SB3734 101ST GENERAL ASSEMBLY

LRB101 19650 BMS 69138 b

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.

A BILL FOR

AN ACT concerning regulation.

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

Section 5. The Illinois Insurance Code is amended by adding Section 513b7 as follows:

(215 ILCS 5/513b7 new)

Sec. 513b7. Reimbursement for prescription drugs or pharmacy services to affiliates.

(a) As used in this Section:

"Insured" means an individual entitled to health care benefits for prescription drugs or pharmacy services under a health insurance policy or contract issued or delivered in this State by an entity subject to this Section.

"Pharmacist" has the meaning given to that term in subsection (k-5) of Section 3 of the Pharmacy Practice Act.

"Pharmacy" has the meaning given to that term in subsection (a) of Section 3 of the Pharmacy Practice Act.

"Pharmacy benefit manager" has the meaning given to that term in subsection (a) of Section 513b1 of this Code.

(b) This Section applies to the following:

(1) An insurer as defined in subsection (b) of Section 370g of this Code that provides coverage for prescription drugs and pharmacy services.

(2) An insurer as defined in subsection (b) of Section 370g of this Code that provides coverage for prescription drugs and pharmacy services through a pharmacy benefit manager.

(c) 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.

Section 99. Effective date. This Act takes effect upon becoming law.