Rep. Laura Fine

Filed: 4/19/2018





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2    AMENDMENT NO. ______. Amend House Bill 4146 on page 3 by
3replacing lines 13 through 16 with the following:
4        "This paragraph (3) does not prohibit a health care
5    plan from removing a brand name drug or changing its
6    preferred or tiered cost-sharing if the plan adds a
7    therapeutically equivalent generic drug (as determined by
8    the United States Food and Drug Administration) if such
9    generic drug was not available on the market at the
10    beginning of the enrollee's plan year if the health care
11    plan does all of the following at least 30 days before
12    making the formulary change:
13            (i) provide general notification of the change in
14        its formulary to current and prospective enrollees;
15        and
16            (ii) provide direct notification to enrollees
17        currently prescribed the drug, including information
18        on the specific drugs involved and steps they may take



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1        to request coverage determinations and exceptions.
2        This paragraph (3) does not apply to a health plan as
3    defined in the State Employees Group Insurance Act of 1971
4    or medical assistance under Article V of the Illinois
5    Public Aid Code.".