101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
SB3734

 

Introduced 2/14/2020, by Sen. Andy Manar

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 5/513b7 new

    Amends the Illinois Insurance Code. Provides that a pharmacy benefit manager may not reimburse a pharmacist or pharmacy for a prescription drug or pharmacy service in an amount less than the amount the pharmacy benefit manager reimburses itself or an affiliate for the same prescription drug or pharmacy service. Provides that the Section applies to insurers that provide coverage for prescription drugs and pharmacy services, including through a pharmacy benefit manager. Defines terms. Effective immediately.


LRB101 19650 BMS 69138 b

 

 

A BILL FOR

 

SB3734LRB101 19650 BMS 69138 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Insurance Code is amended by adding
5Section 513b7 as follows:
 
6    (215 ILCS 5/513b7 new)
7    Sec. 513b7. Reimbursement for prescription drugs or
8pharmacy services to affiliates.
9    (a) As used in this Section:
10    "Insured" means an individual entitled to health care
11benefits for prescription drugs or pharmacy services under a
12health insurance policy or contract issued or delivered in this
13State by an entity subject to this Section.
14    "Pharmacist" has the meaning given to that term in
15subsection (k-5) of Section 3 of the Pharmacy Practice Act.
16    "Pharmacy" has the meaning given to that term in subsection
17(a) of Section 3 of the Pharmacy Practice Act.
18    "Pharmacy benefit manager" has the meaning given to that
19term in subsection (a) of Section 513b1 of this Code.
20    (b) This Section applies to the following:
21        (1) An insurer as defined in subsection (b) of Section
22    370g of this Code that provides coverage for prescription
23    drugs and pharmacy services.

 

 

SB3734- 2 -LRB101 19650 BMS 69138 b

1        (2) An insurer as defined in subsection (b) of Section
2    370g of this Code that provides coverage for prescription
3    drugs and pharmacy services through a pharmacy benefit
4    manager.
5    (c) A pharmacy benefit manager may not reimburse a
6pharmacist or pharmacy for a prescription drug or pharmacy
7service in an amount less than the amount the pharmacy benefit
8manager reimburses itself or an affiliate for the same
9prescription drug or pharmacy service.
 
10    Section 99. Effective date. This Act takes effect upon
11becoming law.