Illinois General Assembly - Bill Status for HB0465
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 Bill Status of HB0465  102nd General Assembly


Short Description:  REGULATION-TECH

House Sponsors
Rep. Gregory Harris - C.D. Davidsmeyer - Anna Moeller - Elizabeth Hernandez, Darren Bailey, Monica Bristow, Mark L. Walker, Michael J. Zalewski, Ann M. Williams, Martin J. Moylan, Will Guzzardi, Robyn Gabel, Robert Martwick, Michael Halpin, Jaime M. Andrade, Jr., Jerry Costello, II, Emanuel Chris Welch, Dan Caulkins, Mike Murphy, Grant Wehrli, Sara Feigenholtz, Dave Severin, Brad Halbrook, Kelly M. Burke, Thomas M. Bennett, Yehiel M. Kalish, Keith P. Sommer, Carol Ammons, Celina Villanueva, Delia C. Ramirez, Kelly M. Cassidy, Anne Stava-Murray, Jennifer Gong-Gershowitz, Lamont J. Robinson, Jr., Maurice A. West, II, Joyce Mason, Aaron M. Ortiz and Tim Butler

Senate Sponsors
(Sen. Andy Manar - Linda Holmes - Dale Fowler - Laura M. Murphy - Melinda Bush, Dan McConchie, Jennifer Bertino-Tarrant, Sue Rezin, Steve McClure, Paul Schimpf, Chuck Weaver, Chapin Rose and Napoleon Harris, III)

Last Action
DateChamber Action
  8/23/2019HousePublic Act . . . . . . . . . 101-0452

Statutes Amended In Order of Appearance
205 ILCS 616/20


Synopsis As Introduced
Amends the Electronic Fund Transfer Act. Makes a technical change in a Section concerning powers and duties under the Act.

House Committee Amendment No. 1
Deletes reference to:
205 ILCS 616/20
Adds reference to:
New Act
5 ILCS 140/7.5
5 ILCS 375/6.11
215 ILCS 5/Art. XXXIIB heading new
215 ILCS 5/513b1 new
215 ILCS 5/513b2 new
215 ILCS 5/513b3 new
215 ILCS 5/513b4 new
215 ILCS 5/513b5 new
215 ILCS 5/513b6 new
215 ILCS 125/5-3from Ch. 111 1/2, par. 1411.2
215 ILCS 134/30
215 ILCS 134/65
225 ILCS 85/42 new
305 ILCS 5/5-36 new

Replaces everything after the enacting clause. Amends the Illinois Insurance Code. Provides that a contract between a health insurer and a pharmacy benefit manager must:(1) require the pharmacy benefit manager to update maximum allowable cost pricing information and maintain a process that will eliminate drugs from maximum allowable cost lists or modify drug prices to remain consistent with changes in pricing data; (2) prohibit the pharmacy benefit manager from limiting a pharmacist's ability to disclose the availability of a more affordable alternative drug; and (3) prohibit the pharmacy benefit manager from requiring an insured to make a payment for a prescription drug in an amount that exceeds the lesser of the applicable cost-sharing amount or the retail price of the drug. Contains provisions concerning the inclusion of prescription drugs on a maximum allowable cost list, State licensing requirements for pharmacy benefit managers, and other matters. Makes conforming changes to other Acts. Amends the Managed Care Reform and Patient Rights Act. Provides that a health care plan shall apply any third-party payments for prescription drugs. Makes changes to provisions concerning the denial of coverage for emergency services. Amends the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services may enter into a contract with any third party on a fee-for-service reimbursement model for the purpose of administering pharmacy benefits. Requires the Department to ensure coordination of care between the third-party administrator and managed care organizations as a consideration in any contracts established. Amends the Freedom of Information Act to exempt from disclosure certain information pharmacy benefits managers are required to provide under the Illinois Public Aid Code. Contains a severability provision.

House Floor Amendment No. 2
Deletes reference to:
215 ILCS 134/65
Adds reference to:
5 ILCS 140/7
215 ILCS 134/10

Replaces everything after the enacting clause. Reinserts the provisions of House Amendment No. 1, but with the following changes: Further amends the Illinois Insurance Code. In a provision concerning contracts between health insurers and pharmacy benefit managers, provides that such contracts must require pharmacy benefit managers to: (1) update maximum allowable cost pricing information at least every 7 calendar days; (2) provide access to its maximum allowable cost list to each pharmacy or pharmacy services administrative organization, as defined, subject to the maximum allowable cost list; (4) provide a process by which a contracted pharmacy can appeal the provider's reimbursement for a drug subject to maximum allowable cost pricing; and other matters. Regarding a drug on the maximum allowable cost list, requires pharmacy benefits managers to ensure that: (i) if a drug is a generically equivalent drug, it is listed as therapeutically equivalent and pharmaceutically equivalent to certain rating standards; (ii) the drug is available for purchase by each pharmacy in the State from national or regional wholesalers operating in Illinois; and (ii) the drug is not obsolete (rather than requiring a drug to have at least 3 or more nationally available, therapeutically equivalent, multiple source generic drugs with a significant cost difference and be available for purchase without limitations by all pharmacies in the State from national or regional wholesalers). Permits the Director of Insurance to examine a pharmacy benefit manager's designee, representative, or other specified persons (rather than any individual) about the business of the pharmacy benefit manager. Contains provisions concerning the denial of a pharmacy benefits manager's registration application or the suspension or revocation of a pharmacy benefits manager's registration. Defines terms. Further amends the Managed Care Reform and Patient Rights Act. Makes changes to the definition of "emergency medical condition". Removes changes made to a provision concerning the denial of coverage and payment for emergency services provided without prior authorization or an approved plan. Further amends the Illinois Public Aid Code. Makes changes to certain reporting requirements imposed on the Director of Healthcare and Family Services. Requires a pharmacy benefit manager to make certain disclosures to the Department of Healthcare and Family Services upon request. Requires a pharmacy benefit manager to make certain written disclosures to a pharmacy provider or pharmacy services administrative organization. Defines "pharmacy services administrative organization." Requires the Department to adopt rules establishing reasonable dispensing fees for fee-for-service payments in accordance with guidance or guidelines from the federal Centers for Medicare and Medicaid Services.

Actions 
DateChamber Action
  1/17/2019HouseFiled with the Clerk by Rep. Michael J. Madigan
  1/18/2019HouseFirst Reading
  1/18/2019HouseReferred to Rules Committee
  2/5/2019HouseAssigned to Executive Committee
  3/11/2019HouseHouse Committee Amendment No. 1 Filed with Clerk by Rep. Gregory Harris
  3/11/2019HouseHouse Committee Amendment No. 1 Referred to Rules Committee
  3/14/2019HouseAdded Chief Co-Sponsor Rep. C.D. Davidsmeyer
  3/14/2019HouseChief Sponsor Changed to Rep. Gregory Harris
  3/14/2019HouseAdded Chief Co-Sponsor Rep. Anna Moeller
  3/14/2019HouseAdded Co-Sponsor Rep. Darren Bailey
  3/14/2019HouseAdded Co-Sponsor Rep. Monica Bristow
  3/14/2019HouseAdded Co-Sponsor Rep. Mark L. Walker
  3/14/2019HouseAdded Co-Sponsor Rep. Michael J. Zalewski
  3/14/2019HouseAdded Co-Sponsor Rep. Ann M. Williams
  3/14/2019HouseAdded Co-Sponsor Rep. Martin J. Moylan
  3/14/2019HouseAdded Co-Sponsor Rep. Will Guzzardi
  3/14/2019HouseAdded Co-Sponsor Rep. Robyn Gabel
  3/14/2019HouseAdded Co-Sponsor Rep. Robert Martwick
  3/14/2019HouseAdded Co-Sponsor Rep. Michael Halpin
  3/14/2019HouseAdded Co-Sponsor Rep. Jaime M. Andrade, Jr.
  3/14/2019HouseAdded Co-Sponsor Rep. Jerry Costello, II
  3/14/2019HouseAdded Co-Sponsor Rep. Emanuel Chris Welch
  3/14/2019HouseAdded Co-Sponsor Rep. Dan Caulkins
  3/14/2019HouseAdded Co-Sponsor Rep. Mike Murphy
  3/14/2019HouseAdded Co-Sponsor Rep. Grant Wehrli
  3/14/2019HouseAdded Co-Sponsor Rep. Sara Feigenholtz
  3/19/2019HouseRe-assigned to Prescription Drug Affordability & Accessibility Committee
  3/19/2019HouseHouse Committee Amendment No. 1 Rules Refers to Prescription Drug Affordability & Accessibility Committee
  3/26/2019HouseAdded Co-Sponsor Rep. Dave Severin
  3/27/2019HouseHouse Committee Amendment No. 1 Adopted in Prescription Drug Affordability & Accessibility Committee; by Voice Vote
  3/27/2019HouseDo Pass as Amended / Short Debate Prescription Drug Affordability & Accessibility Committee; 016-000-000
  3/29/2019HousePlaced on Calendar 2nd Reading - Short Debate
  3/29/2019HouseAdded Co-Sponsor Rep. Brad Halbrook
  3/29/2019HouseAdded Chief Co-Sponsor Rep. Elizabeth Hernandez
  4/1/2019HouseAdded Co-Sponsor Rep. Kelly M. Burke
  4/2/2019HouseAdded Co-Sponsor Rep. Thomas M. Bennett
  4/9/2019HouseHouse Floor Amendment No. 2 Filed with Clerk by Rep. Gregory Harris
  4/9/2019HouseHouse Floor Amendment No. 2 Referred to Rules Committee
  4/10/2019HouseAdded Co-Sponsor Rep. Yehiel M. Kalish
  4/10/2019HouseHouse Floor Amendment No. 2 Rules Refers to Prescription Drug Affordability & Accessibility Committee
  4/10/2019HouseSecond Reading - Short Debate
  4/10/2019HouseHeld on Calendar Order of Second Reading - Short Debate
  4/11/2019HouseHouse Floor Amendment No. 2 Recommends Be Adopted Prescription Drug Affordability & Accessibility Committee; 011-000-000
  4/11/2019HouseAdded Co-Sponsor Rep. Keith P. Sommer
  4/11/2019HouseAdded Co-Sponsor Rep. Carol Ammons
  4/11/2019HouseAdded Co-Sponsor Rep. Celina Villanueva
  4/11/2019HouseAdded Co-Sponsor Rep. Delia C. Ramirez
  4/11/2019HouseAdded Co-Sponsor Rep. Kelly M. Cassidy
  4/11/2019HouseAdded Co-Sponsor Rep. Anne Stava-Murray
  4/11/2019HouseAdded Co-Sponsor Rep. Jennifer Gong-Gershowitz
  4/11/2019HouseAdded Co-Sponsor Rep. Lamont J. Robinson, Jr.
  4/11/2019HouseAdded Co-Sponsor Rep. Maurice A. West, II
  4/11/2019HouseAdded Co-Sponsor Rep. Joyce Mason
  4/11/2019HouseAdded Co-Sponsor Rep. Aaron M. Ortiz
  4/11/2019HouseHouse Floor Amendment No. 2 Adopted
  4/11/2019HousePlaced on Calendar Order of 3rd Reading - Short Debate
  4/11/2019HouseAdded Co-Sponsor Rep. Tim Butler
  4/11/2019HouseThird Reading - Short Debate - Passed 113-000-001
  4/12/2019SenateArrive in Senate
  4/12/2019SenatePlaced on Calendar Order of First Reading
  4/12/2019SenateChief Senate Sponsor Sen. John J. Cullerton
  4/12/2019SenateFirst Reading
  4/12/2019SenateReferred to Assignments
  4/24/2019SenateAssigned to Insurance
  4/25/2019SenateAlternate Chief Sponsor Changed to Sen. Andy Manar
  4/29/2019SenateAdded as Alternate Chief Co-Sponsor Sen. Linda Holmes
  4/30/2019SenateAdded as Alternate Chief Co-Sponsor Sen. Dale Fowler
  4/30/2019SenateAdded as Alternate Chief Co-Sponsor Sen. Laura M. Murphy
  5/1/2019SenateAdded as Alternate Chief Co-Sponsor Sen. Melinda Bush
  5/1/2019SenateAdded as Alternate Co-Sponsor Sen. Dan McConchie
  5/2/2019SenateAdded as Alternate Co-Sponsor Sen. Jennifer Bertino-Tarrant
  5/3/2019SenateAdded as Alternate Co-Sponsor Sen. Sue Rezin
  5/9/2019SenateDo Pass Insurance; 018-000-000
  5/9/2019SenatePlaced on Calendar Order of 2nd Reading May 14, 2019
  5/9/2019SenateAdded as Alternate Co-Sponsor Sen. Steve McClure
  5/14/2019SenateAdded as Alternate Co-Sponsor Sen. Paul Schimpf
  5/16/2019SenateSecond Reading
  5/16/2019SenatePlaced on Calendar Order of 3rd Reading May 17, 2019
  5/23/2019SenateAdded as Alternate Co-Sponsor Sen. Chuck Weaver
  5/23/2019SenateAdded as Alternate Co-Sponsor Sen. Chapin Rose
  5/24/2019SenateRule 2-10 Third Reading Deadline Established As May 31, 2019
  5/29/2019SenateAdded as Alternate Co-Sponsor Sen. Napoleon Harris, III
  5/29/2019SenateThird Reading - Passed; 057-000-000
  5/29/2019HousePassed Both Houses
  6/27/2019HouseSent to the Governor
  8/23/2019HouseGovernor Approved
  8/23/2019HouseEffective Date January 1, 2020
  8/23/2019HousePublic Act . . . . . . . . . 101-0452

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