Illinois General Assembly - Bill Status for HB5769
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 Bill Status of HB5769  102nd General Assembly


Short Description:  DRUGS-PRIOR AUTHORIZATION FORM

House Sponsors
Rep. Deb Conroy - Laura Fine - Ann M. Williams - Steven A. Andersson, Stephanie A. Kifowit, Fred Crespo and Gregory Harris

Senate Sponsors
(Sen. Julie A. Morrison, Kimberly A. Lightford and Dave Syverson)

Last Action
DateChamber Action
  1/15/2019HouseBill Dead - No Positive Action Taken - Amendatory Veto

Statutes Amended In Order of Appearance
215 ILCS 5/364.3 new
305 ILCS 5/5-5.12b new


Synopsis As Introduced
Amends the Illinois Insurance Code and the Illinois Public Aid Code. Requires that on or before July 1, 2019, the Department of Insurance and Department of Healthcare and Family Services shall jointly develop a uniform prior authorization form to be used by prescribing providers to request prior authorization for prescription drug benefits. Provides that on and after January 1, 2020, health insurers and managed care organizations that provide prescription drug benefits shall utilize and accept the uniform prior authorization form and prescribing providers may use the uniform prior authorization form. Provides criteria for developing the uniform prior authorization form. Provides requirements and limitations of prior authorization requests. Effective January 1, 2019.

House Floor Amendment No. 2
Replaces everything after the enacting clause. Amends the Illinois Insurance Code. Requires the Department of Insurance to develop a uniform electronic prior authorization form to be used by an insurer that provides prescription drug benefits when requiring prior authorization for prescription drug benefits. Provides that the development of the uniform electronic prior authorization form shall include input from specified interested parties and that the Department of Insurance shall take into consideration existing prior authorization forms established by the federal Centers for Medicare and Medicaid Services and the Department of Insurance and national standards pertaining to electronic authorization. Provides that if, upon receipt of a completed and accurate electronic prior authorization request from a prescribing provider using the uniform electronic prior authorization form, an insurer fails to accept the uniform electronic prior authorization form or fails to respond within a certain time period, then the prior authorization request shall be deemed to have been granted. Amends the Illinois Public Aid Code. Requires the Department of Healthcare and Family services to develop a uniform electronic prior authorization form to be used by a managed care organization that provides prescription drug benefits when requiring prior authorization for prescription drug benefits. Provides that the development of the uniform electronic prior authorization form shall include input from specified interested parties and that the Department of Healthcare and Family Services shall take into consideration existing prior authorization forms established by the federal Centers for Medicare and Medicaid Services and the Department of Healthcare and Family Services and national standards pertaining to electronic authorization. Provides that if, upon receipt of a completed and accurate electronic prior authorization request from a prescribing provider using the uniform electronic prior authorization form, a managed care organization fails to accept the uniform electronic prior authorization form or fails to respond within a certain time period, then the prior authorization request shall be deemed to have been granted.

House Floor Amendment No. 3
Adds pharmacists recommended by a State organization that represents pharmacists to the individuals appointed by the Director of Insurance and the Director of Healthcare and Family Services to give input in developing the uniform electronic prior authorization form.

Governor Amendatory Veto Message
The amendatory veto message was delivered to the 100th General Assembly after the 100th General Assembly adjourned sine die. The veto therefore has the effect of a total veto.

Actions 
DateChamber Action
  2/16/2018HouseFiled with the Clerk by Rep. Deb Conroy
  2/16/2018HouseFirst Reading
  2/16/2018HouseReferred to Rules Committee
  3/21/2018HouseAssigned to Insurance: Health & Life Committee
  3/26/2018HouseAdded Chief Co-Sponsor Rep. Laura Fine
  4/9/2018HouseAdded Co-Sponsor Rep. Stephanie A. Kifowit
  4/9/2018HouseDo Pass / Short Debate Insurance: Health & Life Committee; 009-005-000
  4/10/2018HousePlaced on Calendar 2nd Reading - Short Debate
  4/11/2018HouseFiscal Note Requested by Rep. Tom Demmer
  4/25/2018HouseSecond Reading - Short Debate
  4/25/2018HouseHeld on Calendar Order of Second Reading - Short Debate
  4/27/2018HouseRule 19(a) / Re-referred to Rules Committee
  5/21/2018HouseApproved for Consideration Rules Committee; 005-000-000
  5/21/2018HousePlaced on Calendar 2nd Reading - Short Debate
  5/21/2018HouseFinal Action Deadline Extended-9(b) May 31, 2018
  5/24/2018HouseHouse Floor Amendment No. 1 Filed with Clerk by Rep. Deb Conroy
  5/24/2018HouseHouse Floor Amendment No. 1 Referred to Rules Committee
  5/25/2018HouseHouse Floor Amendment No. 2 Filed with Clerk by Rep. Deb Conroy
  5/25/2018HouseHouse Floor Amendment No. 2 Referred to Rules Committee
  5/28/2018HouseHouse Floor Amendment No. 2 Rules Refers to Insurance: Health & Life Committee
  5/29/2018HouseHouse Floor Amendment No. 3 Filed with Clerk by Rep. Deb Conroy
  5/29/2018HouseHouse Floor Amendment No. 3 Referred to Rules Committee
  5/30/2018HouseHouse Floor Amendment No. 2 Recommends Be Adopted Insurance: Health & Life Committee; 011-000-000
  5/30/2018HouseHouse Floor Amendment No. 3 Recommends Be Adopted Rules Committee; 004-000-000
  5/31/2018HouseAdded Co-Sponsor Rep. Fred Crespo
  5/31/2018HouseHouse Floor Amendment No. 2 Adopted
  5/31/2018HouseHouse Floor Amendment No. 3 Adopted
  5/31/2018HouseHeld on Calendar Order of Second Reading - Short Debate
  5/31/2018HouseFiscal Note Requested - Withdrawn by Rep. Tom Demmer
  5/31/2018HouseRule 19(a) / Re-referred to Rules Committee
  8/24/2018HouseAdded Chief Co-Sponsor Rep. Ann M. Williams
  10/18/2018HouseAdded Co-Sponsor Rep. Gregory Harris
  11/13/2018HouseApproved for Consideration Rules Committee; 003-000-000
  11/13/2018HousePlaced on Calendar 2nd Reading - Short Debate
  11/14/2018HouseAdded Chief Co-Sponsor Rep. Steven A. Andersson
  11/14/2018HousePlaced on Calendar Order of 3rd Reading - Short Debate
  11/14/2018HouseThird Reading - Short Debate - Passed 110-000-000
  11/14/2018SenateArrive in Senate
  11/14/2018SenatePlaced on Calendar Order of First Reading
  11/14/2018SenateChief Senate Sponsor Sen. Julie A. Morrison
  11/14/2018SenateFirst Reading
  11/14/2018SenateReferred to Assignments
  11/14/2018SenateAdded as Alternate Co-Sponsor Sen. Kimberly A. Lightford
  11/20/2018SenateAssigned to Human Services
  11/27/2018SenateDo Pass Human Services; 008-000-000
  11/27/2018SenatePlaced on Calendar Order of 2nd Reading
  11/27/2018SenateSecond Reading
  11/27/2018SenatePlaced on Calendar Order of 3rd Reading November 28, 2018
  11/28/2018SenateThird Reading - Passed; 050-000-000
  11/28/2018HousePassed Both Houses
  11/28/2018SenateAdded as Alternate Co-Sponsor Sen. Dave Syverson
  12/27/2018HouseSent to the Governor
  1/11/2019HouseGovernor Amendatory Veto
  1/15/2019HouseBill Dead - No Positive Action Taken - Amendatory Veto

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