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| 1 | AN ACT concerning insurance.
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| 2 | Be it enacted by the People of the State of Illinois,
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| 3 | represented in the General Assembly:
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| 4 | Section 1. Short title. This Act may be cited as the Organ | ||||||
| 5 | Transplant Quality Assurance Act. | ||||||
| 6 | Section 5. Definitions. For the purpose of this Act: | ||||||
| 7 | "Health insurance policy or health care service plan" means | ||||||
| 8 | any policy of health or accident insurance subject to the | ||||||
| 9 | provisions of the Illinois Insurance Code, Health Maintenance | ||||||
| 10 | Organization Act, Voluntary Health Services Plan Act, Counties | ||||||
| 11 | Code, Municipal Code, School Code, and State Employees Group | ||||||
| 12 | Insurance Act. | ||||||
| 13 | "Immunosuppressant drugs" mean drugs that are used in | ||||||
| 14 | immunosuppressive therapy to inhibit or prevent the activity of | ||||||
| 15 | the immune system. "Immunosuppressant drugs" are used | ||||||
| 16 | clinically to prevent the rejection of transplanted organs and | ||||||
| 17 | tissues. "Immunosuppressant drugs" do not include drugs for the | ||||||
| 18 | treatment of autoimmune diseases or diseases that are most | ||||||
| 19 | likely of autoimmune origin. | ||||||
| 20 | Section 10. Quality assurance in patient care. When a | ||||||
| 21 | prescribing physician has indicated on a prescription "may not | ||||||
| 22 | substitute", a health insurance policy or health care service | ||||||
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| 1 | plan that covers immunosuppressant drugs may not require or | ||||||
| 2 | cause a pharmacist to interchange another immunosuppressive | ||||||
| 3 | drug or formulation issued on behalf of a person to inhibit or | ||||||
| 4 | prevent the activity of the immune system of a patient to | ||||||
| 5 | prevent the rejection of transplanted organs and tissues | ||||||
| 6 | without notification and the documented consent of the | ||||||
| 7 | prescribing physician and the patient, or the parent or | ||||||
| 8 | guardian if the patient is a child, or the spouse of a patient | ||||||
| 9 | who is authorized to consent to the treatment of the person. | ||||||
| 10 | In accordance with the Pharmacy Practice Act, the | ||||||
| 11 | prescribing person may, in his or her own handwriting, place a | ||||||
| 12 | mark beside "may not substitute" on the prescription form to | ||||||
| 13 | direct the pharmacist in the dispensing of the prescription; | ||||||
| 14 | this marking of the prescription shall control dispensing. | ||||||
| 15 | Patient co-payments, deductibles, or other
charges for the | ||||||
| 16 | prescribed drug for which another immunosuppressive drug or | ||||||
| 17 | formulation is not interchanged shall remain the same for the | ||||||
| 18 | enrollment period established by the health insurance policy or | ||||||
| 19 | plan. This Act does not apply to medication orders issued for | ||||||
| 20 | immunosuppressive drugs for any in-patient care in a licensed | ||||||
| 21 | hospital. | ||||||