Bill Text: IL HB0274 | 2017-2018 | 100th General Assembly | Engrossed


Bill Title: Amends the Pharmacy Practice Act. Provides that "practice of pharmacy" includes the prescribing and dispensing of hormonal contraceptive patches and self-administered oral hormonal contraceptives. Defines "hormonal contraceptive patch" as a transdermal patch applied to the skin of a patient, by the patient or by a practitioner, that releases a drug composed of a combination of hormones that is approved by the United States Food and Drug Administration to prevent pregnancy and "self-administered oral hormonal contraceptive" as a drug composed of a combination of hormones that is approved by the United States Food and Drug Administration to prevent pregnancy and that the patient to whom the drug is prescribed may take orally. Allows pharmacists to prescribe and dispense contraceptives to a person over 18 years of age and a person under 18 years of age only if the person has evidence of a previous prescription from a primary care or a women's health care practitioner. Requires the Department of Financial and Professional Regulation to adopt rules to establish standard procedures for pharmacists to prescribe contraceptives. Provides requirements for the rules to be adopted by the Department. Provides that all State and federal laws governing insurance coverage of contraceptive drugs and products shall apply to the provisions.

Spectrum: Partisan Bill (Democrat 22-0)

Status: (Introduced) 2018-05-18 - Final Action Deadline Extended-9(b) May 25, 2018 [HB0274 Detail]

Download: Illinois-2017-HB0274-Engrossed.html



HB0274 EngrossedLRB100 04385 SMS 14391 b
1 AN ACT concerning regulation.
2 Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4 Section 5. The State Employees Group Insurance Act of 1971
5is amended by changing Section 6.11 as follows:
6 (5 ILCS 375/6.11)
7 Sec. 6.11. Required health benefits; Illinois Insurance
8Code requirements. The program of health benefits shall provide
9the post-mastectomy care benefits required to be covered by a
10policy of accident and health insurance under Section 356t of
11the Illinois Insurance Code. The program of health benefits
12shall provide the coverage required under Sections 356g,
13356g.5, 356g.5-1, 356m, 356u, 356w, 356x, 356z.2, 356z.4,
14356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
15356z.14, 356z.15, 356z.17, 356z.22, and 356z.25, 356z.26, and
16356z.29 of the Illinois Insurance Code. The program of health
17benefits must comply with Sections 155.22a, 155.37, 355b,
18356z.19, 370c, and 370c.1 of the Illinois Insurance Code.
19 Rulemaking authority to implement Public Act 95-1045, if
20any, is conditioned on the rules being adopted in accordance
21with all provisions of the Illinois Administrative Procedure
22Act and all rules and procedures of the Joint Committee on
23Administrative Rules; any purported rule not so adopted, for

HB0274 Engrossed- 2 -LRB100 04385 SMS 14391 b
1whatever reason, is unauthorized.
2(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17;
3100-138, eff. 8-18-17; revised 10-3-17.)
4 Section 10. The Department of Public Health Powers and
5Duties Law of the Civil Administrative Code of Illinois is
6amended by adding Section 2310-700 as follows:
7 (20 ILCS 2310/2310-700 new)
8 Sec. 2310-700. Contraceptive drugs and products; Director
9standing order.
10 (a) As used in this Section:
11 "Hormonal contraceptive" means a prescribed
12medically-acceptable oral drug, transdermal patch, or vaginal
13ring that is approved by the United States Food and Drug
14Administration to prevent pregnancy.
15 "Standing order" has the meaning given to that term in the
16Pharmacy Practice Act.
17 (b) If the Director of Public Health is a physician
18licensed to practice medicine in all its branches in Illinois,
19the Director shall establish a standing order complete with the
20issuance of a prescription for a hormonal contraceptive in
21accordance with this Section. If the Director is not a
22physician licensed to practice medicine in all its branches in
23Illinois, then the Medical Director of the Department of Public
24Health shall establish a standing order in accordance with this

HB0274 Engrossed- 3 -LRB100 04385 SMS 14391 b
1Section.
2 (c) The standing order, at a minimum, shall comply with the
3following:
4 (1) A pharmacist may dispense a 12-month supply of
5 hormonal contraceptives to a patient.
6 (2) A pharmacist shall have the patient complete the
7 self-screening risk assessment tool. The self-screening
8 risk assessment tool is to be based on the most current
9 version of the United States Medical Eligibility Criteria
10 for Contraceptive Use published by the federal Centers for
11 Disease Control and Prevention.
12 (3) Based upon the results of the self-screening risk
13 assessment and the patient assessment, the pharmacist
14 shall use his or her professional and clinical judgment as
15 to when a patient should be referred to the patient's
16 physician or another health care provider.
17 (4) The pharmacist shall provide, during the patient
18 assessment and consultation, counseling and education
19 about all methods of contraception, including methods not
20 covered under the standing order, and their proper use and
21 effectiveness.
22 (5) The patient consultation shall take place in a
23 private manner consistent with rules adopted by the
24 Department of Financial and Professional Regulation.
25 (6) The Department shall adopt rules under this Section
26 that require a pharmacist to:

HB0274 Engrossed- 4 -LRB100 04385 SMS 14391 b
1 (A) complete an educational training program
2 accredited by the Accreditation Council for Pharmacy
3 Education and approved by the Department that is
4 related to the patient self-screening risk assessment,
5 patient assessment, contraceptive counseling and
6 education, and dispensation of hormonal
7 contraceptives; and
8 (B) dispense the hormonal contraceptive to the
9 patient as soon as practicable after meeting the
10 requirements of paragraph (2).
11 (7) All State and federal laws governing insurance
12 coverage of contraceptive drugs shall apply to hormonal
13 contraceptives dispensed by a pharmacist under this
14 Section.
15 Section 15. The Counties Code is amended by changing
16Section 5-1069.3 as follows:
17 (55 ILCS 5/5-1069.3)
18 Sec. 5-1069.3. Required health benefits. If a county,
19including a home rule county, is a self-insurer for purposes of
20providing health insurance coverage for its employees, the
21coverage shall include coverage for the post-mastectomy care
22benefits required to be covered by a policy of accident and
23health insurance under Section 356t and the coverage required
24under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x,

HB0274 Engrossed- 5 -LRB100 04385 SMS 14391 b
1356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
2356z.14, 356z.15, 356z.22, and 356z.25, 356z.26, and 356z.29 of
3the Illinois Insurance Code. The coverage shall comply with
4Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
5Insurance Code. The requirement that health benefits be covered
6as provided in this Section is an exclusive power and function
7of the State and is a denial and limitation under Article VII,
8Section 6, subsection (h) of the Illinois Constitution. A home
9rule county to which this Section applies must comply with
10every provision of this Section.
11 Rulemaking authority to implement Public Act 95-1045, if
12any, is conditioned on the rules being adopted in accordance
13with all provisions of the Illinois Administrative Procedure
14Act and all rules and procedures of the Joint Committee on
15Administrative Rules; any purported rule not so adopted, for
16whatever reason, is unauthorized.
17(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17;
18100-138, eff. 8-18-17; revised 10-5-17.)
19 Section 20. The Illinois Municipal Code is amended by
20changing Section 10-4-2.3 as follows:
21 (65 ILCS 5/10-4-2.3)
22 Sec. 10-4-2.3. Required health benefits. If a
23municipality, including a home rule municipality, is a
24self-insurer for purposes of providing health insurance

HB0274 Engrossed- 6 -LRB100 04385 SMS 14391 b
1coverage for its employees, the coverage shall include coverage
2for the post-mastectomy care benefits required to be covered by
3a policy of accident and health insurance under Section 356t
4and the coverage required under Sections 356g, 356g.5,
5356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.10,
6356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, and
7356z.25, 356z.26, and 356z.29 of the Illinois Insurance Code.
8The coverage shall comply with Sections 155.22a, 355b, 356z.19,
9and 370c of the Illinois Insurance Code. The requirement that
10health benefits be covered as provided in this is an exclusive
11power and function of the State and is a denial and limitation
12under Article VII, Section 6, subsection (h) of the Illinois
13Constitution. A home rule municipality to which this Section
14applies must comply with every provision of this Section.
15 Rulemaking authority to implement Public Act 95-1045, if
16any, is conditioned on the rules being adopted in accordance
17with all provisions of the Illinois Administrative Procedure
18Act and all rules and procedures of the Joint Committee on
19Administrative Rules; any purported rule not so adopted, for
20whatever reason, is unauthorized.
21(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17;
22100-138, eff. 8-18-17; revised 10-5-17.)
23 Section 25. The School Code is amended by changing Section
2410-22.3f as follows:

HB0274 Engrossed- 7 -LRB100 04385 SMS 14391 b
1 (105 ILCS 5/10-22.3f)
2 Sec. 10-22.3f. Required health benefits. Insurance
3protection and benefits for employees shall provide the
4post-mastectomy care benefits required to be covered by a
5policy of accident and health insurance under Section 356t and
6the coverage required under Sections 356g, 356g.5, 356g.5-1,
7356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.11, 356z.12,
8356z.13, 356z.14, 356z.15, 356z.22, and 356z.25, 356z.26, and
9356z.29 of the Illinois Insurance Code. Insurance policies
10shall comply with Section 356z.19 of the Illinois Insurance
11Code. The coverage shall comply with Sections 155.22a and 355b
12of the Illinois Insurance Code.
13 Rulemaking authority to implement Public Act 95-1045, if
14any, is conditioned on the rules being adopted in accordance
15with all provisions of the Illinois Administrative Procedure
16Act and all rules and procedures of the Joint Committee on
17Administrative Rules; any purported rule not so adopted, for
18whatever reason, is unauthorized.
19(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
20revised 9-25-17.)
21 Section 30. The Illinois Insurance Code is amended by
22adding Section 356z.29 as follows:
23 (215 ILCS 5/356z.29 new)
24 Sec. 356z.29. Coverage for patient care services for

HB0274 Engrossed- 8 -LRB100 04385 SMS 14391 b
1hormonal contraceptives provided by a pharmacist. A group or
2individual policy of accident and health insurance or a managed
3care plan that is amended, delivered, issued, or renewed after
4the effective date of this amendatory Act of the 100th General
5Assembly shall provide coverage for patient care services
6provided by a pharmacist for hormonal contraceptives
7assessment and consultation.
8 Section 35. The Pharmacy Practice Act is amended by
9changing Section 3 as follows:
10 (225 ILCS 85/3)
11 (Section scheduled to be repealed on January 1, 2020)
12 Sec. 3. Definitions. For the purpose of this Act, except
13where otherwise limited therein:
14 (a) "Pharmacy" or "drugstore" means and includes every
15store, shop, pharmacy department, or other place where
16pharmacist care is provided by a pharmacist (1) where drugs,
17medicines, or poisons are dispensed, sold or offered for sale
18at retail, or displayed for sale at retail; or (2) where
19prescriptions of physicians, dentists, advanced practice
20registered nurses, physician assistants, veterinarians,
21podiatric physicians, or optometrists, within the limits of
22their licenses, are compounded, filled, or dispensed; or (3)
23which has upon it or displayed within it, or affixed to or used
24in connection with it, a sign bearing the word or words

HB0274 Engrossed- 9 -LRB100 04385 SMS 14391 b
1"Pharmacist", "Druggist", "Pharmacy", "Pharmaceutical Care",
2"Apothecary", "Drugstore", "Medicine Store", "Prescriptions",
3"Drugs", "Dispensary", "Medicines", or any word or words of
4similar or like import, either in the English language or any
5other language; or (4) where the characteristic prescription
6sign (Rx) or similar design is exhibited; or (5) any store, or
7shop, or other place with respect to which any of the above
8words, objects, signs or designs are used in any advertisement.
9 (b) "Drugs" means and includes (1) articles recognized in
10the official United States Pharmacopoeia/National Formulary
11(USP/NF), or any supplement thereto and being intended for and
12having for their main use the diagnosis, cure, mitigation,
13treatment or prevention of disease in man or other animals, as
14approved by the United States Food and Drug Administration, but
15does not include devices or their components, parts, or
16accessories; and (2) all other articles intended for and having
17for their main use the diagnosis, cure, mitigation, treatment
18or prevention of disease in man or other animals, as approved
19by the United States Food and Drug Administration, but does not
20include devices or their components, parts, or accessories; and
21(3) articles (other than food) having for their main use and
22intended to affect the structure or any function of the body of
23man or other animals; and (4) articles having for their main
24use and intended for use as a component or any articles
25specified in clause (1), (2) or (3); but does not include
26devices or their components, parts or accessories.

HB0274 Engrossed- 10 -LRB100 04385 SMS 14391 b
1 (c) "Medicines" means and includes all drugs intended for
2human or veterinary use approved by the United States Food and
3Drug Administration.
4 (d) "Practice of pharmacy" means:
5 (1) the interpretation and the provision of assistance
6 in the monitoring, evaluation, and implementation of
7 prescription drug orders;
8 (2) the dispensing of prescription drug orders;
9 (3) participation in drug and device selection;
10 (4) drug administration limited to the administration
11 of oral, topical, injectable, and inhalation as follows:
12 (A) in the context of patient education on the
13 proper use or delivery of medications;
14 (B) vaccination of patients 14 years of age and
15 older pursuant to a valid prescription or standing
16 order, by a physician licensed to practice medicine in
17 all its branches, upon completion of appropriate
18 training, including how to address contraindications
19 and adverse reactions set forth by rule, with
20 notification to the patient's physician and
21 appropriate record retention, or pursuant to hospital
22 pharmacy and therapeutics committee policies and
23 procedures; and
24 (C) administration of injections of
25 alpha-hydroxyprogesterone caproate, pursuant to a
26 valid prescription, by a physician licensed to

HB0274 Engrossed- 11 -LRB100 04385 SMS 14391 b
1 practice medicine in all its branches, upon completion
2 of appropriate training, including how to address
3 contraindications and adverse reactions set forth by
4 rule, with 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

HB0274 Engrossed- 12 -LRB100 04385 SMS 14391 b
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 2310-700 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
13practice of pharmacy in this State must be actively licensed as
14a pharmacist under this Act.
15 (e) "Prescription" means and includes any written, oral,
16facsimile, or electronically transmitted order for drugs or
17medical devices, issued by a physician licensed to practice
18medicine in all its branches, dentist, veterinarian, podiatric
19physician, or optometrist, within the limits of his or her
20license their licenses, by a physician assistant in accordance
21with subsection (f) of Section 4, or by an advanced practice
22registered nurse in accordance with subsection (g) of Section
234, containing the following: (1) name of the patient; (2) date
24when prescription was issued; (3) name and strength of drug or
25description of the medical device prescribed; and (4) quantity;
26(5) directions for use; (6) prescriber's name, address, and

HB0274 Engrossed- 13 -LRB100 04385 SMS 14391 b
1signature; and (7) DEA registration number where required, for
2controlled substances. The prescription may, but is not
3required to, list the illness, disease, or condition for which
4the drug or device is being prescribed. DEA registration
5numbers shall not be required on inpatient drug orders.
6 (f) "Person" means and includes a natural person,
7partnership, association, corporation, government entity, or
8any other legal entity.
9 (g) "Department" means the Department of Financial and
10Professional Regulation.
11 (h) "Board of Pharmacy" or "Board" means the State Board of
12Pharmacy of the Department of Financial and Professional
13Regulation.
14 (i) "Secretary" means the Secretary of Financial and
15Professional Regulation.
16 (j) "Drug product selection" means the interchange for a
17prescribed pharmaceutical product in accordance with Section
1825 of this Act and Section 3.14 of the Illinois Food, Drug and
19Cosmetic Act.
20 (k) "Inpatient drug order" means an order issued by an
21authorized prescriber for a resident or patient of a facility
22licensed under the Nursing Home Care Act, the ID/DD Community
23Care Act, the MC/DD Act, the Specialized Mental Health
24Rehabilitation Act of 2013, the Hospital Licensing Act, or the
25University of Illinois Hospital Act "An Act in relation to the
26founding and operation of the University of Illinois Hospital

HB0274 Engrossed- 14 -LRB100 04385 SMS 14391 b
1and the conduct of University of Illinois health care
2programs", approved July 3, 1931, as amended, or a facility
3which is operated by the Department of Human Services (as
4successor to the Department of Mental Health and Developmental
5Disabilities) or the Department of Corrections.
6 (k-5) "Pharmacist" means an individual health care
7professional and provider currently licensed by this State to
8engage in the practice of pharmacy.
9 (l) "Pharmacist in charge" means the licensed pharmacist
10whose name appears on a pharmacy license and who is responsible
11for all aspects of the operation related to the practice of
12pharmacy.
13 (m) "Dispense" or "dispensing" means the interpretation,
14evaluation, and implementation of a prescription drug order,
15including the preparation and delivery of a drug or device to a
16patient or patient's agent in a suitable container
17appropriately labeled for subsequent administration to or use
18by a patient in accordance with applicable State and federal
19laws and regulations. "Dispense" or "dispensing" does not mean
20the physical delivery to a patient or a patient's
21representative in a home or institution by a designee of a
22pharmacist or by common carrier. "Dispense" or "dispensing"
23also does not mean the physical delivery of a drug or medical
24device to a patient or patient's representative by a
25pharmacist's designee within a pharmacy or drugstore while the
26pharmacist is on duty and the pharmacy is open.

HB0274 Engrossed- 15 -LRB100 04385 SMS 14391 b
1 (n) "Nonresident pharmacy" means a pharmacy that is located
2in a state, commonwealth, or territory of the United States,
3other than Illinois, that delivers, dispenses, or distributes,
4through the United States Postal Service, commercially
5acceptable parcel delivery service, or other common carrier, to
6Illinois residents, any substance which requires a
7prescription.
8 (o) "Compounding" means the preparation and mixing of
9components, excluding flavorings, (1) as the result of a
10prescriber's prescription drug order or initiative based on the
11prescriber-patient-pharmacist relationship in the course of
12professional practice or (2) for the purpose of, or incident
13to, research, teaching, or chemical analysis and not for sale
14or dispensing. "Compounding" includes the preparation of drugs
15or devices in anticipation of receiving prescription drug
16orders based on routine, regularly observed dispensing
17patterns. Commercially available products may be compounded
18for dispensing to individual patients only if all of the
19following conditions are met: (i) the commercial product is not
20reasonably available from normal distribution channels in a
21timely manner to meet the patient's needs and (ii) the
22prescribing practitioner has requested that the drug be
23compounded.
24 (p) (Blank).
25 (q) (Blank).
26 (r) "Patient counseling" means the communication between a

HB0274 Engrossed- 16 -LRB100 04385 SMS 14391 b
1pharmacist or a student pharmacist under the supervision of a
2pharmacist and a patient or the patient's representative about
3the patient's medication or device for the purpose of
4optimizing proper use of prescription medications or devices.
5"Patient counseling" may include without limitation (1)
6obtaining a medication history; (2) acquiring a patient's
7allergies and health conditions; (3) facilitation of the
8patient's understanding of the intended use of the medication;
9(4) proper directions for use; (5) significant potential
10adverse events; (6) potential food-drug interactions; and (7)
11the need to be compliant with the medication therapy. A
12pharmacy technician may only participate in the following
13aspects of patient counseling under the supervision of a
14pharmacist: (1) obtaining medication history; (2) providing
15the offer for counseling by a pharmacist or student pharmacist;
16and (3) acquiring a patient's allergies and health conditions.
17 (s) "Patient profiles" or "patient drug therapy record"
18means the obtaining, recording, and maintenance of patient
19prescription information, including prescriptions for
20controlled substances, and personal information.
21 (t) (Blank).
22 (u) "Medical device" or "device" means an instrument,
23apparatus, implement, machine, contrivance, implant, in vitro
24reagent, or other similar or related article, including any
25component part or accessory, required under federal law to bear
26the label "Caution: Federal law requires dispensing by or on

HB0274 Engrossed- 17 -LRB100 04385 SMS 14391 b
1the order of a physician". A seller of goods and services who,
2only for the purpose of retail sales, compounds, sells, rents,
3or leases medical devices shall not, by reasons thereof, be
4required to be a licensed pharmacy.
5 (v) "Unique identifier" means an electronic signature,
6handwritten signature or initials, thumb print, or other
7acceptable biometric or electronic identification process as
8approved by the Department.
9 (w) "Current usual and customary retail price" means the
10price that a pharmacy charges to a non-third-party payor.
11 (x) "Automated pharmacy system" means a mechanical system
12located within the confines of the pharmacy or remote location
13that performs operations or activities, other than compounding
14or administration, relative to storage, packaging, dispensing,
15or distribution of medication, and which collects, controls,
16and maintains all transaction information.
17 (y) "Drug regimen review" means and includes the evaluation
18of prescription drug orders and patient records for (1) known
19allergies; (2) drug or potential therapy contraindications;
20(3) reasonable dose, duration of use, and route of
21administration, taking into consideration factors such as age,
22gender, and contraindications; (4) reasonable directions for
23use; (5) potential or actual adverse drug reactions; (6)
24drug-drug interactions; (7) drug-food interactions; (8)
25drug-disease contraindications; (9) therapeutic duplication;
26(10) patient laboratory values when authorized and available;

HB0274 Engrossed- 18 -LRB100 04385 SMS 14391 b
1(11) proper utilization (including over or under utilization)
2and optimum therapeutic outcomes; and (12) abuse and misuse.
3 (z) "Electronically transmitted prescription" means a
4prescription that is created, recorded, or stored by electronic
5means; issued and validated with an electronic signature; and
6transmitted by electronic means directly from the prescriber to
7a pharmacy. An electronic prescription is not an image of a
8physical prescription that is transferred by electronic means
9from computer to computer, facsimile to facsimile, or facsimile
10to computer.
11 (aa) "Medication therapy management services" means a
12distinct service or group of services offered by licensed
13pharmacists, physicians licensed to practice medicine in all
14its branches, advanced practice registered nurses authorized
15in a written agreement with a physician licensed to practice
16medicine in all its branches, or physician assistants
17authorized in guidelines by a supervising physician that
18optimize therapeutic outcomes for individual patients through
19improved medication use. In a retail or other non-hospital
20pharmacy, medication therapy management services shall consist
21of the evaluation of prescription drug orders and patient
22medication records to resolve conflicts with the following:
23 (1) known allergies;
24 (2) drug or potential therapy contraindications;
25 (3) reasonable dose, duration of use, and route of
26 administration, taking into consideration factors such as

HB0274 Engrossed- 19 -LRB100 04385 SMS 14391 b
1 age, gender, and contraindications;
2 (4) reasonable directions for use;
3 (5) potential or actual adverse drug reactions;
4 (6) drug-drug interactions;
5 (7) drug-food interactions;
6 (8) drug-disease contraindications;
7 (9) identification of therapeutic duplication;
8 (10) patient laboratory values when authorized and
9 available;
10 (11) proper utilization (including over or under
11 utilization) and optimum therapeutic outcomes; and
12 (12) drug abuse and misuse.
13 "Medication therapy management services" includes the
14following:
15 (1) documenting the services delivered and
16 communicating the information provided to patients'
17 prescribers within an appropriate time frame, not to exceed
18 48 hours;
19 (2) providing patient counseling designed to enhance a
20 patient's understanding and the appropriate use of his or
21 her medications; and
22 (3) providing information, support services, and
23 resources designed to enhance a patient's adherence with
24 his or her prescribed therapeutic regimens.
25 "Medication therapy management services" may also include
26patient care functions authorized by a physician licensed to

HB0274 Engrossed- 20 -LRB100 04385 SMS 14391 b
1practice medicine in all its branches for his or her identified
2patient or groups of patients under specified conditions or
3limitations in a standing order from the physician.
4 "Medication therapy management services" in a licensed
5hospital may also include the following:
6 (1) reviewing assessments of the patient's health
7 status; and
8 (2) following protocols of a hospital pharmacy and
9 therapeutics committee with respect to the fulfillment of
10 medication orders.
11 (bb) "Pharmacist care" means the provision by a pharmacist
12of medication therapy management services, with or without the
13dispensing of drugs or devices, intended to achieve outcomes
14that improve patient health, quality of life, and comfort and
15enhance patient safety.
16 (cc) "Protected health information" means individually
17identifiable health information that, except as otherwise
18provided, is:
19 (1) transmitted by electronic media;
20 (2) maintained in any medium set forth in the
21 definition of "electronic media" in the federal Health
22 Insurance Portability and Accountability Act; or
23 (3) transmitted or maintained in any other form or
24 medium.
25 "Protected health information" does not include
26individually identifiable health information found in:

HB0274 Engrossed- 21 -LRB100 04385 SMS 14391 b
1 (1) education records covered by the federal Family
2 Educational Right and Privacy Act; or
3 (2) employment records held by a licensee in its role
4 as an employer.
5 (dd) "Standing order" means a specific order for a patient
6or group of patients issued by a physician licensed to practice
7medicine in all its branches in Illinois.
8 (ee) "Address of record" means the designated address
9recorded by the Department in the applicant's application file
10or licensee's license file maintained by the Department's
11licensure maintenance unit.
12 (ff) "Home pharmacy" means the location of a pharmacy's
13primary operations.
14 (gg) "Email address of record" means the designated email
15address recorded by the Department in the applicant's
16application file or the licensee's license file, as maintained
17by the Department's licensure maintenance unit.
18(Source: P.A. 99-180, eff. 7-29-15; 100-208, eff. 1-1-18;
19100-497, eff. 9-8-17; 100-513, eff. 1-1-18; revised 9-29-17.)
20 Section 40. The Illinois Public Aid Code is amended by
21adding Section 5-5.12b as follows:
22 (305 ILCS 5/5-5.12b new)
23 Sec. 5-5.12b. Coverage for patient care services for
24hormonal contraceptives provided by a pharmacist.

HB0274 Engrossed- 22 -LRB100 04385 SMS 14391 b
1 (a) Subject to approval by the federal Centers for Medicare
2and Medicaid Services, the medical assistance program,
3including both the fee-for-service and managed care medical
4assistance programs established under this Article, shall
5cover patient care services provided by a pharmacist for
6hormonal contraceptives assessment and consultation.
7 (b) The Department shall establish a fee schedule for
8patient care services provided by a pharmacist for hormonal
9contraceptives assessment and consultation.
10 (c) The rate of reimbursement for patient care services
11provided by a pharmacist for hormonal contraceptives
12assessment and consultation shall be at 85% of the fee schedule
13for physician services by the medical assistance program.
14 (d) A pharmacist must be enrolled in the medical assistance
15program as an ordering and referring provider prior to
16providing hormonal contraceptives assessment and consultation
17that is submitted by a pharmacy or pharmacist provider for
18reimbursement pursuant to this Section.
19 (e) The Director shall seek any necessary federal waivers
20or approvals to implement this Section. This Section shall not
21be implemented until the receipt of all necessary federal
22waivers or approvals or until January 1, 2021, whichever comes
23first. If federal approval is not obtained by January 1, 2021,
24the provisions of this Section shall be implemented using State
25funds.
26 (f) This Section does not restrict or prohibit any services

HB0274 Engrossed- 23 -LRB100 04385 SMS 14391 b
1currently provided by pharmacists as authorized by law,
2including, but not limited to, pharmacist services provided
3under this Code or authorized under the Illinois Title XIX
4State Plan.
5 (g) The Department shall adopt administrative rules for
6this Section as soon as practicable but no later than May 1,
72019.
feedback