Illinois General Assembly - Full Text of HB2259
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Full Text of HB2259  101st General Assembly




HB2259 EnrolledLRB101 09722 KTG 54822 b

1    AN ACT concerning public aid.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Illinois Public Aid Code is amended by
5adding Section 5-30.11 as follows:
6    (305 ILCS 5/5-30.11 new)
7    Sec. 5-30.11. Medicaid managed care organizations;
8preferred drug lists.
9    (a) No later than January 1, 2020, the Illinois Department
10shall develop a standardized format for all Medicaid managed
11care organization preferred drug lists in collaboration with
12Medicaid managed care organizations and other stakeholders,
13including, but not limited to, organizations that serve
14individuals impacted by HIV/AIDS or epilepsy, and
15community-based organizations, providers, and entities with
16expertise in drug formulary development.
17    (b) Following development of the standardized Preferred
18Drug List format, the Illinois Department shall allow Medicaid
19managed care organizations 6 months from the date of completion
20to comply with the new Preferred Drug List format. Each
21Medicaid managed care organization must post its preferred drug
22list on its website without restricting access and must update
23the preferred drug list posted on its website. Medicaid managed



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1care organizations shall publish updates to their preferred
2drug lists no less than 30 days prior to the date upon which
3any update or change takes effect, including, but not limited
4to, any and all changes to requirements for prior approval
5requirements, step therapy, or other utilization controls.
6    (c)(1) No later than January 1, 2020, the Illinois
7Department shall establish and maintain the Illinois Drug and
8Therapeutics Advisory Board. The Board shall have the authority
9and responsibility to provide recommendations to the Illinois
10Department regarding which drug products to list on the
11Illinois Department's preferred drug list. The Illinois
12Department shall provide administrative support to the Board
13and the Board shall:
14        (A) convene and meet no less than once per calendar
15    quarter;
16        (B) provide regular opportunities for public comment;
17    and
18        (C) comply with the provisions of the Open Meetings
19    Act.
20    All correspondence related to the Board, including
21correspondence to and from Board members, shall be subject to
22the Freedom of Information Act.
23    (2) The Board shall consist of the following voting
24members, all of whom shall be appointed by the Governor and
25shall serve terms of 3 years without compensation:
26        (A) one pharmacist licensed to practice pharmacy in



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1    Illinois who is recommended by a statewide organization
2    representing pharmacists;
3        (B) 4 physicians, recommended by a statewide
4    organization representing physicians, who are licensed to
5    practice medicine in all its branches in Illinois, have
6    knowledge of and adhere to best practice standards, and
7    have experience treating Illinois Medicaid beneficiaries;
8        (C) at least one clinician who specializes in the
9    prevention and treatment of HIV, recommended by an HIV
10    healthcare advocacy organization;
11        (D) at least one clinician recommended by a healthcare
12    advocacy organization that serves individuals who are
13    affected by chronic diseases that require significant
14    pharmaceutical treatments;
15        (E) one clinician representing the Illinois
16    Department; and
17        (F) one licensed psychiatrist, recommended by a
18    statewide organization representing psychiatrists, who has
19    experience treating Illinois Medicaid beneficiaries.
20    One non-voting clinician recommended by an association of
21Medicaid managed care health plans shall serve a term of 3
22years on the Board without compensation.
23    Organizations interested in nominating non-voting
24clinicians to advise the Board may submit requests to
25participate to the Illinois Department.
26    A licensed physician recommended by the Rare Disease



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1Commission who is a rare disease specialist and possesses
2scientific knowledge and medical training with respect to rare
3diseases and is familiar with drug and biological products and
4treatment shall be notified in advance to attend an Illinois
5Drug and Therapeutics Advisory Board meeting when a drug or
6biological product is scheduled to be reviewed in order to
7advise and make recommendations on drugs or biological
9    (d) The Illinois Department shall adopt rules, to be in
10place no later than January 1, 2020, for the purpose of
11establishing and maintaining the Board.
12    Section 99. Effective date. This Act takes effect upon
13becoming law.