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| Public Act 101-0062 | ||||
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AN ACT concerning public aid.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Illinois Public Aid Code is amended by | ||||
adding Section 5-30.11 as follows: | ||||
(305 ILCS 5/5-30.11 new) | ||||
Sec. 5-30.11. Medicaid managed care organizations; | ||||
preferred drug lists. | ||||
(a) No later than January 1, 2020, the Illinois Department | ||||
shall develop a standardized format for all Medicaid managed | ||||
care organization preferred drug lists in collaboration with | ||||
Medicaid managed care organizations and other stakeholders, | ||||
including, but not limited to, organizations that serve | ||||
individuals impacted by HIV/AIDS or epilepsy, and | ||||
community-based organizations, providers, and entities with | ||||
expertise in drug formulary development. | ||||
(b) Following development of the standardized Preferred | ||||
Drug List format, the Illinois Department shall allow Medicaid | ||||
managed care organizations 6 months from the date of completion | ||||
to comply with the new Preferred Drug List format. Each | ||||
Medicaid managed care organization must post its preferred drug | ||||
list on its website without restricting access and must update | ||||
the preferred drug list posted on its website. Medicaid managed | ||||
care organizations shall publish updates to their preferred | ||
drug lists no less than 30 days prior to the date upon which | ||
any update or change takes effect, including, but not limited | ||
to, any and all changes to requirements for prior approval | ||
requirements, step therapy, or other utilization controls. | ||
(c)(1) No later than January 1, 2020, the Illinois | ||
Department shall establish and maintain the Illinois Drug and | ||
Therapeutics Advisory Board. The Board shall have the authority | ||
and responsibility to provide recommendations to the Illinois | ||
Department regarding which drug products to list on the | ||
Illinois Department's preferred drug list. The Illinois | ||
Department shall provide administrative support to the Board | ||
and the Board shall: | ||
(A) convene and meet no less than once per calendar | ||
quarter; | ||
(B)
provide regular opportunities for public comment; | ||
and | ||
(C)
comply with the provisions of the Open Meetings | ||
Act. | ||
All correspondence related to the Board, including | ||
correspondence to and from Board members, shall be subject to | ||
the Freedom of Information Act. | ||
(2) The Board shall consist of the following voting | ||
members, all of whom shall be appointed by the Governor and | ||
shall serve terms of 3 years without compensation: | ||
(A) one pharmacist licensed to practice pharmacy in | ||
Illinois who is recommended by a statewide organization | ||
representing pharmacists; | ||
(B) 4 physicians, recommended by a statewide | ||
organization representing physicians, who are licensed to | ||
practice medicine in all its branches in Illinois, have | ||
knowledge of and adhere to best practice standards, and | ||
have experience treating Illinois Medicaid beneficiaries; | ||
(C) at least one clinician who specializes in the | ||
prevention and treatment of HIV, recommended by an HIV | ||
healthcare advocacy organization; | ||
(D) at least one clinician recommended by a healthcare | ||
advocacy organization that serves individuals who are | ||
affected by chronic diseases that require significant | ||
pharmaceutical treatments; | ||
(E) one clinician representing the Illinois | ||
Department; and | ||
(F) one licensed psychiatrist, recommended by a | ||
statewide organization representing psychiatrists, who has | ||
experience treating Illinois Medicaid beneficiaries. | ||
One non-voting clinician recommended by an association of | ||
Medicaid managed care health plans shall serve a term of 3 | ||
years on the Board without compensation. | ||
Organizations interested in nominating non-voting | ||
clinicians to advise the Board may submit requests to | ||
participate to the Illinois Department. | ||
A licensed physician recommended by the Rare Disease | ||
Commission who is a rare disease specialist and possesses | ||
scientific knowledge and medical training with respect to rare | ||
diseases and is familiar with drug and biological products and | ||
treatment shall be notified in advance to attend an Illinois | ||
Drug and Therapeutics Advisory Board meeting when a drug or | ||
biological product is scheduled to be reviewed in order to | ||
advise and make recommendations on drugs or biological | ||
products. | ||
(d) The Illinois Department shall adopt rules, to be in | ||
place no later than January 1, 2020, for the purpose of | ||
establishing and maintaining the Board.
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Section 99. Effective date. This Act takes effect upon | ||
becoming law.
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