Bill Amendment: IL HB3479 | 2017-2018 | 100th General Assembly
NOTE: For additional amemendments please see the Bill Drafting List
Bill Title: MEDICAID-MCCN-PHARMACY RATES
Status: 2019-01-08 - Session Sine Die [HB3479 Detail]
Download: Illinois-2017-HB3479-Senate_Amendment_001.html
Bill Title: MEDICAID-MCCN-PHARMACY RATES
Status: 2019-01-08 - Session Sine Die [HB3479 Detail]
Download: Illinois-2017-HB3479-Senate_Amendment_001.html
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| 1 | AMENDMENT TO HOUSE BILL 3479
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| 2 | AMENDMENT NO. ______. Amend House Bill 3479 by replacing | ||||||
| 3 | everything after the enacting clause with the following:
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| 4 | "Section 5. The Illinois Insurance Code is amended by | ||||||
| 5 | adding Article XXXIIB as follows:
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| 6 | (215 ILCS 5/Art. XXXIIB heading new) | ||||||
| 7 | ARTICLE XXXIIB. PHARMACY BENEFITS MANAGERS | ||||||
| 8 | (215 ILCS 5/513b1 new) | ||||||
| 9 | Sec. 513b1. Pharmacy benefits managers. | ||||||
| 10 | (a) As used in this Section: | ||||||
| 11 | "Pharmacist" has the meaning given to that term in the | ||||||
| 12 | Pharmacy Practice Act. | ||||||
| 13 | "Pharmacy" has the meaning given to that term in the | ||||||
| 14 | Pharmacy Practice Act. | ||||||
| 15 | "Pharmacy benefits manager" means an entity that | ||||||
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| 1 | administers or manages a pharmacy benefits plan or program. | ||||||
| 2 | "Pharmacy benefits manager affiliate" means a pharmacy or | ||||||
| 3 | pharmacist that directly or indirectly, through one or more | ||||||
| 4 | intermediaries, owns or controls, is owned or controlled by, or | ||||||
| 5 | is under common ownership or control with a pharmacy benefits | ||||||
| 6 | manager. | ||||||
| 7 | (b) By January 1, 2022, no pharmacy benefits manager shall | ||||||
| 8 | operate a pharmacy benefits manager affiliate in the State. | ||||||
| 9 | (c) A pharmacy benefits manager may not reimburse a | ||||||
| 10 | pharmacy or pharmacist in the State an amount less than the | ||||||
| 11 | amount that the pharmacy benefits manager reimburses a pharmacy | ||||||
| 12 | benefits manager affiliate for providing the same pharmacist | ||||||
| 13 | services. A pharmacy benefits manager shall not reimburse a | ||||||
| 14 | pharmacy or pharmacist in the State an amount less than the | ||||||
| 15 | amount that the pharmacy benefits manager reimburses any other | ||||||
| 16 | network pharmacy. | ||||||
| 17 | (d) A pharmacy benefits manager may not prohibit a pharmacy | ||||||
| 18 | or pharmacist from providing a customer with a more affordable | ||||||
| 19 | alternative if a more affordable alternative is available. | ||||||
| 20 | (e) A pharmacy benefits manager may not prohibit a pharmacy | ||||||
| 21 | or pharmacist from allowing a pharmacy or pharmacist to | ||||||
| 22 | disclose any contract information to a legislator or government | ||||||
| 23 | agency. | ||||||
| 24 | (f) The Department of Insurance may examine any contracts | ||||||
| 25 | or audit any books and records of a pharmacy benefits manager | ||||||
| 26 | about which it receives a complaint under this Section. | ||||||
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| 1 | (g) A pharmacy benefits manager contracting with a managed | ||||||
| 2 | care organization to administer pharmacy benefits for the State | ||||||
| 3 | Employee Group Health Insurance or any county, municipal, or | ||||||
| 4 | school health plan shall allow the Auditor General to audit, at | ||||||
| 5 | his or her discretion, contracts, books, and records for | ||||||
| 6 | impermissible conduct under this Section.".
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