Full Text of HJR0007 94th General Assembly
HJ0007 94TH GENERAL ASSEMBLY
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| HOUSE JOINT RESOLUTION
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| WHEREAS, the recent contract between the State of Illinois | 3 |
| and AFSCME has brought increased attention to the management of | 4 |
| prescription drug programs by Pharmacy Benefit Managers | 5 |
| (PBMs); and
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| WHEREAS, An estimated 75% to 90% of managed care | 7 |
| organizations have contracted with PBMs to manage their | 8 |
| prescription drug expenses; and
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| WHEREAS, Prescription drug manufacturers negotiate | 10 |
| directly with PBMs, managed care organizations, and other | 11 |
| payers to create a plan's formulary, address co-pay levels and | 12 |
| prior authorization requirements, and to offer rebates and | 13 |
| other incentives to PBMs; and
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| WHEREAS, Reimbursements paid by PBMs to pharmacies are | 15 |
| generally among the lowest accepted by pharmacies and are | 16 |
| directed at moving patients from "brick and mortar" Illinois | 17 |
| pharmacies to mail-order facilities; and
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| WHEREAS, Cost control strategies and PBM utilization | 19 |
| methods suggest cost savings do exist, however, prescription | 20 |
| expenditures continue to increase and have been the most | 21 |
| rapidly growing component of health care expenditures in recent | 22 |
| years; therefore, be it
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| RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE | 24 |
| NINETY-FOURTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, THE | 25 |
| SENATE CONCURRING HEREIN, that the Illinois Task Force on | 26 |
| Pharmacy Benefit Managers is created; the Task Force shall | 27 |
| consist of 16 members; from the Senate, 2 members shall be | 28 |
| appointed by the President of the Senate and 2 members shall be | 29 |
| appointed by the Minority Leader of the Senate, one of the | 30 |
| Senate members shall serve as co-chairperson; from the House of |
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| Representatives, 2 members shall be appointed by the Speaker of | 2 |
| the House of Representatives and 2 members shall be appointed | 3 |
| by the Minority Leader of the House of Representatives, one of | 4 |
| the House of Representatives members shall serve as | 5 |
| co-chairperson; one member shall be appointed from the Illinois | 6 |
| Pharmacists Association; one member shall be appointed from the | 7 |
| Illinois Retail Merchants Association; one member shall be | 8 |
| appointed from the Illinois Hospital Association; one member | 9 |
| shall be appointed from the Illinois Nurses Association; one | 10 |
| member shall be appointed from the Illinois Insurance | 11 |
| Association; one member shall be appointed from the Illinois | 12 |
| Association of Health Plans; one member shall be appointed from | 13 |
| the Walgreens Health Initiative pharmacy benefit management | 14 |
| program; and one member shall be appointed from the winner of | 15 |
| the contract for prescription management services to be offered | 16 |
| through the State Employees Group Insurance Program, the Local | 17 |
| Government Health Plan, and the College Insurance Program; and | 18 |
| be it further
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| RESOLVED, That the mission of the Task Force shall be to | 20 |
| describe and discuss the different methods to ensure that the | 21 |
| purchasers of PBM services have the transparency necessary to | 22 |
| make a reasoned purchasing decision regarding payment rates, | 23 |
| preferred drug lists, reimbursement rates, manufacturer | 24 |
| rebates to PBMs, and costs and savings associated with forcing | 25 |
| or providing incentives for patients to enroll in mail-order | 26 |
| programs; the Task Force shall examine, along with any other | 27 |
| issues it may choose to investigate with respect to PBMs, the | 28 |
| following issues: (1) the State of Illinois' utilization of | 29 |
| PBMs, including the effect that this utilization has upon | 30 |
| independent pharmacies; (2) pharmacy payments and | 31 |
| reimbursement-negotiated prices; (3) generic substitution; (4) | 32 |
| formularies; (5) disease management programs; and (6) drug | 33 |
| utilization review; and be it further
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| RESOLVED, That the Task Force shall report its preliminary |
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| findings to the General Assembly on or before May 1, 2005; and | 2 |
| be it further
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| RESOLVED, That the Task Force shall make a final report to | 4 |
| the General Assembly on or before July 1, 2005.
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