Bill Amendment: IL HB5051 | 2023-2024 | 103rd General Assembly

NOTE: For additional amemendments please see the Bill Drafting List

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Bill Title: PRIOR AUTH-PRESCRIPTION DRUGS

Status: 2024-04-24 - Added Co-Sponsor Rep. Lilian Jiménez [HB5051 Detail]

Download: Illinois-2023-HB5051-House_Amendment_001.html

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Rep. Jenn Ladisch Douglass

Filed: 3/20/2024

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AMENDMENT TO HOUSE BILL 5051
AMENDMENT NO. ______. Amend House Bill 5051 by replacing
everything after the enacting clause with the following:
"Section 5. The Prior Authorization Reform Act is amended
by adding Section 52 as follows:
(215 ILCS 200/52 new)
Sec. 52. Prior authorization for certain prescription
drugs; 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; and
(2) the following prescription drug types and their
therapeutic equivalents approved by the United States Food

10300HB5051ham001 - 2 - LRB103 38175 RPS 71283 a
and Drug Administration that are on the formulary:
insulin; human immunodeficiency virus pre-exposure
prophylaxis and post-exposure prophylaxis medication;
human immunodeficiency virus treatment medication; viral
hepatitis medication; or hormone therapy medication,
including, but not limited to, estrogen, progesterone, and
testosterone.
Section 10. The Illinois Public Aid Code is amended by
adding Section 5-52 as follows:
(305 ILCS 5/5-52 new)
Sec. 5-52. Prior authorization for certain prescription
drugs; prohibited. The fee-for-service medical assistance
program and a Medicaid managed care organization 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 under the medical assistance
program; and
(2) the following prescription drug types and their
therapeutic equivalents approved by the United States Food
and Drug Administration that are on the formulary:
insulin; human immunodeficiency virus pre-exposure
prophylaxis and post-exposure prophylaxis medication;

10300HB5051ham001 - 3 - LRB103 38175 RPS 71283 a
human immunodeficiency virus treatment medication; viral
hepatitis medication; or hormone therapy medication,
including, but not limited to, estrogen, progesterone, and
testosterone.