in total per 30 days. Provides that coverage for prescription inhalers shall not be subject to any deductible. Provides that nothing in the provisions prevents a health plan from reducing a covered person's cost sharing to an amount less than the cap. Authorizes rulemaking and enforcement by the Department of Insurance. Effective January 1, 2025.


LRB103 36828 RPS 66939 b

 

 

A BILL FOR

 

HB4504LRB103 36828 RPS 66939 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Insurance Code is amended by
5adding Section 356z.71 as follows:
 
6    (215 ILCS 5/356z.71 new)
7    Sec. 356z.71. Prescription inhalers.
8    (a) In this Section:
9    "Health plan" means a policy of accident and health
10insurance or managed care plan that is amended, delivered,
11issued, or renewed on or after the effective date of this
12amendatory Act of the 103rd General Assembly that provides
13coverage for prescription inhalers.
14    "Prescription inhaler" means a prescribed medical device
15that delivers inhaled medications used to treat respiratory
16conditions and the prescribed inhaled medication.
17"Prescription inhaler" includes metered-dose inhalers,
18nebulizers, and dry powder inhalers. "Prescription inhaler"
19does not include inhalers available over the counter without a
20prescription to provide temporary relief from respiratory
21symptoms.
22    (b) A health plan shall limit the total amount that a
23covered person is required to pay for a covered prescription

 

 

HB4504- 2 -LRB103 36828 RPS 66939 b

1inhaler to an amount not to exceed $25 per 30-day supply and
2shall limit the total amount that a covered person is required
3to pay for all covered prescription inhalers to an amount not
4to exceed $50 in total per 30 days. Coverage for prescription
5inhalers shall not be subject to any deductible.
6    (c) Nothing in this Section prevents a health plan from
7reducing a covered person's cost sharing to an amount less
8than the amount specified in subsection (b).
9    (d) The Department may adopt rules necessary to implement
10and administer this Section and to align with federal
11requirements. The Department may use any of its enforcement
12powers to obtain a health plan's compliance with this Section.
 
13    Section 99. Effective date. This Act takes effect January
141, 2025.