Full Text of HB2259 101st General Assembly
HB2259enr 101ST GENERAL ASSEMBLY |
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| 1 | | AN ACT concerning public aid.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Illinois Public Aid Code is amended by | 5 | | adding Section 5-30.11 as follows: | 6 | | (305 ILCS 5/5-30.11 new) | 7 | | Sec. 5-30.11. Medicaid managed care organizations; | 8 | | preferred drug lists. | 9 | | (a) No later than January 1, 2020, the Illinois Department | 10 | | shall develop a standardized format for all Medicaid managed | 11 | | care organization preferred drug lists in collaboration with | 12 | | Medicaid managed care organizations and other stakeholders, | 13 | | including, but not limited to, organizations that serve | 14 | | individuals impacted by HIV/AIDS or epilepsy, and | 15 | | community-based organizations, providers, and entities with | 16 | | expertise in drug formulary development. | 17 | | (b) Following development of the standardized Preferred | 18 | | Drug List format, the Illinois Department shall allow Medicaid | 19 | | managed care organizations 6 months from the date of completion | 20 | | to comply with the new Preferred Drug List format. Each | 21 | | Medicaid managed care organization must post its preferred drug | 22 | | list on its website without restricting access and must update | 23 | | the preferred drug list posted on its website. Medicaid managed |
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| 1 | | care organizations shall publish updates to their preferred | 2 | | drug lists no less than 30 days prior to the date upon which | 3 | | any update or change takes effect, including, but not limited | 4 | | to, any and all changes to requirements for prior approval | 5 | | requirements, step therapy, or other utilization controls. | 6 | | (c)(1) No later than January 1, 2020, the Illinois | 7 | | Department shall establish and maintain the Illinois Drug and | 8 | | Therapeutics Advisory Board. The Board shall have the authority | 9 | | and responsibility to provide recommendations to the Illinois | 10 | | Department regarding which drug products to list on the | 11 | | Illinois Department's preferred drug list. The Illinois | 12 | | Department shall provide administrative support to the Board | 13 | | and 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 | 21 | | correspondence to and from Board members, shall be subject to | 22 | | the Freedom of Information Act. | 23 | | (2) The Board shall consist of the following voting | 24 | | members, all of whom shall be appointed by the Governor and | 25 | | shall 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 | 21 | | Medicaid managed care health plans shall serve a term of 3 | 22 | | years on the Board without compensation. | 23 | | Organizations interested in nominating non-voting | 24 | | clinicians to advise the Board may submit requests to | 25 | | participate to the Illinois Department. | 26 | | A licensed physician recommended by the Rare Disease |
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| 1 | | Commission who is a rare disease specialist and possesses | 2 | | scientific knowledge and medical training with respect to rare | 3 | | diseases and is familiar with drug and biological products and | 4 | | treatment shall be notified in advance to attend an Illinois | 5 | | Drug and Therapeutics Advisory Board meeting when a drug or | 6 | | biological product is scheduled to be reviewed in order to | 7 | | advise and make recommendations on drugs or biological | 8 | | products. | 9 | | (d) The Illinois Department shall adopt rules, to be in | 10 | | place no later than January 1, 2020, for the purpose of | 11 | | establishing and maintaining the Board.
| 12 | | Section 99. Effective date. This Act takes effect upon | 13 | | becoming law.
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