HB0152ham002 96TH GENERAL ASSEMBLY

Health Care Availability and Accessibility Committee

Filed: 3/10/2009

09600HB0152ham002 LRB096 02980 RPM 23254 a

AMENDMENT TO HOUSE BILL 152

AMENDMENT NO. ______. Amend House Bill 152, AS AMENDED, by replacing everything after the enacting clause with the following:

"Section 1. Short title. This Act may be cited as the Organ Transplant Quality Assurance Act.

Section 5. Definitions. For the purpose of this Act:

"Health insurance policy or health care service plan" means any policy of health or accident insurance subject to the provisions of the Illinois Insurance Code, Health Maintenance Organization Act, Voluntary Health Services Plan Act, Counties Code, Municipal Code, School Code, and State Employees Group Insurance Act.

"Immunosuppressant drugs" means drugs that are used in immunosuppressive therapy to inhibit or prevent the activity of the immune system. "Immunosuppressant drugs" are used clinically to prevent the rejection of transplanted organs and tissues. "Immunosuppressant drugs" do not include drugs for the treatment of autoimmune diseases or diseases that are most likely of autoimmune origin.

Section 10. Quality assurance in patient care. When a prescribing physician has indicated on a prescription "may not substitute", a health insurance policy or health care service plan that covers immunosuppressant drugs may not require or cause a pharmacist to interchange another immunosuppressive drug or formulation issued on behalf of a person to inhibit or prevent the activity of the immune system of a patient to prevent the rejection of transplanted organs and tissues without notification and the documented consent of the prescribing physician and the patient, or the parent or guardian if the patient is a child, or the spouse of a patient who is authorized to consent to the treatment of the person.

In accordance with the Pharmacy Practice Act, the prescribing person may, in his or her own handwriting, place a mark beside "may not substitute" on the prescription form to direct the pharmacist in the dispensing of the prescription; this marking of the prescription shall control dispensing and the coverage under the health insurance policy or health care service plan. Patient co-payments, deductibles, or other charges for any prescription for which another immunosuppressive drug or formulation is not interchanged shall remain the same for the enrollment period established by the health insurance policy or plan. This Act does not apply to medication orders issued for immunosuppressive drugs for any in-patient care in a licensed hospital.".