SB1756 103RD GENERAL ASSEMBLY

LRB103 27161 BMS 53531 b

103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB1756

Introduced 2/9/2023, by Sen. Doris Turner

SYNOPSIS AS INTRODUCED:

215 ILCS 5/356z.41

Amends the Accident and Health Article of the Illinois Insurance Code. Provides that an insurer that provides coverage for prescription insulin drugs pursuant to the terms of a health coverage plan the insurer offers shall limit the total amount that an insured is required to pay for a 30-day supply of covered prescription insulin drugs at an amount not to exceed $35 (rather than $100). Provides that on January 1 of each year, the limit on the amount that an insured is required to pay for a 30-day supply of a covered prescription insulin drug may increase to an amount that shall not exceed the maximum cost-sharing amount for covered insulin products of a plan subject to regulation under the Medicare prescription drug benefit program (rather than shall increase by a percentage equal to the percentage change from the preceding year in the medical care component of the Consumer Price Index of the Bureau of Labor Statistics of the United States Department of Labor). Effective immediately.

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 changing Section 356z.41 as follows:

(215 ILCS 5/356z.41)

Sec. 356z.41. Cost sharing in prescription insulin drugs; limits; confidentiality of rebate information.

(a) As used in this Section, "prescription insulin drug" means a prescription drug that contains insulin and is used to control blood glucose levels to treat diabetes but does not include an insulin drug that is administered to a patient intravenously.

(b) This Section applies to a group or individual policy of accident and health insurance amended, delivered, issued, or renewed on or after the effective date of this amendatory Act of the 101st General Assembly.

(c) An insurer that provides coverage for prescription insulin drugs pursuant to the terms of a health coverage plan the insurer offers shall limit the total amount that an insured is required to pay for a 30-day supply of covered prescription insulin drugs at an amount not to exceed $35 $100, regardless of the quantity or type of covered prescription insulin drug used to fill the insured's prescription.

(d) Nothing in this Section prevents an insurer from reducing an insured's cost sharing by an amount greater than the amount specified in subsection (c).

(e) The Director may use any of the Director's enforcement powers to obtain an insurer's compliance with this Section.

(f) The Department may adopt rules as necessary to implement and administer this Section and to align it with federal requirements.

(g) On January 1 of each year, the limit on the amount that an insured is required to pay for a 30-day supply of a covered prescription insulin drug may increase to an amount that shall not exceed the maximum cost-sharing amount for covered insulin products of a plan subject to regulation under Medicare Part D, 42 U.S.C. 1395w-101, et seq. increase by a percentage equal to the percentage change from the preceding year in the medical care component of the Consumer Price Index of the Bureau of Labor Statistics of the United States Department of Labor.

(Source: P.A. 101-625, eff. 1-1-21.)

Section 99. Effective date. This Act takes effect upon becoming law.