95TH GENERAL ASSEMBLY
State of Illinois
2007 and 2008
HB5250


 
Introduced , by Rep. Elaine Nekritz
 
SYNOPSIS AS INTRODUCED:
 		













215 ILCS 5/512-4.5 new






225 ILCS 85/15.7 new






225 ILCS 120/53 new










    Amends the Third Party Prescription Programs Article of the Insurance Code, the Pharmacy Practice Act of 1987, and the Wholesale Drug Distribution Licensing Act.  Prohibits the licensure, transference, use, or sale of any records relative to prescription information containing patient-identifiable or prescriber-identifiable data by any licensee or registrant of the Acts for commercial purposes, except for limited purposes or under certain circumstances. 
















LRB095 14905 RAS 40849 b

















FISCAL NOTE ACT MAY APPLY
















 


 


A BILL FOR









 











HB5250

LRB095 14905 RAS 40849 b






1
    AN ACT concerning regulation, which may be known as the 
2
Prescription Data Opt-in Act.

 
3
    Be it enacted by the People of the State of Illinois,
 
4
represented in the General Assembly:


 
5
    Section 5. The Illinois Insurance Code is amended  by adding 
6
Section 512-4.5 as follows:
 
7
    (215 ILCS 5/512-4.5  new)
8
    Sec. 512-4.5. License, transfer, use, and sale of 
9
prescription information prohibited.

10
    (a) In this Section, "commercial purpose" includes, 
11
without limitation, advertising, marketing, promotion, or any 
12
activity that could be used to (i) influence sales or market 
13
share of a pharmaceutical product, (ii) influence or evaluate 
14
the prescribing behavior of an individual health care 
15
professional, or (iii) evaluate the effectiveness of a 
16
professional pharmaceutical sales force.

17
    (b) Except as provided in subsection (c) of this Section, 
18
records relative to prescription information containing 
19
patient-identifiable or prescriber-identifiable data may not 
20
be licensed, transferred, used, or sold by any registrant under 
21
this Act for any commercial purpose, except for any of the 
22
following limited purposes:
23
        (1) Pharmacy reimbursement.
 


 






HB5250
- 2 -
LRB095 14905 RAS 40849 b




1
        (2) Formulary compliance.
2
        (3) Care management.
3
        (4) Utilization review by a health care provider, the 
4
    patient's insurance provider, or the agent of either.
5
        (5) Health care research.
6
        (6) Any purpose otherwise provided by law.
7
    (c) A prescriber may authorize the transfer, use, or sale 
8
of his or her prescriber-identifiable data in writing or 
9
electronically if the prescriber has transmitted the 
10
authorization to an entity that (i) is involved in the 
11
transfer, sale, or use of prescriber-identifiable data, (ii) 
12
has designated an address, location, or system to which 
13
authorization may be transmitted electronically or in writing, 
14
and (iii) has established a process for prescribers to revoke 
15
their authorization in writing or electronically upon 
16
reasonable notice to the entity. 
17
    (d) Nothing in this Section shall prohibit the dispensing 
18
of prescription medications to a patient or to the patient's 
19
authorized representative; the transmission of prescription 
20
information between an authorized prescriber and a licensed 
21
pharmacy; the transfer of prescription information between 
22
licensed pharmacies; the transfer of prescription records that 
23
may occur in the event a pharmacy ownership is changed or 
24
transferred; or care management educational communications 
25
provided to a patient about the patient's health condition, 
26
adherence to a prescribed course of therapy, or other 
 


 






HB5250
- 3 -
LRB095 14905 RAS 40849 b




1
information about the drug being dispensed, treatment options, 
2
or clinical trials.
3
    (e) Nothing in this Section shall prohibit the collection, 
4
use, transfer, or sale of patient and prescriber de-identified 
5
data by zip code, geographic region, or medical specialty for 
6
commercial purposes.
 
7
    Section 10. The Pharmacy Practice Act of 1987 is amended  by 
8
adding Section 15.7 as follows:
 
9
    (225 ILCS 85/15.7  new)
10
    Sec. 15.7. License, transfer, use, and sale of prescription 
11
information prohibited.

12
    (a) In this Section, "commercial purpose" includes, 
13
without limitation, advertising, marketing, promotion, or any 
14
activity that could be used to (i) influence sales or market 
15
share of a pharmaceutical product, (ii) influence or evaluate 
16
the prescribing behavior of an individual health care 
17
professional, or (iii) evaluate the effectiveness of a 
18
professional pharmaceutical sales force.
19
    (b) Except as provided in subsection (c) of this Section, 
20
records relative to prescription information containing 
21
patient-identifiable or prescriber-identifiable data may not 
22
be licensed, transferred, used, or sold by any licensee or 
23
registrant under this Act for any commercial purpose, except 
24
for any of the following limited purposes:
 


 






HB5250
- 4 -
LRB095 14905 RAS 40849 b




1
        (1) Pharmacy reimbursement.
2
        (2) Formulary compliance.
3
        (3) Care management.
4
        (4) Utilization review by a health care provider, the 
5
    patient's insurance provider, or the agent of either.
6
        (5) Health care research.
7
        (6) Any purpose otherwise provided by law.
8
    (c) A prescriber may authorize the transfer, use, or sale 
9
of his or her prescriber-identifiable data in writing or 
10
electronically if the prescriber has transmitted the 
11
authorization to an entity that (i) is involved in the 
12
transfer, sale, or use of prescriber-identifiable data, (ii) 
13
has designated an address, location, or system to which 
14
authorization may be transmitted electronically or in writing, 
15
and (iii) has established a process for prescribers to revoke 
16
their authorization in writing or electronically upon 
17
reasonable notice to the entity. 
18
    (d) Nothing in this Section shall prohibit the dispensing 
19
of prescription medications to a patient or to the patient's 
20
authorized representative; the transmission of prescription 
21
information between an authorized prescriber and a licensed 
22
pharmacy; the transfer of prescription information between 
23
licensed pharmacies; the transfer of prescription records that 
24
may occur in the event a pharmacy ownership is changed or 
25
transferred; or care management educational communications 
26
provided to a patient about the patient's health condition, 
 


 






HB5250
- 5 -
LRB095 14905 RAS 40849 b




1
adherence to a prescribed course of therapy, or other 
2
information about the drug being dispensed, treatment options, 
3
or clinical trials.
4
    (e) Nothing in this Section shall prohibit the collection, 
5
use, transfer, or sale of patient and prescriber de-identified 
6
data by zip code, geographic region, or medical specialty for 
7
commercial purposes.
 
8
    Section 15. The Wholesale Drug Distribution Licensing Act 
9
is amended  by adding Section 53 as follows:
 
10
    (225 ILCS 120/53  new)
11
    Sec. 53. License, transfer, use, and sale of prescription 
12
information prohibited.

13
    (a) In this Section, "commercial purpose" includes, 
14
without limitation, advertising, marketing, promotion, or any 
15
activity that could be used to (i) influence sales or market 
16
share of a pharmaceutical product, (ii) influence or evaluate 
17
the prescribing behavior of an individual health care 
18
professional, or (iii) evaluate the effectiveness of a 
19
professional pharmaceutical sales force.
20
    (b) Except as provided in subsection (c) of this Section, 
21
records relative to prescription information containing 
22
patient-identifiable or prescriber-identifiable data may not 
23
be licensed, transferred, used, or sold by any licensee under 
24
this Act for any commercial purpose, except for any of the 
 


 






HB5250
- 6 -
LRB095 14905 RAS 40849 b




1
following limited purposes:
2
        (1) Pharmacy reimbursement.
3
        (2) Formulary compliance.
4
        (3) Care management.
5
        (4) Utilization review by a health care provider, the 
6
    patient's insurance provider, or the agent of either.
7
        (5) Health care research.
8
        (6) Any purpose otherwise provided by law.
9
    (c) A prescriber may authorize the transfer, use, or sale 
10
of his or her prescriber-identifiable data in writing or 
11
electronically if the prescriber has transmitted the 
12
authorization to an entity that (i) is involved in the 
13
transfer, sale, or use of prescriber-identifiable data, (ii) 
14
has designated an address, location, or system to which 
15
authorization may be transmitted electronically or in writing, 
16
and (iii) has established a process for prescribers to revoke 
17
their authorization in writing or electronically upon 
18
reasonable notice to the entity. 
19
    (d) Nothing in this Section shall prohibit the dispensing 
20
of prescription medications to a patient or to the patient's 
21
authorized representative; the transmission of prescription 
22
information between an authorized prescriber and a licensed 
23
pharmacy; the transfer of prescription information between 
24
licensed pharmacies; the transfer of prescription records that 
25
may occur in the event a pharmacy ownership is changed or 
26
transferred; or care management educational communications 
 


 






HB5250
- 7 -
LRB095 14905 RAS 40849 b




1
provided to a patient about the patient's health condition, 
2
adherence to a prescribed course of therapy, or other 
3
information about the drug being dispensed, treatment options, 
4
or clinical trials.
5
    (e) Nothing in this Section shall prohibit the collection, 
6
use, transfer, or sale of patient and prescriber de-identified 
7
data by zip code, geographic region, or medical specialty for 
8
commercial purposes.