Illinois General Assembly - Bill Status for HB4146
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 Bill Status of HB4146  100th General Assembly


Short Description:  PATIENT RIGHTS-TRANSITION

House Sponsors
Rep. Laura Fine - David Harris - Patricia R. Bellock - Deb Conroy - Mary E. Flowers, David S. Olsen, Jonathan Carroll, Linda Chapa LaVia, Scott Drury, Robert Martwick, Will Guzzardi, Kelly M. Cassidy, Sam Yingling, Juliana Stratton, Litesa E. Wallace, Sonya M. Harper, Sue Scherer, Carol Ammons, La Shawn K. Ford, Martin J. Moylan, Robert Rita, Cynthia Soto, Robyn Gabel, Kathleen Willis, Natalie A. Manley, Katie Stuart, Rita Mayfield, LaToya Greenwood, Frances Ann Hurley, Michelle Mussman, Ann M. Williams, Theresa Mah, Marcus C. Evans, Jr., Anna Moeller, Sara Feigenholtz, Christian L. Mitchell, Camille Y. Lilly, Natalie Phelps Finnie, Elgie R. Sims, Jr., Jaime M. Andrade, Jr., Brian W. Stewart, Daniel V. Beiser, Steven A. Andersson, Michael P. McAuliffe, Michael J. Zalewski, John M. Cabello, Joe Sosnowski, Gregory Harris, Melissa Conyears-Ervin, Stephanie A. Kifowit, Carol Sente, Fred Crespo, Michael Halpin, Lou Lang, John Cavaletto, Barbara Flynn Currie, Kelly M. Burke, Sheri Jesiel, Jim Durkin, Luis Arroyo, Thaddeus Jones, John C. D'Amico and Monica Bristow

Senate Sponsors
(Sen. Heather A. Steans - Antonio Muñoz - Linda Holmes - Pamela J. Althoff - Melinda Bush, Terry Link, Michael E. Hastings, Kimberly A. Lightford, Mattie Hunter, Karen McConnaughay, David Koehler, Jacqueline Y. Collins, Dan McConchie, Laura M. Murphy, Julie A. Morrison, Omar Aquino, Bill Cunningham, Pat McGuire, Iris Y. Martinez, Patricia Van Pelt, Kwame Raoul, Ira I. Silverstein, Andy Manar, Jennifer Bertino-Tarrant, Toi W. Hutchinson, Cristina Castro, Steve Stadelman, Scott M. Bennett, Don Harmon, Neil Anderson, Thomas Cullerton, Steven M. Landek, Emil Jones, III, Martin A. Sandoval and Daniel Biss)

Last Action
DateChamber Action
  8/24/2018HousePublic Act . . . . . . . . . 100-1052

Statutes Amended In Order of Appearance
215 ILCS 134/25


Synopsis As Introduced
Amends the Managed Care Reform and Patient Rights Act. In provisions concerning transition of services, provides that the health care plan shall not modify an enrollee's coverage of a drug during the plan year if the drug has been previously approved for coverage by the plan for a medical condition, the plan's prescribing provider continues to prescribe the drug for the medical condition, and the patient continues to be an enrollee of the health care plan. Provides specific prohibited modifications of drug coverage in the health plan. Provides that the provisions do not prohibit a health care plan from requiring a pharmacist to effect generic substitutions of prescription drugs. Provides that the provisions do not prohibit the addition of prescription drugs to a health care plan's list of covered drugs during the coverage year. Provides that the provisions do not apply to a health care plan as defined in the State Employees Group Insurance Act of 1971 or medical assistance under the Illinois Public Aid Code. Effective immediately.

House Committee Amendment No. 1
In language providing that a health care plan is not prohibited from requiring a pharmacist to effect substitutions of prescription drugs, provides that the health care plan is not prohibited from requiring a pharmacist to effect substitutions consistent with provisions from the Pharmacy Practice Act that allow a pharmacist to substitute an interchangeable biologic for a prescribed biologic product and select a generic drug determined to be therapeutically equivalent by the United States Food and Drug Administration and in accordance with the Illinois Food, Drug and Cosmetic Act.

 Fiscal Note, House Committee Amendment No. 1 (Dept. of Central Management Services)
 The fiscal impact to the Department of Central Management Services is negligible.

Senate Committee Amendment No. 1
Replaces everything after the enacting clause. Amends the Managed Care Reform and Patient Rights Act. During an enrollee's plan year, prohibits a health care plan from removing a drug from its formulary or negatively changing its preferred or cost-tier sharing unless, at least 60 days before making the formulary change, the health care plan provides certain notifications to current and prospective enrollees and prescribing providers. Provides that the notification to a prescribing provider shall include a one-page form and may direct the provider to an electronic portal through which the provider may certify that coverage of the drug for the enrollee is medically necessary. Provides that if a provider certifies that a drug is medically necessary, the health care plan shall authorize coverage for the drug based solely on the provider's assertion that coverage is medically necessary and prohibits the health care plan from making certain modifications to the coverage related to the covered drug. Provides that the provisions do not prevent a health care plan from removing a drug from its formulary or denying an enrollee coverage if the U.S. Food and Drug Administration calls into question the clinical safety of the drug, the drug manufacturer notifies the U.S. Food and Drug Administration of a manufacturing discontinuance or potential discontinuance, or the drug manufacturer removes the drug from the market. Provides that the provisions do not prohibit a health care plan from requiring a pharmacist to effect generic substitutions of prescription drugs. Provides that the provisions apply to a policy or contract that is amended, delivered, issued, or renewed on or after January 1, 2019. Provides that the provisions do not apply to a health care plan as defined in the State Employees Group Insurance Act of 1971 or medical assistance under the Illinois Public Aid Code. Provides that the provisions concerning transition of services shall not be construed to prohibit the addition of prescription drugs to a health care plan's list of covered drugs during the coverage year. Effective immediately.

Actions 
DateChamber Action
  11/2/2017HouseFiled with the Clerk by Rep. Laura Fine
  11/2/2017HouseAdded Chief Co-Sponsor Rep. Patricia R. Bellock
  11/2/2017HouseAdded Chief Co-Sponsor Rep. Gregory Harris
  11/2/2017HouseFirst Reading
  11/2/2017HouseReferred to Rules Committee
  11/2/2017HouseRemove Chief Co-Sponsor Rep. Gregory Harris
  11/8/2017HouseAdded Chief Co-Sponsor Rep. Deb Conroy
  11/8/2017HouseAdded Co-Sponsor Rep. David S. Olsen
  11/8/2017HouseAdded Co-Sponsor Rep. Jonathan Carroll
  11/8/2017HouseAdded Co-Sponsor Rep. Linda Chapa LaVia
  11/8/2017HouseAdded Co-Sponsor Rep. Scott Drury
  11/8/2017HouseAdded Co-Sponsor Rep. Robert Martwick
  11/8/2017HouseAdded Co-Sponsor Rep. Jerry Costello, II
  11/8/2017HouseAdded Co-Sponsor Rep. Will Guzzardi
  11/8/2017HouseAdded Co-Sponsor Rep. Kelly M. Cassidy
  11/8/2017HouseAdded Co-Sponsor Rep. Sam Yingling
  11/8/2017HouseAdded Co-Sponsor Rep. Juliana Stratton
  11/8/2017HouseAdded Co-Sponsor Rep. Litesa E. Wallace
  11/8/2017HouseAdded Co-Sponsor Rep. Sonya M. Harper
  11/8/2017HouseAdded Co-Sponsor Rep. Sue Scherer
  11/8/2017HouseAdded Co-Sponsor Rep. Carol Ammons
  11/8/2017HouseAdded Co-Sponsor Rep. Emanuel Chris Welch
  11/8/2017HouseAdded Co-Sponsor Rep. La Shawn K. Ford
  11/8/2017HouseAdded Co-Sponsor Rep. Martin J. Moylan
  11/8/2017HouseAdded Co-Sponsor Rep. Robert Rita
  11/8/2017HouseAdded Co-Sponsor Rep. Cynthia Soto
  11/8/2017HouseAdded Co-Sponsor Rep. Robyn Gabel
  11/8/2017HouseAdded Co-Sponsor Rep. Kathleen Willis
  11/8/2017HouseAdded Co-Sponsor Rep. Natalie A. Manley
  11/8/2017HouseAdded Co-Sponsor Rep. Katie Stuart
  11/8/2017HouseAdded Co-Sponsor Rep. Rita Mayfield
  11/8/2017HouseAdded Co-Sponsor Rep. LaToya Greenwood
  11/8/2017HouseAdded Co-Sponsor Rep. Frances Ann Hurley
  11/8/2017HouseAdded Co-Sponsor Rep. Michelle Mussman
  11/8/2017HouseAdded Co-Sponsor Rep. Ann M. Williams
  11/8/2017HouseAdded Co-Sponsor Rep. Theresa Mah
  11/8/2017HouseAdded Co-Sponsor Rep. Marcus C. Evans, Jr.
  11/8/2017HouseAdded Co-Sponsor Rep. Anna Moeller
  11/8/2017HouseAdded Co-Sponsor Rep. Sara Feigenholtz
  11/8/2017HouseAdded Co-Sponsor Rep. Christian L. Mitchell
  11/8/2017HouseAdded Co-Sponsor Rep. Camille Y. Lilly
  11/8/2017HouseAdded Co-Sponsor Rep. Natalie Phelps Finnie
  11/8/2017HouseAdded Co-Sponsor Rep. Mary E. Flowers
  11/8/2017HouseAdded Co-Sponsor Rep. Elgie R. Sims, Jr.
  11/8/2017HouseAdded Co-Sponsor Rep. Jaime M. Andrade, Jr.
  11/8/2017HouseRemoved Co-Sponsor Rep. Mary E. Flowers
  11/9/2017HouseAdded Co-Sponsor Rep. Brian W. Stewart
  11/13/2017HouseAdded Co-Sponsor Rep. Daniel V. Beiser
  11/15/2017HouseAdded Chief Co-Sponsor Rep. Mary E. Flowers
  11/16/2017HouseAdded Co-Sponsor Rep. Steven A. Andersson
  1/30/2018HouseAdded Co-Sponsor Rep. Michael P. McAuliffe
  1/30/2018HouseRemove Chief Co-Sponsor Rep. Mary E. Flowers
  1/30/2018HouseAdded Chief Co-Sponsor Rep. David Harris
  1/30/2018HouseAdded Co-Sponsor Rep. Mary E. Flowers
  1/30/2018HouseRemoved Co-Sponsor Rep. Mary E. Flowers
  1/31/2018HouseAdded Co-Sponsor Rep. Michael J. Zalewski
  1/31/2018HouseAdded Co-Sponsor Rep. John M. Cabello
  1/31/2018HouseAdded Co-Sponsor Rep. Joe Sosnowski
  1/31/2018HouseAdded Co-Sponsor Rep. Gregory Harris
  1/31/2018HouseAdded Co-Sponsor Rep. Melissa Conyears-Ervin
  2/6/2018HouseRemoved Co-Sponsor Rep. Jerry Costello, II
  2/6/2018HouseAdded Co-Sponsor Rep. Robert W. Pritchard
  2/7/2018HouseRemoved Co-Sponsor Rep. Emanuel Chris Welch
  2/13/2018HouseAdded Co-Sponsor Rep. Stephanie A. Kifowit
  2/14/2018HouseAdded Co-Sponsor Rep. Carol Sente
  2/23/2018HouseAdded Chief Co-Sponsor Rep. Mary E. Flowers
  2/23/2018HouseChief Co-Sponsor Changed to Rep. Mary E. Flowers
  3/5/2018HouseAssigned to Insurance: Health & Life Committee
  3/6/2018HouseHouse Committee Amendment No. 1 Filed with Clerk by Rep. Laura Fine
  3/6/2018HouseHouse Committee Amendment No. 1 Referred to Rules Committee
  3/7/2018HouseHouse Committee Amendment No. 1 Rules Refers to Insurance: Health & Life Committee
  3/12/2018HouseAdded Co-Sponsor Rep. Fred Crespo
  4/2/2018HouseAdded Co-Sponsor Rep. Michael Halpin
  4/9/2018HouseAdded Co-Sponsor Rep. Lou Lang
  4/9/2018HouseHouse Committee Amendment No. 1 Adopted in Insurance: Health & Life Committee; by Voice Vote
  4/9/2018HouseDo Pass as Amended / Short Debate Insurance: Health & Life Committee; 009-005-000
  4/10/2018HousePlaced on Calendar 2nd Reading - Short Debate
  4/11/2018HouseAdded Co-Sponsor Rep. John Cavaletto
  4/11/2018HouseHouse Committee Amendment No. 1 Fiscal Note Requested as Amended by Rep. Keith R. Wheeler
  4/11/2018HouseHouse Committee Amendment No. 1 State Mandates Fiscal Note Requested as Amended by Rep. Keith R. Wheeler
  4/13/2018HouseAdded Co-Sponsor Rep. Barbara Flynn Currie
  4/13/2018HouseAdded Co-Sponsor Rep. Kelly M. Burke
  4/13/2018HouseAdded Co-Sponsor Rep. Sheri Jesiel
  4/18/2018HouseHouse Committee Amendment No. 1 Fiscal Note Filed as Amended
  4/19/2018HouseAdded Co-Sponsor Rep. Jim Durkin
  4/19/2018HouseAdded Co-Sponsor Rep. Arthur Turner
  4/19/2018HouseAdded Co-Sponsor Rep. Luis Arroyo
  4/19/2018HouseAdded Co-Sponsor Rep. Thaddeus Jones
  4/19/2018HouseAdded Co-Sponsor Rep. John C. D'Amico
  4/19/2018HouseHouse Floor Amendment No. 2 Filed with Clerk by Rep. Laura Fine
  4/19/2018HouseHouse Floor Amendment No. 2 Referred to Rules Committee
  4/19/2018HouseRemoved Co-Sponsor Rep. Arthur Turner
  4/23/2018HouseHouse Floor Amendment No. 2 Rules Refers to Insurance: Health & Life Committee
  4/23/2018HouseAdded Co-Sponsor Rep. Monica Bristow
  4/25/2018HouseHouse Floor Amendment No. 2 Recommends Be Adopted - Lost Insurance: Health & Life Committee; 008-003-000
  4/25/2018HouseRemoved Co-Sponsor Rep. Robert W. Pritchard
  4/25/2018HouseSecond Reading - Short Debate
  4/25/2018HouseHeld on Calendar Order of Second Reading - Short Debate
  4/26/2018HouseSecond Reading - Short Debate
  4/26/2018HouseHeld on Calendar Order of Second Reading - Short Debate
  4/26/2018HouseAdded Co-Sponsor Rep. Jay Hoffman
  4/26/2018HouseHouse Committee Amendment No. 1 Note / Motion Filed - Note Act Does Not Apply Rep. Laura Fine
  4/26/2018HouseHouse Committee Amendment No. 1 Motion Prevailed 061-044-000
  4/26/2018HouseState Mandates Fiscal Note Request is Inapplicable
  4/26/2018HousePlaced on Calendar Order of 3rd Reading - Short Debate
  4/26/2018HouseRemoved from Short Debate Status
  4/26/2018HousePlaced on Calendar Order of 3rd Reading - Standard Debate
  4/26/2018HouseThird Reading - Standard Debate - Passed 071-027-000
  4/26/2018HouseRemoved Co-Sponsor Rep. Jay Hoffman
  5/1/2018SenateArrive in Senate
  5/1/2018SenatePlaced on Calendar Order of First Reading
  5/1/2018SenateChief Senate Sponsor Sen. Heather A. Steans
  5/1/2018SenateFirst Reading
  5/1/2018SenateReferred to Assignments
  5/1/2018SenateAdded as Alternate Co-Sponsor Sen. Terry Link
  5/1/2018SenateAdded as Alternate Co-Sponsor Sen. Michael E. Hastings
  5/1/2018SenateAdded as Alternate Co-Sponsor Sen. Kimberly A. Lightford
  5/1/2018SenateAdded as Alternate Co-Sponsor Sen. Napoleon Harris, III
  5/1/2018SenateAdded as Alternate Co-Sponsor Sen. Mattie Hunter
  5/1/2018SenateAdded as Alternate Chief Co-Sponsor Sen. Linda Holmes
  5/1/2018SenateAdded as Alternate Chief Co-Sponsor Sen. Antonio Muñoz
  5/1/2018SenateAlternate Chief Co-Sponsor Changed to Sen. Antonio Muñoz
  5/1/2018SenateAlternate Chief Co-Sponsor Changed to Sen. Linda Holmes
  5/1/2018SenateAdded as Alternate Chief Co-Sponsor Sen. Pamela J. Althoff
  5/1/2018SenateSponsor Removed Sen. Napoleon Harris, III
  5/2/2018SenateAdded as Alternate Chief Co-Sponsor Sen. Melinda Bush
  5/2/2018SenateAdded as Alternate Co-Sponsor Sen. Karen McConnaughay
  5/2/2018SenateAdded as Alternate Co-Sponsor Sen. David Koehler
  5/2/2018SenateAdded as Alternate Co-Sponsor Sen. Jacqueline Y. Collins
  5/2/2018SenateAdded as Alternate Co-Sponsor Sen. Emil Jones, III
  5/2/2018SenateAdded as Alternate Co-Sponsor Sen. Dan McConchie
  5/2/2018SenateAdded as Alternate Co-Sponsor Sen. Laura M. Murphy
  5/2/2018SenateAdded as Alternate Co-Sponsor Sen. Julie A. Morrison
  5/2/2018SenateAssigned to Special Committee on Oversight of Medicaid Managed Care
  5/2/2018SenateAdded as Alternate Co-Sponsor Sen. Omar Aquino
  5/2/2018SenateAdded as Alternate Co-Sponsor Sen. Bill Cunningham
  5/2/2018SenateAdded as Alternate Co-Sponsor Sen. Pat McGuire
  5/2/2018SenateAdded as Alternate Co-Sponsor Sen. Iris Y. Martinez
  5/2/2018SenateSponsor Removed Sen. Emil Jones, III
  5/2/2018SenateAdded as Alternate Co-Sponsor Sen. Patricia Van Pelt
  5/2/2018SenateAdded as Alternate Co-Sponsor Sen. Kwame Raoul
  5/2/2018SenateAdded as Alternate Co-Sponsor Sen. Ira I. Silverstein
  5/2/2018SenateAdded as Alternate Co-Sponsor Sen. Andy Manar
  5/2/2018SenateAdded as Alternate Co-Sponsor Sen. Jennifer Bertino-Tarrant
  5/2/2018SenateAdded as Alternate Co-Sponsor Sen. Toi W. Hutchinson
  5/3/2018SenateAdded as Alternate Co-Sponsor Sen. Cristina Castro
  5/3/2018SenateAdded as Alternate Co-Sponsor Sen. Steve Stadelman
  5/3/2018SenateAdded as Alternate Co-Sponsor Sen. Scott M. Bennett
  5/3/2018SenateAdded as Alternate Co-Sponsor Sen. Don Harmon
  5/8/2018SenateAdded as Alternate Co-Sponsor Sen. Neil Anderson
  5/8/2018SenateAdded as Alternate Co-Sponsor Sen. Thomas Cullerton
  5/9/2018SenateAdded as Alternate Co-Sponsor Sen. Steven M. Landek
  5/9/2018SenateAdded as Alternate Co-Sponsor Sen. Emil Jones, III
  5/10/2018SenatePostponed - Special Committee on Oversight of Medicaid Managed Care
  5/10/2018SenateAdded as Alternate Co-Sponsor Sen. Martin A. Sandoval
  5/11/2018SenateRule 2-10 Committee Deadline Established As May 31, 2018
  5/18/2018SenateAdded as Alternate Co-Sponsor Sen. Daniel Biss
  5/18/2018SenateSenate Committee Amendment No. 1 Filed with Secretary by Sen. Heather A. Steans
  5/18/2018SenateSenate Committee Amendment No. 1 Referred to Assignments
  5/21/2018SenateSenate Committee Amendment No. 1 Assignments Refers to Special Committee on Oversight of Medicaid Managed Care
  5/23/2018SenateSenate Committee Amendment No. 1 Adopted
  5/23/2018SenateDo Pass as Amended Special Committee on Oversight of Medicaid Managed Care; 009-000-000
  5/23/2018SenatePlaced on Calendar Order of 2nd Reading May 24, 2018
  5/24/2018SenateSecond Reading
  5/24/2018SenatePlaced on Calendar Order of 3rd Reading May 25, 2018
  5/25/2018SenateThird Reading - Passed; 049-000-000
  5/25/2018HouseArrived in House
  5/25/2018HousePlaced on Calendar Order of Concurrence Senate Amendment(s) 1
  5/28/2018HouseSenate Committee Amendment No. 1 Motion Filed Concur Rep. Laura Fine
  5/28/2018HouseSenate Committee Amendment No. 1 Motion to Concur Referred to Rules Committee
  5/28/2018HouseSenate Committee Amendment No. 1 Motion to Concur Rules Referred to Insurance: Health & Life Committee
  5/30/2018HouseSenate Committee Amendment No. 1 Motion to Concur Recommends Be Adopted Insurance: Health & Life Committee; 011-000-000
  5/31/2018HouseSenate Committee Amendment No. 1 House Concurs 109-000-000
  5/31/2018HouseHouse Concurs
  5/31/2018HousePassed Both Houses
  6/29/2018HouseSent to the Governor
  8/24/2018HouseGovernor Approved
  8/24/2018HouseEffective Date August 24, 2018
  8/24/2018HousePublic Act . . . . . . . . . 100-1052

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