093_SB0003sam002

 










                                     LRB093 03778 SJM 13557 a

 1                     AMENDMENT TO SENATE BILL 3

 2        AMENDMENT NO.     .  Amend Senate  Bill  3,  AS  AMENDED,
 3    with  reference  to page and line numbers of Senate Amendment
 4    No. 1, on page 5, immediately below line 28, by inserting the
 5    following:

 6        "Section  27.  Emergency  drug  pricing.  Maximum  retail
 7    prices for prescription drugs sold  in  Illinois  by  a  drug
 8    manufacturer  not  participating  in  the  program  shall  be
 9    established pursuant to this Section.
10        (a)  Emergency  drug  pricing  procedures.  The following
11    provisions apply to determinations regarding  maximum  retail
12    prices  for  prescription  drugs  and  to  the procedures for
13    establishing those prices.
14             (1) By January 1, 2004, the Department  shall  adopt
15        rules   establishing  the  procedures  for  adoption  and
16        periodic review of maximum retail prices, the  procedures
17        for   establishing   maximum   retail   prices   for  new
18        prescription  drugs  and  for  reviewing  maximum  retail
19        prices of selected drugs, and the procedures for  phasing
20        out or terminating maximum retail prices.
21             (2)   By  January  1,  2005,  the  Department  shall
22        determine whether the cost of prescription drugs provided
23        to qualified  residents  under  this  Act  is  reasonably
 
                            -2-      LRB093 03778 SJM 13557 a
 1        comparable  to  the  lowest  cost paid for the same drugs
 2        delivered or dispensed  in  the  State.  In  making  this
 3        determination the following provisions apply.
 4                  (A)  The  Department  shall review prescription
 5             drug use in the Medicaid program using data from the
 6             most  recent  6-month  period  for  which  data   is
 7             available.
 8                  (B)  Using  the  data  reviewed  in subdivision
 9             (a)(2)(A), the Department shall  determine  the  100
10             drugs for which the most units were provided and the
11             100 drugs for which the total cost was the highest.
12                  (C)   For  each  prescription  drug  listed  in
13             subdivision   (a)(2)(B),   the   Department    shall
14             determine  the  cost  for  each  drug  for qualified
15             residents provided those drugs under this Act  on  a
16             certain  date.  The  average cost for each such drug
17             must be calculated.
18                  (D)  For  each  prescription  drug  listed   in
19             subdivision    (a)(2)(B),   the   Department   shall
20             determine the lowest cost for each drug paid by  any
21             purchaser  on  the date that is used for subdivision
22             (a)(2)(C)  delivered  or  dispensed  in  the  State,
23             taking  into  consideration   the   federal   supply
24             schedule  and prices paid by pharmaceutical benefits
25             managers and by large purchasers and excluding drugs
26             purchased under this Act. The average cost for  each
27             such drug must be calculated.
28                  (E)  If  the  average  cost  for  one  or  more
29             prescription  drugs  under this Act as determined in
30             subdivision (a)(2)(C) is not  reasonably  comparable
31             to  the  average  lowest  cost  for the same drug or
32             drugs as determined in  subdivision  (a)(2)(D),  the
33             Department shall establish maximum retail prices for
34             any  or  all  prescription  drugs sold in the State.
 
                            -3-      LRB093 03778 SJM 13557 a
 1             Maximum prescription drug prices  established  under
 2             this  subdivision (a)(2)(E) must take effect on July
 3             1, 2005.
 4        (b) Select prescription drugs. In making a  determination
 5    under  this  Section,  the  Department  may  rely  on pricing
 6    information on a selected number  of  prescription  drugs  if
 7    that list is representative of the prescription drug needs of
 8    the  residents of the State and is made public as part of the
 9    process of establishing maximum retail prices.
10        (c) Public health or welfare.  The  Department  may  take
11    actions that the Department determines are necessary if there
12    is  a  severe  limitation or shortage of or lack of access to
13    prescription drugs  in  the  State  that  could  threaten  or
14    endanger the public health or welfare.
15        (d)  Dispensing  fees.   The  maximum  retail price shall
16    include the agreed dispensing fee contained in subsection (b)
17    of Section 25 of this Act.
18        (e) Appeals. A retailer of prescription drugs may  appeal
19    the  maximum  retail price of a prescription drug established
20    under  this  Section  in   accordance   with   the   Illinois
21    Administrative Procedure Act.
22        (f) Enforcement. A violation of the maximum retail prices
23    established under this Section is a violation of the Consumer
24    Fraud and Deceptive Business Practices Act."; and

25    on  page  9,  immediately  below  line  4,  by  inserting the
26    following:

27        "Section 41. Rebate agreement. A drug  manufacturer  that
28    sells  prescription  drugs  in  this State through the Senior
29    Citizens  and  Disabled  Persons  Property  Tax  Relief   and
30    Pharmaceutical Assistance Act or any other publicly supported
31    pharmaceutical  assistance  program shall enter into a rebate
32    agreement with the Department  under  this  Act.  The  rebate
33    agreement  must  require the drug manufacturer to make rebate
 
                            -4-      LRB093 03778 SJM 13557 a
 1    payments to the State each calendar quarter or according to a
 2    schedule established by the Department.

 3        Section 42. Action with regard to non-participating  drug
 4    manufacturers.  The names of drug manufacturers who do and do
 5    not enter into rebate agreements under this  Act  are  public
 6    information.  The Department of Public Aid shall release this
 7    information to health care providers  and  the  public  on  a
 8    regular  basis  and  shall  publicize  participation  by drug
 9    manufacturers that is of particular benefit  to  the  public.
10    The Department of Public Aid shall impose prior authorization
11    requirements  in  the  Medicaid program, as permitted by law,
12    for  the  dispensing  of  prescription  drugs   provided   by
13    non-participating drug manufacturers."; and

14    on  page  10,  immediately  below  line  15, by inserting the
15    following:

16        "Section 44. Profiteering.
17        (a)  Prescription  drugs  are  a   necessity   of   life.
18    Profiteering in prescription drugs is unlawful and is subject
19    to  the  provisions  of this Section. This Section applies to
20    drug manufacturers not participating in the program.
21        (b) A drug manufacturer not participating in the  program
22    engages in illegal profiteering if that manufacturer does any
23    of the following:
24             (1) Exacts or demands an unconscionable price.
25             (2)  Exacts  or demands prices or terms that lead to
26        any unjust or unreasonable profit.
27             (3) Discriminates unreasonably against any person in
28        the  sale,  exchange,  distribution,   or   handling   of
29        prescription drugs dispensed or delivered in the State.
30             (4)  Intentionally  prevents,  limits,  lessens,  or
31        restricts  the sale or distribution of prescription drugs
32        in this State in retaliation for the provisions  of  this
 
                            -5-      LRB093 03778 SJM 13557 a
 1        Act.
 2        (c)  The  State  may  bring a civil action in the circuit
 3    court for a direct or indirect injury to any person, group of
 4    persons, the State, or a political subdivision of  the  State
 5    caused  by a violation of this Section. There is a right to a
 6    jury trial in any action brought under this Section.  If  the
 7    State prevails, the defendant shall pay 3 times the amount of
 8    damages  and  the  costs  of  suit,  including  necessary and
 9    reasonable investigative costs, reasonable expert  fees,  and
10    reasonable   attorney's  fees.  For  a  willful  or  repeated
11    violation of this Section, punitive damages may  be  awarded.
12    After  deduction  of  the  costs of distribution, the damages
13    must be equitably distributed by the  State  to  all  injured
14    parties.
15        (d)  Each  violation of this Section is a civil violation
16    for which the Attorney General may  obtain,  in  addition  to
17    other  remedies,  injunctive relief and a civil penalty in an
18    amount not to  exceed  $100,000,  plus  the  costs  of  suit,
19    including   necessary  and  reasonable  investigative  costs,
20    reasonable expert fees, and reasonable attorney's fees.
21        (e) A violation of this Section is also  a  violation  of
22    the  Consumer  Fraud  and Deceptive Business Practices Act.";
23    and

24    on page 11, immediately  below  line  15,  by  inserting  the
25    following:

26        "Section  995.  The Consumer Fraud and Deceptive Business
27    Practices Act is amended by adding Sections 2MM  and  2NN  as
28    follows:

29        (815 ILCS 505/2MM new)
30        Sec.  2MM.  Retail  prices  of drugs.  A violation of the
31    maximum retail prices established under  Section  27  of  the
32    Senior   Citizens  and  Disabled  Persons  Prescription  Drug
 
                            -6-      LRB093 03778 SJM 13557 a
 1    Discount Program Act is an unlawful practice under this Act.

 2        (815 ILCS 505/2NN new)
 3        Sec. 2NN. Prescription drugs; profiteering.  A  violation
 4    of  Section  44  of  the Senior Citizens and Disabled Persons
 5    Prescription  Drug  Discount  Program  Act  is  an   unlawful
 6    practice under this Act.".