Illinois General Assembly - Full Text of HB0135
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Full Text of HB0135  102nd General Assembly

HB0135eng 102ND GENERAL ASSEMBLY

  
  
  

 


 
HB0135 EngrossedLRB102 02749 BMS 12752 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The State Employees Group Insurance Act of 1971
5is amended by changing Section 6.11 as follows:
 
6    (5 ILCS 375/6.11)
7    Sec. 6.11. Required health benefits; Illinois Insurance
8Code requirements. The program of health benefits shall
9provide the post-mastectomy care benefits required to be
10covered by a policy of accident and health insurance under
11Section 356t of the Illinois Insurance Code. The program of
12health benefits shall provide the coverage required under
13Sections 356g, 356g.5, 356g.5-1, 356m, 356u, 356w, 356x,
14356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
15356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
16356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
17356z.36, and 356z.41, and 356z.43 of the Illinois Insurance
18Code. The program of health benefits must comply with Sections
19155.22a, 155.37, 355b, 356z.19, 370c, and 370c.1 and Article
20XXXIIB of the Illinois Insurance Code. The Department of
21Insurance shall enforce the requirements of this Section with
22respect to Sections 370c and 370c.1 of the Illinois Insurance
23Code; all other requirements of this Section shall be enforced

 

 

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1by the Department of Central Management Services.
2    Rulemaking authority to implement Public Act 95-1045, if
3any, is conditioned on the rules being adopted in accordance
4with all provisions of the Illinois Administrative Procedure
5Act and all rules and procedures of the Joint Committee on
6Administrative Rules; any purported rule not so adopted, for
7whatever reason, is unauthorized.
8(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
9100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
101-1-19; 100-1102, eff. 1-1-19; 100-1170, eff. 6-1-19; 101-13,
11eff. 6-12-19; 101-281, eff. 1-1-20; 101-393, eff. 1-1-20;
12101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
131-1-21.)
 
14    Section 10. The Counties Code is amended by changing
15Section 5-1069.3 as follows:
 
16    (55 ILCS 5/5-1069.3)
17    Sec. 5-1069.3. Required health benefits. If a county,
18including a home rule county, is a self-insurer for purposes
19of providing health insurance coverage for its employees, the
20coverage shall include coverage for the post-mastectomy care
21benefits required to be covered by a policy of accident and
22health insurance under Section 356t and the coverage required
23under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x,
24356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,

 

 

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1356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
2356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41, and 356z.43
3of the Illinois Insurance Code. The coverage shall comply with
4Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
5Insurance Code. The Department of Insurance shall enforce the
6requirements of this Section. The requirement that health
7benefits be covered as provided in this Section is an
8exclusive power and function of the State and is a denial and
9limitation under Article VII, Section 6, subsection (h) of the
10Illinois Constitution. A home rule county to which this
11Section applies must comply with every provision of this
12Section.
13    Rulemaking authority to implement Public Act 95-1045, if
14any, is conditioned on the rules being adopted in accordance
15with all provisions of the Illinois Administrative Procedure
16Act and all rules and procedures of the Joint Committee on
17Administrative Rules; any purported rule not so adopted, for
18whatever reason, is unauthorized.
19(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
20100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
211-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
22eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
23101-625, eff. 1-1-21.)
 
24    Section 15. The Illinois Municipal Code is amended by
25changing Section 10-4-2.3 as follows:
 

 

 

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1    (65 ILCS 5/10-4-2.3)
2    Sec. 10-4-2.3. Required health benefits. If a
3municipality, including a home rule municipality, is a
4self-insurer for purposes of providing health insurance
5coverage for its employees, the coverage shall include
6coverage for the post-mastectomy care benefits required to be
7covered by a policy of accident and health insurance under
8Section 356t and the coverage required under Sections 356g,
9356g.5, 356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9,
10356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
11356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
12356z.36, and 356z.41, and 356z.43 of the Illinois Insurance
13Code. The coverage shall comply with Sections 155.22a, 355b,
14356z.19, and 370c of the Illinois Insurance Code. The
15Department of Insurance shall enforce the requirements of this
16Section. The requirement that health benefits be covered as
17provided in this is an exclusive power and function of the
18State and is a denial and limitation under Article VII,
19Section 6, subsection (h) of the Illinois Constitution. A home
20rule municipality to which this Section applies must comply
21with every provision of this Section.
22    Rulemaking authority to implement Public Act 95-1045, if
23any, is conditioned on the rules being adopted in accordance
24with all provisions of the Illinois Administrative Procedure
25Act and all rules and procedures of the Joint Committee on

 

 

HB0135 Engrossed- 5 -LRB102 02749 BMS 12752 b

1Administrative Rules; any purported rule not so adopted, for
2whatever reason, is unauthorized.
3(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
4100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
51-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
6eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
7101-625, eff. 1-1-21.)
 
8    Section 20. The School Code is amended by changing Section
910-22.3f as follows:
 
10    (105 ILCS 5/10-22.3f)
11    Sec. 10-22.3f. Required health benefits. Insurance
12protection and benefits for employees shall provide the
13post-mastectomy care benefits required to be covered by a
14policy of accident and health insurance under Section 356t and
15the coverage required under Sections 356g, 356g.5, 356g.5-1,
16356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.11, 356z.12,
17356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
18356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41, and 356z.43
19of the Illinois Insurance Code. Insurance policies shall
20comply with Section 356z.19 of the Illinois Insurance Code.
21The coverage shall comply with Sections 155.22a, 355b, and
22370c of the Illinois Insurance Code. The Department of
23Insurance shall enforce the requirements of this Section.
24    Rulemaking authority to implement Public Act 95-1045, if

 

 

HB0135 Engrossed- 6 -LRB102 02749 BMS 12752 b

1any, is conditioned on the rules being adopted in accordance
2with all provisions of the Illinois Administrative Procedure
3Act and all rules and procedures of the Joint Committee on
4Administrative Rules; any purported rule not so adopted, for
5whatever reason, is unauthorized.
6(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
7100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
81-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
9eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
10101-625, eff. 1-1-21.)
 
11    Section 25. The Illinois Insurance Code is amended by
12adding Section 356z.43 as follows:
 
13    (215 ILCS 5/356z.43 new)
14    Sec. 356z.43. Coverage for patient care services for
15hormonal contraceptives provided by a pharmacist. A group or
16individual policy of accident and health insurance or a
17managed care plan that is amended, delivered, issued, or
18renewed after the effective date of this amendatory Act of the
19102nd General Assembly shall provide coverage for patient care
20services provided by a pharmacist for hormonal contraceptives
21assessment and consultation.
 
22    Section 30. The Pharmacy Practice Act is amended by
23changing Section 3 and by adding Section 43 as follows:
 

 

 

HB0135 Engrossed- 7 -LRB102 02749 BMS 12752 b

1    (225 ILCS 85/3)
2    (Section scheduled to be repealed on January 1, 2023)
3    Sec. 3. Definitions. For the purpose of this Act, except
4where otherwise limited therein:
5    (a) "Pharmacy" or "drugstore" means and includes every
6store, shop, pharmacy department, or other place where
7pharmacist care is provided by a pharmacist (1) where drugs,
8medicines, or poisons are dispensed, sold or offered for sale
9at retail, or displayed for sale at retail; or (2) where
10prescriptions of physicians, dentists, advanced practice
11registered nurses, physician assistants, veterinarians,
12podiatric physicians, or optometrists, within the limits of
13their licenses, are compounded, filled, or dispensed; or (3)
14which has upon it or displayed within it, or affixed to or used
15in connection with it, a sign bearing the word or words
16"Pharmacist", "Druggist", "Pharmacy", "Pharmaceutical Care",
17"Apothecary", "Drugstore", "Medicine Store", "Prescriptions",
18"Drugs", "Dispensary", "Medicines", or any word or words of
19similar or like import, either in the English language or any
20other language; or (4) where the characteristic prescription
21sign (Rx) or similar design is exhibited; or (5) any store, or
22shop, or other place with respect to which any of the above
23words, objects, signs or designs are used in any
24advertisement.
25    (b) "Drugs" means and includes (1) articles recognized in

 

 

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1the official United States Pharmacopoeia/National Formulary
2(USP/NF), or any supplement thereto and being intended for and
3having for their main use the diagnosis, cure, mitigation,
4treatment or prevention of disease in man or other animals, as
5approved by the United States Food and Drug Administration,
6but does not include devices or their components, parts, or
7accessories; and (2) all other articles intended for and
8having for their main use the diagnosis, cure, mitigation,
9treatment or prevention of disease in man or other animals, as
10approved by the United States Food and Drug Administration,
11but does not include devices or their components, parts, or
12accessories; and (3) articles (other than food) having for
13their main use and intended to affect the structure or any
14function of the body of man or other animals; and (4) articles
15having for their main use and intended for use as a component
16or any articles specified in clause (1), (2) or (3); but does
17not include devices or their components, parts or accessories.
18    (c) "Medicines" means and includes all drugs intended for
19human or veterinary use approved by the United States Food and
20Drug Administration.
21    (d) "Practice of pharmacy" means:
22        (1) the interpretation and the provision of assistance
23    in the monitoring, evaluation, and implementation of
24    prescription drug orders;
25        (2) the dispensing of prescription drug orders;
26        (3) participation in drug and device selection;

 

 

HB0135 Engrossed- 9 -LRB102 02749 BMS 12752 b

1        (4) drug administration limited to the administration
2    of oral, topical, injectable, and inhalation as follows:
3            (A) in the context of patient education on the
4        proper use or delivery of medications;
5            (B) vaccination of patients 14 years of age and
6        older pursuant to a valid prescription or standing
7        order, by a physician licensed to practice medicine in
8        all its branches, upon completion of appropriate
9        training, including how to address contraindications
10        and adverse reactions set forth by rule, with
11        notification to the patient's physician and
12        appropriate record retention, or pursuant to hospital
13        pharmacy and therapeutics committee policies and
14        procedures;
15            (B-5) following the initial administration of
16        long-acting or extended-release extended release form
17        opioid antagonists by a physician licensed to practice
18        medicine in all its branches, administration of
19        injections of long-acting or extended-release form
20        opioid antagonists for the treatment of substance use
21        disorder, pursuant to a valid prescription by a
22        physician licensed to practice medicine in all its
23        branches, upon completion of appropriate training,
24        including how to address contraindications and adverse
25        reactions, including, but not limited to, respiratory
26        depression and the performance of cardiopulmonary

 

 

HB0135 Engrossed- 10 -LRB102 02749 BMS 12752 b

1        resuscitation, set forth by rule, with notification to
2        the patient's physician and appropriate record
3        retention, or pursuant to hospital pharmacy and
4        therapeutics committee policies and procedures;
5            (C) administration of injections of
6        alpha-hydroxyprogesterone caproate, pursuant to a
7        valid prescription, by a physician licensed to
8        practice medicine in all its branches, upon completion
9        of appropriate training, including how to address
10        contraindications and adverse reactions set forth by
11        rule, with notification to the patient's physician and
12        appropriate record retention, or pursuant to hospital
13        pharmacy and therapeutics committee policies and
14        procedures; and
15            (D) administration of injections of long-term
16        antipsychotic medications pursuant to a valid
17        prescription by a physician licensed to practice
18        medicine in all its branches, upon completion of
19        appropriate training conducted by an Accreditation
20        Council of Pharmaceutical Education accredited
21        provider, including how to address contraindications
22        and adverse reactions set forth by rule, with
23        notification to the patient's physician and
24        appropriate record retention, or pursuant to hospital
25        pharmacy and therapeutics committee policies and
26        procedures.

 

 

HB0135 Engrossed- 11 -LRB102 02749 BMS 12752 b

1        (5) vaccination of patients ages 10 through 13 limited
2    to the Influenza (inactivated influenza vaccine and live
3    attenuated influenza intranasal vaccine) and Tdap (defined
4    as tetanus, diphtheria, acellular pertussis) vaccines,
5    pursuant to a valid prescription or standing order, by a
6    physician licensed to practice medicine in all its
7    branches, upon completion of appropriate training,
8    including how to address contraindications and adverse
9    reactions set forth by rule, with notification to the
10    patient's physician and appropriate record retention, or
11    pursuant to hospital pharmacy and therapeutics committee
12    policies and procedures;
13        (6) drug regimen review;
14        (7) drug or drug-related research;
15        (8) the provision of patient counseling;
16        (9) the practice of telepharmacy;
17        (10) the provision of those acts or services necessary
18    to provide pharmacist care;
19        (11) medication therapy management; and
20        (12) the responsibility for compounding and labeling
21    of drugs and devices (except labeling by a manufacturer,
22    repackager, or distributor of non-prescription drugs and
23    commercially packaged legend drugs and devices), proper
24    and safe storage of drugs and devices, and maintenance of
25    required records; and .
26        (13) the assessment and consultation of patients and

 

 

HB0135 Engrossed- 12 -LRB102 02749 BMS 12752 b

1    dispensing of hormonal contraceptives pursuant to the
2    standing order under Section 2310-705 of the Department of
3    Public Health Powers and Duties Law of the Civil
4    Administrative Code of Illinois.
5    A pharmacist who performs any of the acts defined as the
6practice of pharmacy in this State must be actively licensed
7as a pharmacist under this Act.
8    (e) "Prescription" means and includes any written, oral,
9facsimile, or electronically transmitted order for drugs or
10medical devices, issued by a physician licensed to practice
11medicine in all its branches, dentist, veterinarian, podiatric
12physician, or optometrist, within the limits of his or her
13license, by a physician assistant in accordance with
14subsection (f) of Section 4, or by an advanced practice
15registered nurse in accordance with subsection (g) of Section
164, containing the following: (1) name of the patient; (2) date
17when prescription was issued; (3) name and strength of drug or
18description of the medical device prescribed; and (4)
19quantity; (5) directions for use; (6) prescriber's name,
20address, and signature; and (7) DEA registration number where
21required, for controlled substances. The prescription may, but
22is not required to, list the illness, disease, or condition
23for which the drug or device is being prescribed. DEA
24registration numbers shall not be required on inpatient drug
25orders. A prescription for medication other than controlled
26substances shall be valid for up to 15 months from the date

 

 

HB0135 Engrossed- 13 -LRB102 02749 BMS 12752 b

1issued for the purpose of refills, unless the prescription
2states otherwise.
3    (f) "Person" means and includes a natural person,
4partnership, association, corporation, government entity, or
5any other legal entity.
6    (g) "Department" means the Department of Financial and
7Professional Regulation.
8    (h) "Board of Pharmacy" or "Board" means the State Board
9of Pharmacy of the Department of Financial and Professional
10Regulation.
11    (i) "Secretary" means the Secretary of Financial and
12Professional Regulation.
13    (j) "Drug product selection" means the interchange for a
14prescribed pharmaceutical product in accordance with Section
1525 of this Act and Section 3.14 of the Illinois Food, Drug and
16Cosmetic Act.
17    (k) "Inpatient drug order" means an order issued by an
18authorized prescriber for a resident or patient of a facility
19licensed under the Nursing Home Care Act, the ID/DD Community
20Care Act, the MC/DD Act, the Specialized Mental Health
21Rehabilitation Act of 2013, the Hospital Licensing Act, or the
22University of Illinois Hospital Act, or a facility which is
23operated by the Department of Human Services (as successor to
24the Department of Mental Health and Developmental
25Disabilities) or the Department of Corrections.
26    (k-5) "Pharmacist" means an individual health care

 

 

HB0135 Engrossed- 14 -LRB102 02749 BMS 12752 b

1professional and provider currently licensed by this State to
2engage in the practice of pharmacy.
3    (l) "Pharmacist in charge" means the licensed pharmacist
4whose name appears on a pharmacy license and who is
5responsible for all aspects of the operation related to the
6practice of pharmacy.
7    (m) "Dispense" or "dispensing" means the interpretation,
8evaluation, and implementation of a prescription drug order,
9including the preparation and delivery of a drug or device to a
10patient or patient's agent in a suitable container
11appropriately labeled for subsequent administration to or use
12by a patient in accordance with applicable State and federal
13laws and regulations. "Dispense" or "dispensing" does not mean
14the physical delivery to a patient or a patient's
15representative in a home or institution by a designee of a
16pharmacist or by common carrier. "Dispense" or "dispensing"
17also does not mean the physical delivery of a drug or medical
18device to a patient or patient's representative by a
19pharmacist's designee within a pharmacy or drugstore while the
20pharmacist is on duty and the pharmacy is open.
21    (n) "Nonresident pharmacy" means a pharmacy that is
22located in a state, commonwealth, or territory of the United
23States, other than Illinois, that delivers, dispenses, or
24distributes, through the United States Postal Service,
25commercially acceptable parcel delivery service, or other
26common carrier, to Illinois residents, any substance which

 

 

HB0135 Engrossed- 15 -LRB102 02749 BMS 12752 b

1requires a prescription.
2    (o) "Compounding" means the preparation and mixing of
3components, excluding flavorings, (1) as the result of a
4prescriber's prescription drug order or initiative based on
5the prescriber-patient-pharmacist relationship in the course
6of professional practice or (2) for the purpose of, or
7incident to, research, teaching, or chemical analysis and not
8for sale or dispensing. "Compounding" includes the preparation
9of drugs or devices in anticipation of receiving prescription
10drug orders based on routine, regularly observed dispensing
11patterns. Commercially available products may be compounded
12for dispensing to individual patients only if all of the
13following conditions are met: (i) the commercial product is
14not reasonably available from normal distribution channels in
15a timely manner to meet the patient's needs and (ii) the
16prescribing practitioner has requested that the drug be
17compounded.
18    (p) (Blank).
19    (q) (Blank).
20    (r) "Patient counseling" means the communication between a
21pharmacist or a student pharmacist under the supervision of a
22pharmacist and a patient or the patient's representative about
23the patient's medication or device for the purpose of
24optimizing proper use of prescription medications or devices.
25"Patient counseling" may include without limitation (1)
26obtaining a medication history; (2) acquiring a patient's

 

 

HB0135 Engrossed- 16 -LRB102 02749 BMS 12752 b

1allergies and health conditions; (3) facilitation of the
2patient's understanding of the intended use of the medication;
3(4) proper directions for use; (5) significant potential
4adverse events; (6) potential food-drug interactions; and (7)
5the need to be compliant with the medication therapy. A
6pharmacy technician may only participate in the following
7aspects of patient counseling under the supervision of a
8pharmacist: (1) obtaining medication history; (2) providing
9the offer for counseling by a pharmacist or student
10pharmacist; and (3) acquiring a patient's allergies and health
11conditions.
12    (s) "Patient profiles" or "patient drug therapy record"
13means the obtaining, recording, and maintenance of patient
14prescription information, including prescriptions for
15controlled substances, and personal information.
16    (t) (Blank).
17    (u) "Medical device" or "device" means an instrument,
18apparatus, implement, machine, contrivance, implant, in vitro
19reagent, or other similar or related article, including any
20component part or accessory, required under federal law to
21bear the label "Caution: Federal law requires dispensing by or
22on the order of a physician". A seller of goods and services
23who, only for the purpose of retail sales, compounds, sells,
24rents, or leases medical devices shall not, by reasons
25thereof, be required to be a licensed pharmacy.
26    (v) "Unique identifier" means an electronic signature,

 

 

HB0135 Engrossed- 17 -LRB102 02749 BMS 12752 b

1handwritten signature or initials, thumb print, or other
2acceptable biometric or electronic identification process as
3approved by the Department.
4    (w) "Current usual and customary retail price" means the
5price that a pharmacy charges to a non-third-party payor.
6    (x) "Automated pharmacy system" means a mechanical system
7located within the confines of the pharmacy or remote location
8that performs operations or activities, other than compounding
9or administration, relative to storage, packaging, dispensing,
10or distribution of medication, and which collects, controls,
11and maintains all transaction information.
12    (y) "Drug regimen review" means and includes the
13evaluation of prescription drug orders and patient records for
14(1) known allergies; (2) drug or potential therapy
15contraindications; (3) reasonable dose, duration of use, and
16route of administration, taking into consideration factors
17such as age, gender, and contraindications; (4) reasonable
18directions for use; (5) potential or actual adverse drug
19reactions; (6) drug-drug interactions; (7) drug-food
20interactions; (8) drug-disease contraindications; (9)
21therapeutic duplication; (10) patient laboratory values when
22authorized and available; (11) proper utilization (including
23over or under utilization) and optimum therapeutic outcomes;
24and (12) abuse and misuse.
25    (z) "Electronically transmitted prescription" means a
26prescription that is created, recorded, or stored by

 

 

HB0135 Engrossed- 18 -LRB102 02749 BMS 12752 b

1electronic means; issued and validated with an electronic
2signature; and transmitted by electronic means directly from
3the prescriber to a pharmacy. An electronic prescription is
4not an image of a physical prescription that is transferred by
5electronic means from computer to computer, facsimile to
6facsimile, or facsimile to computer.
7    (aa) "Medication therapy management services" means a
8distinct service or group of services offered by licensed
9pharmacists, physicians licensed to practice medicine in all
10its branches, advanced practice registered nurses authorized
11in a written agreement with a physician licensed to practice
12medicine in all its branches, or physician assistants
13authorized in guidelines by a supervising physician that
14optimize therapeutic outcomes for individual patients through
15improved medication use. In a retail or other non-hospital
16pharmacy, medication therapy management services shall consist
17of the evaluation of prescription drug orders and patient
18medication records to resolve conflicts with the following:
19        (1) known allergies;
20        (2) drug or potential therapy contraindications;
21        (3) reasonable dose, duration of use, and route of
22    administration, taking into consideration factors such as
23    age, gender, and contraindications;
24        (4) reasonable directions for use;
25        (5) potential or actual adverse drug reactions;
26        (6) drug-drug interactions;

 

 

HB0135 Engrossed- 19 -LRB102 02749 BMS 12752 b

1        (7) drug-food interactions;
2        (8) drug-disease contraindications;
3        (9) identification of therapeutic duplication;
4        (10) patient laboratory values when authorized and
5    available;
6        (11) proper utilization (including over or under
7    utilization) and optimum therapeutic outcomes; and
8        (12) drug abuse and misuse.
9    "Medication therapy management services" includes the
10following:
11        (1) documenting the services delivered and
12    communicating the information provided to patients'
13    prescribers within an appropriate time frame, not to
14    exceed 48 hours;
15        (2) providing patient counseling designed to enhance a
16    patient's understanding and the appropriate use of his or
17    her medications; and
18        (3) providing information, support services, and
19    resources designed to enhance a patient's adherence with
20    his or her prescribed therapeutic regimens.
21    "Medication therapy management services" may also include
22patient care functions authorized by a physician licensed to
23practice medicine in all its branches for his or her
24identified patient or groups of patients under specified
25conditions or limitations in a standing order from the
26physician.

 

 

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1    "Medication therapy management services" in a licensed
2hospital may also include the following:
3        (1) reviewing assessments of the patient's health
4    status; and
5        (2) following protocols of a hospital pharmacy and
6    therapeutics committee with respect to the fulfillment of
7    medication orders.
8    (bb) "Pharmacist care" means the provision by a pharmacist
9of medication therapy management services, with or without the
10dispensing of drugs or devices, intended to achieve outcomes
11that improve patient health, quality of life, and comfort and
12enhance patient safety.
13    (cc) "Protected health information" means individually
14identifiable health information that, except as otherwise
15provided, is:
16        (1) transmitted by electronic media;
17        (2) maintained in any medium set forth in the
18    definition of "electronic media" in the federal Health
19    Insurance Portability and Accountability Act; or
20        (3) transmitted or maintained in any other form or
21    medium.
22    "Protected health information" does not include
23individually identifiable health information found in:
24        (1) education records covered by the federal Family
25    Educational Right and Privacy Act; or
26        (2) employment records held by a licensee in its role

 

 

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1    as an employer.
2    (dd) "Standing order" means a specific order for a patient
3or group of patients issued by a physician licensed to
4practice medicine in all its branches in Illinois.
5    (ee) "Address of record" means the designated address
6recorded by the Department in the applicant's application file
7or licensee's license file maintained by the Department's
8licensure maintenance unit.
9    (ff) "Home pharmacy" means the location of a pharmacy's
10primary operations.
11    (gg) "Email address of record" means the designated email
12address recorded by the Department in the applicant's
13application file or the licensee's license file, as maintained
14by the Department's licensure maintenance unit.
15(Source: P.A. 100-208, eff. 1-1-18; 100-497, eff. 9-8-17;
16100-513, eff. 1-1-18; 100-804, eff. 1-1-19; 100-863, eff.
178-14-18; 101-349, eff. 1-1-20; revised 8-21-20.)
 
18    (225 ILCS 85/43 new)
19    Sec. 43. Dispensation of hormonal contraceptives.
20    (a) The dispensing of hormonal contraceptives to a patient
21shall be pursuant to a valid prescription or standing order by
22a physician licensed to practice medicine in all its branches
23or the medical director of a local health department, pursuant
24to the following:
25        (1) a pharmacist may dispense no more than a 12-month

 

 

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1    supply of hormonal contraceptives to a patient;
2        (2) a pharmacist must complete an educational training
3    program accredited by the Accreditation Council for
4    Pharmacy Education and approved by the Department that is
5    related to the patient self-screening risk assessment,
6    patient assessment contraceptive counseling and education,
7    and dispensation of hormonal contraceptives;
8        (3) a pharmacist shall have the patient complete the
9    self-screening risk assessment tool; the self-screening
10    risk assessment tool is to be based on the most current
11    version of the United States Medical Eligibility Criteria
12    for Contraceptive Use published by the federal Centers for
13    Disease Control and Prevention;
14        (4) based upon the results of the self-screening risk
15    assessment and the patient assessment, the pharmacist
16    shall use his or her professional and clinical judgment as
17    to when a patient should be referred to the patient's
18    physician or another health care provider;
19        (5) a pharmacist shall provide, during the patient
20    assessment and consultation, counseling and education
21    about all methods of contraception, including methods not
22    covered under the standing order, and their proper use and
23    effectiveness;
24        (6) the patient consultation shall take place in a
25    private manner; and
26        (7) a pharmacist and pharmacy must maintain

 

 

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1    appropriate records.
2    (b) The Department may adopt rules to implement this
3Section.
4    (c) Nothing in this Section shall be interpreted to
5require a pharmacist to dispense hormonal contraception under
6a standing order issued by a physician licensed to practice
7medicine in all its branches, the medical director of a local
8health department, or the Medical Director of the Department
9of Public Health.
 
10    Section 35. The Illinois Public Aid Code is amended by
11adding Section 5-5.12d as follows:
 
12    (305 ILCS 5/5-5.12d new)
13    Sec. 5-5.12d. Coverage for patient care services for
14hormonal contraceptives provided by a pharmacist.
15    (a) Subject to approval by the federal Centers for
16Medicare and Medicaid Services, the medical assistance
17program, including both the fee-for-service and managed care
18medical assistance programs established under this Article,
19shall cover patient care services provided by a pharmacist for
20hormonal contraceptives assessment and consultation.
21    (b) The Department shall establish a fee schedule for
22patient care services provided by a pharmacist for hormonal
23contraceptives assessment and consultation.
24    (c) The rate of reimbursement for patient care services

 

 

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1provided by a pharmacist for hormonal contraceptives
2assessment and consultation shall be at 85% of the fee
3schedule for physician services by the medical assistance
4program.
5    (d) A pharmacist must be enrolled in the medical
6assistance program as an ordering and referring provider prior
7to providing hormonal contraceptives assessment and
8consultation that is submitted by a pharmacy or pharmacist
9provider for reimbursement pursuant to this Section.
10    (e) The Department shall apply for any necessary federal
11waivers or approvals to implement this Section by January 1,
122022.
13    (f) This Section does not restrict or prohibit any
14services currently provided by pharmacists as authorized by
15law, including, but not limited to, pharmacist services
16provided under this Code or authorized under the Illinois
17Title XIX State Plan.
18    (g) The Department shall submit to the Joint Committee on
19Administrative Rules administrative rules for this Section as
20soon as practicable but no later than 6 months after federal
21approval is received.
 
22    Section 99. Effective date. This Act takes effect January
231, 2022.