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SB1258 - 104th General Assembly

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
SB1258
 
Introduced 1/28/2025, by Sen. Graciela Guzmán
 
SYNOPSIS AS INTRODUCED:
 
215 ILCS 200/52 new
    Amends the Prior Authorization Reform Act. Provides that a health insurance issuer may not require prior authorization for: a prescription drug prescribed to a patient by a health care professional for 6 or more consecutive months, regardless of whether the prescription drug is a non-preferred medication pursuant to the patient's health insurance coverage; the following prescription drugs or the therapeutic equivalent approved by the United States Food and Drug Administration: insulin; human immunodeficiency virus prevention medication; human immunodeficiency virus treatment medication; viral hepatitis medication; estrogen; and progesterone; or human immunodeficiency virus pre-exposure prophylaxis and post-exposure prophylaxis drugs approved by the United States Food and Drug Administration; Truvada; Harvoni; Descovy; and Apretude.


LRB104 08130 BAB 18176 b

 
 
A BILL FOR
 
SB1258LRB104 08130 BAB 18176 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois, 
3represented in the General Assembly:
 
4    Section 5. The Prior Authorization Reform Act is amended 
5by adding Section 52 as follows:
 
6    (215 ILCS 200/52 new)
7    Sec. 52. Prior authorization prohibited. A health 
8insurance issuer may not require prior authorization for:
9        (1) a prescription drug prescribed to a patient by a 
10    health care professional for 6 or more consecutive months, 
11    regardless of whether the prescription drug is a 
12    non-preferred medication pursuant to the patient's health 
13    insurance coverage;
14        (2) the following prescription drugs or the 
15    therapeutic equivalent approved by the United States Food 
16    and Drug Administration: insulin; human immunodeficiency 
17    virus prevention medication; human immunodeficiency virus 
18    treatment medication; viral hepatitis medication; 
19    estrogen; and progesterone; or
20        (3) human immunodeficiency virus pre-exposure 
21    prophylaxis and post-exposure prophylaxis drugs approved 
22    by the United States Food and Drug Administration; 
23    Truvada; Harvoni; Descovy; and Apretude.