HB5051 103RD GENERAL ASSEMBLY

LRB103 38175 RPS 68308 b

103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB5051

Introduced 2/8/2024, by Rep. Jenn Ladisch Douglass

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; or for specified prescription drugs, including insulin, human immunodeficiency virus prevention medication; human immunodeficiency virus treatment medication; viral hepatitis medication; estrogen; and progesterone.

A BILL FOR

AN ACT concerning regulation.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Prior Authorization Reform Act is amended by adding Section 52 as follows:

(215 ILCS 200/52 new)

Sec. 52. Prior authorization prohibited. A health insurance issuer may not require prior authorization for:

(1) 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;

(2) 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

(3) 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.