Illinois General Assembly

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 Bill Status of HB3549  99th General Assembly


Short Description:  MANAGED CARE ACT-STEP THERAPY

House Sponsors
Rep. Laura Fine - Ann M. Williams - Norine K. Hammond - Sara Feigenholtz, Elizabeth Hernandez, Monique D. Davis, Kelly M. Burke, Robyn Gabel, Esther Golar, Kathleen Willis, William Davis, Mary E. Flowers, Kelly M. Cassidy, Jaime M. Andrade, Jr., Linda Chapa LaVia, Mike Smiddy, Gregory Harris, Carol Sente and Michelle Mussman

Senate Sponsors
(Sen. Julie A. Morrison - Linda Holmes - Terry Link, Daniel Biss, John G. Mulroe, Antonio Muņoz, Pamela J. Althoff, Ira I. Silverstein and Laura M. Murphy)

Last Action
DateChamber Action
  8/12/2016HousePublic Act . . . . . . . . . 99-0761

Statutes Amended In Order of Appearance
215 ILCS 134/45.1
215 ILCS 134/45.3 new
215 ILCS 134/45.4 new


Synopsis As Introduced
Amends the Managed Care Reform and Patient Rights Act. Applies the medical exemptions process to all entities licensed in the State to sell a policy of group or individual accident and health insurance or health benefits plan. Provides certain exceptions upon which a step therapy override will always be provided. Sets clinical review criteria that must be used to establish step therapy protocols. Effective immediately.

House Floor Amendment No. 1
Deletes reference to:
215 ILCS 134/45.3 new
215 ILCS 134/45.4 new

Replaces everything after the enacting clause with the introduced bill with the following changes: Removes provisions concerning step therapy overrides and protocols. Removes the immediate effective date.

Senate Committee Amendment No. 1
Deletes reference to:
215 ILCS 134/45.1
Adds reference to:
215 ILCS 5/1from Ch. 73, par. 613

Replaces everything after the enacting clause. Amends the Illinois Insurance Code. Makes a technical change in a Section concerning the short title.

Senate Committee Amendment No. 3
Deletes reference to:
215 ILCS 5/1
Adds reference to:
215 ILCS 125/5-3from Ch. 111 1/2, par. 1411.2
215 ILCS 134/45.1

Replaces everything after the enacting clause. Amends the Managed Care Reform and Patient Rights Act. Applies the medical exemptions process to all insurers licensed in the State to sell policy of group or individual accident and health insurance or health benefits plan. Provides certain provisions upon which a step therapy requirement exception request shall be approved, including if: (1) the required prescription drug is contraindicated; (2) the patient has tried the required prescription drug while under the patient's current or previous health insurance or health benefit plan and the prescribing provider submits evidence of failure or intolerance; or (3) the patient is stable on a prescription drug selected by his or her health care provider for the medical condition under consideration while on a current or previous health insurance or health benefit plan. Provides that the insurer, health plan, utilization review organization, or other entity shall authorize coverage for the drug prescribed by the enrollee's treating health care provider to the extent the prescribed drug is a covered drug under the policy or contract up to the quantity covered. Provides that the exceptions approved shall be honored for 12 months after the approval date or until renewal of the plan. Provides limitations of prescription drug coverage pursuant to the established provisions. Excludes application of the provisions from prescription drug coverage under the medical assistance program under the Illinois Public Aid Code. Amends the Health Maintenance Organization Act to provide that health maintenance organizations are subject to provisions of the Illinois Insurance Code regarding discrimination in the issuance of policies. Effective January 1, 2018.

Actions 
DateChamber Action
  2/26/2015HouseFiled with the Clerk by Rep. Laura Fine
  2/26/2015HouseFirst Reading
  2/26/2015HouseReferred to Rules Committee
  3/4/2015HouseAdded Chief Co-Sponsor Rep. Ann M. Williams
  3/4/2015HouseAdded Chief Co-Sponsor Rep. Norine K. Hammond
  3/4/2015HouseAdded Chief Co-Sponsor Rep. Sara Feigenholtz
  3/5/2015HouseAdded Co-Sponsor Rep. Elizabeth Hernandez
  3/5/2015HouseAdded Co-Sponsor Rep. Monique D. Davis
  3/5/2015HouseAdded Co-Sponsor Rep. Kelly M. Burke
  3/5/2015HouseAdded Co-Sponsor Rep. Robyn Gabel
  3/5/2015HouseAdded Co-Sponsor Rep. Esther Golar
  3/5/2015HouseAdded Co-Sponsor Rep. Kathleen Willis
  3/5/2015HouseAdded Co-Sponsor Rep. William Davis
  3/10/2015HouseAssigned to Human Services Committee
  3/12/2015HouseAdded Co-Sponsor Rep. Mary E. Flowers
  3/12/2015HouseAdded Co-Sponsor Rep. Kelly M. Cassidy
  3/12/2015HouseAdded Co-Sponsor Rep. Jaime M. Andrade, Jr.
  3/12/2015HouseAdded Co-Sponsor Rep. Linda Chapa LaVia
  3/12/2015HouseAdded Co-Sponsor Rep. Mike Smiddy
  3/12/2015HouseAdded Co-Sponsor Rep. Gregory Harris
  3/18/2015HouseDo Pass / Short Debate Human Services Committee; 012-000-000
  3/18/2015HousePlaced on Calendar 2nd Reading - Short Debate
  3/26/2015HouseSecond Reading - Short Debate
  3/26/2015HousePlaced on Calendar Order of 3rd Reading - Short Debate
  4/20/2015HouseHouse Floor Amendment No. 1 Filed with Clerk by Rep. Laura Fine
  4/20/2015HouseHouse Floor Amendment No. 1 Referred to Rules Committee
  4/21/2015HouseHouse Floor Amendment No. 1 Recommends Be Adopted Rules Committee; 004-000-000
  4/22/2015HouseRecalled to Second Reading - Short Debate
  4/22/2015HouseHouse Floor Amendment No. 1 Adopted
  4/22/2015HousePlaced on Calendar Order of 3rd Reading - Short Debate
  4/23/2015HouseThird Reading - Short Debate - Passed 092-018-000
  4/23/2015SenateArrive in Senate
  4/23/2015SenatePlaced on Calendar Order of First Reading
  4/23/2015SenateChief Senate Sponsor Sen. Julie A. Morrison
  4/28/2015SenateFirst Reading
  4/28/2015SenateReferred to Assignments
  4/29/2015SenateAssigned to Insurance
  5/6/2015SenateAdded as Alternate Co-Sponsor Sen. Daniel Biss
  5/7/2015SenateSenate Committee Amendment No. 1 Filed with Secretary by Sen. Julie A. Morrison
  5/7/2015SenateSenate Committee Amendment No. 1 Referred to Assignments
  5/12/2015SenateSenate Committee Amendment No. 1 Assignments Refers to Insurance
  5/13/2015SenateSenate Committee Amendment No. 1 Adopted
  5/14/2015SenatePostponed - Insurance
  5/15/2015SenateRule 2-10 Committee Deadline Established As May 31, 2015
  5/22/2015SenateRule 2-10 Third Reading Deadline Established As May 31, 2015
  10/10/2015SenatePursuant to Senate Rule 3-9(b) / Referred to Assignments
  5/4/2016SenateRe-assigned to Insurance
  5/4/2016SenateSenate Committee Amendment No. 2 Filed with Secretary by Sen. Julie A. Morrison
  5/4/2016SenateSenate Committee Amendment No. 2 Referred to Assignments
  5/5/2016SenateAdded as Alternate Chief Co-Sponsor Sen. Linda Holmes
  5/5/2016SenateAdded as Alternate Co-Sponsor Sen. John G. Mulroe
  5/5/2016SenateAdded as Alternate Chief Co-Sponsor Sen. Terry Link
  5/6/2016SenateSenate Committee Amendment No. 3 Filed with Secretary by Sen. Julie A. Morrison
  5/6/2016SenateSenate Committee Amendment No. 3 Referred to Assignments
  5/6/2016SenateAdded as Alternate Co-Sponsor Sen. Antonio Muņoz
  5/10/2016SenateSenate Committee Amendment No. 3 Assignments Refers to Insurance
  5/10/2016SenateSenate Committee Amendment No. 2 Pursuant to Senate Rule 3-8(b-1), this amendment will remain in the Committee on Assignments.
  5/11/2016SenateSenate Committee Amendment No. 3 Adopted
  5/12/2016SenateDo Pass as Amended Insurance; 010-000-000
  5/12/2016SenatePlaced on Calendar Order of 2nd Reading May 17, 2016
  5/18/2016SenateSecond Reading
  5/18/2016SenatePlaced on Calendar Order of 3rd Reading May 19, 2016
  5/18/2016SenateAdded as Alternate Co-Sponsor Sen. Pamela J. Althoff
  5/24/2016SenateAdded as Alternate Co-Sponsor Sen. Ira I. Silverstein
  5/24/2016SenateAdded as Alternate Co-Sponsor Sen. Laura M. Murphy
  5/26/2016SenateThird Reading - Passed; 054-000-000
  5/26/2016SenateSenate Committee Amendment No. 2 Tabled Pursuant to Rule 5-4(a)
  5/26/2016HouseArrived in House
  5/26/2016HousePlaced on Calendar Order of Concurrence Senate Amendment(s) 1, 3
  5/29/2016HouseSenate Committee Amendment No. 1 Motion Filed Concur Rep. Laura Fine
  5/29/2016HouseSenate Committee Amendment No. 3 Motion Filed Concur Rep. Laura Fine
  5/29/2016HouseSenate Committee Amendment No. 1 Motion to Concur Referred to Rules Committee
  5/29/2016HouseSenate Committee Amendment No. 3 Motion to Concur Referred to Rules Committee
  5/29/2016HouseSenate Committee Amendment No. 1 Motion to Concur Rules Referred to Human Services Committee
  5/29/2016HouseSenate Committee Amendment No. 3 Motion to Concur Rules Referred to Human Services Committee
  5/29/2016HouseSenate Committee Amendment No. 1 Motion to Concur Recommends Be Adopted Human Services Committee; 013-000-000
  5/29/2016HouseSenate Committee Amendment No. 3 Motion to Concur Recommends Be Adopted Human Services Committee; 013-000-000
  5/31/2016HouseSenate Committee Amendment No. 1 House Concurs 117-000-000
  5/31/2016HouseSenate Committee Amendment No. 3 House Concurs 117-000-000
  5/31/2016HouseHouse Concurs
  5/31/2016HousePassed Both Houses
  5/31/2016HouseAdded Co-Sponsor Rep. Carol Sente
  5/31/2016HouseAdded Co-Sponsor Rep. Michelle Mussman
  6/27/2016HouseSent to the Governor
  8/12/2016HouseGovernor Approved
  8/12/2016HouseEffective Date January 1, 2018
  8/12/2016HousePublic Act . . . . . . . . . 99-0761

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