(215 ILCS 134/72)
(a) Before entering into an agreement with pharmacy providers, a
health care plan must establish terms and conditions that must be met by
pharmacy providers desiring to contract with the health
care plan. The terms and conditions shall not discriminate against a pharmacy
provider. A health care plan may
not refuse to contract
with a pharmacy provider that meets the terms and conditions established by the
health care plan.
If a pharmacy provider rejects the
terms and conditions established, the health care plan may
offer other terms and conditions necessary to comply with network adequacy
(b) A health care plan shall apply the same co-insurance, copayment, and
deductible factors to all drug prescriptions filled by a pharmacy provider that
participates in the health care plan's network.
Nothing in this subsection, however, prohibits a health care plan
from applying different co-insurance,
copayment, and deductible factors between brand name drugs and generic drugs
when a generic equivalent exists for the brand name drug.
(c) A health care
plan may not set a limit on
the quantity of drugs that an enrollee may obtain at one time with a
prescription unless the limit is applied uniformly to all pharmacy providers in
the health care plan's network.
(Source: P.A. 91-617, eff. 1-1-00.)