Bill Amendment: IL HB0135 | 2021-2022 | 102nd General Assembly
NOTE: For additional amemendments please see the Bill Drafting List
Bill Title: INS CODE-BIRTH CONTROL
Status: 2021-07-22 - Public Act . . . . . . . . . 102-0103 [HB0135 Detail]
Download: Illinois-2021-HB0135-House_Amendment_001.html
Bill Title: INS CODE-BIRTH CONTROL
Status: 2021-07-22 - Public Act . . . . . . . . . 102-0103 [HB0135 Detail]
Download: Illinois-2021-HB0135-House_Amendment_001.html
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1 | AMENDMENT TO HOUSE BILL 135
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2 | AMENDMENT NO. ______. Amend House Bill 135 by replacing | ||||||
3 | everything after the enacting clause with the following:
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4 | "Section 5. The State Employees Group Insurance Act of | ||||||
5 | 1971 is amended by changing Section 6.11 as follows:
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6 | (5 ILCS 375/6.11)
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7 | Sec. 6.11. Required health benefits; Illinois Insurance | ||||||
8 | Code
requirements. The program of health
benefits shall | ||||||
9 | provide the post-mastectomy care benefits required to be | ||||||
10 | covered
by a policy of accident and health insurance under | ||||||
11 | Section 356t of the Illinois
Insurance Code. The program of | ||||||
12 | health benefits shall provide the coverage
required under | ||||||
13 | Sections 356g, 356g.5, 356g.5-1, 356m,
356u, 356w, 356x, | ||||||
14 | 356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, | ||||||
15 | 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22, | ||||||
16 | 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, |
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1 | 356z.36, and 356z.41 , and 356z.43 of the
Illinois Insurance | ||||||
2 | Code.
The program of health benefits must comply with Sections | ||||||
3 | 155.22a, 155.37, 355b, 356z.19, 370c, and 370c.1 and Article | ||||||
4 | XXXIIB of the
Illinois Insurance Code. The Department of | ||||||
5 | Insurance shall enforce the requirements of this Section with | ||||||
6 | respect to Sections 370c and 370c.1 of the Illinois Insurance | ||||||
7 | Code; all other requirements of this Section shall be enforced | ||||||
8 | by the Department of Central Management Services.
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9 | Rulemaking authority to implement Public Act 95-1045, if | ||||||
10 | any, is conditioned on the rules being adopted in accordance | ||||||
11 | with all provisions of the Illinois Administrative Procedure | ||||||
12 | Act and all rules and procedures of the Joint Committee on | ||||||
13 | Administrative Rules; any purported rule not so adopted, for | ||||||
14 | whatever reason, is unauthorized. | ||||||
15 | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; | ||||||
16 | 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. | ||||||
17 | 1-1-19; 100-1102, eff. 1-1-19; 100-1170, eff. 6-1-19; 101-13, | ||||||
18 | eff. 6-12-19; 101-281, eff. 1-1-20; 101-393, eff. 1-1-20; | ||||||
19 | 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff. | ||||||
20 | 1-1-21 .)
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21 | Section 10. The Counties Code is amended by changing | ||||||
22 | Section 5-1069.3 as follows:
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23 | (55 ILCS 5/5-1069.3)
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24 | Sec. 5-1069.3. Required health benefits. If a county, |
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1 | including a home
rule
county, is a self-insurer for purposes | ||||||
2 | of providing health insurance coverage
for its employees, the | ||||||
3 | coverage shall include coverage for the post-mastectomy
care | ||||||
4 | benefits required to be covered by a policy of accident and | ||||||
5 | health
insurance under Section 356t and the coverage required | ||||||
6 | under Sections 356g, 356g.5, 356g.5-1, 356u,
356w, 356x, | ||||||
7 | 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, | ||||||
8 | 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, | ||||||
9 | 356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41 , and 356z.43 | ||||||
10 | of
the Illinois Insurance Code. The coverage shall comply with | ||||||
11 | Sections 155.22a, 355b, 356z.19, and 370c of
the Illinois | ||||||
12 | Insurance Code. The Department of Insurance shall enforce the | ||||||
13 | requirements of this Section. The requirement that health | ||||||
14 | benefits be covered
as provided in this Section is an
| ||||||
15 | exclusive power and function of the State and is a denial and | ||||||
16 | limitation under
Article VII, Section 6, subsection (h) of the | ||||||
17 | Illinois Constitution. A home
rule county to which this | ||||||
18 | Section applies must comply with every provision of
this | ||||||
19 | Section.
| ||||||
20 | Rulemaking authority to implement Public Act 95-1045, if | ||||||
21 | any, is conditioned on the rules being adopted in accordance | ||||||
22 | with all provisions of the Illinois Administrative Procedure | ||||||
23 | Act and all rules and procedures of the Joint Committee on | ||||||
24 | Administrative Rules; any purported rule not so adopted, for | ||||||
25 | whatever reason, is unauthorized. | ||||||
26 | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; |
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1 | 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. | ||||||
2 | 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281, | ||||||
3 | eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; | ||||||
4 | 101-625, eff. 1-1-21 .)
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5 | Section 15. The Illinois Municipal Code is amended by | ||||||
6 | changing Section 10-4-2.3 as follows:
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7 | (65 ILCS 5/10-4-2.3)
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8 | Sec. 10-4-2.3. Required health benefits. If a | ||||||
9 | municipality, including a
home rule municipality, is a | ||||||
10 | self-insurer for purposes of providing health
insurance | ||||||
11 | coverage for its employees, the coverage shall include | ||||||
12 | coverage for
the post-mastectomy care benefits required to be | ||||||
13 | covered by a policy of
accident and health insurance under | ||||||
14 | Section 356t and the coverage required
under Sections 356g, | ||||||
15 | 356g.5, 356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, | ||||||
16 | 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, | ||||||
17 | 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, | ||||||
18 | 356z.36, and 356z.41 , and 356z.43 of the Illinois
Insurance
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19 | Code. The coverage shall comply with Sections 155.22a, 355b, | ||||||
20 | 356z.19, and 370c of
the Illinois Insurance Code. The | ||||||
21 | Department of Insurance shall enforce the requirements of this | ||||||
22 | Section. The requirement that health
benefits be covered as | ||||||
23 | provided in this is an exclusive power and function of
the | ||||||
24 | State and is a denial and limitation under Article VII, |
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1 | Section 6,
subsection (h) of the Illinois Constitution. A home | ||||||
2 | rule municipality to which
this Section applies must comply | ||||||
3 | with every provision of this Section.
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4 | Rulemaking authority to implement Public Act 95-1045, if | ||||||
5 | any, is conditioned on the rules being adopted in accordance | ||||||
6 | with all provisions of the Illinois Administrative Procedure | ||||||
7 | Act and all rules and procedures of the Joint Committee on | ||||||
8 | Administrative Rules; any purported rule not so adopted, for | ||||||
9 | whatever reason, is unauthorized. | ||||||
10 | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; | ||||||
11 | 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. | ||||||
12 | 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281, | ||||||
13 | eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; | ||||||
14 | 101-625, eff. 1-1-21 .)
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15 | Section 20. The School Code is amended by changing Section | ||||||
16 | 10-22.3f as follows:
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17 | (105 ILCS 5/10-22.3f)
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18 | Sec. 10-22.3f. Required health benefits. Insurance | ||||||
19 | protection and
benefits
for employees shall provide the | ||||||
20 | post-mastectomy care benefits required to be
covered by a | ||||||
21 | policy of accident and health insurance under Section 356t and | ||||||
22 | the
coverage required under Sections 356g, 356g.5, 356g.5-1, | ||||||
23 | 356u, 356w, 356x,
356z.6, 356z.8, 356z.9, 356z.11, 356z.12, | ||||||
24 | 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, |
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1 | 356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41 , and 356z.43 | ||||||
2 | of
the
Illinois Insurance Code.
Insurance policies shall | ||||||
3 | comply with Section 356z.19 of the Illinois Insurance Code. | ||||||
4 | The coverage shall comply with Sections 155.22a, 355b, and | ||||||
5 | 370c of
the Illinois Insurance Code. The Department of | ||||||
6 | Insurance shall enforce the requirements of this Section.
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7 | Rulemaking authority to implement Public Act 95-1045, if | ||||||
8 | any, is conditioned on the rules being adopted in accordance | ||||||
9 | with all provisions of the Illinois Administrative Procedure | ||||||
10 | Act and all rules and procedures of the Joint Committee on | ||||||
11 | Administrative Rules; any purported rule not so adopted, for | ||||||
12 | whatever reason, is unauthorized. | ||||||
13 | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; | ||||||
14 | 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. | ||||||
15 | 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281, | ||||||
16 | eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; | ||||||
17 | 101-625, eff. 1-1-21 .)
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18 | Section 25. The Illinois Insurance Code is amended by | ||||||
19 | adding Section 356z.43 as follows:
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20 | (215 ILCS 5/356z.43 new) | ||||||
21 | Sec. 356z.43. Coverage for patient care services for | ||||||
22 | hormonal contraceptives provided by a pharmacist. A group or | ||||||
23 | individual policy of accident and health insurance or a | ||||||
24 | managed care plan that is amended, delivered, issued, or |
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1 | renewed after the effective date of this amendatory Act of the | ||||||
2 | 102nd General Assembly shall provide coverage for patient care | ||||||
3 | services provided by a pharmacist for hormonal contraceptives | ||||||
4 | assessment and consultation.
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5 | Section 30. The Pharmacy Practice Act is amended by | ||||||
6 | changing Section 3 and by adding Section 43 as follows:
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7 | (225 ILCS 85/3)
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8 | (Section scheduled to be repealed on January 1, 2023)
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9 | Sec. 3. Definitions. For the purpose of this Act, except | ||||||
10 | where otherwise
limited therein:
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11 | (a) "Pharmacy" or "drugstore" means and includes every | ||||||
12 | store, shop,
pharmacy department, or other place where | ||||||
13 | pharmacist
care is
provided
by a pharmacist (1) where drugs, | ||||||
14 | medicines, or poisons are
dispensed, sold or
offered for sale | ||||||
15 | at retail, or displayed for sale at retail; or
(2)
where
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16 | prescriptions of physicians, dentists, advanced practice | ||||||
17 | registered nurses, physician assistants, veterinarians, | ||||||
18 | podiatric physicians, or
optometrists, within the limits of | ||||||
19 | their
licenses, are
compounded, filled, or dispensed; or (3) | ||||||
20 | which has upon it or
displayed within
it, or affixed to or used | ||||||
21 | in connection with it, a sign bearing the word or
words | ||||||
22 | "Pharmacist", "Druggist", "Pharmacy", "Pharmaceutical
Care", | ||||||
23 | "Apothecary", "Drugstore",
"Medicine Store", "Prescriptions", | ||||||
24 | "Drugs", "Dispensary", "Medicines", or any word
or words of |
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1 | similar or like import, either in the English language
or any | ||||||
2 | other language; or (4) where the characteristic prescription
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3 | sign (Rx) or similar design is exhibited; or (5) any store, or
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4 | shop,
or other place with respect to which any of the above | ||||||
5 | words, objects,
signs or designs are used in any | ||||||
6 | advertisement.
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7 | (b) "Drugs" means and includes (1) articles recognized
in | ||||||
8 | the official United States Pharmacopoeia/National Formulary | ||||||
9 | (USP/NF),
or any supplement thereto and being intended for and | ||||||
10 | having for their
main use the diagnosis, cure, mitigation, | ||||||
11 | treatment or prevention of
disease in man or other animals, as | ||||||
12 | approved by the United States Food and
Drug Administration, | ||||||
13 | but does not include devices or their components, parts,
or | ||||||
14 | accessories; and (2) all other articles intended
for and | ||||||
15 | having for their main use the diagnosis, cure, mitigation,
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16 | treatment or prevention of disease in man or other animals, as | ||||||
17 | approved
by the United States Food and Drug Administration, | ||||||
18 | but does not include
devices or their components, parts, or | ||||||
19 | accessories; and (3) articles
(other than food) having for | ||||||
20 | their main use and intended
to affect the structure or any | ||||||
21 | function of the body of man or other
animals; and (4) articles | ||||||
22 | having for their main use and intended
for use as a component | ||||||
23 | or any articles specified in clause (1), (2)
or (3); but does | ||||||
24 | not include devices or their components, parts or
accessories.
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25 | (c) "Medicines" means and includes all drugs intended for
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26 | human or veterinary use approved by the United States Food and |
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1 | Drug
Administration.
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2 | (d) "Practice of pharmacy" means: | ||||||
3 | (1) the interpretation and the provision of assistance | ||||||
4 | in the monitoring, evaluation, and implementation of | ||||||
5 | prescription drug orders; | ||||||
6 | (2) the dispensing of prescription drug orders; | ||||||
7 | (3) participation in drug and device selection; | ||||||
8 | (4) drug administration limited to the administration | ||||||
9 | of oral, topical, injectable, and inhalation as follows: | ||||||
10 | (A) in the context of patient education on the | ||||||
11 | proper use or delivery of medications; | ||||||
12 | (B) vaccination of patients 14 years of age and | ||||||
13 | older pursuant to a valid prescription or standing | ||||||
14 | order, by a physician licensed to practice medicine in | ||||||
15 | all its branches, upon completion of appropriate | ||||||
16 | training, including how to address contraindications | ||||||
17 | and adverse reactions set forth by rule, with | ||||||
18 | notification to the patient's physician and | ||||||
19 | appropriate record retention, or pursuant to hospital | ||||||
20 | pharmacy and therapeutics committee policies and | ||||||
21 | procedures; | ||||||
22 | (B-5) following the initial administration of | ||||||
23 | long-acting or extended-release extended release form | ||||||
24 | opioid antagonists by a physician licensed to practice | ||||||
25 | medicine in all its branches, administration of | ||||||
26 | injections of long-acting or extended-release form |
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1 | opioid antagonists for the treatment of substance use | ||||||
2 | disorder, pursuant to a valid prescription by a | ||||||
3 | physician licensed to practice medicine in all its | ||||||
4 | branches, upon completion of appropriate training, | ||||||
5 | including how to address contraindications and adverse | ||||||
6 | reactions, including, but not limited to, respiratory | ||||||
7 | depression and the performance of cardiopulmonary | ||||||
8 | resuscitation, set forth by rule, with notification to | ||||||
9 | the patient's physician and appropriate record | ||||||
10 | retention, or pursuant to hospital pharmacy and | ||||||
11 | therapeutics committee policies and procedures; | ||||||
12 | (C) administration of injections of | ||||||
13 | alpha-hydroxyprogesterone caproate, pursuant to a | ||||||
14 | valid prescription, by a physician licensed to | ||||||
15 | practice medicine in all its branches, upon completion | ||||||
16 | of appropriate training, including how to address | ||||||
17 | contraindications and adverse reactions set forth by | ||||||
18 | rule, with notification to the patient's physician and | ||||||
19 | appropriate record retention, or pursuant to hospital | ||||||
20 | pharmacy and therapeutics committee policies and | ||||||
21 | procedures; and | ||||||
22 | (D) administration of injections of long-term | ||||||
23 | antipsychotic medications pursuant to a valid | ||||||
24 | prescription by a physician licensed to practice | ||||||
25 | medicine in all its branches, upon completion of | ||||||
26 | appropriate training conducted by an Accreditation |
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1 | Council of Pharmaceutical Education accredited | ||||||
2 | provider, including how to address contraindications | ||||||
3 | and adverse reactions set forth by rule, with | ||||||
4 | notification to the patient's physician and | ||||||
5 | appropriate record retention, or pursuant to hospital | ||||||
6 | pharmacy and therapeutics committee policies and | ||||||
7 | procedures. | ||||||
8 | (5) vaccination of patients ages 10 through 13 limited | ||||||
9 | to the Influenza (inactivated influenza vaccine and live | ||||||
10 | attenuated influenza intranasal vaccine) and Tdap (defined | ||||||
11 | as tetanus, diphtheria, acellular pertussis) vaccines, | ||||||
12 | pursuant to a valid prescription or standing order, by a | ||||||
13 | physician licensed to practice medicine in all its | ||||||
14 | branches, upon completion of appropriate training, | ||||||
15 | including how to address contraindications and adverse | ||||||
16 | reactions set forth by rule, with notification to the | ||||||
17 | patient's physician and appropriate record retention, or | ||||||
18 | pursuant to hospital pharmacy and therapeutics committee | ||||||
19 | policies and procedures; | ||||||
20 | (6) drug regimen review; | ||||||
21 | (7) drug or drug-related research; | ||||||
22 | (8) the provision of patient counseling; | ||||||
23 | (9) the practice of telepharmacy; | ||||||
24 | (10) the provision of those acts or services necessary | ||||||
25 | to provide pharmacist care; | ||||||
26 | (11) medication therapy management; and |
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1 | (12) the responsibility for compounding and labeling | ||||||
2 | of drugs and devices (except labeling by a manufacturer, | ||||||
3 | repackager, or distributor of non-prescription drugs and | ||||||
4 | commercially packaged legend drugs and devices), proper | ||||||
5 | and safe storage of drugs and devices, and maintenance of | ||||||
6 | required records ; and . | ||||||
7 | (13) the assessment and consultation of patients and | ||||||
8 | dispensing of hormonal contraceptives pursuant to the | ||||||
9 | standing order under Section 2310-705 of the Department of | ||||||
10 | Public Health Powers and Duties Law of the Civil | ||||||
11 | Administrative Code of Illinois. | ||||||
12 | A pharmacist who performs any of the acts defined as the | ||||||
13 | practice of pharmacy in this State must be actively licensed | ||||||
14 | as a pharmacist under this Act.
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15 | (e) "Prescription" means and includes any written, oral, | ||||||
16 | facsimile, or
electronically transmitted order for drugs
or | ||||||
17 | medical devices, issued by a physician licensed to practice | ||||||
18 | medicine in
all its branches, dentist, veterinarian, podiatric | ||||||
19 | physician, or
optometrist, within the
limits of his or her | ||||||
20 | license, by a physician assistant in accordance with
| ||||||
21 | subsection (f) of Section 4, or by an advanced practice | ||||||
22 | registered nurse in
accordance with subsection (g) of Section | ||||||
23 | 4, containing the
following: (1) name
of the patient; (2) date | ||||||
24 | when prescription was issued; (3) name
and strength of drug or | ||||||
25 | description of the medical device prescribed;
and (4) | ||||||
26 | quantity; (5) directions for use; (6) prescriber's name,
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1 | address,
and signature; and (7) DEA registration number where | ||||||
2 | required, for controlled
substances.
The prescription may, but | ||||||
3 | is not required to, list the illness, disease, or condition | ||||||
4 | for which the drug or device is being prescribed. DEA | ||||||
5 | registration numbers shall not be required on inpatient drug | ||||||
6 | orders. A prescription for medication other than controlled | ||||||
7 | substances shall be valid for up to 15 months from the date | ||||||
8 | issued for the purpose of refills, unless the prescription | ||||||
9 | states otherwise.
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10 | (f) "Person" means and includes a natural person, | ||||||
11 | partnership,
association, corporation, government entity, or | ||||||
12 | any other legal
entity.
| ||||||
13 | (g) "Department" means the Department of Financial and
| ||||||
14 | Professional Regulation.
| ||||||
15 | (h) "Board of Pharmacy" or "Board" means the State Board
| ||||||
16 | of Pharmacy of the Department of Financial and Professional | ||||||
17 | Regulation.
| ||||||
18 | (i) "Secretary"
means the Secretary
of Financial and | ||||||
19 | Professional Regulation.
| ||||||
20 | (j) "Drug product selection" means the interchange for a
| ||||||
21 | prescribed pharmaceutical product in accordance with Section | ||||||
22 | 25 of
this Act and Section 3.14 of the Illinois Food, Drug and | ||||||
23 | Cosmetic Act.
| ||||||
24 | (k) "Inpatient drug order" means an order issued by an | ||||||
25 | authorized
prescriber for a resident or patient of a facility | ||||||
26 | licensed under the
Nursing Home Care Act, the ID/DD Community |
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| |||||||
1 | Care Act, the MC/DD Act, the Specialized Mental Health | ||||||
2 | Rehabilitation Act of 2013, the Hospital Licensing Act, or the | ||||||
3 | University of Illinois Hospital Act, or a facility which is | ||||||
4 | operated by the Department of Human
Services (as successor to | ||||||
5 | the Department of Mental Health
and Developmental | ||||||
6 | Disabilities) or the Department of Corrections.
| ||||||
7 | (k-5) "Pharmacist" means an individual health care | ||||||
8 | professional and
provider currently licensed by this State to | ||||||
9 | engage in the practice of
pharmacy.
| ||||||
10 | (l) "Pharmacist in charge" means the licensed pharmacist | ||||||
11 | whose name appears
on a pharmacy license and who is | ||||||
12 | responsible for all aspects of the
operation related to the | ||||||
13 | practice of pharmacy.
| ||||||
14 | (m) "Dispense" or "dispensing" means the interpretation, | ||||||
15 | evaluation, and implementation of a prescription drug order, | ||||||
16 | including the preparation and delivery of a drug or device to a | ||||||
17 | patient or patient's agent in a suitable container | ||||||
18 | appropriately labeled for subsequent administration to or use | ||||||
19 | by a patient in accordance with applicable State and federal | ||||||
20 | laws and regulations.
"Dispense" or "dispensing" does not mean | ||||||
21 | the physical delivery to a patient or a
patient's | ||||||
22 | representative in a home or institution by a designee of a | ||||||
23 | pharmacist
or by common carrier. "Dispense" or "dispensing" | ||||||
24 | also does not mean the physical delivery
of a drug or medical | ||||||
25 | device to a patient or patient's representative by a
| ||||||
26 | pharmacist's designee within a pharmacy or drugstore while the |
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| |||||||
1 | pharmacist is
on duty and the pharmacy is open.
| ||||||
2 | (n) "Nonresident pharmacy"
means a pharmacy that is | ||||||
3 | located in a state, commonwealth, or territory
of the United | ||||||
4 | States, other than Illinois, that delivers, dispenses, or
| ||||||
5 | distributes, through the United States Postal Service, | ||||||
6 | commercially acceptable parcel delivery service, or other | ||||||
7 | common
carrier, to Illinois residents, any substance which | ||||||
8 | requires a prescription.
| ||||||
9 | (o) "Compounding" means the preparation and mixing of | ||||||
10 | components, excluding flavorings, (1) as the result of a | ||||||
11 | prescriber's prescription drug order or initiative based on | ||||||
12 | the prescriber-patient-pharmacist relationship in the course | ||||||
13 | of professional practice or (2) for the purpose of, or | ||||||
14 | incident to, research, teaching, or chemical analysis and not | ||||||
15 | for sale or dispensing. "Compounding" includes the preparation | ||||||
16 | of drugs or devices in anticipation of receiving prescription | ||||||
17 | drug orders based on routine, regularly observed dispensing | ||||||
18 | patterns. Commercially available products may be compounded | ||||||
19 | for dispensing to individual patients only if all of the | ||||||
20 | following conditions are met: (i) the commercial product is | ||||||
21 | not reasonably available from normal distribution channels in | ||||||
22 | a timely manner to meet the patient's needs and (ii) the | ||||||
23 | prescribing practitioner has requested that the drug be | ||||||
24 | compounded.
| ||||||
25 | (p) (Blank).
| ||||||
26 | (q) (Blank).
|
| |||||||
| |||||||
1 | (r) "Patient counseling" means the communication between a | ||||||
2 | pharmacist or a student pharmacist under the supervision of a | ||||||
3 | pharmacist and a patient or the patient's representative about | ||||||
4 | the patient's medication or device for the purpose of | ||||||
5 | optimizing proper use of prescription medications or devices. | ||||||
6 | "Patient counseling" may include without limitation (1) | ||||||
7 | obtaining a medication history; (2) acquiring a patient's | ||||||
8 | allergies and health conditions; (3) facilitation of the | ||||||
9 | patient's understanding of the intended use of the medication; | ||||||
10 | (4) proper directions for use; (5) significant potential | ||||||
11 | adverse events; (6) potential food-drug interactions; and (7) | ||||||
12 | the need to be compliant with the medication therapy. A | ||||||
13 | pharmacy technician may only participate in the following | ||||||
14 | aspects of patient counseling under the supervision of a | ||||||
15 | pharmacist: (1) obtaining medication history; (2) providing | ||||||
16 | the offer for counseling by a pharmacist or student | ||||||
17 | pharmacist; and (3) acquiring a patient's allergies and health | ||||||
18 | conditions.
| ||||||
19 | (s) "Patient profiles" or "patient drug therapy record" | ||||||
20 | means the
obtaining, recording, and maintenance of patient | ||||||
21 | prescription
information, including prescriptions for | ||||||
22 | controlled substances, and
personal information.
| ||||||
23 | (t) (Blank).
| ||||||
24 | (u) "Medical device" or "device" means an instrument, | ||||||
25 | apparatus, implement, machine,
contrivance, implant, in vitro | ||||||
26 | reagent, or other similar or related article,
including any |
| |||||||
| |||||||
1 | component part or accessory, required under federal law to
| ||||||
2 | bear the label "Caution: Federal law requires dispensing by or | ||||||
3 | on the order
of a physician". A seller of goods and services | ||||||
4 | who, only for the purpose of
retail sales, compounds, sells, | ||||||
5 | rents, or leases medical devices shall not,
by reasons | ||||||
6 | thereof, be required to be a licensed pharmacy.
| ||||||
7 | (v) "Unique identifier" means an electronic signature, | ||||||
8 | handwritten
signature or initials, thumb print, or other | ||||||
9 | acceptable biometric
or electronic identification process as | ||||||
10 | approved by the Department.
| ||||||
11 | (w) "Current usual and customary retail price" means the | ||||||
12 | price that a pharmacy charges to a non-third-party payor.
| ||||||
13 | (x) "Automated pharmacy system" means a mechanical system | ||||||
14 | located within the confines of the pharmacy or remote location | ||||||
15 | that performs operations or activities, other than compounding | ||||||
16 | or administration, relative to storage, packaging, dispensing, | ||||||
17 | or distribution of medication, and which collects, controls, | ||||||
18 | and maintains all transaction information. | ||||||
19 | (y) "Drug regimen review" means and includes the | ||||||
20 | evaluation of prescription drug orders and patient records for | ||||||
21 | (1)
known allergies; (2) drug or potential therapy | ||||||
22 | contraindications;
(3) reasonable dose, duration of use, and | ||||||
23 | route of administration, taking into consideration factors | ||||||
24 | such as age, gender, and contraindications; (4) reasonable | ||||||
25 | directions for use; (5) potential or actual adverse drug | ||||||
26 | reactions; (6) drug-drug interactions; (7) drug-food |
| |||||||
| |||||||
1 | interactions; (8) drug-disease contraindications; (9) | ||||||
2 | therapeutic duplication; (10) patient laboratory values when | ||||||
3 | authorized and available; (11) proper utilization (including | ||||||
4 | over or under utilization) and optimum therapeutic outcomes; | ||||||
5 | and (12) abuse and misuse.
| ||||||
6 | (z) "Electronically transmitted prescription" means a | ||||||
7 | prescription that is created, recorded, or stored by | ||||||
8 | electronic means; issued and validated with an electronic | ||||||
9 | signature; and transmitted by electronic means directly from | ||||||
10 | the prescriber to a pharmacy. An electronic prescription is | ||||||
11 | not an image of a physical prescription that is transferred by | ||||||
12 | electronic means from computer to computer, facsimile to | ||||||
13 | facsimile, or facsimile to computer.
| ||||||
14 | (aa) "Medication therapy management services" means a | ||||||
15 | distinct service or group of services offered by licensed | ||||||
16 | pharmacists, physicians licensed to practice medicine in all | ||||||
17 | its branches, advanced practice registered nurses authorized | ||||||
18 | in a written agreement with a physician licensed to practice | ||||||
19 | medicine in all its branches, or physician assistants | ||||||
20 | authorized in guidelines by a supervising physician that | ||||||
21 | optimize therapeutic outcomes for individual patients through | ||||||
22 | improved medication use. In a retail or other non-hospital | ||||||
23 | pharmacy, medication therapy management services shall consist | ||||||
24 | of the evaluation of prescription drug orders and patient | ||||||
25 | medication records to resolve conflicts with the following: | ||||||
26 | (1) known allergies; |
| |||||||
| |||||||
1 | (2) drug or potential therapy contraindications; | ||||||
2 | (3) reasonable dose, duration of use, and route of | ||||||
3 | administration, taking into consideration factors such as | ||||||
4 | age, gender, and contraindications; | ||||||
5 | (4) reasonable directions for use; | ||||||
6 | (5) potential or actual adverse drug reactions; | ||||||
7 | (6) drug-drug interactions; | ||||||
8 | (7) drug-food interactions; | ||||||
9 | (8) drug-disease contraindications; | ||||||
10 | (9) identification of therapeutic duplication; | ||||||
11 | (10) patient laboratory values when authorized and | ||||||
12 | available; | ||||||
13 | (11) proper utilization (including over or under | ||||||
14 | utilization) and optimum therapeutic outcomes; and | ||||||
15 | (12) drug abuse and misuse. | ||||||
16 | "Medication therapy management services" includes the | ||||||
17 | following: | ||||||
18 | (1) documenting the services delivered and | ||||||
19 | communicating the information provided to patients' | ||||||
20 | prescribers within an appropriate time frame, not to | ||||||
21 | exceed 48 hours; | ||||||
22 | (2) providing patient counseling designed to enhance a | ||||||
23 | patient's understanding and the appropriate use of his or | ||||||
24 | her medications; and | ||||||
25 | (3) providing information, support services, and | ||||||
26 | resources designed to enhance a patient's adherence with |
| |||||||
| |||||||
1 | his or her prescribed therapeutic regimens. | ||||||
2 | "Medication therapy management services" may also include | ||||||
3 | patient care functions authorized by a physician licensed to | ||||||
4 | practice medicine in all its branches for his or her | ||||||
5 | identified patient or groups of patients under specified | ||||||
6 | conditions or limitations in a standing order from the | ||||||
7 | physician. | ||||||
8 | "Medication therapy management services" in a licensed | ||||||
9 | hospital may also include the following: | ||||||
10 | (1) reviewing assessments of the patient's health | ||||||
11 | status; and | ||||||
12 | (2) following protocols of a hospital pharmacy and | ||||||
13 | therapeutics committee with respect to the fulfillment of | ||||||
14 | medication orders.
| ||||||
15 | (bb) "Pharmacist care" means the provision by a pharmacist | ||||||
16 | of medication therapy management services, with or without the | ||||||
17 | dispensing of drugs or devices, intended to achieve outcomes | ||||||
18 | that improve patient health, quality of life, and comfort and | ||||||
19 | enhance patient safety.
| ||||||
20 | (cc) "Protected health information" means individually | ||||||
21 | identifiable health information that, except as otherwise | ||||||
22 | provided, is:
| ||||||
23 | (1) transmitted by electronic media; | ||||||
24 | (2) maintained in any medium set forth in the | ||||||
25 | definition of "electronic media" in the federal Health | ||||||
26 | Insurance Portability and Accountability Act; or |
| |||||||
| |||||||
1 | (3) transmitted or maintained in any other form or | ||||||
2 | medium. | ||||||
3 | "Protected health information" does not include | ||||||
4 | individually identifiable health information found in: | ||||||
5 | (1) education records covered by the federal Family | ||||||
6 | Educational Right and Privacy Act; or | ||||||
7 | (2) employment records held by a licensee in its role | ||||||
8 | as an employer. | ||||||
9 | (dd) "Standing order" means a specific order for a patient | ||||||
10 | or group of patients issued by a physician licensed to | ||||||
11 | practice medicine in all its branches in Illinois. | ||||||
12 | (ee) "Address of record" means the designated address | ||||||
13 | recorded by the Department in the applicant's application file | ||||||
14 | or licensee's license file maintained by the Department's | ||||||
15 | licensure maintenance unit. | ||||||
16 | (ff) "Home pharmacy" means the location of a pharmacy's | ||||||
17 | primary operations.
| ||||||
18 | (gg) "Email address of record" means the designated email | ||||||
19 | address recorded by the Department in the applicant's | ||||||
20 | application file or the licensee's license file, as maintained | ||||||
21 | by the Department's licensure maintenance unit. | ||||||
22 | (Source: P.A. 100-208, eff. 1-1-18; 100-497, eff. 9-8-17; | ||||||
23 | 100-513, eff. 1-1-18; 100-804, eff. 1-1-19; 100-863, eff. | ||||||
24 | 8-14-18; 101-349, eff. 1-1-20; revised 8-21-20.)
| ||||||
25 | (225 ILCS 85/43 new) |
| |||||||
| |||||||
1 | Sec. 43. Dispensation of hormonal contraceptives. | ||||||
2 | (a) The dispensing of hormonal contraceptives to a patient | ||||||
3 | shall be pursuant to a valid prescription or standing order by | ||||||
4 | a physician licensed to practice medicine in all its branches | ||||||
5 | or the medical director of a local health department, pursuant | ||||||
6 | to the following: | ||||||
7 | (1) a pharmacist may dispense no more than a 12-month | ||||||
8 | supply of hormonal contraceptives to a patient; | ||||||
9 | (2) a pharmacist must complete an educational training | ||||||
10 | program accredited by the Accreditation Council for | ||||||
11 | Pharmacy Education and approved by the Department that is | ||||||
12 | related to the patient self-screening risk assessment, | ||||||
13 | patient assessment contraceptive counseling and education, | ||||||
14 | and dispensation of hormonal contraceptives; | ||||||
15 | (3) a pharmacist shall have the patient complete the | ||||||
16 | self-screening risk assessment tool; the self-screening | ||||||
17 | risk assessment tool is to be based on the most current | ||||||
18 | version of the United States Medical Eligibility Criteria | ||||||
19 | for Contraceptive Use published by the federal Centers for | ||||||
20 | Disease Control and Prevention; | ||||||
21 | (4) based upon the results of the self-screening risk | ||||||
22 | assessment and the patient assessment, the pharmacist | ||||||
23 | shall use his or her professional and clinical judgment as | ||||||
24 | to when a patient should be referred to the patient's | ||||||
25 | physician or another health care provider; | ||||||
26 | (5) a pharmacist shall provide, during the patient |
| |||||||
| |||||||
1 | assessment and consultation, counseling and education | ||||||
2 | about all methods of contraception, including methods not | ||||||
3 | covered under the standing order, and their proper use and | ||||||
4 | effectiveness; | ||||||
5 | (6) the patient consultation shall take place in a | ||||||
6 | private manner; and | ||||||
7 | (7) a pharmacist and pharmacy must maintain | ||||||
8 | appropriate records. | ||||||
9 | (b) The Department may adopt rules to implement this | ||||||
10 | Section. | ||||||
11 | (c) Nothing in this Section shall be interpreted to | ||||||
12 | require a pharmacist to dispense hormonal contraception under | ||||||
13 | a standing order issued by a physician licensed to practice | ||||||
14 | medicine in all its branches,
the medical director of a local | ||||||
15 | health department, or the Medical Director of the Department | ||||||
16 | of Public Health.
| ||||||
17 | Section 35. The Illinois Public Aid Code is amended by | ||||||
18 | adding Section 5-5.12d as follows:
| ||||||
19 | (305 ILCS 5/5-5.12d new) | ||||||
20 | Sec. 5-5.12d. Coverage for patient care services for | ||||||
21 | hormonal contraceptives provided by a pharmacist. | ||||||
22 | (a) Subject to approval by the federal Centers for | ||||||
23 | Medicare and Medicaid Services, the medical assistance | ||||||
24 | program, including both the fee-for-service and managed care |
| |||||||
| |||||||
1 | medical assistance programs established under this Article, | ||||||
2 | shall cover patient care services provided by a pharmacist for | ||||||
3 | hormonal contraceptives assessment and consultation. | ||||||
4 | (b) The Department shall establish a fee schedule for | ||||||
5 | patient care services provided by a pharmacist for hormonal | ||||||
6 | contraceptives assessment and consultation. | ||||||
7 | (c) The rate of reimbursement for patient care services | ||||||
8 | provided by a pharmacist for hormonal contraceptives | ||||||
9 | assessment and consultation shall be at 85% of the fee | ||||||
10 | schedule for physician services by the medical assistance | ||||||
11 | program. | ||||||
12 | (d) A pharmacist must be enrolled in the medical | ||||||
13 | assistance program as an ordering and referring provider prior | ||||||
14 | to providing hormonal contraceptives assessment and | ||||||
15 | consultation that is submitted by a pharmacy or pharmacist | ||||||
16 | provider for reimbursement pursuant to this Section. | ||||||
17 | (e) The Department shall apply for any necessary federal | ||||||
18 | waivers or approvals to implement this Section by January 1, | ||||||
19 | 2022. | ||||||
20 | (f) This Section does not restrict or prohibit any | ||||||
21 | services currently provided by pharmacists as authorized by | ||||||
22 | law, including, but not limited to, pharmacist services | ||||||
23 | provided under this Code or authorized under the Illinois | ||||||
24 | Title XIX State Plan. | ||||||
25 | (g) The Department shall submit to the Joint Committee on | ||||||
26 | Administrative Rules administrative rules for this Section as |
| |||||||
| |||||||
1 | soon as practicable but no later than 6 months after federal | ||||||
2 | approval is received.
| ||||||
3 | Section 99. Effective date. This Act takes effect January | ||||||
4 | 1, 2022.".
|