|
| | 101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB0891 Introduced , by Rep. Joe Sosnowski SYNOPSIS AS INTRODUCED:
|
| 215 ILCS 5/Art. XXXIIB heading new | | 215 ILCS 5/521.1 new | | 215 ILCS 5/521.5 new | |
|
Amends the Illinois Insurance Code. Creates the Pharmacy Benefits Managers Article. Provides that a pharmacy or pharmacist shall have the right to provide an insured information regarding the amount of the insured's cost share for a prescription drug and that neither a pharmacy nor a pharmacist shall be penalized by a pharmacy benefits manager for discussing certain information or for selling a lower-priced drug to the insured if one is available. Provides that a pharmacy benefits manager shall not, through contract, prohibit a pharmacy from offering and providing direct and limited delivery services to an insured as an ancillary service of the pharmacy, as delineated in the contract between the pharmacy benefits manager and the pharmacy. Provides that a pharmacy benefits manager shall not charge, or attempt to collect from, an insured a copayment that exceeds the total charges submitted by the network pharmacy.
|
| |
| | A BILL FOR |
|
|
| | HB0891 | | LRB101 05148 SMS 50160 b |
|
|
| 1 | | AN ACT concerning regulation.
|
| 2 | | Be it enacted by the People of the State of Illinois,
|
| 3 | | represented in the General Assembly:
|
| 4 | | Section 5. The Illinois Insurance Code is amended by adding |
| 5 | | Article XXXIIB as follows:
|
| 6 | | (215 ILCS 5/Art. XXXIIB heading new) |
| 7 | | ARTICLE XXXIIB. PHARMACY BENEFITS MANAGERS
|
| 8 | | (215 ILCS 5/521.1 new) |
| 9 | | Sec. 521.1. Definitions. As used in this Article: |
| 10 | | "Health benefit plan" means any accident and health |
| 11 | | insurance policy or certificate; nonprofit hospital or medical |
| 12 | | service corporation contract; health, hospital, or medical |
| 13 | | service corporation plan contract; health maintenance |
| 14 | | organization subscriber contract; plan provided by a multiple |
| 15 | | employer welfare arrangement or plan provided by another |
| 16 | | benefit arrangement, to the extent permitted by the federal |
| 17 | | Employee Retirement Income Security Act of 1974. |
| 18 | | "Insured" means an individual covered by a health benefit |
| 19 | | plan. |
| 20 | | "Insurer" means any entity that provides or offers a health |
| 21 | | benefit plan. |
| 22 | | "Pharmacist" has the same meaning given to that term in the |