Full Text of HB0135 102nd General Assembly
HB0135ham002 102ND GENERAL ASSEMBLY | Rep. Michelle Mussman Filed: 4/20/2021
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| 1 | | AMENDMENT TO HOUSE BILL 135
| 2 | | AMENDMENT NO. ______. Amend House Bill 135 by replacing | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 5. The State Employees Group Insurance Act of | 5 | | 1971 is amended by changing Section 6.11 as follows:
| 6 | | (5 ILCS 375/6.11)
| 7 | | Sec. 6.11. Required health benefits; Illinois Insurance | 8 | | Code
requirements. The program of health
benefits shall | 9 | | provide the post-mastectomy care benefits required to be | 10 | | covered
by a policy of accident and health insurance under | 11 | | Section 356t of the Illinois
Insurance Code. The program of | 12 | | health benefits shall provide the coverage
required under | 13 | | Sections 356g, 356g.5, 356g.5-1, 356m,
356u, 356w, 356x, | 14 | | 356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, | 15 | | 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22, | 16 | | 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, |
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| 1 | | 356z.36, and 356z.41 , and 356z.43 of the
Illinois Insurance | 2 | | Code.
The program of health benefits must comply with Sections | 3 | | 155.22a, 155.37, 355b, 356z.19, 370c, and 370c.1 and Article | 4 | | XXXIIB of the
Illinois Insurance Code. The Department of | 5 | | Insurance shall enforce the requirements of this Section with | 6 | | respect to Sections 370c and 370c.1 of the Illinois Insurance | 7 | | Code; all other requirements of this Section shall be enforced | 8 | | by the Department of Central Management Services.
| 9 | | Rulemaking authority to implement Public Act 95-1045, if | 10 | | any, is conditioned on the rules being adopted in accordance | 11 | | with all provisions of the Illinois Administrative Procedure | 12 | | Act and all rules and procedures of the Joint Committee on | 13 | | Administrative Rules; any purported rule not so adopted, for | 14 | | whatever reason, is unauthorized. | 15 | | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; | 16 | | 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. | 17 | | 1-1-19; 100-1102, eff. 1-1-19; 100-1170, eff. 6-1-19; 101-13, | 18 | | eff. 6-12-19; 101-281, eff. 1-1-20; 101-393, eff. 1-1-20; | 19 | | 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff. | 20 | | 1-1-21 .) | 21 | | Section 10. The Department of Public Health Powers and | 22 | | Duties Law of the
Civil Administrative Code of Illinois is | 23 | | amended by adding Section 2310-705 as follows: | 24 | | (20 ILCS 2310/2310-705 new) |
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| 1 | | Sec. 2310-705. Contraceptive drugs and products; Director | 2 | | standing order. | 3 | | (a) As used in this Section: | 4 | | "Hormonal contraceptive" means a prescribed | 5 | | medically-acceptable oral drug, transdermal patch, or vaginal | 6 | | ring that is approved by the United States Food and Drug | 7 | | Administration to prevent pregnancy. | 8 | | "Standing order" has the meaning given to that term in the | 9 | | Pharmacy Practice Act. | 10 | | (b) If the Director of Public Health is a physician | 11 | | licensed to practice medicine in all its branches in Illinois, | 12 | | the Director shall establish a standing order complete with | 13 | | the issuance of a prescription for a hormonal contraceptive in | 14 | | accordance with this Section. If the Director is not a | 15 | | physician licensed to practice medicine in all its branches in | 16 | | Illinois, then the Medical Director of the Department of | 17 | | Public Health shall establish a standing order in accordance | 18 | | with this Section. | 19 | | (c) The standing order, at a minimum, shall comply with | 20 | | the following: | 21 | | (1) A pharmacist may dispense a 12-month supply of | 22 | | hormonal contraceptives to a patient. | 23 | | (2) A pharmacist shall have the patient complete the | 24 | | self-screening risk assessment tool. The self-screening | 25 | | risk assessment tool is to be based on the most current | 26 | | version of the United States Medical Eligibility Criteria |
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| 1 | | for Contraceptive Use published by the federal Centers for | 2 | | Disease Control and Prevention. | 3 | | (3) Based upon the results of the self-screening risk | 4 | | assessment and the patient assessment, the pharmacist | 5 | | shall use his or her professional and clinical judgment as | 6 | | to when a patient should be referred to the patient's | 7 | | physician or another health care provider. | 8 | | (4) The pharmacist shall provide, during the patient | 9 | | assessment and consultation, counseling and education | 10 | | about all methods of contraception, including methods not | 11 | | covered under the standing order, and their proper use and | 12 | | effectiveness. | 13 | | (5) The patient consultation shall take place in a | 14 | | private manner consistent with rules adopted by the | 15 | | Department of Financial and Professional Regulation. | 16 | | (6) The Department shall adopt rules under this | 17 | | Section that require a pharmacist to: | 18 | | (A) complete an educational training program | 19 | | accredited by the Accreditation Council for Pharmacy | 20 | | Education and approved by the Department that is | 21 | | related to the patient self-screening risk assessment, | 22 | | patient assessment, contraceptive counseling and | 23 | | education, and dispensation of hormonal | 24 | | contraceptives; and | 25 | | (B) dispense the hormonal contraceptive to the | 26 | | patient as soon as practicable after meeting the |
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| 1 | | requirements of paragraph (2). | 2 | | (7) All State and federal laws governing insurance | 3 | | coverage of contraceptive drugs shall apply to hormonal | 4 | | contraceptives dispensed by a pharmacist under this | 5 | | Section. | 6 | | Section 15. The Counties Code is amended by changing | 7 | | Section 5-1069.3 as follows: | 8 | | (55 ILCS 5/5-1069.3)
| 9 | | Sec. 5-1069.3. Required health benefits. If a county, | 10 | | including a home
rule
county, is a self-insurer for purposes | 11 | | of providing health insurance coverage
for its employees, the | 12 | | coverage shall include coverage for the post-mastectomy
care | 13 | | benefits required to be covered by a policy of accident and | 14 | | health
insurance under Section 356t and the coverage required | 15 | | under Sections 356g, 356g.5, 356g.5-1, 356u,
356w, 356x, | 16 | | 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, | 17 | | 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, | 18 | | 356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41 , and 356z.43 | 19 | | of
the Illinois Insurance Code. The coverage shall comply with | 20 | | Sections 155.22a, 355b, 356z.19, and 370c of
the Illinois | 21 | | Insurance Code. The Department of Insurance shall enforce the | 22 | | requirements of this Section. The requirement that health | 23 | | benefits be covered
as provided in this Section is an
| 24 | | exclusive power and function of the State and is a denial and |
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| 1 | | limitation under
Article VII, Section 6, subsection (h) of the | 2 | | Illinois Constitution. A home
rule county to which this | 3 | | Section applies must comply with every provision of
this | 4 | | Section.
| 5 | | Rulemaking authority to implement Public Act 95-1045, if | 6 | | any, is conditioned on the rules being adopted in accordance | 7 | | with all provisions of the Illinois Administrative Procedure | 8 | | Act and all rules and procedures of the Joint Committee on | 9 | | Administrative Rules; any purported rule not so adopted, for | 10 | | whatever reason, is unauthorized. | 11 | | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; | 12 | | 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. | 13 | | 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281, | 14 | | eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; | 15 | | 101-625, eff. 1-1-21 .) | 16 | | Section 20. The Illinois Municipal Code is amended by | 17 | | changing Section 10-4-2.3 as follows: | 18 | | (65 ILCS 5/10-4-2.3)
| 19 | | Sec. 10-4-2.3. Required health benefits. If a | 20 | | municipality, including a
home rule municipality, is a | 21 | | self-insurer for purposes of providing health
insurance | 22 | | coverage for its employees, the coverage shall include | 23 | | coverage for
the post-mastectomy care benefits required to be | 24 | | covered by a policy of
accident and health insurance under |
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| 1 | | Section 356t and the coverage required
under Sections 356g, | 2 | | 356g.5, 356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, | 3 | | 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, | 4 | | 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, | 5 | | 356z.36, and 356z.41 , and 356z.43 of the Illinois
Insurance
| 6 | | Code. The coverage shall comply with Sections 155.22a, 355b, | 7 | | 356z.19, and 370c of
the Illinois Insurance Code. The | 8 | | Department of Insurance shall enforce the requirements of this | 9 | | Section. The requirement that health
benefits be covered as | 10 | | provided in this is an exclusive power and function of
the | 11 | | State and is a denial and limitation under Article VII, | 12 | | Section 6,
subsection (h) of the Illinois Constitution. A home | 13 | | rule municipality to which
this Section applies must comply | 14 | | with every provision of this Section.
| 15 | | Rulemaking authority to implement Public Act 95-1045, if | 16 | | any, is conditioned on the rules being adopted in accordance | 17 | | with all provisions of the Illinois Administrative Procedure | 18 | | Act and all rules and procedures of the Joint Committee on | 19 | | Administrative Rules; any purported rule not so adopted, for | 20 | | whatever reason, is unauthorized. | 21 | | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; | 22 | | 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. | 23 | | 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281, | 24 | | eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; | 25 | | 101-625, eff. 1-1-21 .) |
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| 1 | | Section 25. The School Code is amended by changing Section | 2 | | 10-22.3f as follows: | 3 | | (105 ILCS 5/10-22.3f)
| 4 | | Sec. 10-22.3f. Required health benefits. Insurance | 5 | | protection and
benefits
for employees shall provide the | 6 | | post-mastectomy care benefits required to be
covered by a | 7 | | policy of accident and health insurance under Section 356t and | 8 | | the
coverage required under Sections 356g, 356g.5, 356g.5-1, | 9 | | 356u, 356w, 356x,
356z.6, 356z.8, 356z.9, 356z.11, 356z.12, | 10 | | 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, | 11 | | 356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41 , and 356z.43 | 12 | | of
the
Illinois Insurance Code.
Insurance policies shall | 13 | | comply with Section 356z.19 of the Illinois Insurance Code. | 14 | | The coverage shall comply with Sections 155.22a, 355b, and | 15 | | 370c of
the Illinois Insurance Code. The Department of | 16 | | Insurance shall enforce the requirements of this Section.
| 17 | | Rulemaking authority to implement Public Act 95-1045, if | 18 | | any, is conditioned on the rules being adopted in accordance | 19 | | with all provisions of the Illinois Administrative Procedure | 20 | | Act and all rules and procedures of the Joint Committee on | 21 | | Administrative Rules; any purported rule not so adopted, for | 22 | | whatever reason, is unauthorized. | 23 | | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; | 24 | | 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. | 25 | | 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281, |
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| 1 | | eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; | 2 | | 101-625, eff. 1-1-21 .) | 3 | | Section 30. The Illinois Insurance Code is amended by | 4 | | adding Section 356z.43 as follows: | 5 | | (215 ILCS 5/356z.43 new) | 6 | | Sec. 356z.43. Coverage for patient care services for | 7 | | hormonal contraceptives provided by a pharmacist. A group or | 8 | | individual policy of accident and health insurance or a | 9 | | managed care plan that is amended, delivered, issued, or | 10 | | renewed after the effective date of this amendatory Act of the | 11 | | 102nd General Assembly shall provide coverage for patient care | 12 | | services provided by a pharmacist for hormonal contraceptives | 13 | | assessment and consultation. | 14 | | Section 35. The Pharmacy Practice Act is amended by | 15 | | changing Section 3 and by adding Section 43 as follows:
| 16 | | (225 ILCS 85/3)
| 17 | | (Section scheduled to be repealed on January 1, 2023)
| 18 | | Sec. 3. Definitions. For the purpose of this Act, except | 19 | | where otherwise
limited therein:
| 20 | | (a) "Pharmacy" or "drugstore" means and includes every | 21 | | store, shop,
pharmacy department, or other place where | 22 | | pharmacist
care is
provided
by a pharmacist (1) where drugs, |
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| 1 | | medicines, or poisons are
dispensed, sold or
offered for sale | 2 | | at retail, or displayed for sale at retail; or
(2)
where
| 3 | | prescriptions of physicians, dentists, advanced practice | 4 | | registered nurses, physician assistants, veterinarians, | 5 | | podiatric physicians, or
optometrists, within the limits of | 6 | | their
licenses, are
compounded, filled, or dispensed; or (3) | 7 | | which has upon it or
displayed within
it, or affixed to or used | 8 | | in connection with it, a sign bearing the word or
words | 9 | | "Pharmacist", "Druggist", "Pharmacy", "Pharmaceutical
Care", | 10 | | "Apothecary", "Drugstore",
"Medicine Store", "Prescriptions", | 11 | | "Drugs", "Dispensary", "Medicines", or any word
or words of | 12 | | similar or like import, either in the English language
or any | 13 | | other language; or (4) where the characteristic prescription
| 14 | | sign (Rx) or similar design is exhibited; or (5) any store, or
| 15 | | shop,
or other place with respect to which any of the above | 16 | | words, objects,
signs or designs are used in any | 17 | | advertisement.
| 18 | | (b) "Drugs" means and includes (1) articles recognized
in | 19 | | the official United States Pharmacopoeia/National Formulary | 20 | | (USP/NF),
or any supplement thereto and being intended for and | 21 | | having for their
main use the diagnosis, cure, mitigation, | 22 | | treatment or prevention of
disease in man or other animals, as | 23 | | approved by the United States Food and
Drug Administration, | 24 | | but does not include devices or their components, parts,
or | 25 | | accessories; and (2) all other articles intended
for and | 26 | | having for their main use the diagnosis, cure, mitigation,
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| 1 | | treatment or prevention of disease in man or other animals, as | 2 | | approved
by the United States Food and Drug Administration, | 3 | | but does not include
devices or their components, parts, or | 4 | | accessories; and (3) articles
(other than food) having for | 5 | | their main use and intended
to affect the structure or any | 6 | | function of the body of man or other
animals; and (4) articles | 7 | | having for their main use and intended
for use as a component | 8 | | or any articles specified in clause (1), (2)
or (3); but does | 9 | | not include devices or their components, parts or
accessories.
| 10 | | (c) "Medicines" means and includes all drugs intended for
| 11 | | human or veterinary use approved by the United States Food and | 12 | | Drug
Administration.
| 13 | | (d) "Practice of pharmacy" means: | 14 | | (1) the interpretation and the provision of assistance | 15 | | in the monitoring, evaluation, and implementation of | 16 | | prescription drug orders; | 17 | | (2) the dispensing of prescription drug orders; | 18 | | (3) participation in drug and device selection; | 19 | | (4) drug administration limited to the administration | 20 | | of oral, topical, injectable, and inhalation as follows: | 21 | | (A) in the context of patient education on the | 22 | | proper use or delivery of medications; | 23 | | (B) vaccination of patients 14 years of age and | 24 | | older pursuant to a valid prescription or standing | 25 | | order, by a physician licensed to practice medicine in | 26 | | all its branches, upon completion of appropriate |
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| 1 | | training, including how to address contraindications | 2 | | and adverse reactions set forth by rule, with | 3 | | notification to the patient's physician and | 4 | | appropriate record retention, or pursuant to hospital | 5 | | pharmacy and therapeutics committee policies and | 6 | | procedures; | 7 | | (B-5) following the initial administration of | 8 | | long-acting or extended-release extended release form | 9 | | opioid antagonists by a physician licensed to practice | 10 | | medicine in all its branches, administration of | 11 | | injections of long-acting or extended-release form | 12 | | opioid antagonists for the treatment of substance use | 13 | | disorder, pursuant to a valid prescription by a | 14 | | physician licensed to practice medicine in all its | 15 | | branches, upon completion of appropriate training, | 16 | | including how to address contraindications and adverse | 17 | | reactions, including, but not limited to, respiratory | 18 | | depression and the performance of cardiopulmonary | 19 | | resuscitation, set forth by rule, with notification to | 20 | | the patient's physician and appropriate record | 21 | | retention, or pursuant to hospital pharmacy and | 22 | | therapeutics committee policies and procedures; | 23 | | (C) administration of injections of | 24 | | alpha-hydroxyprogesterone caproate, pursuant to a | 25 | | valid prescription, by a physician licensed to | 26 | | practice medicine in all its branches, upon completion |
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| 1 | | of appropriate training, including how to address | 2 | | contraindications and adverse reactions set forth by | 3 | | rule, with notification to the patient's physician and | 4 | | appropriate record retention, or pursuant to hospital | 5 | | pharmacy and therapeutics committee policies and | 6 | | procedures; and | 7 | | (D) administration of injections of long-term | 8 | | antipsychotic medications pursuant to a valid | 9 | | prescription by a physician licensed to practice | 10 | | medicine in all its branches, upon completion of | 11 | | appropriate training conducted by an Accreditation | 12 | | Council of Pharmaceutical Education accredited | 13 | | provider, including how to address contraindications | 14 | | and adverse reactions set forth by rule, with | 15 | | notification to the patient's physician and | 16 | | appropriate record retention, or pursuant to hospital | 17 | | pharmacy and therapeutics committee policies and | 18 | | procedures. | 19 | | (5) vaccination of patients ages 10 through 13 limited | 20 | | to the Influenza (inactivated influenza vaccine and live | 21 | | attenuated influenza intranasal vaccine) and Tdap (defined | 22 | | as tetanus, diphtheria, acellular pertussis) vaccines, | 23 | | pursuant to a valid prescription or standing order, by a | 24 | | physician licensed to practice medicine in all its | 25 | | branches, upon completion of appropriate training, | 26 | | including how to address contraindications and adverse |
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| 1 | | reactions set forth by rule, with notification to the | 2 | | patient's physician and appropriate record retention, or | 3 | | pursuant to hospital pharmacy and therapeutics committee | 4 | | policies and procedures; | 5 | | (6) drug regimen review; | 6 | | (7) drug or drug-related research; | 7 | | (8) the provision of patient counseling; | 8 | | (9) the practice of telepharmacy; | 9 | | (10) the provision of those acts or services necessary | 10 | | to provide pharmacist care; | 11 | | (11) medication therapy management; and | 12 | | (12) the responsibility for compounding and labeling | 13 | | of drugs and devices (except labeling by a manufacturer, | 14 | | repackager, or distributor of non-prescription drugs and | 15 | | commercially packaged legend drugs and devices), proper | 16 | | and safe storage of drugs and devices, and maintenance of | 17 | | required records ; and . | 18 | | (13) the assessment and consultation of patients and | 19 | | dispensing of hormonal contraceptives pursuant to the | 20 | | standing order under Section 2310-705 of the Department of | 21 | | Public Health Powers and Duties Law of the Civil | 22 | | Administrative Code of Illinois. | 23 | | A pharmacist who performs any of the acts defined as the | 24 | | practice of pharmacy in this State must be actively licensed | 25 | | as a pharmacist under this Act.
| 26 | | (e) "Prescription" means and includes any written, oral, |
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| 1 | | facsimile, or
electronically transmitted order for drugs
or | 2 | | medical devices, issued by a physician licensed to practice | 3 | | medicine in
all its branches, dentist, veterinarian, podiatric | 4 | | physician, or
optometrist, within the
limits of his or her | 5 | | license, by a physician assistant in accordance with
| 6 | | subsection (f) of Section 4, or by an advanced practice | 7 | | registered nurse in
accordance with subsection (g) of Section | 8 | | 4, containing the
following: (1) name
of the patient; (2) date | 9 | | when prescription was issued; (3) name
and strength of drug or | 10 | | description of the medical device prescribed;
and (4) | 11 | | quantity; (5) directions for use; (6) prescriber's name,
| 12 | | address,
and signature; and (7) DEA registration number where | 13 | | required, for controlled
substances.
The prescription may, but | 14 | | is not required to, list the illness, disease, or condition | 15 | | for which the drug or device is being prescribed. DEA | 16 | | registration numbers shall not be required on inpatient drug | 17 | | orders. A prescription for medication other than controlled | 18 | | substances shall be valid for up to 15 months from the date | 19 | | issued for the purpose of refills, unless the prescription | 20 | | states otherwise.
| 21 | | (f) "Person" means and includes a natural person, | 22 | | partnership,
association, corporation, government entity, or | 23 | | any other legal
entity.
| 24 | | (g) "Department" means the Department of Financial and
| 25 | | Professional Regulation.
| 26 | | (h) "Board of Pharmacy" or "Board" means the State Board
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| 1 | | of Pharmacy of the Department of Financial and Professional | 2 | | Regulation.
| 3 | | (i) "Secretary"
means the Secretary
of Financial and | 4 | | Professional Regulation.
| 5 | | (j) "Drug product selection" means the interchange for a
| 6 | | prescribed pharmaceutical product in accordance with Section | 7 | | 25 of
this Act and Section 3.14 of the Illinois Food, Drug and | 8 | | Cosmetic Act.
| 9 | | (k) "Inpatient drug order" means an order issued by an | 10 | | authorized
prescriber for a resident or patient of a facility | 11 | | licensed under the
Nursing Home Care Act, the ID/DD Community | 12 | | Care Act, the MC/DD Act, the Specialized Mental Health | 13 | | Rehabilitation Act of 2013, the Hospital Licensing Act, or the | 14 | | University of Illinois Hospital Act, or a facility which is | 15 | | operated by the Department of Human
Services (as successor to | 16 | | the Department of Mental Health
and Developmental | 17 | | Disabilities) or the Department of Corrections.
| 18 | | (k-5) "Pharmacist" means an individual health care | 19 | | professional and
provider currently licensed by this State to | 20 | | engage in the practice of
pharmacy.
| 21 | | (l) "Pharmacist in charge" means the licensed pharmacist | 22 | | whose name appears
on a pharmacy license and who is | 23 | | responsible for all aspects of the
operation related to the | 24 | | practice of pharmacy.
| 25 | | (m) "Dispense" or "dispensing" means the interpretation, | 26 | | evaluation, and implementation of a prescription drug order, |
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| 1 | | including the preparation and delivery of a drug or device to a | 2 | | patient or patient's agent in a suitable container | 3 | | appropriately labeled for subsequent administration to or use | 4 | | by a patient in accordance with applicable State and federal | 5 | | laws and regulations.
"Dispense" or "dispensing" does not mean | 6 | | the physical delivery to a patient or a
patient's | 7 | | representative in a home or institution by a designee of a | 8 | | pharmacist
or by common carrier. "Dispense" or "dispensing" | 9 | | also does not mean the physical delivery
of a drug or medical | 10 | | device to a patient or patient's representative by a
| 11 | | pharmacist's designee within a pharmacy or drugstore while the | 12 | | pharmacist is
on duty and the pharmacy is open.
| 13 | | (n) "Nonresident pharmacy"
means a pharmacy that is | 14 | | located in a state, commonwealth, or territory
of the United | 15 | | States, other than Illinois, that delivers, dispenses, or
| 16 | | distributes, through the United States Postal Service, | 17 | | commercially acceptable parcel delivery service, or other | 18 | | common
carrier, to Illinois residents, any substance which | 19 | | requires a prescription.
| 20 | | (o) "Compounding" means the preparation and mixing of | 21 | | components, excluding flavorings, (1) as the result of a | 22 | | prescriber's prescription drug order or initiative based on | 23 | | the prescriber-patient-pharmacist relationship in the course | 24 | | of professional practice or (2) for the purpose of, or | 25 | | incident to, research, teaching, or chemical analysis and not | 26 | | for sale or dispensing. "Compounding" includes the preparation |
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| 1 | | of drugs or devices in anticipation of receiving prescription | 2 | | drug orders based on routine, regularly observed dispensing | 3 | | patterns. Commercially available products may be compounded | 4 | | for dispensing to individual patients only if all of the | 5 | | following conditions are met: (i) the commercial product is | 6 | | not reasonably available from normal distribution channels in | 7 | | a timely manner to meet the patient's needs and (ii) the | 8 | | prescribing practitioner has requested that the drug be | 9 | | compounded.
| 10 | | (p) (Blank).
| 11 | | (q) (Blank).
| 12 | | (r) "Patient counseling" means the communication between a | 13 | | pharmacist or a student pharmacist under the supervision of a | 14 | | pharmacist and a patient or the patient's representative about | 15 | | the patient's medication or device for the purpose of | 16 | | optimizing proper use of prescription medications or devices. | 17 | | "Patient counseling" may include without limitation (1) | 18 | | obtaining a medication history; (2) acquiring a patient's | 19 | | allergies and health conditions; (3) facilitation of the | 20 | | patient's understanding of the intended use of the medication; | 21 | | (4) proper directions for use; (5) significant potential | 22 | | adverse events; (6) potential food-drug interactions; and (7) | 23 | | the need to be compliant with the medication therapy. A | 24 | | pharmacy technician may only participate in the following | 25 | | aspects of patient counseling under the supervision of a | 26 | | pharmacist: (1) obtaining medication history; (2) providing |
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| 1 | | the offer for counseling by a pharmacist or student | 2 | | pharmacist; and (3) acquiring a patient's allergies and health | 3 | | conditions.
| 4 | | (s) "Patient profiles" or "patient drug therapy record" | 5 | | means the
obtaining, recording, and maintenance of patient | 6 | | prescription
information, including prescriptions for | 7 | | controlled substances, and
personal information.
| 8 | | (t) (Blank).
| 9 | | (u) "Medical device" or "device" means an instrument, | 10 | | apparatus, implement, machine,
contrivance, implant, in vitro | 11 | | reagent, or other similar or related article,
including any | 12 | | component part or accessory, required under federal law to
| 13 | | bear the label "Caution: Federal law requires dispensing by or | 14 | | on the order
of a physician". A seller of goods and services | 15 | | who, only for the purpose of
retail sales, compounds, sells, | 16 | | rents, or leases medical devices shall not,
by reasons | 17 | | thereof, be required to be a licensed pharmacy.
| 18 | | (v) "Unique identifier" means an electronic signature, | 19 | | handwritten
signature or initials, thumb print, or other | 20 | | acceptable biometric
or electronic identification process as | 21 | | approved by the Department.
| 22 | | (w) "Current usual and customary retail price" means the | 23 | | price that a pharmacy charges to a non-third-party payor.
| 24 | | (x) "Automated pharmacy system" means a mechanical system | 25 | | located within the confines of the pharmacy or remote location | 26 | | that performs operations or activities, other than compounding |
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| 1 | | or administration, relative to storage, packaging, dispensing, | 2 | | or distribution of medication, and which collects, controls, | 3 | | and maintains all transaction information. | 4 | | (y) "Drug regimen review" means and includes the | 5 | | evaluation of prescription drug orders and patient records for | 6 | | (1)
known allergies; (2) drug or potential therapy | 7 | | contraindications;
(3) reasonable dose, duration of use, and | 8 | | route of administration, taking into consideration factors | 9 | | such as age, gender, and contraindications; (4) reasonable | 10 | | directions for use; (5) potential or actual adverse drug | 11 | | reactions; (6) drug-drug interactions; (7) drug-food | 12 | | interactions; (8) drug-disease contraindications; (9) | 13 | | therapeutic duplication; (10) patient laboratory values when | 14 | | authorized and available; (11) proper utilization (including | 15 | | over or under utilization) and optimum therapeutic outcomes; | 16 | | and (12) abuse and misuse.
| 17 | | (z) "Electronically transmitted prescription" means a | 18 | | prescription that is created, recorded, or stored by | 19 | | electronic means; issued and validated with an electronic | 20 | | signature; and transmitted by electronic means directly from | 21 | | the prescriber to a pharmacy. An electronic prescription is | 22 | | not an image of a physical prescription that is transferred by | 23 | | electronic means from computer to computer, facsimile to | 24 | | facsimile, or facsimile to computer.
| 25 | | (aa) "Medication therapy management services" means a | 26 | | distinct service or group of services offered by licensed |
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| 1 | | pharmacists, physicians licensed to practice medicine in all | 2 | | its branches, advanced practice registered nurses authorized | 3 | | in a written agreement with a physician licensed to practice | 4 | | medicine in all its branches, or physician assistants | 5 | | authorized in guidelines by a supervising physician that | 6 | | optimize therapeutic outcomes for individual patients through | 7 | | improved medication use. In a retail or other non-hospital | 8 | | pharmacy, medication therapy management services shall consist | 9 | | of the evaluation of prescription drug orders and patient | 10 | | medication records to resolve conflicts with the following: | 11 | | (1) known allergies; | 12 | | (2) drug or potential therapy contraindications; | 13 | | (3) reasonable dose, duration of use, and route of | 14 | | administration, taking into consideration factors such as | 15 | | age, gender, and contraindications; | 16 | | (4) reasonable directions for use; | 17 | | (5) potential or actual adverse drug reactions; | 18 | | (6) drug-drug interactions; | 19 | | (7) drug-food interactions; | 20 | | (8) drug-disease contraindications; | 21 | | (9) identification of therapeutic duplication; | 22 | | (10) patient laboratory values when authorized and | 23 | | available; | 24 | | (11) proper utilization (including over or under | 25 | | utilization) and optimum therapeutic outcomes; and | 26 | | (12) drug abuse and misuse. |
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| 1 | | "Medication therapy management services" includes the | 2 | | following: | 3 | | (1) documenting the services delivered and | 4 | | communicating the information provided to patients' | 5 | | prescribers within an appropriate time frame, not to | 6 | | exceed 48 hours; | 7 | | (2) providing patient counseling designed to enhance a | 8 | | patient's understanding and the appropriate use of his or | 9 | | her medications; and | 10 | | (3) providing information, support services, and | 11 | | resources designed to enhance a patient's adherence with | 12 | | his or her prescribed therapeutic regimens. | 13 | | "Medication therapy management services" may also include | 14 | | patient care functions authorized by a physician licensed to | 15 | | practice medicine in all its branches for his or her | 16 | | identified patient or groups of patients under specified | 17 | | conditions or limitations in a standing order from the | 18 | | physician. | 19 | | "Medication therapy management services" in a licensed | 20 | | hospital may also include the following: | 21 | | (1) reviewing assessments of the patient's health | 22 | | status; and | 23 | | (2) following protocols of a hospital pharmacy and | 24 | | therapeutics committee with respect to the fulfillment of | 25 | | medication orders.
| 26 | | (bb) "Pharmacist care" means the provision by a pharmacist |
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| 1 | | of medication therapy management services, with or without the | 2 | | dispensing of drugs or devices, intended to achieve outcomes | 3 | | that improve patient health, quality of life, and comfort and | 4 | | enhance patient safety.
| 5 | | (cc) "Protected health information" means individually | 6 | | identifiable health information that, except as otherwise | 7 | | provided, is:
| 8 | | (1) transmitted by electronic media; | 9 | | (2) maintained in any medium set forth in the | 10 | | definition of "electronic media" in the federal Health | 11 | | Insurance Portability and Accountability Act; or | 12 | | (3) transmitted or maintained in any other form or | 13 | | medium. | 14 | | "Protected health information" does not include | 15 | | individually identifiable health information found in: | 16 | | (1) education records covered by the federal Family | 17 | | Educational Right and Privacy Act; or | 18 | | (2) employment records held by a licensee in its role | 19 | | as an employer. | 20 | | (dd) "Standing order" means a specific order for a patient | 21 | | or group of patients issued by a physician licensed to | 22 | | practice medicine in all its branches in Illinois. | 23 | | (ee) "Address of record" means the designated address | 24 | | recorded by the Department in the applicant's application file | 25 | | or licensee's license file maintained by the Department's | 26 | | licensure maintenance unit. |
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| 1 | | (ff) "Home pharmacy" means the location of a pharmacy's | 2 | | primary operations.
| 3 | | (gg) "Email address of record" means the designated email | 4 | | address recorded by the Department in the applicant's | 5 | | application file or the licensee's license file, as maintained | 6 | | by the Department's licensure maintenance unit. | 7 | | (Source: P.A. 100-208, eff. 1-1-18; 100-497, eff. 9-8-17; | 8 | | 100-513, eff. 1-1-18; 100-804, eff. 1-1-19; 100-863, eff. | 9 | | 8-14-18; 101-349, eff. 1-1-20; revised 8-21-20.) | 10 | | (225 ILCS 85/43 new) | 11 | | Sec. 43. Dispensation of hormonal contraceptives. | 12 | | (a) The dispensing of hormonal contraceptives to a patient | 13 | | shall be pursuant to a valid prescription or standing order by | 14 | | a physician licensed to practice medicine in all its branches | 15 | | or the medical director of a local health department, pursuant | 16 | | to the following: | 17 | | (1) a pharmacist may dispense no more than a 12-month | 18 | | supply of hormonal contraceptives to a patient; | 19 | | (2) a pharmacist must complete an educational training | 20 | | program accredited by the Accreditation Council for | 21 | | Pharmacy Education and approved by the Department that is | 22 | | related to the patient self-screening risk assessment, | 23 | | patient assessment contraceptive counseling and education, | 24 | | and dispensation of hormonal contraceptives; | 25 | | (3) a pharmacist shall have the patient complete the |
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| 1 | | self-screening risk assessment tool; the self-screening | 2 | | risk assessment tool is to be based on the most current | 3 | | version of the United States Medical Eligibility Criteria | 4 | | for Contraceptive Use published by the federal Centers for | 5 | | Disease Control and Prevention; | 6 | | (4) based upon the results of the self-screening risk | 7 | | assessment and the patient assessment, the pharmacist | 8 | | shall use his or her professional and clinical judgment as | 9 | | to when a patient should be referred to the patient's | 10 | | physician or another health care provider; | 11 | | (5) a pharmacist shall provide, during the patient | 12 | | assessment and consultation, counseling and education | 13 | | about all methods of contraception, including methods not | 14 | | covered under the standing order, and their proper use and | 15 | | effectiveness; | 16 | | (6) the patient consultation shall take place in a | 17 | | private manner; and | 18 | | (7) a pharmacist and pharmacy must maintain | 19 | | appropriate records. | 20 | | (b) The Department may adopt rules to implement this | 21 | | Section. | 22 | | (c) Nothing in this Section shall be interpreted to | 23 | | require a pharmacist to dispense hormonal contraception under | 24 | | a standing order issued by the Director of Public Health or the | 25 | | Medical Director of the Department of Public Health. |
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| 1 | | Section 40. The Illinois Public Aid Code is amended by | 2 | | adding Section 5-5.12d as follows: | 3 | | (305 ILCS 5/5-5.12d new) | 4 | | Sec. 5-5.12d. Coverage for patient care services for | 5 | | hormonal contraceptives provided by a pharmacist. | 6 | | (a) Subject to approval by the federal Centers for | 7 | | Medicare and Medicaid Services, the medical assistance | 8 | | program, including both the fee-for-service and managed care | 9 | | medical assistance programs established under this Article, | 10 | | shall cover patient care services provided by a pharmacist for | 11 | | hormonal contraceptives assessment and consultation. | 12 | | (b) The Department shall establish a fee schedule for | 13 | | patient care services provided by a pharmacist for hormonal | 14 | | contraceptives assessment and consultation. | 15 | | (c) The rate of reimbursement for patient care services | 16 | | provided by a pharmacist for hormonal contraceptives | 17 | | assessment and consultation shall be at 85% of the fee | 18 | | schedule for physician services by the medical assistance | 19 | | program. | 20 | | (d) A pharmacist must be enrolled in the medical | 21 | | assistance program as an ordering and referring provider prior | 22 | | to providing hormonal contraceptives assessment and | 23 | | consultation that is submitted by a pharmacy or pharmacist | 24 | | provider for reimbursement pursuant to this Section. | 25 | | (e) The Department shall apply for any necessary federal |
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| 1 | | waivers or approvals to implement this Section by January 1, | 2 | | 2022. | 3 | | (f) This Section does not restrict or prohibit any | 4 | | services currently provided by pharmacists as authorized by | 5 | | law, including, but not limited to, pharmacist services | 6 | | provided under this Code or authorized under the Illinois | 7 | | Title XIX State Plan. | 8 | | (g) The Department shall submit to the Joint Committee on | 9 | | Administrative Rules administrative rules for this Section as | 10 | | soon as practicable but no later than 6 months after federal | 11 | | approval is received.
| 12 | | Section 99. Effective date. This Act takes effect January | 13 | | 1, 2022.".
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