HB5917 103RD GENERAL ASSEMBLY

LRB103 43256 RPS 76539 b

103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB5917

Introduced 11/21/2024, by Rep. Cyril Nichols

SYNOPSIS AS INTRODUCED:

215 ILCS 5/513b8 new

Amends the Pharmacy Benefit Manager Article of the Illinois Insurance Code. Provides that, on or before July 1 of each calendar year, each pharmacy benefit manager registered in this State must submit a report to the Director of Insurance detailing specified information concerning pricing discounts, rebates, or other financial incentives received by the pharmacy benefit manager during the previous calendar year; the terms and conditions of any contract between the pharmacy benefit manager and any party related to providing pharmacy benefit manager services to a health plan; and any activity, policy, practice, contract, or arrangement of the pharmacy benefit manager that may directly or indirectly present a conflict of interest. Provides that the Director may, at the Director's discretion, require additional quarterly reports. Sets forth provisions concerning confidentiality and rulemaking. Effective January 1, 2026.

A BILL FOR

AN ACT concerning regulation.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Illinois Insurance Code is amended by adding Section 513b8 as follows:

(215 ILCS 5/513b8 new)

Sec. 513b8. Annual reports.

(a) On or before July 1 of each calendar year, each pharmacy benefit manager registered in this State under this Article must submit a report to the Director detailing the following:

(1) any pricing discounts, rebates, reimbursements, or other financial incentives received by the pharmacy benefit manager during the previous calendar year;

(2) the terms and conditions of any contract or arrangement between the pharmacy benefit manager and any party related to providing pharmacy benefit manager services to a health plan, including any dispensing fees paid to pharmacies;

(3) any activity, policy, practice, contract, or arrangement of the pharmacy benefit manager that may directly or indirectly present a conflict of interest in the pharmacy benefit manager's relationship with or obligation to a health plan provider.

(b) The Director may, at the Director's discretion, require additional quarterly reports to be filed encompassing the information required under subsection (a).

(c) Any information required to be disclosed under this Section that is reasonably designated by the pharmacy benefit manager as proprietary or trade secret information shall be kept confidential by the Department.

(d) The Department shall adopt any rules necessary to implement this Section.

Section 99. Effective date. This Act takes effect January 1, 2026.