Bill Text: IL HB0767 | 2025-2026 | 104th General Assembly | Enrolled

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Bill Title: Amends the Civil Administrative Code of Illinois. Establishes advisory duties for the Medical Director of the Department of Public Health. Amends the Department of Commerce and Economic Opportunity Law of the Civil Administrative Code of Illinois. Sets forth provisions concerning a grant to a statewide retail association representing pharmacies and makes a conforming change. Amends the Department of Public Health Act. Provides that the Immunization Advisory Committee shall advise the Director of Public Health on the control of diseases for which an immunization or medical countermeasure is licensed or regulated in the United States by the United States Food and Drug Administration and the use of immunizations or medical countermeasures to control disease in Illinois. Requires the Department to publish any recommendations issued by the Immunization Advisory Committee on the Department's website. Sets forth membership provisions for the Committee. Amends the Illinois Insurance Code. Requires coverage for immunizations and medical countermeasures that have in effect a recommendation within the State Guidelines for Communicable Disease Prevention issued by the Director of Public Health, with respect to the individual. Makes changes to provisions concerning pharmacy benefit manager contracts and pharmacy benefit manager reporting and licensure requirements. Amends the Pharmacy Practice Act. Provides that a pharmacist shall not administer to patients below the age of 7 any vaccine required to be administered under Part 665 of the Illinois Administrative Code. Makes other changes to vaccine administration requirements for pharmacists, pharmacy technicians, and student pharmacists. Amends the Communicable Disease Prevention Act. Requires the Director of Public Health to provide State Guidelines for Communicable Disease Prevention for which there is an immunization or medical countermeasure. Makes other changes. Effective immediately.

Sponsorship: Partisan Bill (Democrat 9)

Status: (Passed) 2025-12-02 - Public Act . . . . . . . . . 104-0439 [HB0767 Detail]

Download: Illinois-2025-HB0767-Enrolled.html

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HB0767 Enrolled LRB104 04666 BAB 14693 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Civil Administrative Code of Illinois is
amended by changing Section 5-235 as follows:
(20 ILCS 5/5-235) (was 20 ILCS 5/7.03)
Sec. 5-235. In the Department of Public Health.
(a) The Director of Public Health shall be either a
physician licensed to practice medicine in all of its branches
in Illinois or a person who has administrative experience in
public health work at the local, state, or national level in
accordance with subsection (b).
If the Director is not a physician licensed to practice
medicine in all its branches, then a Medical Director shall be
appointed who shall be a physician licensed to practice
medicine in all its branches. The Medical Director shall
report directly to the Director. If the Director is not a
physician, the Medical Director shall have primary
responsibility for overseeing the following regulatory and
policy areas:
(1) Department responsibilities concerning hospital
and health care facility regulation, emergency services,
ambulatory surgical treatment centers, health care

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professional regulation and credentialing, advising the
Board of Health, patient safety initiatives, and the
State's response to disease prevention and outbreak
management and control.
(2) Advising the Director on the control of diseases
for which an immunization is licensed by the United States
Food and Drug Administration. The advice may include
guidance for the use of immunizations or medical
countermeasures based on medical and scientific evidence,
if circumstances warrant. The Medical Director may issue
guidance and recommendations on immunizations or medical
countermeasures in the absence of such recommendations
from the Director or to further supplement recommendations
as necessary.
(3) (2) Any other duties assigned by the Director or
required by law.
(b) A Director of Public Health who is not a physician
licensed to practice medicine in all its branches shall at a
minimum have the following education and experience:
(1) 5 years of full-time administrative experience in
public health and a master's degree in public health from
(i) a college or university accredited by the North
Central Association or (ii) any other nationally
recognized regional accrediting agency; or
(2) 5 years of full-time administrative experience in
public health and a graduate degree in a related field

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from (i) a college or university accredited by the North
Central Association or (ii) any other nationally
recognized regional accrediting agency. For the purposes
of this item (2), "a graduate degree in a related field"
includes, but is not limited to, a master's degree in
public administration, nursing, environmental health,
community health, or health education.
(c) The Assistant Director of Public Health shall be a
person who has administrative experience in public health
work.
(Source: P.A. 97-798, eff. 7-13-12.)
Section 10. The Department of Commerce and Economic
Opportunity Law of the Civil Administrative Code of Illinois
is amended by changing Section 605-60 and adding Section
605-70 as follows:
(20 ILCS 605/605-60)
(Text of Section before amendment by P.A. 104-27)
Sec. 605-60. DCEO Projects Fund. The DCEO Projects Fund is
created as a trust fund in the State treasury. The Department
is authorized to accept and deposit into the Fund moneys
received from any gifts, grants, transfers, or other sources,
public or private, unless deposit into a different fund is
otherwise mandated. Subject to appropriation, the Department
shall use moneys in the Fund to make grants or loans to and

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enter into contracts with units of local government, local and
regional economic development corporations, and not-for-profit
organizations for municipal development projects, for the
specific purposes established by the terms and conditions of
the gift, grant, or award, and for related administrative
expenses. As used in this Section, the term "municipal
development projects" includes, but is not limited to, grants
for reducing food insecurity in urban and rural areas.
(Source: P.A. 103-588, eff. 6-5-24.)
(Text of Section after amendment by P.A. 104-27)
Sec. 605-60. DCEO Projects Fund.
(a) The DCEO Projects Fund is created as a trust fund in
the State treasury. The Department is authorized to accept and
deposit into the Fund moneys received from any gifts, grants,
transfers, or other sources, public or private, unless deposit
into a different fund is otherwise mandated.
(b) Subject to appropriation, the Department shall use
moneys in the Fund to make grants or loans to and enter into
contracts with units of local government, local and regional
economic development corporations, retail associations, and
not-for-profit organizations for municipal development
projects, for the specific purposes established by the terms
and conditions of the gift, grant, or award, and for related
administrative expenses. As used in this Section, the term
"municipal development projects" includes, but is not limited

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to, grants for reducing food insecurity in urban and rural
areas.
(c) In this subsection, "rural tract" and "urban tract"
have the meanings given to those terms in Section 5 of the
Grocery Initiative Act.
Subject to appropriation, the Department shall use moneys
deposited into the Fund pursuant to Section 513b2 of the
Illinois Insurance Code to make a grant to a statewide retail
association representing pharmacies to promote access to
pharmacies and pharmacist services. Grant funds under this
subsection shall be made available to the following
beneficiaries:
(1) critical access care pharmacies as defined in
Section 5-5.12b of the Illinois Public Aid Code;
(2) retail pharmacies with a physical location in
Illinois owned by a person or entity with an ownership or
control interest in fewer than 10 pharmacies;
(3) retail pharmacies with a physical location in a
county in Illinois with fewer than 50,000 residents;
(4) retail pharmacies with a physical location in a
county in Illinois with 50,000 or more residents and in an
area within Illinois that is designated by the United
States Department of Health and Human Services as either:
(A) a Medically Underserved Area, including Governor's
Exceptions; or (B) a Medically Underserved Population,
including Governor's Exceptions;

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(5) pharmacies whose claims constitute 65% or greater
for Medicaid services and at least 80% of their total
claims are for pharmacy services administered in Illinois;
(6) a pharmacy located in an Illinois census tract
that meets both of the following poverty and population
density and pharmacy accessibility standards:
(A) the census tract has either: (i) 20% or more of
its population living below the poverty guidelines
updated periodically in the Federal Register by the
U.S. Department of Health and Human Services under the
authority of 42 U.S.C. 9902(2); or (ii) a median
household income of less than 80% of the median income
of the nearest metropolitan area; and
(B) the census tract has at least 33% of its
population living one mile or more from the pharmacy
for urban tracts or more than 10 miles from the
pharmacy for rural tracts.
At least annually, the Department shall file with the
Governor and the General Assembly a report that includes:
(1) the number of beneficiaries who applied for
funding;
(2) the number of beneficiaries who received funding;
and
(3) the pharmacies that were awarded funding,
including the location, the amount of funding, and the
subsection category or categories under which the pharmacy

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qualified.
(Source: P.A. 103-588, eff. 6-5-24; 104-27, eff. 1-1-26.)
(20 ILCS 605/605-70 new)
Sec. 605-70. Pharmacy support program.
(a) Subject to appropriation, the Department shall use
moneys deposited into the DCEO Projects Fund pursuant to
Section 513b2 of the Illinois Insurance Code to make a grant to
a statewide retail association representing pharmacies to
promote access to pharmacies and pharmacist services.
(b) Grant funds under subsection (a) shall be made
available to the following beneficiaries:
(1) critical access care pharmacies as defined in
Section 5-5.12b of the Illinois Public Aid Code;
(2) retail pharmacies with a physical location in
Illinois owned by a person or entity with an ownership or
control interest in fewer than 10 pharmacies;
(3) retail pharmacies with a physical location in a
county in Illinois with fewer than 50,000 residents;
(4) retail pharmacies with a physical location in a
county in Illinois with 50,000 or more residents and in an
area within Illinois that is designated by the United
States Department of Health and Human Services as either:
(A) a Medically Underserved Area, including
Governor's Exceptions; or
(B) a Medically Underserved Population, including

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Governor's Exceptions;
(5) pharmacies whose claims constitute 65% or greater
for Medicaid services and at least 80% of their total
claims are for pharmacy services administered in Illinois;
(6) a pharmacy located in an Illinois census tract
that meets both of the following poverty and population
density and pharmacy accessibility standards:
(A) the census tract has either: (i) 20% or more of
its population living below the poverty guidelines
updated periodically in the Federal Register by the
U.S. Department of Health and Human Services under the
authority of 42 U.S.C. 9902(2); or (ii) a median
household income of less than 80% of the median income
of the nearest metropolitan area; and
(B) the census tract has at least 33% of its
population living one mile or more from the pharmacy
for urban tracts or more than 10 miles from the
pharmacy for rural tracts.
(c) In subsection (b), "rural tract" and "urban tract"
have the meanings given to those terms in Section 5 of the
Grocery Initiative Act.
(d) Grant funds under subsection (a) shall be disbursed in
equal amounts to each beneficiary eligible under subsection
(b) that applies for an award. To determine the equal amount
available for each beneficiary eligible under subsection (b)
each State fiscal year, the total amount appropriated from the

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DCEO Projects Fund using moneys deposited under Section 513b2
of the Illinois Insurance Code less any amount provided to a
statewide retail association for administrative expenses shall
be divided by the total number of nonduplicate beneficiaries
eligible under subsection (b) that apply for an award in the
same fiscal year. A beneficiary may only receive one award per
fiscal year even if the beneficiary may qualify under multiple
beneficiary categories in subsection (b).
(e) At least annually, the Department shall file with the
Governor and the General Assembly a report on the
implementation of subsections (a) through (d) that includes:
(1) the number of beneficiaries who applied for
funding;
(2) the number of beneficiaries who received funding;
and
(3) the pharmacies that were awarded funding,
including the location, the amount of funding, and the
subsection (b) category or categories under which the
pharmacy qualified.
Section 15. The Department of Public Health Act is amended
by changing Section 8.4 as follows:
(20 ILCS 2305/8.4)
Sec. 8.4. Immunization Advisory Committee.
(a) Definitions. For the purposes of this Section:

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"Committee" means the Immunization Advisory Committee.
"Immunization" means the treatment of an individual with
any vaccine or immunologic drug licensed, approved, or
authorized for use by the United States Food and Drug
Administration, including emergency use authorization agents,
or meeting World Health Organization requirements, and
designed for the purpose of producing or enhancing an immune
response against a vaccine-preventable disease.
"Medical countermeasures" means products regulated by the
United States Food and Drug Administration that may be used in
a public health emergency, stemming from a terrorist attack or
accidental release of a biological, chemical, or
radiological/nuclear agent or a naturally occurring emerging
infectious disease.
(b) The Director of Public Health shall appoint an
Immunization Advisory Committee to advise the Director on
immunization issues, including:
(1) The control of diseases for which an immunization
or medical countermeasure is licensed or regulated in the
United States by the United States Food and Drug
Administration. The advice shall address the use of
immunizations or medical countermeasures shown to be
effective in controlling a disease for which an
immunization is available. Advice for the use of
unlicensed but regulated immunizations or medical
countermeasures may be provided based on medical and

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scientific evidence, if circumstances warrant. For each
immunization or medical countermeasure, the Committee
shall advise on population groups or circumstances in
which it is recommended. The Committee shall also provide
recommendations on contraindications and precautions for
the use of the immunization or medical countermeasures and
provide information on recognized adverse events. The
Committee may provide recommendations that address the
general use of immunizations or medical countermeasures
and special situations or populations that may warrant
modification of the routine recommendations.
(2) The use of immunizations or medical
countermeasures to control disease in Illinois, which
shall include consideration of disease epidemiology and
burden of disease, immunization or medical countermeasure
safety, immunization or medical countermeasure efficacy
and effectiveness, the quality of evidence reviewed,
economic analyses, and implementation issues. The
Committee may revise or withdraw its recommendations
regarding a particular immunization or medical
countermeasure as new information on disease epidemiology,
vaccine effectiveness or safety, economic considerations,
or other data become available.
(3) The Department of Public Health shall publish any
recommendations issued by the Immunization Advisory
Committee on the Department's website.

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(c) The Director shall take into consideration any
comments or recommendations made by the Immunization Advisory
Committee.
(d) The Immunization Advisory Committee shall be composed
of no more than 21 the following members with knowledge of
immunization issues. Members shall serve for terms totaling 6
years for a maximum of 2 terms. On the effective date of this
amendatory Act of the 104th General Assembly, existing members
and any members appointed after the effective date of this
amendatory Act of the 104th General Assembly shall be assigned
equally into one of 3 classes. Members of the first class shall
vacate their seats after 2 years; the second class shall
vacate their seats after 4 years; and the third class shall
vacate their seats after 6 years so that one-third of members
may be appointed every 2 years. Any members serving on the
effective date of this amendatory Act of the 104th General
Assembly shall continue as members for whatever remainder of
time left for the class they are assigned until the completion
of that class's term. Members serving on the effective date of
this amendatory Act of the 104th General Assembly may serve 2
terms after their current term expires.
Members of the Immunization Advisory Committee appointed
after the effective date of this amendatory Act of the 104th
General Assembly shall include: (i) the Medical Director of
the Department of Public Health or the Medical Director's
delegate, (ii) a representative from an Illinois local health

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department, (iii) a certified school nurse or a registered
nurse working in a public school, (iv) a public health officer
or administrator, (v) a representative of an immunization
advocacy organization, (vi) a representative from the State
Board of Education, and (vii) licensed health care
professionals with knowledge of immunization issues in good
standing with the Department of Financial and Professional
Regulation, including, but not limited to, a pediatrician, a
family physician, an internal medicine physician, an
obstetrician-gynecologist, a pharmacist, an academic
infectious disease clinician, a public health medical
provider, and at least one registered nurse. Physician members
must be licensed to practice medicine in all its branches. The
Department of Public Health may adopt rules and bylaws, as
necessary, on membership eligibility, voting procedures, and
other administrative matters for the Immunization Advisory
Committee in accordance with the Illinois Administrative
Procedure Act and any other applicable laws : a pediatrician, a
physician licensed to practice medicine in all its branches, a
family physician, an infectious disease specialist from a
university based center, 2 representatives of a local health
department, a registered nurse, a school nurse, a public
health provider, a public health officer or administrator, a
representative of a children's hospital, 2 representatives of
immunization advocacy organizations, a representative from the
State Board of Education, a person with expertise in

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bioterrorism issues, and any other individuals or organization
representatives designated by the Director. The Director shall
designate one of the Advisory Committee members with a degree
of doctor of medicine or doctor of osteopathy to serve as the
Chairperson of the Advisory Committee.
(e) If, in the opinion of the Chairperson of the
Immunization Advisory Committee, the Director of Public Health
does not adequately consider the recommendations of the
Immunization Advisory Committee in issuing the State
Guidelines for Communicable Disease Prevention pursuant to
Section 1.2 of the Communicable Disease Prevention Act, the
Chairperson may call for an override vote. If two-thirds of
the Immunization Advisory Committee vote to override the
Director's published State Guidelines for Communicable Disease
Prevention, the Immunization Advisory Committee may republish
recommendations to serve as the State Guidelines for
Communicable Disease Prevention. These recommendations shall
serve as the State Guidelines for Communicable Disease
Prevention for not less than 6 months.
(Source: P.A. 92-561, eff. 6-24-02.)
Section 20. The Illinois Insurance Code is amended by
changing Sections 356z.62, 356z.77, and 424 as follows:
(215 ILCS 5/356z.62)
Sec. 356z.62. Coverage of preventive health services.

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(a) A policy of group health insurance coverage or
individual health insurance coverage as defined in Section 5
of the Illinois Health Insurance Portability and
Accountability Act shall, at a minimum, provide coverage for
and shall not impose any cost-sharing requirements, including
a copayment, coinsurance, or deductible, for:
(1) evidence-based items or services that have in
effect a rating of "A" or "B" in the current
recommendations of the United States Preventive Services
Task Force;
(2) immunizations that have in effect a recommendation
from the Advisory Committee on Immunization Practices of
the Centers for Disease Control and Prevention with
respect to the individual involved;
(3) with respect to infants, children, and
adolescents, evidence-informed preventive care and
screenings provided for in the comprehensive guidelines
supported by the Health Resources and Services
Administration; and
(4) with respect to women, such additional preventive
care and screenings not described in paragraph (1) of this
subsection (a) as provided for in comprehensive guidelines
supported by the Health Resources and Services
Administration for purposes of this paragraph; and .
(5) immunizations and medical countermeasures that
have in effect a recommendation within the State

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Guidelines for Communicable Disease Prevention issued by
the Director of Public Health pursuant to Section 1.2 of
the Communicable Disease Prevention Act, with respect to
the individual involved. For this paragraph, the
prohibition on cost-sharing requirements does not apply if
and to the extent that the coverage would disqualify a
high-deductible health plan from eligibility for a health
savings account pursuant to Section 223 of the Internal
Revenue Code.
(b) For purposes of this Section, and for purposes of any
other provision of State law, recommendations of the United
States Preventive Services Task Force regarding breast cancer
screening, mammography, and prevention issued in or around
November 2009 are not considered to be current.
(c) For office visits:
(1) if an item or service described in subsection (a)
is billed separately or is tracked as individual encounter
data separately from an office visit, then a policy may
impose cost-sharing requirements with respect to the
office visit;
(2) if an item or service described in subsection (a)
is not billed separately or is not tracked as individual
encounter data separately from an office visit and the
primary purpose of the office visit is the delivery of
such an item or service, then a policy may not impose
cost-sharing requirements with respect to the office

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visit; and
(3) if an item or service described in subsection (a)
is not billed separately or is not tracked as individual
encounter data separately from an office visit and the
primary purpose of the office visit is not the delivery of
such an item or service, then a policy may impose
cost-sharing requirements with respect to the office
visit.
(d) A policy must provide coverage pursuant to subsection
(a) for plan or policy years that begin on or after the date
that is one year after the date the recommendation or
guideline is issued. If a recommendation or guideline is in
effect on the first day of the plan or policy year, or if a
recommendation becomes effective for an in-force policy under
the circumstances described in subsection (d-5), the policy
shall cover the items and services specified in the
recommendation or guideline through the last day of the plan
or policy year unless either:
(1) a recommendation under paragraph (1) of subsection
(a) is downgraded to a "D" rating; or
(2) the item or service is subject to a safety recall
or is otherwise determined to pose a significant safety
concern by a federal agency authorized to regulate the
item or service during the plan or policy year.
(d-5) Notwithstanding subsection (d), a policy, including
an in-force policy, must provide coverage pursuant to

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paragraph (5) of subsection (a) within 15 business days after
the date the State Guidelines for Communicable Disease
Prevention are issued if the Guidelines reinstate any
recommendation or portion thereof under paragraph (2) of
subsection (a) that the Advisory Committee on Immunization
Practices has reduced or withdrawn.
(e) Network limitations.
(1) Subject to paragraph (3) of this subsection,
nothing in this Section requires coverage for items or
services described in subsection (a) that are delivered by
an out-of-network provider under a health maintenance
organization health care plan, other than a
point-of-service contract, or under a voluntary health
services plan that generally excludes coverage for
out-of-network services except as otherwise required by
law.
(2) Subject to paragraph (3) of this subsection,
nothing in this Section precludes a policy with a
preferred provider program under Article XX-1/2 of this
Code, a health maintenance organization point-of-service
contract, or a similarly designed voluntary health
services plan from imposing cost-sharing requirements for
items or services described in subsection (a) that are
delivered by an out-of-network provider.
(3) If a policy does not have in its network a provider
who can provide an item or service described in subsection

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(a), then the policy must cover the item or service when
performed by an out-of-network provider and it may not
impose cost-sharing with respect to the item or service.
(f) Nothing in this Section prevents a company from using
reasonable medical management techniques to determine the
frequency, method, treatment, or setting for an item or
service described in subsection (a) to the extent not
specified in the recommendation or guideline.
(g) Nothing in this Section shall be construed to prohibit
a policy from providing coverage for items or services in
addition to those required under subsection (a) or from
denying coverage for items or services that are not required
under subsection (a). Unless prohibited by other law, a policy
may impose cost-sharing requirements for a treatment not
described in subsection (a) even if the treatment results from
an item or service described in subsection (a). Nothing in
this Section shall be construed to limit coverage requirements
provided under other law.
(h) The Director may develop guidelines to permit a
company to utilize value-based insurance designs. In the
absence of guidelines developed by the Director, any such
guidelines developed by the Secretary of the U.S. Department
of Health and Human Services that are in force under 42 U.S.C.
300gg-13 shall apply.
(i) For student health insurance coverage as defined at 45
CFR 147.145, student administrative health fees are not

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considered cost-sharing requirements with respect to
preventive services specified under subsection (a). As used in
this subsection, "student administrative health fee" means a
fee charged by an institution of higher education on a
periodic basis to its students to offset the cost of providing
health care through health clinics regardless of whether the
students utilize the health clinics or enroll in student
health insurance coverage.
(j) For any recommendation or guideline specifically
referring to women or men, a company shall not deny or limit
the coverage required or a claim made under subsection (a)
based solely on the individual's recorded sex or actual or
perceived gender identity, or for the reason that the
individual is gender nonconforming, intersex, transgender, or
has undergone, or is in the process of undergoing, gender
transition, if, notwithstanding the sex or gender assigned at
birth, the covered individual meets the conditions for the
recommendation or guideline at the time the item or service is
furnished.
(k) This Section does not apply to grandfathered health
plans, excepted benefits, or short-term, limited-duration
health insurance coverage.
(Source: P.A. 103-551, eff. 8-11-23.)
(215 ILCS 5/356z.77)
Sec. 356z.77 356z.71. Coverage of vaccination

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administration fees.
(a) A group or individual policy of accident and health
insurance or a managed care plan that is amended, delivered,
issued, or renewed on or after January 1, 2026 shall provide
coverage for vaccinations for COVID-19, influenza, and
respiratory syncytial virus, including the administration of
the vaccine by a pharmacist or health care provider authorized
to administer such a vaccine, without imposing a deductible,
coinsurance, copayment, or any other cost-sharing requirement,
if the following conditions are met:
(1) the vaccine is authorized or licensed by the
United States Food and Drug Administration; and
(2) the vaccine is ordered and administered according
to the State Guidelines for Communicable Disease
Prevention issued by the Director of Public Health
pursuant to Section 1.2 of the Communicable Disease
Prevention Act or the Advisory Committee on Immunization
Practices standard immunization schedule.
(b) If the vaccinations provided for in subsection (a) are
not otherwise available to be administered by a contracted
pharmacist or health care provider, the group or individual
policy of accident and health insurance or a managed care plan
shall cover the vaccination, including administration fees,
without imposing a deductible, coinsurance, copayment, or any
other cost-sharing requirement.
(c) The coverage required in this Section does not apply

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to the extent that the coverage would disqualify a
high-deductible health plan from eligibility for a health
savings account pursuant to Section 223 of the Internal
Revenue Code of 1986.
(Source: P.A. 103-918, eff. 1-1-25; revised 12-3-24.)
(215 ILCS 5/424) (from Ch. 73, par. 1031)
(Text of Section before amendment by P.A. 104-55)
Sec. 424. Unfair methods of competition and unfair or
deceptive acts or practices defined. The following are hereby
defined as unfair methods of competition and unfair and
deceptive acts or practices in the business of insurance:
(1) The commission by any person of any one or more of
the acts defined or prohibited by Sections 134, 143.24c,
147, 148, 149, 151, 155.22, 155.22a, 155.42, 236, 237,
364, 469, and 513b1 of this Code.
(2) Entering into any agreement to commit, or by any
concerted action committing, any act of boycott, coercion
or intimidation resulting in or tending to result in
unreasonable restraint of, or monopoly in, the business of
insurance.
(3) Making or permitting, in the case of insurance of
the types enumerated in Classes 1, 2, and 3 of Section 4,
any unfair discrimination between individuals or risks of
the same class or of essentially the same hazard and
expense element because of the race, color, religion, or

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national origin of such insurance risks or applicants. The
application of this Article to the types of insurance
enumerated in Class 1 of Section 4 shall in no way limit,
reduce, or impair the protections and remedies already
provided for by Sections 236 and 364 of this Code or any
other provision of this Code.
(4) Engaging in any of the acts or practices defined
in or prohibited by Sections 154.5 through 154.8 of this
Code.
(5) Making or charging any rate for insurance against
losses arising from the use or ownership of a motor
vehicle which requires a higher premium of any person by
reason of his physical disability, race, color, religion,
or national origin.
(6) Failing to meet any requirement of the Unclaimed
Life Insurance Benefits Act with such frequency as to
constitute a general business practice.
(Source: P.A. 102-778, eff. 7-1-22.)
(Text of Section after amendment by P.A. 104-55)
Sec. 424. Unfair methods of competition and unfair or
deceptive acts or practices defined. The following are hereby
defined as unfair methods of competition and unfair and
deceptive acts or practices in the business of insurance:
(1) The commission by any person of any one or more of
the acts defined or prohibited by Sections 134, 143.24c,

HB0767 Enrolled - 24 - LRB104 04666 BAB 14693 b
147, 148, 149, 151, 155.22, 155.22a, 155.42, 236, 237,
364, 469, and 513b1 of this Code.
(2) Entering into any agreement to commit, or by any
concerted action committing, any act of boycott, coercion
or intimidation resulting in or tending to result in
unreasonable restraint of, or monopoly in, the business of
insurance.
(3) Making or permitting, in the case of insurance of
the types enumerated in Classes 1, 2, and 3 of Section 4,
any unfair discrimination between individuals or risks of
the same class or of essentially the same hazard and
expense element because of the race, color, religion, or
national origin of such insurance risks or applicants. The
application of this Article to the types of insurance
enumerated in Class 1 of Section 4 shall in no way limit,
reduce, or impair the protections and remedies already
provided for by Sections 236 and 364 of this Code or any
other provision of this Code.
(4) Engaging in any of the acts or practices defined
in or prohibited by Sections 154.5 through 154.8 of this
Code.
(5) Making or charging any rate for insurance against
losses arising from the use or ownership of a motor
vehicle which requires a higher premium of any person by
reason of his physical disability, race, color, religion,
or national origin.

HB0767 Enrolled - 25 - LRB104 04666 BAB 14693 b
(6) Failing to meet any requirement of the Unclaimed
Life Insurance Benefits Act with such frequency as to
constitute a general business practice.
(7) Soliciting either an individual who is a resident
of a nursing home or long-term care facility or an
individual who is over the age of 65, as described in
paragraph (8) of this Section, to purchase accident or
health insurance, unless the person who is selling the
insurance:
(A) advises the potential enrollee of the benefit
of examining the potential enrollee's current
insurance plan, discusses all proposed
insurance-related changes with a family member,
friend, or other advisor of the potential enrollee,
and then waits 48 hours before making any
insurance-related changes concerning the potential
enrollee;
(B) provides a phone number that may be called if
the potential enrollee or the potential enrollee's
family members, friends, or other advisors have any
questions; and
(C) allows the potential enrollee to opt out of
any future communications with the person.
(8) Entering into or amending an accident or health
insurance policy with an individual who is over the age of
65 and who has executed a health care power of attorney or

HB0767 Enrolled - 26 - LRB104 04666 BAB 14693 b
has a medical condition, such as dementia, that reduces
the person's capacity to make informed decisions
independently, unless the potential enrollee's agent under
a health care power of attorney executes the agreement and
the agreement is reduced to writing.
(Source: P.A. 104-55, eff. 1-1-26.)
Section 25. The Illinois Insurance Code is amended by
changing Section 513b1, 513b1.1, and 513b2 as follows:
(215 ILCS 5/513b1)
(Text of Section before amendment by P.A. 104-27)
Sec. 513b1. Pharmacy benefit manager contracts.
(a) As used in this Article Section:
"340B drug discount program" means the program established
under Section 340B of the federal Public Health Service Act,
42 U.S.C. 256b.
"340B entity" means a covered entity as defined in 42
U.S.C. 256b(a)(4) authorized to participate in the 340B drug
discount program.
"340B pharmacy" means any pharmacy used to dispense 340B
drugs for a covered entity, whether entity-owned or external.
"Affiliate" means a person or entity that directly or
indirectly through one or more intermediaries controls or is
controlled by, or is under common control with, the person or
entity specified. The location of a person or entity's

HB0767 Enrolled - 27 - LRB104 04666 BAB 14693 b
domicile, whether in Illinois or a foreign or alien
jurisdiction, does not affect the person or entity's status as
an affiliate.
"Biological product" has the meaning ascribed to that term
in Section 19.5 of the Pharmacy Practice Act.
"Brand name drug" means a drug that has been approved
under 42 U.S.C. 262 or 21 U.S.C. 355(c), as applicable, and is
marketed, sold, or distributed under a proprietary,
trademark-protected name.
"Complex or chronic medical condition" means a physical,
behavioral, or developmental condition that has no known cure,
is progressive, or can be debilitating or fatal if unmanaged
or untreated.
"Covered individual" means a member, participant,
enrollee, contract holder, policyholder, or beneficiary of a
health benefit plan who is provided a drug benefit by the
health benefit plan.
"Critical access pharmacy" means a critical access care
pharmacy as defined in Section 5-5.12b of the Illinois Public
Aid Code.
"Drugs" has the meaning ascribed to that term in Section 3
of the Pharmacy Practice Act and includes biological products.
"Employee welfare benefit plan" has the meaning given to
that term in 29 U.S.C. 1002(1), without regard for whether the
employee welfare benefit plan is covered under 29 U.S.C. 1003.
"Federal governmental plan" has the meaning given to that

HB0767 Enrolled - 28 - LRB104 04666 BAB 14693 b
term in 42 U.S.C. 300gg-91(d)(8)(B).
"Generic drug" means a drug that has been approved under
42 U.S.C. 262 or 21 U.S.C. 355(c), as applicable, and is
marketed, sold, or distributed directly or indirectly to the
retail class of trade with labeling, packaging (other than
repackaging as the listed drug in blister packs, unit doses,
or similar packaging for use in institutions), product code,
labeler code, trade name, or trademark that differs from that
of the brand name drug.
"Health benefit plan" means a policy, contract,
certificate, or agreement entered into, offered, or issued by
an insurer to provide, deliver, arrange for, pay for, or
reimburse any of the costs of physical, mental, or behavioral
health care services. Notwithstanding Sections 122-1 through
122-4 of this Code, "health benefit plan" includes self-funded
employee welfare benefit plans except for self-funded
multiemployer plans that are not nonfederal government plans.
"Health benefit plan" does not include:
(1) workers compensation insurance, a federal
governmental plan, Medicare Advantage, Medicare Part D, a
Medicare demonstration program, or Tricare; or
(2) any program for dually eligible Medicare-Medicaid
beneficiaries enrolled in a program under which Medicare
pays for most or all of the covered drugs.
"Health benefit plan sponsor" or "plan sponsor" means:
(1) a plan sponsor, as defined in 29 U.S.C.

HB0767 Enrolled - 29 - LRB104 04666 BAB 14693 b
1002(16)(B), without regard for whether the employee
welfare benefit plan is covered under 29 U.S.C. 1003.
Except as provided by subsection (m), "plan sponsor"
includes the plan sponsor of a nonfederal governmental
plan, including a joint insurance pool described in
Section 6 of the Intergovernmental Cooperation Act; and
(2) any other governmental unit or public agency to
which any State law grants the rights of a plan sponsor
when incorporating this Article by reference.
"Maximum allowable cost" means the maximum amount that a
pharmacy benefit manager will reimburse a pharmacy for the
cost of a drug.
"Maximum allowable cost list" means a list of drugs for
which a maximum allowable cost has been established by a
pharmacy benefit manager.
"Multiemployer plan" has the meaning given to that term in
29 U.S.C. 1002(37).
"Nonfederal governmental plan" has the meaning given to
that term in 42 U.S.C. 300gg-91(d)(8)(C).
"Pharmacy benefit manager" means a person, business, or
entity, including a wholly or partially owned or controlled
subsidiary of a pharmacy benefit manager, that provides claims
processing services or other prescription drug or device
services, or both, for health benefit plans.
"Pharmacy" has the meaning given to that term in Section 3
of the Pharmacy Practice Act.

HB0767 Enrolled - 30 - LRB104 04666 BAB 14693 b
"Pharmacy services" means the provision of any services
listed within the definition of "practice of pharmacy" under
subsection (d) of Section 3 of the Pharmacy Practice Act.
"Rare medical condition" means a physical, behavioral, or
developmental condition that affects fewer than 200,000
individuals in the United States or approximately 1 in 1,500
individuals worldwide.
"Rebate" means a discount or pricing concession based on
drug utilization or administration that is paid by the
manufacturer to a pharmacy benefit manager or its client.
"Rebate aggregator" means a person or entity, including
group purchasing organizations, that negotiate rebates or
other fees with drug manufacturers on behalf or for the
benefit of a pharmacy benefit manager or its client and may
also be involved in contracts that entitle the rebate
aggregator or its client to receive rebates or other fees from
drug manufacturers based on drug utilization or
administration.
"Retail price" means the price an individual without
prescription drug coverage would pay at a retail pharmacy, not
including a pharmacist dispensing fee.
"Specialty drug" means a drug that:
(1) is prescribed for a person with a complex or
chronic medical condition or a rare medical condition;
(2) has limited or exclusive distribution; and
(3) requires both:

HB0767 Enrolled - 31 - LRB104 04666 BAB 14693 b
(A) specialized product handling by the dispensing
pharmacy or administration by the dispensing pharmacy;
and
(B) specialized clinical care, including frequent
dosing adjustments, intensive clinical monitoring, or
expanded services for patients, including intensive
patient counseling, education, or ongoing clinical
support beyond traditional dispensing activities, such
as individualized disease and therapy management to
support improved health outcomes.
"Spread pricing" means the model of drug pricing in which
the pharmacy benefit manager charges a health benefit plan a
contracted price for drugs, and the contracted price for the
drugs differs from the amount the pharmacy benefit manager
directly or indirectly pays the pharmacist or pharmacy for the
drugs, pharmacist services, or drug and dispensing fees.
"Steer" includes, but is not limited to:
(1) requiring a covered individual to only use a
pharmacy, including a mail-order or specialty pharmacy, in
which the pharmacy benefit manager or its affiliate, or an
insurer or its affiliate, maintains an ownership interest
or control;
(2) offering or implementing a plan design that
encourages a covered individual to only use a pharmacy in
which the pharmacy benefit manager or an affiliate, or an
insurer or its affiliate, maintains an ownership interest

HB0767 Enrolled - 32 - LRB104 04666 BAB 14693 b
or control, if the plan design increases costs for the
covered individual. This includes a plan design that
requires a covered individual to pay higher costs or an
increased share of costs for a drug or drug-related
service if the covered individual uses a pharmacy that is
not owned or controlled by the pharmacy benefit manager or
its affiliate or an insurer or its affiliate; and
(3) reimbursing a pharmacy or pharmacist for a drug
and pharmacist service in an amount less than the amount
that the pharmacy benefit manager or an insurer reimburses
itself or an affiliate, including affiliated manufacturers
or joint ventures for providing the same drug or service.
"Third-party payer" means any entity that pays for
prescription drugs on behalf of a patient other than a health
care provider or sponsor of a plan subject to regulation under
Medicare Part D, 42 U.S.C. 1395w-101 et seq.
The changes made to this subsection by this amendatory Act
of the 104th General Assembly shall be deemed to be operative
on and after July 1, 2025.
(a-5) In this Article, references to an "insurer" or
"health insurer" shall include commercial private health
insurance issuers, managed care organizations, managed care
community networks, and any other third-party payer that
contracts with pharmacy benefit managers or with the
Department of Healthcare and Family Services to provide
benefits or services under the Medicaid program or to

HB0767 Enrolled - 33 - LRB104 04666 BAB 14693 b
otherwise engage in the administration or payment of pharmacy
benefits. However, the terms do not refer to the plan sponsor
of a self-funded, single-employer employee welfare benefit
plan or self-funded multiemployer plan if either plan is
covered by 29 U.S.C. 1003. This subsection shall be deemed to
be operative on and after July 1, 2025.
(b) A contract between a health insurer and a pharmacy
benefit manager must require that the pharmacy benefit
manager:
(1) Update maximum allowable cost pricing information
at least every 7 calendar days.
(2) Maintain a process that will, in a timely manner,
eliminate drugs from maximum allowable cost lists or
modify drug prices to remain consistent with changes in
pricing data used in formulating maximum allowable cost
prices and product availability.
(3) Provide access to its maximum allowable cost list
to each pharmacy or pharmacy services administrative
organization subject to the maximum allowable cost list.
Access may include a real-time pharmacy website portal to
be able to view the maximum allowable cost list. As used in
this Section, "pharmacy services administrative
organization" means an entity operating within the State
that contracts with independent pharmacies to conduct
business on their behalf with third-party payers. A
pharmacy services administrative organization may provide

HB0767 Enrolled - 34 - LRB104 04666 BAB 14693 b
administrative services to pharmacies and negotiate and
enter into contracts with third-party payers or pharmacy
benefit managers on behalf of pharmacies.
(4) Provide a process by which a contracted pharmacy
can appeal the provider's reimbursement for a drug subject
to maximum allowable cost pricing. The appeals process
must, at a minimum, include the following:
(A) A requirement that a contracted pharmacy has
14 calendar days after the applicable fill date to
appeal a maximum allowable cost if the reimbursement
for the drug is less than the net amount that the
network provider paid to the supplier of the drug.
(B) A requirement that a pharmacy benefit manager
must respond to a challenge within 14 calendar days of
the contracted pharmacy making the claim for which the
appeal has been submitted.
(C) A telephone number and e-mail address or
website to network providers, at which the provider
can contact the pharmacy benefit manager to process
and submit an appeal.
(D) A requirement that, if an appeal is denied,
the pharmacy benefit manager must provide the reason
for the denial and the name and the national drug code
number from national or regional wholesalers.
(E) A requirement that, if an appeal is sustained,
the pharmacy benefit manager must make an adjustment

HB0767 Enrolled - 35 - LRB104 04666 BAB 14693 b
in the drug price effective the date the challenge is
resolved and make the adjustment applicable to all
similarly situated network pharmacy providers, as
determined by the managed care organization or
pharmacy benefit manager.
(5) Allow a plan sponsor contracting with a pharmacy
benefit manager an annual right to audit compliance with
the terms of the contract by the pharmacy benefit manager,
including, but not limited to, full disclosure of any and
all rebate amounts secured, whether product specific or
generalized rebates, that were provided to the pharmacy
benefit manager by a pharmaceutical manufacturer.
(6) Allow a plan sponsor contracting with a pharmacy
benefit manager to request that the pharmacy benefit
manager disclose the actual amounts paid by the pharmacy
benefit manager to the pharmacy.
(7) Provide notice to the party contracting with the
pharmacy benefit manager of any consideration that the
pharmacy benefit manager receives from the manufacturer
for dispense as written prescriptions once a generic or
biologically similar product becomes available.
(c) In order to place a particular prescription drug on a
maximum allowable cost list, the pharmacy benefit manager
must, at a minimum, ensure that:
(1) if the drug is a generically equivalent drug, it
is listed as therapeutically equivalent and

HB0767 Enrolled - 36 - LRB104 04666 BAB 14693 b
pharmaceutically equivalent "A" or "B" rated in the United
States Food and Drug Administration's most recent version
of the "Orange Book" or have an NR or NA rating by
Medi-Span, Gold Standard, or a similar rating by a
nationally recognized reference;
(2) the drug is available for purchase by each
pharmacy in the State from national or regional
wholesalers operating in Illinois; and
(3) the drug is not obsolete.
(d) A pharmacy benefit manager is prohibited from limiting
a pharmacist's ability to disclose whether the cost-sharing
obligation exceeds the retail price for a covered prescription
drug, and the availability of a more affordable alternative
drug, if one is available in accordance with Section 42 of the
Pharmacy Practice Act.
(e) A health insurer or pharmacy benefit manager shall not
require an insured to make a payment for a prescription drug at
the point of sale in an amount that exceeds the lesser of:
(1) the applicable cost-sharing amount; or
(2) the retail price of the drug in the absence of
prescription drug coverage.
(f) Unless required by law, a contract between a pharmacy
benefit manager or third-party payer and a 340B entity or 340B
pharmacy shall not contain any provision that:
(1) distinguishes between drugs purchased through the
340B drug discount program and other drugs when

HB0767 Enrolled - 37 - LRB104 04666 BAB 14693 b
determining reimbursement or reimbursement methodologies,
or contains otherwise less favorable payment terms or
reimbursement methodologies for 340B entities or 340B
pharmacies when compared to similarly situated non-340B
entities;
(2) imposes any fee, chargeback, or rate adjustment
that is not similarly imposed on similarly situated
pharmacies that are not 340B entities or 340B pharmacies;
(3) imposes any fee, chargeback, or rate adjustment
that exceeds the fee, chargeback, or rate adjustment that
is not similarly imposed on similarly situated pharmacies
that are not 340B entities or 340B pharmacies;
(4) prevents or interferes with an individual's choice
to receive a covered prescription drug from a 340B entity
or 340B pharmacy through any legally permissible means,
except that nothing in this paragraph shall prohibit the
establishment of differing copayments or other
cost-sharing amounts within the benefit plan for covered
persons who acquire covered prescription drugs from a
nonpreferred or nonparticipating provider;
(5) excludes a 340B entity or 340B pharmacy from a
pharmacy network on any basis that includes consideration
of whether the 340B entity or 340B pharmacy participates
in the 340B drug discount program;
(6) prevents a 340B entity or 340B pharmacy from using
a drug purchased under the 340B drug discount program; or

HB0767 Enrolled - 38 - LRB104 04666 BAB 14693 b
(7) any other provision that discriminates against a
340B entity or 340B pharmacy by treating the 340B entity
or 340B pharmacy differently than non-340B entities or
non-340B pharmacies for any reason relating to the
entity's participation in the 340B drug discount program.
As used in this subsection, "pharmacy benefit manager" and
"third-party payer" do not include pharmacy benefit managers
and third-party payers acting on behalf of a Medicaid program.
(g) A violation of this Section by a pharmacy benefit
manager constitutes an unfair or deceptive act or practice in
the business of insurance under Section 424.
(h) A provision that violates subsection (f) in a contract
between a pharmacy benefit manager or a third-party payer and
a 340B entity that is entered into, amended, or renewed after
July 1, 2022 shall be void and unenforceable.
(i)(1) A pharmacy benefit manager may not retaliate
against a pharmacist or pharmacy for disclosing information in
a court, in an administrative hearing, before a legislative
commission or committee, or in any other proceeding, if the
pharmacist or pharmacy has reasonable cause to believe that
the disclosed information is evidence of a violation of a
State or federal law, rule, or regulation.
(2) A pharmacy benefit manager may not retaliate against a
pharmacist or pharmacy for disclosing information to a
government or law enforcement agency, if the pharmacist or
pharmacy has reasonable cause to believe that the disclosed

HB0767 Enrolled - 39 - LRB104 04666 BAB 14693 b
information is evidence of a violation of a State or federal
law, rule, or regulation.
(3) A pharmacist or pharmacy shall make commercially
reasonable efforts to limit the disclosure of confidential and
proprietary information.
(4) Retaliatory actions against a pharmacy or pharmacist
include cancellation of, restriction of, or refusal to renew
or offer a contract to a pharmacy solely because the pharmacy
or pharmacist has:
(A) made disclosures of information that the
pharmacist or pharmacy has reasonable cause to believe is
evidence of a violation of a State or federal law, rule, or
regulation;
(B) filed complaints with the plan or pharmacy benefit
manager; or
(C) filed complaints against the plan or pharmacy
benefit manager with the Department.
(j) This Section applies to contracts entered into or
renewed on or after July 1, 2022.
(k) This Section applies to any group or individual policy
of accident and health insurance or managed care plan that
provides coverage for prescription drugs and that is amended,
delivered, issued, or renewed on or after July 1, 2020.
(m) This Article applies in relation to plan sponsors of
self-funded nonfederal governmental plans only when a State
law organizing the governmental unit incorporates this Article

HB0767 Enrolled - 40 - LRB104 04666 BAB 14693 b
by reference. Nothing shall be construed to exclude a joint
self-insurance pool created under Section 6 of the
Intergovernmental Cooperation Act from references to a plan
sponsor if any pool member's organizing State law incorporates
this Article by reference, but a pharmacy benefit manager is
not subject to the requirements of this Article in relation to
any pool member whose organizing State law does not
incorporate this Article. This subsection shall be deemed to
be operative on and after July 1, 2025.
(n) Regardless of whether a health benefit plan is
insurance, the applicability of this Article to a health
benefit plan shall be determined in the same manner as the
determination of whether a person is transacting insurance in
this State under Sections 121-2.03, 121-2.04, and 121-2.05 and
subsections (a), (c), and (e) of Section 121-3. For any health
benefit plan subject to this Article, unless specifically
provided otherwise, this Article applies to all covered
individuals under the health benefit plan, regardless of the
individual's residence. The exemption for group accident and
health insurance described in subsection (c) of Section 352,
as implemented by Department regulation, extends in the same
manner to all other health benefit plans with respect to the
requirements of this Article. This subsection shall be deemed
to be operative on and after July 1, 2025.
(Source: P.A. 102-778, eff. 7-1-22; 103-154, eff. 6-30-23;
103-453, eff. 8-4-23.)

HB0767 Enrolled - 41 - LRB104 04666 BAB 14693 b
(Text of Section after amendment by P.A. 104-27)
Sec. 513b1. Pharmacy benefit manager contracts.
(a) As used in this Article Section:
"340B drug discount program" means the program established
under Section 340B of the federal Public Health Service Act,
42 U.S.C. 256b.
"340B entity" means a covered entity as defined in 42
U.S.C. 256b(a)(4) authorized to participate in the 340B drug
discount program.
"340B pharmacy" means any pharmacy used to dispense 340B
drugs for a covered entity, whether entity-owned or external.
"Affiliate" means a person or entity that directly or
indirectly through one or more intermediaries controls or is
controlled by, or is under common control with, the person or
entity specified. The location of a person or entity's
domicile, whether in Illinois or a foreign or alien
jurisdiction, does not affect the person or entity's status as
an affiliate.
"Biological product" has the meaning ascribed to that term
in Section 19.5 of the Pharmacy Practice Act.
"Brand name drug" means a drug that has been approved
under 42 U.S.C. 262 or 21 U.S.C. 355(c), as applicable, and is
marketed, sold, or distributed under a proprietary,
trademark-protected name.
"Complex or chronic medical condition" means a physical,

HB0767 Enrolled - 42 - LRB104 04666 BAB 14693 b
behavioral, or developmental condition that has no known cure,
is progressive, or can be debilitating or fatal if unmanaged
or untreated.
"Covered individual" means a member, participant,
enrollee, contract holder, policyholder, or beneficiary of a
health benefit plan who is provided a drug benefit by the
health benefit plan.
"Critical access pharmacy" means a critical access care
pharmacy as defined in Section 5-5.12b of the Illinois Public
Aid Code.
"Drugs" has the meaning ascribed to that term in Section 3
of the Pharmacy Practice Act and includes biological products.
"Employee welfare benefit plan" has the meaning given to
that term in 29 U.S.C. 1002(1), without regard for whether the
employee welfare benefit plan is covered under 29 U.S.C. 1003.
"Federal governmental plan" has the meaning given to that
term in 42 U.S.C. 300gg-91(d)(8)(B).
"Generic drug" means a drug that has been approved under
42 U.S.C. 262 or 21 U.S.C. 355(c), as applicable, and is
marketed, sold, or distributed directly or indirectly to the
retail class of trade with labeling, packaging (other than
repackaging as the listed drug in blister packs, unit doses,
or similar packaging for use in institutions), product code,
labeler code, trade name, or trademark that differs from that
of the brand name drug.
"Health benefit plan" means a policy, contract,

HB0767 Enrolled - 43 - LRB104 04666 BAB 14693 b
certificate, or agreement entered into, offered, or issued by
an insurer to provide, deliver, arrange for, pay for, or
reimburse any of the costs of physical, mental, or behavioral
health care services. Notwithstanding Sections 122-1 through
122-4 of this Code, "health benefit plan" includes self-funded
employee welfare benefit plans. Notwithstanding Sections 122-1
through 122-4 of this Code, "health benefit plan" includes
self-funded employee welfare benefit plans except for
self-funded multiemployer plans that are not nonfederal
government plans. "Health benefit plan" does not include:
(1) workers compensation insurance, a federal
governmental plan, Medicare Advantage, Medicare Part D, a
Medicare demonstration program, or Tricare; or
(2) any program for dually eligible Medicare-Medicaid
beneficiaries enrolled in a program under which Medicare
pays for most or all of the covered drugs.
"Health benefit plan sponsor" or "plan sponsor" means:
(1) a plan sponsor, as defined in 29 U.S.C.
1002(16)(B), without regard for whether the employee
welfare benefit plan is covered under 29 U.S.C. 1003.
Except as provided by subsection (m), "plan sponsor"
includes the plan sponsor of a nonfederal governmental
plan, including a joint insurance pool described in
Section 6 of the Intergovernmental Cooperation Act; and
(2) any other governmental unit or public agency to
which any State law grants the rights of a plan sponsor

HB0767 Enrolled - 44 - LRB104 04666 BAB 14693 b
when incorporating this Article by reference.
"Maximum allowable cost" means the maximum amount that a
pharmacy benefit manager will reimburse a pharmacy for the
cost of a drug.
"Maximum allowable cost list" means a list of drugs for
which a maximum allowable cost has been established by a
pharmacy benefit manager.
"Multiemployer plan" has the meaning given to that term in
29 U.S.C. 1002(37).
"Nonfederal governmental plan" has the meaning given to
that term in 42 U.S.C. 300gg-91(d)(8)(C).
"Pharmacy benefit manager" means a person, business, or
entity, including a wholly or partially owned or controlled
subsidiary of a pharmacy benefit manager, that provides claims
processing services or other drug or device services, or both,
for health benefit plans.
"Pharmacy" has the meaning given to that term in Section 3
of the Pharmacy Practice Act.
"Pharmacy services" means the provision of any services
listed within the definition of "practice of pharmacy" under
subsection (d) of Section 3 of the Pharmacy Practice Act.
"Rare medical condition" means a physical, behavioral, or
developmental condition that affects fewer than 200,000
individuals in the United States or approximately 1 in 1,500
individuals worldwide.
"Rebate" means a discount or pricing concession based on

HB0767 Enrolled - 45 - LRB104 04666 BAB 14693 b
drug utilization or administration that is paid by the
manufacturer to a pharmacy benefit manager or its client.
"Rebate aggregator" means a person or entity, including
group purchasing organizations, that negotiate rebates or
other fees with drug manufacturers on behalf or for the
benefit of a pharmacy benefit manager or its client and may
also be involved in contracts that entitle the rebate
aggregator or its client to receive rebates or other fees from
drug manufacturers based on drug utilization or
administration.
"Retail price" means the price an individual without drug
coverage would pay at a retail pharmacy, not including a
pharmacist dispensing fee.
"Specialty drug" means a drug that:
(1) is prescribed for a person with a complex or
chronic medical condition or a rare medical condition;
(2) has limited or exclusive distribution; and
(3) requires both:
(A) specialized product handling by the dispensing
pharmacy or administration by the dispensing pharmacy;
and
(B) specialized clinical care, including frequent
dosing adjustments, intensive clinical monitoring, or
expanded services for patients, including intensive
patient counseling, education, or ongoing clinical
support beyond traditional dispensing activities, such

HB0767 Enrolled - 46 - LRB104 04666 BAB 14693 b
as individualized disease and therapy management to
support improved health outcomes.
"Spread pricing" means the model of drug pricing in which
the pharmacy benefit manager charges a health benefit plan a
contracted price for drugs, and the contracted price for the
drugs differs from the amount the pharmacy benefit manager
directly or indirectly pays the pharmacist or pharmacy for the
drugs, pharmacist services, or drug and dispensing fees.
"Steer" includes, but is not limited to:
(1) requiring a covered individual to only use a
pharmacy, including a mail-order or specialty pharmacy, in
which the pharmacy benefit manager or its affiliate, or an
insurer or its affiliate, maintains an ownership interest
or control;
(2) offering or implementing a plan design that
encourages a covered individual to only use a pharmacy in
which the pharmacy benefit manager or an affiliate, or an
insurer or its affiliate, maintains an ownership interest
or control, if the plan design increases costs for the
covered individual. This includes a plan design that
requires a covered individual to pay higher costs or an
increased share of costs for a drug or drug-related
service if the covered individual uses a pharmacy that is
not owned or controlled by the pharmacy benefit manager or
its affiliate or an insurer or its affiliate; and .
(3) reimbursing a pharmacy or pharmacist for a drug

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and pharmacist service in an amount less than the amount
that the pharmacy benefit manager or an insurer reimburses
itself or an affiliate, including affiliated manufacturers
or joint ventures for providing the same drug or service.
"Third-party payer" means any entity that pays for drugs
on behalf of a patient other than a health care provider or
sponsor of a plan subject to regulation under Medicare Part D,
42 U.S.C. 1395w-101 et seq.
The changes made to this subsection by this amendatory Act
of the 104th General Assembly shall be deemed to be operative
on and after July 1, 2025.
(a-5) In this Article, references to an "insurer" or
"health insurer" shall include commercial private health
insurance issuers, managed care organizations, managed care
community networks, and any other third-party payer that
contracts with pharmacy benefit managers or with the
Department of Healthcare and Family Services to provide
benefits or services under the Medicaid program or to
otherwise engage in the administration or payment of pharmacy
benefits. However, the terms do not refer to the plan sponsor
of a self-funded, single-employer employee welfare benefit
plan or self-funded multiemployer plan if either plan is
covered by 29 U.S.C. 1003 subject to 29 U.S.C. 1144. This
subsection shall be deemed to be operative on and after July 1,
2025.
(b) A contract between a health insurer or plan sponsor

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and a pharmacy benefit manager must require that the pharmacy
benefit manager:
(1) Update maximum allowable cost pricing information
at least every 7 calendar days.
(2) Maintain a process that will, in a timely manner,
eliminate drugs from maximum allowable cost lists or
modify drug prices to remain consistent with changes in
pricing data used in formulating maximum allowable cost
prices and product availability.
(3) Provide access to its maximum allowable cost list
to each pharmacy or pharmacy services administrative
organization subject to the maximum allowable cost list.
Access may include a real-time pharmacy website portal to
be able to view the maximum allowable cost list. As used in
this Section, "pharmacy services administrative
organization" means an entity operating within the State
that contracts with independent pharmacies to conduct
business on their behalf with third-party payers. A
pharmacy services administrative organization may provide
administrative services to pharmacies and negotiate and
enter into contracts with third-party payers or pharmacy
benefit managers on behalf of pharmacies.
(4) Provide a process by which a contracted pharmacy
can appeal the provider's reimbursement for a drug subject
to maximum allowable cost pricing. The appeals process
must, at a minimum, include the following:

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(A) A requirement that a contracted pharmacy has
14 calendar days after the applicable fill date to
appeal a maximum allowable cost if the reimbursement
for the drug is less than the net amount that the
network provider paid to the supplier of the drug.
(B) A requirement that a pharmacy benefit manager
must respond to a challenge within 14 calendar days of
the contracted pharmacy making the claim for which the
appeal has been submitted.
(C) A telephone number and e-mail address or
website to network providers, at which the provider
can contact the pharmacy benefit manager to process
and submit an appeal.
(D) A requirement that, if an appeal is denied,
the pharmacy benefit manager must provide the reason
for the denial and the name and the national drug code
number from national or regional wholesalers.
(E) A requirement that, if an appeal is sustained,
the pharmacy benefit manager must make an adjustment
in the drug price effective the date the challenge is
resolved and make the adjustment applicable to all
similarly situated network pharmacy providers, as
determined by the managed care organization or
pharmacy benefit manager.
(5) Allow a plan sponsor or insurer whose coverage is
administered by the pharmacy benefit manager an annual

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right to audit compliance with the terms of the contract
by the pharmacy benefit manager, including, but not
limited to, full disclosure of any and all rebate amounts
secured, whether product specific or generalized rebates,
that were provided to the pharmacy benefit manager by a
pharmaceutical manufacturer. The cost of the audit shall
be borne exclusively by the pharmacy benefit manager.
(6) Allow a plan sponsor or insurer whose coverage is
administered by the pharmacy benefit manager to request
that the pharmacy benefit manager disclose the actual
amounts paid by the pharmacy benefit manager to the
pharmacy.
(7) Provide notice to the plan sponsor or the insurer
party contracting with the pharmacy benefit manager of any
consideration that the pharmacy benefit manager receives
from the manufacturer for dispense as written once a
generic or biologically similar product becomes available.
(c) In order to place a particular drug on a maximum
allowable cost list, the pharmacy benefit manager described in
subsection (b) must, at a minimum, ensure that:
(1) if the drug is a generically equivalent drug, it
is listed as therapeutically equivalent and
pharmaceutically equivalent "A" or "B" rated in the United
States Food and Drug Administration's most recent version
of the "Orange Book" or have an NR or NA rating by
Medi-Span, Gold Standard, or a similar rating by a

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nationally recognized reference;
(2) the drug is available for purchase by each
pharmacy in the State from national or regional
wholesalers operating in Illinois; and
(3) the drug is not obsolete.
(d) A pharmacy benefit manager or an insurer is prohibited
from limiting a pharmacist's ability to disclose whether the
cost-sharing obligation exceeds the retail price for a covered
drug, and the availability of a more affordable alternative
drug, if one is available in accordance with Section 42 of the
Pharmacy Practice Act.
(e) A health insurer or pharmacy benefit manager shall not
require a covered individual to make a payment for a drug at
the point of sale in an amount that exceeds the lesser of:
(1) the applicable cost-sharing amount;
(2) the retail price of the drug in the absence of drug
coverage;
(3) the discounted price presented by the covered
individual through a no-cost drug program or drug
manufacturer voucher provided by or for the covered
individual at the point of sale; or
(4) the discounted price presented by the covered
individual through a discounted health care services plan
provided by or for the covered individual at the point of
sale.
This subsection applies to any covered individual of a

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health benefit plan from an insurer, a nonfederal governmental
plan sponsor, or any other governmental unit or public agency
to which any State law grants the rights of a plan sponsor when
incorporating this Article by reference.
(f) Unless required by law, a contract between a pharmacy
benefit manager or third-party payer and a 340B entity or 340B
pharmacy shall not contain any provision that:
(1) distinguishes between drugs purchased through the
340B drug discount program and other drugs when
determining reimbursement or reimbursement methodologies,
or contains otherwise less favorable payment terms or
reimbursement methodologies for 340B entities or 340B
pharmacies when compared to similarly situated non-340B
entities;
(2) imposes any fee, chargeback, or rate adjustment
that is not similarly imposed on similarly situated
pharmacies that are not 340B entities or 340B pharmacies;
(3) imposes any fee, chargeback, or rate adjustment
that exceeds the fee, chargeback, or rate adjustment that
is not similarly imposed on similarly situated pharmacies
that are not 340B entities or 340B pharmacies;
(4) prevents or interferes with an individual's choice
to receive a covered drug from a 340B entity or 340B
pharmacy through any legally permissible means, except
that nothing in this paragraph shall prohibit the
establishment of differing copayments or other

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cost-sharing amounts within the health benefit plan for
covered individuals who acquire covered drugs from a
nonpreferred or nonparticipating provider;
(5) excludes a 340B entity or 340B pharmacy from a
pharmacy network on any basis that includes consideration
of whether the 340B entity or 340B pharmacy participates
in the 340B drug discount program;
(6) prevents a 340B entity or 340B pharmacy from using
a drug purchased under the 340B drug discount program; or
(7) any other provision that discriminates against a
340B entity or 340B pharmacy by treating the 340B entity
or 340B pharmacy differently than non-340B entities or
non-340B pharmacies for any reason relating to the
entity's participation in the 340B drug discount program.
As used in this subsection, "pharmacy benefit manager" and
"third-party payer" do not include pharmacy benefit managers
and third-party payers acting on behalf of a Medicaid program.
(f-5) A pharmacy benefit manager or an affiliate acting on
its behalf shall not conduct spread pricing.
(f-10) A pharmacy benefit manager or an affiliate acting
on its behalf shall not steer a covered individual. This
prohibition also applies to an insurer and its affiliates.
Existing agreements entered into before the effective date of
this amendatory Act of the 104th General Assembly shall
supersede this subsection until the termination of the current
term of such agreement.

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(f-15) A pharmacy benefit manager or affiliated rebate
aggregator must remit no less than 100% of any amounts paid by
a pharmaceutical manufacturer, wholesaler, or other
distributor of a drug, including, but not limited to, rebates,
group purchasing fees, and other fees, to the health benefit
plan sponsor, covered individual, or employer. Records of
rebates and fees remitted from the pharmacy benefit manager or
rebate aggregator must be disclosed to the Department annually
in a format to be specified by the Department. The records
received by the Department shall be considered confidential
and privileged for all purposes, including for purposes of the
Freedom of Information Act, shall not be subject to subpoena
from any private party, and shall not be admissible as
evidence in a civil action.
(f-20) A pharmacy benefit manager or an affiliate acting
on its behalf is prohibited from limiting a covered
individual's access to drugs from a pharmacy or pharmacist
enrolled with the health benefit plan under the terms offered
to all pharmacies in the plan coverage area by designating the
covered drug as a specialty drug contrary to the definition in
this Section. This prohibition also applies to an insurer and
its affiliates.
(f-25) The contract between the pharmacy benefit manager
and the insurer or health benefit plan sponsor must allow and
provide for the pharmacy benefit manager's compliance with an
audit at least once per calendar year of the rebate and fee

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records remitted from a pharmacy benefit manager or its
affiliated party to a health benefit plan. This audit may be
incorporated into the audit under paragraph (5) of subsection
(b) of this Section. Contracts with rebate aggregators,
pharmacy services administrative organizations, pharmacies, or
drug manufacturers must be available for audit by health
benefit plan sponsors, insurers, or their designees at least
once per plan year. Audits shall be performed by an auditor
selected by the health benefit plan sponsor, insurer, or its
designee. Health benefit plan sponsors and insurers shall give
the pharmacy benefit manager a complete copy of the audit and
the pharmacy benefit manager shall provide a complete copy of
those findings to the Department within 60 days of initial
receipt. Rebate contracts with rebate aggregators, pharmacy
services administrative organizations, pharmacies, or drug
manufacturers shall be available for audit by health benefit
plan sponsor, insurer, or designee. Nothing in this Section
shall limit the Department's ability to access the books and
records and any and all copies thereof of pharmacy benefit
managers, their affiliates, or affiliated rebate aggregators.
The records received by the Department shall be considered
confidential and privileged for all purposes, including for
purposes of the Freedom of Information Act, shall not be
subject to subpoena from any private party, and shall not be
admissible as evidence in a civil action.
(g) A violation of this Section by a pharmacy benefit

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manager constitutes an unfair or deceptive act or practice in
the business of insurance under Section 424.
(h) A provision that violates subsection (f) in a contract
between a pharmacy benefit manager or a third-party payer and
a 340B entity that is entered into, amended, or renewed after
July 1, 2022 shall be void and unenforceable. This subsection
and subsection (f) do not apply to a contract directly between
a 340B entity and the plan sponsor of a self-funded,
single-employer or multiemployer employee welfare benefit plan
subject to 29 U.S.C. 1003 1144.
(i)(1) A pharmacy benefit manager may not retaliate
against a pharmacist or pharmacy for disclosing information in
a court, in an administrative hearing, before a legislative
commission or committee, or in any other proceeding, if the
pharmacist or pharmacy has reasonable cause to believe that
the disclosed information is evidence of a violation of a
State or federal law, rule, or regulation.
(2) A pharmacy benefit manager may not retaliate against a
pharmacist or pharmacy for disclosing information to a
government or law enforcement agency, if the pharmacist or
pharmacy has reasonable cause to believe that the disclosed
information is evidence of a violation of a State or federal
law, rule, or regulation.
(3) A pharmacist or pharmacy shall make commercially
reasonable efforts to limit the disclosure of confidential and
proprietary information.

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(4) Retaliatory actions against a pharmacy or pharmacist
include cancellation of, restriction of, or refusal to renew
or offer a contract to a pharmacy solely because the pharmacy
or pharmacist has:
(A) made disclosures of information that the
pharmacist or pharmacy has reasonable cause to believe is
evidence of a violation of a State or federal law, rule, or
regulation;
(B) filed complaints with the plan or pharmacy benefit
manager; or
(C) filed complaints against the plan or pharmacy
benefit manager with the Department.
(j) This Section applies to contracts entered into or
renewed on or after July 1, 2022. Unless and, unless provided
otherwise in this Section or in the Illinois Public Aid Code,
this Section applies to pharmacy benefit managers that are
contracted with a Medicaid managed care entity on or after
January 1, 2026. To the extent not otherwise provided, this
Section applies to contracts entered into, renewed, or amended
on or after January 1, 2026.
(k) This Section applies to any health benefit plan that
provides coverage for drugs and that is amended, delivered,
issued, or renewed on or after July 1, 2020. The changes made
to this Section by Public Act 104-27 this amendatory Act of the
104th General Assembly shall apply with respect to any health
benefit plan that provides coverage for drugs that is amended,

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delivered, issued, or renewed on or after January 1, 2026.
(l) A pharmacy benefit manager is responsible for
compliance with all State requirements applicable to pharmacy
benefit managers even if an action or responsibility of a
pharmacy benefit manager is delegated to or completed by an
affiliate.
(m) This Article applies in relation to plan sponsors of
self-funded nonfederal governmental plans only when a State
law organizing the governmental unit incorporates this Article
by reference. Nothing shall be construed to exclude a joint
self-insurance pool created under Section 6 of the
Intergovernmental Cooperation Act from references to a plan
sponsor if any pool member's organizing State law incorporates
this Article by reference, but a pharmacy benefit manager is
not subject to the requirements of this Article in relation to
any pool member whose organizing State law does not
incorporate this Article. This subsection shall be deemed to
be operative on and after July 1, 2025.
(n) Regardless of whether a health benefit plan is
insurance, the applicability of this Article to a health
benefit plan shall be determined in the same manner as the
determination of whether a person is transacting insurance in
this State under Sections 121-2.03, 121-2.04, and 121-2.05 and
subsections (a), (c), and (e) of Section 121-3. For any health
benefit plan subject to this Article, unless specifically
provided otherwise, this Article applies to all covered

HB0767 Enrolled - 59 - LRB104 04666 BAB 14693 b
individuals under the health benefit plan, regardless of the
individual's residence. The exemption for group accident and
health insurance described in subsection (c) of Section 352,
as implemented by Department regulation, extends in the same
manner to all other health benefit plans with respect to the
requirements of this Article. This subsection shall be deemed
to be operative on and after July 1, 2025.
(Source: P.A. 103-154, eff. 6-30-23; 103-453, eff. 8-4-23;
104-27, eff. 1-1-26.)
(215 ILCS 5/513b1.1)
(This Section may contain text from a Public Act with a
delayed effective date)
Sec. 513b1.1. Pharmacy benefit manager reporting
requirements.
(a) A pharmacy benefit manager that provides services for
a health benefit plan must submit an annual report no later
than September 1, to the Department, each health benefit plan
sponsor, and each insurer that includes the following:
(1) data on the health benefit plan including:
(A) a list of drugs including corresponding
information on therapeutic class, brand name, generic
name, or specialty drug name;
(B) the total number of covered individuals and
number of Illinois residents who are covered
individuals;

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(C) number of drug-related claims;
(D) dosage units;
(E) dispensing channel used;
(F) average wholesale acquisition cost per drug;
and
(G) total out-of-pocket spending by deidentified
covered individual per drug, per transaction;
(2) amount received by the health benefit plan in
rebates, fees, or discounts related to drug utilization or
spending;
(3) total gross spending on drugs by the health
benefit plan;
(4) total net spending, gross spending less
administrative portion of the medical loss ratio, on drugs
by the health benefit plan;
(5) the amount paid by the health benefit plan to the
pharmacy benefit manager for reimbursement cost of a drug
and service per transaction;
(6) the amount a pharmacy benefit manager paid for
pharmacists' services and drugs rendered related to the
health benefit plan per transaction, including, but not
limited to, any dispensing fee;
(7) the specific rebate amount received by the
pharmacy benefit manager per transaction, the amount of
the rebates passed through to the health benefit plan per
transaction, and the amount of the rebates passed on to

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covered individuals at the point of sale that reduced the
covered individuals' applicable deductible, copayment,
coinsurance, or other cost-sharing amount per transaction;
(8) any information collected from drug manufacturers
pertaining to copayment assistance to the extent such
information is collected;
(9) any compensation paid to brokers, consultants,
advisors, or any other individual or firm for referrals,
consideration, or retention by the health benefit plan;
(10) explanation of benefit design parameters
encouraging or requiring covered individuals to use
affiliated pharmacies, percentage of drugs charged by
these pharmacies, and a list of drugs dispensed by
affiliated pharmacies with their associated costs; and
(11) a complete copy of each unredacted contract the
pharmacy benefit manager has with the health benefit plan
sponsor or insurer.
(b) Annual reports pursuant to subsection (a):
(1) must be written in plain language to ensure ease
of reading and accessibility;
(2) must only contain summary health information to
ensure plan, coverage, or covered individual information
remains private and confidential;
(3) upon request by a covered individual, must be
available in summary format and provide aggregated
information to help covered individuals understand their

HB0767 Enrolled - 62 - LRB104 04666 BAB 14693 b
health benefit plan's drug coverage; and
(4) must be filed with the Department no later than
September 1 of each year via the Systems for Electronic
Rates & Forms Filing (SERFF). The filing shall include the
summary version of the report described in paragraph (3)
of this subsection, which shall be marked for public
access.
The Department may share all reports with an established
institution of higher education in this State for the creation
of a pharmacist dispensing cost report to be produced
annually. This annual pharmacist dispensing cost report shall
provide a survey of the average cost of dispensing a
prescription for pharmacists in Illinois. The institution of
higher education shall have the ability to request additional
information from pharmacists for its analysis. The institution
of higher education shall issue the report to the General
Assembly no later than December 31, 2026 and annually
thereafter.
(c) A pharmacy benefit manager may petition the Department
for a filing submission extension. The Director may grant or
deny the extension within 5 business days.
(d) Failure by a pharmacy benefit manager to submit all
required elements in an annual report to the Department may
result in a fine levied by the Director not to exceed $10,000
per day, per offense. Funds derived from fines levied shall be
deposited into the Insurance Producer Administration Fund.

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Fine information shall be posted on the Department's website.
(e) A pharmacy benefit manager found in violation of
subsection (a) or paragraph (4) of subsection (b) may request
a hearing from the Director within 10 days of receipt of the
Director's order, or, if the violation is found in a market
conduct examination, as provided in Section 132 of this Code.
(f) Except for the summary version, the annual reports
submitted by pharmacy benefit managers shall be considered
confidential and privileged for all purposes, including for
purposes of the Freedom of Information Act, shall not be
subject to subpoena from any private party, and shall not be
admissible as evidence in a civil action.
(g) A copy of an adverse decision against a pharmacy
benefit manager for failing to submit an annual report to the
Department must be posted to the Department's website.
(h) Nothing in this Section shall be construed as
permitting a pharmacy benefit manager to avoid or otherwise
fail to comply with the reporting requirements set forth in
Section 5-36 of the Illinois Public Aid Code.
(Source: P.A. 104-27, eff. 1-1-26.)
(215 ILCS 5/513b2)
Sec. 513b2. Licensure requirements.
(a) Beginning on July 1, 2020, to conduct business in this
State, a pharmacy benefit manager must register with the
Director. To initially register or renew a registration, a

HB0767 Enrolled - 64 - LRB104 04666 BAB 14693 b
pharmacy benefit manager shall submit:
(1) A nonrefundable fee not to exceed $500.
(2) A copy of the registrant's corporate charter,
articles of incorporation, or other charter document.
(3) A completed registration form adopted by the
Director containing:
(A) The name and address of the registrant.
(B) The name, address, and official position of
each officer and director of the registrant.
(b) The registrant shall report any change in information
required under this Section to the Director in writing within
60 days after the change occurs.
(c) Upon receipt of a completed registration form, the
required documents, and the registration fee, the Director
shall issue a registration certificate. The certificate may be
in paper or electronic form, and shall clearly indicate the
expiration date of the registration. Registration certificates
are nontransferable.
(d) A registration certificate is valid for 2 years after
its date of issue. The Director shall adopt by rule an initial
registration fee not to exceed $500 and a registration renewal
fee not to exceed $500, both of which shall be nonrefundable.
Total fees may not exceed the cost of administering this
Section.
(e) The Department shall adopt any rules necessary to
implement this Section.

HB0767 Enrolled - 65 - LRB104 04666 BAB 14693 b
(f) On or before August 1, 2025, the pharmacy benefit
manager shall submit a report to the Department that lists the
name of each health benefit plan it administers, provides the
number of Illinois residents who are covered individuals for
each health benefit plan as of the date of submission, and
provides the total number of Illinois residents who are
covered individuals across all health benefit plans the
pharmacy benefit manager administers. On or before September
1, 2025, a registered pharmacy benefit manager, as a condition
of its authority to transact business in this State, must
submit to the Department an amount equal to $15 or an alternate
amount as determined by the Director by rule per covered
individual enrolled by the pharmacy benefit manager in this
State, as detailed in the report submitted to the Department
under this subsection, during the preceding calendar year. On
or before September 1, 2026 and each September 1 thereafter,
payments submitted under this subsection shall be based on the
number of Illinois residents who are covered individuals
reported to the Department in Section 513b1.1.
If a pharmacy benefit manager submitted a payment or
failed to submit a payment under this subsection by September
2, 2025, and if the amount paid or the failure to pay was based
on the pharmacy benefit manager's determination of
applicability or inapplicability to any of its health benefit
plans or covered individuals in a manner contrary to the
requirements clarified by this amendatory Act of the 104th

HB0767 Enrolled - 66 - LRB104 04666 BAB 14693 b
General Assembly, then the pharmacy benefit manager shall
submit a revised report under this subsection by December 1,
2025 in conformity with these clarified requirements. The
revised report shall relate to health benefit plans and
Illinois residents who were covered individuals as of the date
of the previous report. When submitting the revised report,
the pharmacy benefit manager shall identify the types of
health benefit plans and covered individuals that it has added
or removed from its previous report because of the
clarification of applicability. Additionally:
(1) If the revised report indicates that the total
number of Illinois residents who were covered individuals
was too low in the previous report, the pharmacy benefit
manager shall pay the difference to the Department by
January 2, 2026.
(2) If the revised report indicates that the total
number of Illinois residents who were covered individuals
was too high in the previous report, the pharmacy benefit
manager may request a refund from the Department to the
extent provided in subsection (h). The refund request
shall be included with the submission of the revised
report on or before December 1, 2025.
(g) All amounts collected under this Section shall be
deposited into the Prescription Drug Affordability Fund, which
is hereby created as a special fund in the State treasury. Of
the amounts collected under this Section each fiscal year, at

HB0767 Enrolled - 67 - LRB104 04666 BAB 14693 b
the direction of the Department, the Comptroller shall direct
and the Treasurer shall transfer the first $25,000,000 into
the DCEO Projects Fund for grants to support pharmacies under
Section 605-70 605-60 of the Department of Commerce and
Economic Opportunity Law; then, at the direction of the
Department, the Comptroller shall direct and the Treasurer
shall transfer the remainder of the amounts collected under
this Section into the General Revenue Fund.
(h) Whenever it appears to the satisfaction of the
Director that because of some mistake of fact, error in
calculation, or erroneous interpretation of a statute of this
State that any pharmacy benefit manager has paid to the
Department an amount under subsection (f) in excess of the
amount required by subsection (f), the Director shall have the
power to refund to the pharmacy benefit manager the amount of
the excess. No refund shall be paid in relation to any health
benefit plan to which State law makes this Article applicable.
No refund shall be paid without the pharmacy benefit manager
first submitting a revised version of the report described in
subsection (f) along with an explanation of the mistake of
fact, error in calculation, or erroneous interpretation of
State statute that caused the overpayment. No refund shall be
paid for any request submitted after December 1, or in a year
when that date falls on a Saturday or Sunday, the first working
day after December 1, of the same calendar year for which a
report was due under subsection (f) that the pharmacy benefit

HB0767 Enrolled - 68 - LRB104 04666 BAB 14693 b
manager claims to have been the basis for an overpayment. If
the Director approves a refund, it shall be paid:
(1) by applying the amount thereof toward the payment
of fees or other charges already due to the Department, or
which may thereafter become due to the Department, from
that pharmacy benefit manager until the excess has been
fully refunded; or
(2) upon a written request from the pharmacy benefit
manager, the Director shall provide a cash refund within
120 days after receipt of the written request if all
necessary information has been filed with the Department
in order for it to perform an audit of the report described
in subsection (f) or in Section 513b1.1 for the year in
which the overpayment occurred; or within 120 days after
the date the Department receives all the necessary
information to perform the audit.
(A) The Director shall not provide a cash refund
if there are insufficient funds in the Prescription
Drug Affordability Fund to provide a cash refund or if
the amount of the overpayment is less than $100. Funds
shall not be deemed sufficient if the transfer to the
DCEO Projects Fund described in subsection (g) of
Section 513b2 cannot be fully satisfied for the year
of the overpayment.
(B) Any cash refund shall be paid from the
Prescription Drug Affordability Fund.

HB0767 Enrolled - 69 - LRB104 04666 BAB 14693 b
(3) In the absence of a rule specific to pharmacy
benefit managers, paragraphs (1) and (2) shall be
implemented in the same manner as provided by Department
rules enacted under Section 412 of this Code to the extent
the rules do not conflict with this subsection.
(Source: P.A. 104-2, eff. 7-1-25; 104-27, eff. 7-1-25.)
Section 30. The Pharmacy Practice Act is amended by
changing Sections 3 and 9.6 as follows:
(225 ILCS 85/3)
(Section scheduled to be repealed on January 1, 2028)
Sec. 3. Definitions. For the purpose of this Act, except
where otherwise limited therein:
(a) "Pharmacy" or "drugstore" means and includes every
store, shop, pharmacy department, or other place where
pharmacist care is provided by a pharmacist (1) where drugs,
medicines, or poisons are dispensed, sold or offered for sale
at retail, or displayed for sale at retail; or (2) where
prescriptions of physicians, dentists, advanced practice
registered nurses, physician assistants, veterinarians,
podiatric physicians, or optometrists, within the limits of
their licenses, are compounded, filled, or dispensed; or (3)
which has upon it or displayed within it, or affixed to or used
in connection with it, a sign bearing the word or words
"Pharmacist", "Druggist", "Pharmacy", "Pharmaceutical Care",

HB0767 Enrolled - 70 - LRB104 04666 BAB 14693 b
"Apothecary", "Drugstore", "Medicine Store", "Prescriptions",
"Drugs", "Dispensary", "Medicines", or any word or words of
similar or like import, either in the English language or any
other language; or (4) where the characteristic prescription
sign (Rx) or similar design is exhibited; or (5) any store, or
shop, or other place with respect to which any of the above
words, objects, signs or designs are used in any
advertisement.
(b) "Drugs" means and includes (1) articles recognized in
the official United States Pharmacopoeia/National Formulary
(USP/NF), or any supplement thereto and being intended for and
having for their main use the diagnosis, cure, mitigation,
treatment or prevention of disease in man or other animals, as
approved by the United States Food and Drug Administration,
but does not include devices or their components, parts, or
accessories; and (2) all other articles intended for and
having for their main use the diagnosis, cure, mitigation,
treatment or prevention of disease in man or other animals, as
approved by the United States Food and Drug Administration,
but does not include devices or their components, parts, or
accessories; and (3) articles (other than food) having for
their main use and intended to affect the structure or any
function of the body of man or other animals; and (4) articles
having for their main use and intended for use as a component
or any articles specified in clause (1), (2) or (3); but does
not include devices or their components, parts or accessories.

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(c) "Medicines" means and includes all drugs intended for
human or veterinary use approved by the United States Food and
Drug Administration.
(d) "Practice of pharmacy" means:
(1) the interpretation and the provision of assistance
in the monitoring, evaluation, and implementation of
prescription drug orders;
(2) the dispensing of prescription drug orders;
(3) participation in drug and device selection;
(4) drug administration limited to the administration
of oral, topical, injectable, intranasal, and inhalation
as follows:
(A) in the context of patient education on the
proper use or delivery of medications;
(B) vaccination of patients 3 7 years of age and
older pursuant to a valid prescription or standing
order, by a physician licensed to practice medicine in
all its branches, except for vaccinations covered by
paragraph (15), upon completion of appropriate
training, including how to address contraindications
and adverse reactions set forth by rule, with
notification to the patient's primary care provider
physician and appropriate record retention, or
pursuant to hospital pharmacy and therapeutics
committee policies and procedures. Eligible vaccines
are those listed on the U.S. Centers for Disease

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Control and Prevention (CDC) Recommended Immunization
Schedule, the CDC's Health Information for
International Travel, or the U.S. Food and Drug
Administration's Vaccines Licensed and Authorized for
Use in the United States, or the State Guidelines for
Communicable Disease Prevention issued by the Director
of Public Health pursuant to Section 1.2 of the
Communicable Disease Prevention Act, except that a
pharmacist shall not administer to patients below the
age of 7 any vaccine required to be administered under
77 Ill. Adm. Code 665. All vaccines administered in
accordance with this subsection shall be reported to
the Department of Public Health's Immunization
Information System. As applicable to the State's
Medicaid program and other payers, vaccines ordered
and administered in accordance with this subsection
shall be covered and reimbursed at no less than the
rate that the vaccine is reimbursed when ordered and
administered by a physician;
(B-5) (blank);
(C) administration of injections of
alpha-hydroxyprogesterone caproate, pursuant to a
valid prescription, by a physician licensed to
practice medicine in all its branches, upon completion
of appropriate training, including how to address
contraindications and adverse reactions set forth by

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rule, with notification to the patient's physician and
appropriate record retention, or pursuant to hospital
pharmacy and therapeutics committee policies and
procedures; and
(D) administration of long-acting injectables for
mental health or substance use disorders pursuant to a
valid prescription by the patient's physician licensed
to practice medicine in all its branches, advanced
practice registered nurse, or physician assistant upon
completion of appropriate training conducted by an
Accreditation Council of Pharmaceutical Education
accredited provider, including how to address
contraindications and adverse reactions set forth by
rule, with notification to the patient's physician and
appropriate record retention, or pursuant to hospital
pharmacy and therapeutics committee policies and
procedures;
(5) (blank);
(6) drug regimen review;
(7) drug or drug-related research;
(8) the provision of patient counseling;
(9) the practice of telepharmacy;
(10) the provision of those acts or services necessary
to provide pharmacist care;
(11) medication therapy management;
(12) the responsibility for compounding and labeling

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of drugs and devices (except labeling by a manufacturer,
repackager, or distributor of non-prescription drugs and
commercially packaged legend drugs and devices), proper
and safe storage of drugs and devices, and maintenance of
required records;
(13) the assessment and consultation of patients and
dispensing of hormonal contraceptives;
(14) the initiation, dispensing, or administration of
drugs, laboratory tests, assessments, referrals, and
consultations for human immunodeficiency virus
pre-exposure prophylaxis and human immunodeficiency virus
post-exposure prophylaxis under Section 43.5;
(15) without a valid prescription or standing order,
vaccination of patients 3 7 years of age and older for
COVID-19 or influenza subcutaneously, intramuscularly, or
intranasally orally as authorized, approved, or licensed
by the United States Food and Drug Administration,
pursuant to the following conditions:
(A) the vaccine must be authorized or licensed by
the United States Food and Drug Administration;
(B) the vaccine must be ordered and administered
according to the recommendations of the Advisory
Committee on Immunization Practices as adopted by the
United States Centers for Disease Control and
Prevention or the State Guidelines for Communicable
Disease Prevention issued by the Director of Public

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Health pursuant to Section 1.2 of the Communicable
Disease Prevention Act standard immunization schedule;
(C) the pharmacist must complete a course of
training accredited by the Accreditation Council on
Pharmacy Education or a similar health authority or
professional body approved by the Division of
Professional Regulation;
(D) the pharmacist must have a current certificate
in basic cardiopulmonary resuscitation;
(E) the pharmacist must complete, during each
State licensing period, a minimum of 2 hours of
immunization-related continuing pharmacy education
approved by the Accreditation Council on Pharmacy
Education;
(F) the pharmacist must report all vaccines
administered to the Department of Public Health
Immunization Information System in addition to
complying comply with recordkeeping and reporting
requirements of the jurisdiction in which the
pharmacist administers vaccines, including informing
the patient's primary-care provider, when available,
and complying with requirements whereby the person
administering a vaccine must review the vaccine
registry or other vaccination records prior to
administering the vaccine; and
(G) the pharmacist must inform the pharmacist's

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patients who are less than 18 years old, as well as the
adult caregiver accompanying the child, of the
importance of a well-child visit with a pediatrician
or other licensed primary-care provider and must refer
patients as appropriate;
(16) the ordering and administration of COVID-19
therapeutics subcutaneously, intramuscularly, or orally
with notification to the patient's physician and
appropriate record retention or pursuant to hospital
pharmacy and therapeutics committee policies and
procedures. Eligible therapeutics are those approved,
authorized, or licensed by the United States Food and Drug
Administration and must be administered subcutaneously,
intramuscularly, or orally in accordance with that
approval, authorization, or licensing; and
(17) the ordering and administration of point of care
tests, screenings, and treatments for (i) influenza, (ii)
SARS-CoV-2, (iii) Group A Streptococcus, (iv) respiratory
syncytial virus, (v) adult-stage head louse, and (vi)
health conditions identified by a statewide public health
emergency, as defined in the Illinois Emergency Management
Agency Act, with notification to the patient's physician,
if any, and appropriate record retention or pursuant to
hospital pharmacy and therapeutics committee policies and
procedures. Eligible tests and screenings are those
approved, authorized, or licensed by the United States

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Food and Drug Administration and must be administered in
accordance with that approval, authorization, or
licensing.
A pharmacist who orders or administers tests or
screenings for health conditions described in this
paragraph may use a test that may guide clinical
decision-making for the health condition that is waived
under the federal Clinical Laboratory Improvement
Amendments of 1988 and regulations promulgated thereunder
or any established screening procedure that is established
under a statewide protocol.
A pharmacist may delegate the administrative and
technical tasks of performing a test for the health
conditions described in this paragraph to a registered
pharmacy technician or student pharmacist acting under the
supervision of the pharmacist.
The testing, screening, and treatment ordered under
this paragraph by a pharmacist shall not be denied
reimbursement under health benefit plans that are within
the scope of the pharmacist's license and shall be covered
as if the services or procedures were performed by a
physician, an advanced practice registered nurse, or a
physician assistant.
A pharmacy benefit manager, health carrier, health
benefit plan, or third-party payor shall not discriminate
against a pharmacy or a pharmacist with respect to

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participation referral, reimbursement of a covered
service, or indemnification if a pharmacist is acting
within the scope of the pharmacist's license and the
pharmacy is operating in compliance with all applicable
laws and rules.
A pharmacist who performs any of the acts defined as the
practice of pharmacy in this State must be actively licensed
as a pharmacist under this Act.
(e) "Prescription" means and includes any written, oral,
facsimile, or electronically transmitted order for drugs or
medical devices, issued by a physician licensed to practice
medicine in all its branches, dentist, veterinarian, podiatric
physician, or optometrist, within the limits of his or her
license, by a physician assistant in accordance with
subsection (f) of Section 4, or by an advanced practice
registered nurse in accordance with subsection (g) of Section
4, containing the following: (1) name of the patient; (2) date
when prescription was issued; (3) name and strength of drug or
description of the medical device prescribed; and (4)
quantity; (5) directions for use; (6) prescriber's name,
address, and signature; and (7) DEA registration number where
required, for controlled substances. The prescription may, but
is not required to, list the illness, disease, or condition
for which the drug or device is being prescribed. DEA
registration numbers shall not be required on inpatient drug
orders. A prescription for medication other than controlled

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substances shall be valid for up to 15 months from the date
issued for the purpose of refills, unless the prescription
states otherwise.
(f) "Person" means and includes a natural person,
partnership, association, corporation, government entity, or
any other legal entity.
(g) "Department" means the Department of Financial and
Professional Regulation.
(h) "Board of Pharmacy" or "Board" means the State Board
of Pharmacy of the Department of Financial and Professional
Regulation.
(i) "Secretary" means the Secretary of Financial and
Professional Regulation.
(j) "Drug product selection" means the interchange for a
prescribed pharmaceutical product in accordance with Section
25 of this Act and Section 3.14 of the Illinois Food, Drug and
Cosmetic Act.
(k) "Inpatient drug order" means an order issued by an
authorized prescriber for a resident or patient of a facility
licensed under the Nursing Home Care Act, the ID/DD Community
Care Act, the MC/DD Act, the Specialized Mental Health
Rehabilitation Act of 2013, the Hospital Licensing Act, or the
University of Illinois Hospital Act, or a facility which is
operated by the Department of Human Services (as successor to
the Department of Mental Health and Developmental
Disabilities) or the Department of Corrections.

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(k-5) "Pharmacist" means an individual health care
professional and provider currently licensed by this State to
engage in the practice of pharmacy.
(l) "Pharmacist in charge" means the licensed pharmacist
whose name appears on a pharmacy license and who is
responsible for all aspects of the operation related to the
practice of pharmacy.
(m) "Dispense" or "dispensing" means the interpretation,
evaluation, and implementation of a prescription drug order,
including the preparation and delivery of a drug or device to a
patient or patient's agent in a suitable container
appropriately labeled for subsequent administration to or use
by a patient in accordance with applicable State and federal
laws and regulations. "Dispense" or "dispensing" does not mean
the physical delivery to a patient or a patient's
representative in a home or institution by a designee of a
pharmacist or by common carrier. "Dispense" or "dispensing"
also does not mean the physical delivery of a drug or medical
device to a patient or patient's representative by a
pharmacist's designee within a pharmacy or drugstore while the
pharmacist is on duty and the pharmacy is open.
(n) "Nonresident pharmacy" means a pharmacy that is
located in a state, commonwealth, or territory of the United
States, other than Illinois, that delivers, dispenses, or
distributes, through the United States Postal Service,
commercially acceptable parcel delivery service, or other

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common carrier, to Illinois residents, any substance which
requires a prescription.
(o) "Compounding" means the preparation and mixing of
components, excluding flavorings, (1) as the result of a
prescriber's prescription drug order or initiative based on
the prescriber-patient-pharmacist relationship in the course
of professional practice or (2) for the purpose of, or
incident to, research, teaching, or chemical analysis and not
for sale or dispensing. "Compounding" includes the preparation
of drugs or devices in anticipation of receiving prescription
drug orders based on routine, regularly observed dispensing
patterns. Commercially available products may be compounded
for dispensing to individual patients only if all of the
following conditions are met: (i) the commercial product is
not reasonably available from normal distribution channels in
a timely manner to meet the patient's needs and (ii) the
prescribing practitioner has requested that the drug be
compounded.
(p) (Blank).
(q) (Blank).
(r) "Patient counseling" means the communication between a
pharmacist or a student pharmacist under the supervision of a
pharmacist and a patient or the patient's representative about
the patient's medication or device for the purpose of
optimizing proper use of prescription medications or devices.
"Patient counseling" may include without limitation (1)

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obtaining a medication history; (2) acquiring a patient's
allergies and health conditions; (3) facilitation of the
patient's understanding of the intended use of the medication;
(4) proper directions for use; (5) significant potential
adverse events; (6) potential food-drug interactions; and (7)
the need to be compliant with the medication therapy. A
pharmacy technician may only participate in the following
aspects of patient counseling under the supervision of a
pharmacist: (1) obtaining medication history; (2) providing
the offer for counseling by a pharmacist or student
pharmacist; and (3) acquiring a patient's allergies and health
conditions.
(s) "Patient profiles" or "patient drug therapy record"
means the obtaining, recording, and maintenance of patient
prescription information, including prescriptions for
controlled substances, and personal information.
(t) (Blank).
(u) "Medical device" or "device" means an instrument,
apparatus, implement, machine, contrivance, implant, in vitro
reagent, or other similar or related article, including any
component part or accessory, required under federal law to
bear the label "Caution: Federal law requires dispensing by or
on the order of a physician". A seller of goods and services
who, only for the purpose of retail sales, compounds, sells,
rents, or leases medical devices shall not, by reasons
thereof, be required to be a licensed pharmacy.

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(v) "Unique identifier" means an electronic signature,
handwritten signature or initials, thumbprint thumb print, or
other acceptable biometric or electronic identification
process as approved by the Department.
(w) "Current usual and customary retail price" means the
price that a pharmacy charges to a non-third-party payor.
(x) "Automated pharmacy system" means a mechanical system
located within the confines of the pharmacy or remote location
that performs operations or activities, other than compounding
or administration, relative to storage, packaging, dispensing,
or distribution of medication, and which collects, controls,
and maintains all transaction information.
(y) "Drug regimen review" means and includes the
evaluation of prescription drug orders and patient records for
(1) known allergies; (2) drug or potential therapy
contraindications; (3) reasonable dose, duration of use, and
route of administration, taking into consideration factors
such as age, gender, and contraindications; (4) reasonable
directions for use; (5) potential or actual adverse drug
reactions; (6) drug-drug interactions; (7) drug-food
interactions; (8) drug-disease contraindications; (9)
therapeutic duplication; (10) patient laboratory values when
authorized and available; (11) proper utilization (including
over or under utilization) and optimum therapeutic outcomes;
and (12) abuse and misuse.
(z) "Electronically transmitted prescription" means a

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prescription that is created, recorded, or stored by
electronic means; issued and validated with an electronic
signature; and transmitted by electronic means directly from
the prescriber to a pharmacy. An electronic prescription is
not an image of a physical prescription that is transferred by
electronic means from computer to computer, facsimile to
facsimile, or facsimile to computer.
(aa) "Medication therapy management services" means a
distinct service or group of services offered by licensed
pharmacists, physicians licensed to practice medicine in all
its branches, advanced practice registered nurses authorized
in a written agreement with a physician licensed to practice
medicine in all its branches, or physician assistants
authorized in guidelines by a supervising physician that
optimize therapeutic outcomes for individual patients through
improved medication use. In a retail or other non-hospital
pharmacy, medication therapy management services shall consist
of the evaluation of prescription drug orders and patient
medication records to resolve conflicts with the following:
(1) known allergies;
(2) drug or potential therapy contraindications;
(3) reasonable dose, duration of use, and route of
administration, taking into consideration factors such as
age, gender, and contraindications;
(4) reasonable directions for use;
(5) potential or actual adverse drug reactions;

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(6) drug-drug interactions;
(7) drug-food interactions;
(8) drug-disease contraindications;
(9) identification of therapeutic duplication;
(10) patient laboratory values when authorized and
available;
(11) proper utilization (including over or under
utilization) and optimum therapeutic outcomes; and
(12) drug abuse and misuse.
"Medication therapy management services" includes the
following:
(1) documenting the services delivered and
communicating the information provided to patients'
prescribers within an appropriate time frame, not to
exceed 48 hours;
(2) providing patient counseling designed to enhance a
patient's understanding and the appropriate use of his or
her medications; and
(3) providing information, support services, and
resources designed to enhance a patient's adherence with
his or her prescribed therapeutic regimens.
"Medication therapy management services" may also include
patient care functions authorized by a physician licensed to
practice medicine in all its branches for his or her
identified patient or groups of patients under specified
conditions or limitations in a standing order from the

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physician.
"Medication therapy management services" in a licensed
hospital may also include the following:
(1) reviewing assessments of the patient's health
status; and
(2) following protocols of a hospital pharmacy and
therapeutics committee with respect to the fulfillment of
medication orders.
(bb) "Pharmacist care" means the provision by a pharmacist
of medication therapy management services, with or without the
dispensing of drugs or devices, intended to achieve outcomes
that improve patient health, quality of life, and comfort and
enhance patient safety.
(cc) "Protected health information" means individually
identifiable health information that, except as otherwise
provided, is:
(1) transmitted by electronic media;
(2) maintained in any medium set forth in the
definition of "electronic media" in the federal Health
Insurance Portability and Accountability Act; or
(3) transmitted or maintained in any other form or
medium.
"Protected health information" does not include
individually identifiable health information found in:
(1) education records covered by the federal Family
Educational Right and Privacy Act; or

HB0767 Enrolled - 87 - LRB104 04666 BAB 14693 b
(2) employment records held by a licensee in its role
as an employer.
(dd) "Standing order" means a specific order for a patient
or group of patients issued by a physician licensed to
practice medicine in all its branches in Illinois.
(ee) "Address of record" means the designated address
recorded by the Department in the applicant's application file
or licensee's license file maintained by the Department's
licensure maintenance unit.
(ff) "Home pharmacy" means the location of a pharmacy's
primary operations.
(gg) "Email address of record" means the designated email
address recorded by the Department in the applicant's
application file or the licensee's license file, as maintained
by the Department's licensure maintenance unit.
(Source: P.A. 102-16, eff. 6-17-21; 102-103, eff. 1-1-22;
102-558, eff. 8-20-21; 102-813, eff. 5-13-22; 102-1051, eff.
1-1-23; 103-1, eff. 4-27-23; 103-593, eff. 6-7-24; 103-612,
eff. 1-1-25; revised 11-26-24.)
(225 ILCS 85/9.6)
Sec. 9.6. Administration of vaccines and therapeutics by
registered pharmacy technicians and student pharmacists.
(a) Under the supervision of an appropriately trained
pharmacist, a registered pharmacy technician or student
pharmacist may administer COVID-19, SARS-CoV-2, respiratory

HB0767 Enrolled - 88 - LRB104 04666 BAB 14693 b
syncytial virus, and influenza vaccines subcutaneously,
intramuscularly, or intranasally or orally as authorized,
approved, or licensed by the United States Food and Drug
Administration, subject to the following conditions:
(1) the vaccination must be ordered by the supervising
pharmacist;
(2) the supervising pharmacist must be readily and
immediately available to the immunizing pharmacy
technician or student pharmacist;
(3) the pharmacy technician or student pharmacist must
complete a practical training program that is approved by
the Accreditation Council for Pharmacy Education and that
includes hands-on injection technique training and
training in the recognition and treatment of emergency
reactions to vaccines;
(4) the pharmacy technician or student pharmacist must
have a current certificate in basic cardiopulmonary
resuscitation;
(5) the pharmacy technician or student pharmacist must
complete, during the relevant licensing period, a minimum
of 2 hours of immunization-related continuing pharmacy
education that is approved by the Accreditation Council
for Pharmacy Education;
(6) the supervising pharmacist must comply with all
relevant recordkeeping and reporting requirements;
(7) the supervising pharmacist must be responsible for

HB0767 Enrolled - 89 - LRB104 04666 BAB 14693 b
complying with requirements related to reporting adverse
events;
(8) the supervising pharmacist must review the vaccine
registry or other vaccination records prior to ordering
the vaccination to be administered by the pharmacy
technician or student pharmacist;
(9) the pharmacy technician or student pharmacist
must, if the patient is 18 years of age or younger, inform
the patient and the adult caregiver accompanying the
patient of the importance of a well-child visit with a
pediatrician or other licensed primary-care provider and
must refer patients as appropriate;
(10) in the case of a COVID-19 vaccine, the
vaccination must be ordered and administered according to
the Advisory Committee on Immunization Practices' COVID-19
vaccine recommendations or the State Guidelines for
Communicable Disease Prevention issued by the Director of
Public Health pursuant to Section 1.2 of the Communicable
Disease Prevention Act;
(11) in the case of a COVID-19 vaccine, the
supervising pharmacist must comply with any applicable
requirements or conditions of use as set forth in the
Centers for Disease Control and Prevention COVID-19
vaccination provider agreement and any other State or
federal requirements that apply to the administration of
the COVID-19 vaccines being administered; and

HB0767 Enrolled - 90 - LRB104 04666 BAB 14693 b
(12) the registered pharmacy technician or student
pharmacist and the supervising pharmacist must comply with
all other requirements of this Act and the rules adopted
thereunder pertaining to the administration of drugs.
(b) Under the supervision of an appropriately trained
pharmacist, a registered pharmacy technician or student
pharmacist may administer COVID-19 therapeutics
subcutaneously, intramuscularly, or orally as authorized,
approved, or licensed by the United States Food and Drug
Administration, subject to the following conditions:
(1) the COVID-19 therapeutic must be authorized,
approved or licensed by the United States Food and Drug
Administration;
(2) the COVID-19 therapeutic must be administered
subcutaneously, intramuscularly, or orally in accordance
with the United States Food and Drug Administration
approval, authorization, or licensing;
(3) a pharmacy technician or student pharmacist
practicing pursuant to this Section must complete a
practical training program that is approved by the
Accreditation Council for Pharmacy Education and that
includes hands-on injection technique training, clinical
evaluation of indications and contraindications of
COVID-19 therapeutics training, training in the
recognition and treatment of emergency reactions to
COVID-19 therapeutics, and any additional training

HB0767 Enrolled - 91 - LRB104 04666 BAB 14693 b
required in the United States Food and Drug Administration
approval, authorization, or licensing;
(4) the pharmacy technician or student pharmacist must
have a current certificate in basic cardiopulmonary
resuscitation;
(5) the pharmacy technician or student pharmacist must
comply with any applicable requirements or conditions of
use that apply to the administration of COVID-19
therapeutics;
(6) the supervising pharmacist must comply with all
relevant recordkeeping and reporting requirements;
(7) the supervising pharmacist must be readily and
immediately available to the pharmacy technician or
student pharmacist; and
(8) the registered pharmacy technician or student
pharmacist and the supervising pharmacist must comply with
all other requirements of this Act and the rules adopted
thereunder pertaining to the administration of drugs.
(Source: P.A. 103-1, eff. 4-27-23; 103-593, eff. 6-7-24.)
Section 35. The Communicable Disease Prevention Act is
amended by adding Sections 0.05 and 1.2 as follows:
(410 ILCS 315/0.05 new)
Sec. 0.05. Definitions. For the purposes of this Act:
"Immunization" means treatment of an individual with any

HB0767 Enrolled - 92 - LRB104 04666 BAB 14693 b
vaccine or immunologic drug licensed, approved, or authorized
for use by the United States Food and Drug Administration,
including emergency use authorization agents, or meeting World
Health Organization requirements, and designed for the purpose
of producing or enhancing an immune response against a disease
for which such immunization exists.
"Medical countermeasures" means products regulated by the
United States Food and Drug Administration that may be used in
a public health emergency stemming from a terrorist attack or
accidental release of a biological, chemical, or
radiological/nuclear agent or a naturally occurring emerging
disease, pandemic, or other large-scale outbreak.
(410 ILCS 315/1.2 new)
Sec. 1.2. State Guidelines for Communicable Disease
Prevention.
(a) The Director of Public Health shall provide State
Guidelines for Communicable Disease Prevention for which there
is an immunization or medical countermeasure. The Guidelines
shall address the use of immunizations and may include
recommendations for the administration of products such as
vaccines or immune globulin preparations that are defined as
immunizations or medical countermeasures and shown to be
effective in controlling a disease for which an immunization
is available. The Guidelines for the use of unlicensed but
regulated immunizations or medical countermeasures may be

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developed based on medical and scientific evidence if
circumstances warrant. For each immunization or medical
countermeasure, the Guidelines shall include population groups
or circumstances in which a vaccine or related immunization
agent is recommended. The Director of Public Health shall also
provide recommendations on contraindications and precautions
for the use of the immunizations and medical countermeasures
and provide information on recognized adverse events. The
Director also may provide recommendations that address the
general use of immunization products and special situations or
populations that may warrant modification of the routine
recommendations.
(b) The Guidelines shall include consideration of disease
epidemiology and the burden of disease, immunization safety,
immunization efficacy and effectiveness, the quality of
evidence reviewed, economic analyses, and implementation
issues. The Director of Public Health may revise or withdraw
recommendations regarding a particular immunization or medical
countermeasure as new information on disease epidemiology,
immunization effectiveness or safety, economic considerations,
or other data become available.
(c) In developing these Guidelines, the Director may
consider the advice, recommendations, and feedback of:
(1) the Medical Director of the Department of Public
Health;
(2) the Immunization Advisory Committee;

HB0767 Enrolled - 94 - LRB104 04666 BAB 14693 b
(3) the Advisory Committee on Immunization Practices
of the United States Centers for Disease Control and
Prevention;
(4) medical and scientific experts in the field of
disease prevention; and
(5) other widely accepted sources of medical and
scientific evidence, such as recommendations from the
United States Preventive Services Task Force.
(d) The Department of Public Health shall publish
Guidelines or recommendations issued by the Director on the
Department's website. The Department of Public Health or the
Director shall not endanger the public health by publishing or
endorsing public health guidelines or recommendations that
significantly deviate from evidence-based immunization
practices established by credible scientific and medical
communities, experts, and practitioners.
Section 95. No acceleration or delay. Except for the
changes made in subsections (a), (a-5), (m), and (n) of
Section 513b1 of the Illinois Insurance Code, where this Act
makes changes in a statute that is represented in this Act by
text that is not yet or no longer in effect (for example, a
Section represented by multiple versions), the use of that
text does not accelerate or delay the taking effect of (i) the
changes made by this Act or (ii) provisions derived from any
other Public Act.

HB0767 Enrolled - 95 - LRB104 04666 BAB 14693 b
Section 99. Effective date. This Act takes effect upon
becoming law, except that the changes to Section 424 of the
Illinois Insurance Code take effect January 1, 2026.