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

Sen. Andy Manar

Filed: 5/8/2018

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1
AMENDMENT TO HOUSE BILL 3479
2 AMENDMENT NO. ______. Amend House Bill 3479 by replacing
3everything after the enacting clause with the following:
4 "Section 5. The Illinois Insurance Code is amended by
5adding Article XXXIIB as follows:
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
12Pharmacy Practice Act.
13 "Pharmacy" has the meaning given to that term in the
14Pharmacy Practice Act.
15 "Pharmacy benefits manager" means an entity that

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1administers or manages a pharmacy benefits plan or program.
2 "Pharmacy benefits manager affiliate" means a pharmacy or
3pharmacist that directly or indirectly, through one or more
4intermediaries, owns or controls, is owned or controlled by, or
5is under common ownership or control with a pharmacy benefits
6manager.
7 (b) By January 1, 2022, no pharmacy benefits manager shall
8operate a pharmacy benefits manager affiliate in the State.
9 (c) A pharmacy benefits manager may not reimburse a
10pharmacy or pharmacist in the State an amount less than the
11amount that the pharmacy benefits manager reimburses a pharmacy
12benefits manager affiliate for providing the same pharmacist
13services. A pharmacy benefits manager shall not reimburse a
14pharmacy or pharmacist in the State an amount less than the
15amount that the pharmacy benefits manager reimburses any other
16network pharmacy.
17 (d) A pharmacy benefits manager may not prohibit a pharmacy
18or pharmacist from providing a customer with a more affordable
19alternative if a more affordable alternative is available.
20 (e) A pharmacy benefits manager may not prohibit a pharmacy
21or pharmacist from allowing a pharmacy or pharmacist to
22disclose any contract information to a legislator or government
23agency.
24 (f) The Department of Insurance may examine any contracts
25or audit any books and records of a pharmacy benefits manager
26about which it receives a complaint under this Section.

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1 (g) A pharmacy benefits manager contracting with a managed
2care organization to administer pharmacy benefits for the State
3Employee Group Health Insurance or any county, municipal, or
4school health plan shall allow the Auditor General to audit, at
5his or her discretion, contracts, books, and records for
6impermissible conduct under this Section.".
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