103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB3336
 
Introduced 2/7/2024, by Sen. Julie A. Morrison
 
SYNOPSIS AS INTRODUCED:

215 ILCS 5/356z.63
225 ILCS 85/3
 Amends the Pharmacy Practice Act and the Illinois Insurance Code. In the definition of "practice of pharmacy", includes the ordering of testing, screening, and treatment (rather than the ordering and administration of tests and screenings) for influenza. Makes conforming changes. Effective January 1, 2025.


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A BILL FOR
 
SB3336LRB103 37463 RTM 67586 b


1 AN ACT concerning regulation.

2 Be it enacted by the People of the State of Illinois, 
3represented in the General Assembly:

4 Section 5. The Illinois Insurance Code is amended by 
5changing Section 356z.63 as follows:

6 (215 ILCS 5/356z.63)
7 Sec. 356z.63 356z.61. Coverage of pharmacy testing, 
8screening, vaccinations, and treatment. A group or individual 
9policy of accident and health insurance or a managed care plan 
10that is amended, delivered, issued, or renewed on or after 
11January 1, 2025 shall provide coverage for health care or 
12patient care services provided by a pharmacist if:
13  (1) the pharmacist meets the requirements and scope of 
14 practice described in paragraph (15), (16), or (17), or 
15 (18) of subsection (d) of Section 3 of the Pharmacy 
16 Practice Act;
17  (2) the health plan provides coverage for the same 
18 service provided by a licensed physician, an advanced 
19 practice registered nurse, or a physician assistant;
20  (3) the pharmacist is included in the health benefit 
21 plan's network of participating providers; and
22  (4) reimbursement has been successfully negotiated in 
23 good faith between the pharmacist and the health plan.
 
 
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1(Source: P.A. 103-1, eff. 4-27-23; revised 8-29-23.)

2 Section 10. The Pharmacy Practice Act is amended by 
3changing Section 3 as follows:

4 (225 ILCS 85/3)
5 (Section scheduled to be repealed on January 1, 2028)
6 Sec. 3. Definitions. For the purpose of this Act, except 
7where otherwise limited therein:
8 (a) "Pharmacy" or "drugstore" means and includes every 
9store, shop, pharmacy department, or other place where 
10pharmacist care is provided by a pharmacist (1) where drugs, 
11medicines, or poisons are dispensed, sold or offered for sale 
12at retail, or displayed for sale at retail; or (2) where 
13prescriptions of physicians, dentists, advanced practice 
14registered nurses, physician assistants, veterinarians, 
15podiatric physicians, or optometrists, within the limits of 
16their licenses, are compounded, filled, or dispensed; or (3) 
17which has upon it or displayed within it, or affixed to or used 
18in connection with it, a sign bearing the word or words 
19"Pharmacist", "Druggist", "Pharmacy", "Pharmaceutical Care", 
20"Apothecary", "Drugstore", "Medicine Store", "Prescriptions", 
21"Drugs", "Dispensary", "Medicines", or any word or words of 
22similar or like import, either in the English language or any 
23other language; or (4) where the characteristic prescription 
24sign (Rx) or similar design is exhibited; or (5) any store, or 
 
 
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1shop, or other place with respect to which any of the above 
2words, objects, signs or designs are used in any 
3advertisement.
4 (b) "Drugs" means and includes (1) articles recognized in 
5the official United States Pharmacopoeia/National Formulary 
6(USP/NF), or any supplement thereto and being intended for and 
7having for their main use the diagnosis, cure, mitigation, 
8treatment or prevention of disease in man or other animals, as 
9approved by the United States Food and Drug Administration, 
10but does not include devices or their components, parts, or 
11accessories; and (2) all other articles intended for and 
12having for their main use the diagnosis, cure, mitigation, 
13treatment or prevention of disease in man or other animals, as 
14approved by the United States Food and Drug Administration, 
15but does not include devices or their components, parts, or 
16accessories; and (3) articles (other than food) having for 
17their main use and intended to affect the structure or any 
18function of the body of man or other animals; and (4) articles 
19having for their main use and intended for use as a component 
20or any articles specified in clause (1), (2) or (3); but does 
21not include devices or their components, parts or accessories.
22 (c) "Medicines" means and includes all drugs intended for 
23human or veterinary use approved by the United States Food and 
24Drug Administration.
25 (d) "Practice of pharmacy" means:
26  (1) the interpretation and the provision of assistance 
 
 
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1 in the monitoring, evaluation, and implementation of 
2 prescription drug orders; 
3  (2) the dispensing of prescription drug orders; 
4  (3) participation in drug and device selection; 
5  (4) drug administration limited to the administration 
6 of oral, topical, injectable, and inhalation as follows: 
7   (A) in the context of patient education on the 
8 proper use or delivery of medications; 
9   (B) vaccination of patients 7 years of age and 
10 older pursuant to a valid prescription or standing 
11 order, by a physician licensed to practice medicine in 
12 all its branches, except for vaccinations covered by 
13 paragraph (15), upon completion of appropriate 
14 training, including how to address contraindications 
15 and adverse reactions set forth by rule, with 
16 notification to the patient's physician and 
17 appropriate record retention, or pursuant to hospital 
18 pharmacy and therapeutics committee policies and 
19 procedures. Eligible vaccines are those listed on the 
20 U.S. Centers for Disease Control and Prevention (CDC) 
21 Recommended Immunization Schedule, the CDC's Health 
22 Information for International Travel, or the U.S. Food 
23 and Drug Administration's Vaccines Licensed and 
24 Authorized for Use in the United States. As applicable 
25 to the State's Medicaid program and other payers, 
26 vaccines ordered and administered in accordance with 
 
 
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1 this subsection shall be covered and reimbursed at no 
2 less than the rate that the vaccine is reimbursed when 
3 ordered and administered by a physician; 
4   (B-5) following the initial administration of 
5 long-acting or extended-release form opioid 
6 antagonists by a physician licensed to practice 
7 medicine in all its branches, administration of 
8 injections of long-acting or extended-release form 
9 opioid antagonists for the treatment of substance use 
10 disorder, pursuant to a valid prescription by a 
11 physician licensed to practice medicine in all its 
12 branches, upon completion of appropriate training, 
13 including how to address contraindications and adverse 
14 reactions, including, but not limited to, respiratory 
15 depression and the performance of cardiopulmonary 
16 resuscitation, set forth by rule, with notification to 
17 the patient's physician and appropriate record 
18 retention, or pursuant to hospital pharmacy and 
19 therapeutics committee policies and procedures; 
20   (C) administration of injections of 
21 alpha-hydroxyprogesterone caproate, pursuant to a 
22 valid prescription, by a physician licensed to 
23 practice medicine in all its branches, upon completion 
24 of appropriate training, including how to address 
25 contraindications and adverse reactions set forth by 
26 rule, with notification to the patient's physician and 
 
 
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1 appropriate record retention, or pursuant to hospital 
2 pharmacy and therapeutics committee policies and 
3 procedures; and 
4   (D) administration of injections of long-term 
5 antipsychotic medications pursuant to a valid 
6 prescription by a physician licensed to practice 
7 medicine in all its branches, upon completion of 
8 appropriate training conducted by an Accreditation 
9 Council of Pharmaceutical Education accredited 
10 provider, including how to address contraindications 
11 and adverse reactions set forth by rule, with 
12 notification to the patient's physician and 
13 appropriate record retention, or pursuant to hospital 
14 pharmacy and therapeutics committee policies and 
15 procedures. 
16  (5) (blank); 
17  (6) drug regimen review; 
18  (7) drug or drug-related research; 
19  (8) the provision of patient counseling; 
20  (9) the practice of telepharmacy; 
21  (10) the provision of those acts or services necessary 
22 to provide pharmacist care; 
23  (11) medication therapy management;
24  (12) the responsibility for compounding and labeling 
25 of drugs and devices (except labeling by a manufacturer, 
26 repackager, or distributor of non-prescription drugs and 
 
 
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1 commercially packaged legend drugs and devices), proper 
2 and safe storage of drugs and devices, and maintenance of 
3 required records; 
4  (13) the assessment and consultation of patients and 
5 dispensing of hormonal contraceptives; 
6  (14) the initiation, dispensing, or administration of 
7 drugs, laboratory tests, assessments, referrals, and 
8 consultations for human immunodeficiency virus 
9 pre-exposure prophylaxis and human immunodeficiency virus 
10 post-exposure prophylaxis under Section 43.5;
11  (15) vaccination of patients 7 years of age and older 
12 for COVID-19 or influenza subcutaneously, intramuscularly, 
13 or orally as authorized, approved, or licensed by the 
14 United States Food and Drug Administration, pursuant to 
15 the following conditions:
16   (A) the vaccine must be authorized or licensed by 
17 the United States Food and Drug Administration;
18   (B) the vaccine must be ordered and administered 
19 according to the Advisory Committee on Immunization 
20 Practices standard immunization schedule;
21   (C) the pharmacist must complete a course of 
22 training accredited by the Accreditation Council on 
23 Pharmacy Education or a similar health authority or 
24 professional body approved by the Division of 
25 Professional Regulation;
26   (D) the pharmacist must have a current certificate 
 
 
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1 in basic cardiopulmonary resuscitation;
2   (E) the pharmacist must complete, during each 
3 State licensing period, a minimum of 2 hours of 
4 immunization-related continuing pharmacy education 
5 approved by the Accreditation Council on Pharmacy 
6 Education;
7   (F) the pharmacist must comply with recordkeeping 
8 and reporting requirements of the jurisdiction in 
9 which the pharmacist administers vaccines, including 
10 informing the patient's primary-care provider, when 
11 available, and complying with requirements whereby the 
12 person administering a vaccine must review the vaccine 
13 registry or other vaccination records prior to 
14 administering the vaccine; and
15   (G) the pharmacist must inform the pharmacist's 
16 patients who are less than 18 years old, as well as the 
17 adult caregiver accompanying the child, of the 
18 importance of a well-child visit with a pediatrician 
19 or other licensed primary-care provider and must refer 
20 patients as appropriate;
21  (16) the ordering and administration of COVID-19 
22 therapeutics subcutaneously, intramuscularly, or orally 
23 with notification to the patient's physician and 
24 appropriate record retention or pursuant to hospital 
25 pharmacy and therapeutics committee policies and 
26 procedures. Eligible therapeutics are those approved, 
 
 
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1 authorized, or licensed by the United States Food and Drug 
2 Administration and must be administered subcutaneously, 
3 intramuscularly, or orally in accordance with that 
4 approval, authorization, or licensing; and
5  (17) the ordering and administration of tests and 
6 screenings for SARS-CoV-2
 (i) influenza, (ii) SARS-COV 2, 
7 and (iii) health conditions identified by a statewide 
8 public health emergency, as defined in the Illinois 
9 Emergency Management Agency Act, with notification to the 
10 patient's physician and appropriate record retention or 
11 pursuant to hospital pharmacy and therapeutics committee 
12 policies and procedures. Eligible tests and screenings are 
13 those approved, authorized, or licensed by the United 
14 States Food and Drug Administration and must be 
15 administered in accordance with that approval, 
16 authorization, or licensing; and .
17  (18) the ordering of testing, screening, and treatment 
18 for influenza. 
19 A pharmacist who orders testing, screening, or treatments 
20or administers tests or screenings for health conditions 
21described in paragraphs (17) and (18) this paragraph may use a 
22test that may guide clinical decision-making for the health 
23condition that is waived under the federal Clinical Laboratory 
24Improvement Amendments of 1988 and regulations promulgated 
25thereunder or any established screening procedure that is 
26established under a statewide protocol.
 
 
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1 A pharmacist may delegate the administrative and technical 
2tasks of performing a test for the health conditions described 
3in paragraphs (17) and (18) this paragraph to a registered 
4pharmacy technician or student pharmacist acting under the 
5supervision of the pharmacist. 
6 A pharmacist who performs any of the acts defined as the 
7practice of pharmacy in this State must be actively licensed 
8as a pharmacist under this Act. 
9 (e) "Prescription" means and includes any written, oral, 
10facsimile, or electronically transmitted order for drugs or 
11medical devices, issued by a physician licensed to practice 
12medicine in all its branches, dentist, veterinarian, podiatric 
13physician, or optometrist, within the limits of his or her 
14license, by a physician assistant in accordance with 
15subsection (f) of Section 4, or by an advanced practice 
16registered nurse in accordance with subsection (g) of Section 
174, containing the following: (1) name of the patient; (2) date 
18when prescription was issued; (3) name and strength of drug or 
19description of the medical device prescribed; and (4) 
20quantity; (5) directions for use; (6) prescriber's name, 
21address, and signature; and (7) DEA registration number where 
22required, for controlled substances. The prescription may, but 
23is not required to, list the illness, disease, or condition 
24for which the drug or device is being prescribed. DEA 
25registration numbers shall not be required on inpatient drug 
26orders. A prescription for medication other than controlled 
 
 
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1substances shall be valid for up to 15 months from the date 
2issued for the purpose of refills, unless the prescription 
3states otherwise. 
4 (f) "Person" means and includes a natural person, 
5partnership, association, corporation, government entity, or 
6any other legal entity.
7 (g) "Department" means the Department of Financial and 
8Professional Regulation.
9 (h) "Board of Pharmacy" or "Board" means the State Board 
10of Pharmacy of the Department of Financial and Professional 
11Regulation.
12 (i) "Secretary" means the Secretary of Financial and 
13Professional Regulation.
14 (j) "Drug product selection" means the interchange for a 
15prescribed pharmaceutical product in accordance with Section 
1625 of this Act and Section 3.14 of the Illinois Food, Drug and 
17Cosmetic Act.
18 (k) "Inpatient drug order" means an order issued by an 
19authorized prescriber for a resident or patient of a facility 
20licensed under the Nursing Home Care Act, the ID/DD Community 
21Care Act, the MC/DD Act, the Specialized Mental Health 
22Rehabilitation Act of 2013, the Hospital Licensing Act, or the 
23University of Illinois Hospital Act, or a facility which is 
24operated by the Department of Human Services (as successor to 
25the Department of Mental Health and Developmental 
26Disabilities) or the Department of Corrections.
 
 
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1 (k-5) "Pharmacist" means an individual health care 
2professional and provider currently licensed by this State to 
3engage in the practice of pharmacy.
4 (l) "Pharmacist in charge" means the licensed pharmacist 
5whose name appears on a pharmacy license and who is 
6responsible for all aspects of the operation related to the 
7practice of pharmacy.
8 (m) "Dispense" or "dispensing" means the interpretation, 
9evaluation, and implementation of a prescription drug order, 
10including the preparation and delivery of a drug or device to a 
11patient or patient's agent in a suitable container 
12appropriately labeled for subsequent administration to or use 
13by a patient in accordance with applicable State and federal 
14laws and regulations. "Dispense" or "dispensing" does not mean 
15the physical delivery to a patient or a patient's 
16representative in a home or institution by a designee of a 
17pharmacist or by common carrier. "Dispense" or "dispensing" 
18also does not mean the physical delivery of a drug or medical 
19device to a patient or patient's representative by a 
20pharmacist's designee within a pharmacy or drugstore while the 
21pharmacist is on duty and the pharmacy is open.
22 (n) "Nonresident pharmacy" means a pharmacy that is 
23located in a state, commonwealth, or territory of the United 
24States, other than Illinois, that delivers, dispenses, or 
25distributes, through the United States Postal Service, 
26commercially acceptable parcel delivery service, or other 
 
 
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1common carrier, to Illinois residents, any substance which 
2requires a prescription.
3 (o) "Compounding" means the preparation and mixing of 
4components, excluding flavorings, (1) as the result of a 
5prescriber's prescription drug order or initiative based on 
6the prescriber-patient-pharmacist relationship in the course 
7of professional practice or (2) for the purpose of, or 
8incident to, research, teaching, or chemical analysis and not 
9for sale or dispensing. "Compounding" includes the preparation 
10of drugs or devices in anticipation of receiving prescription 
11drug orders based on routine, regularly observed dispensing 
12patterns. Commercially available products may be compounded 
13for dispensing to individual patients only if all of the 
14following conditions are met: (i) the commercial product is 
15not reasonably available from normal distribution channels in 
16a timely manner to meet the patient's needs and (ii) the 
17prescribing practitioner has requested that the drug be 
18compounded.
19 (p) (Blank). 
20 (q) (Blank). 
21 (r) "Patient counseling" means the communication between a 
22pharmacist or a student pharmacist under the supervision of a 
23pharmacist and a patient or the patient's representative about 
24the patient's medication or device for the purpose of 
25optimizing proper use of prescription medications or devices. 
26"Patient counseling" may include without limitation (1) 
 
 
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1obtaining a medication history; (2) acquiring a patient's 
2allergies and health conditions; (3) facilitation of the 
3patient's understanding of the intended use of the medication; 
4(4) proper directions for use; (5) significant potential 
5adverse events; (6) potential food-drug interactions; and (7) 
6the need to be compliant with the medication therapy. A 
7pharmacy technician may only participate in the following 
8aspects of patient counseling under the supervision of a 
9pharmacist: (1) obtaining medication history; (2) providing 
10the offer for counseling by a pharmacist or student 
11pharmacist; and (3) acquiring a patient's allergies and health 
12conditions. 
13 (s) "Patient profiles" or "patient drug therapy record" 
14means the obtaining, recording, and maintenance of patient 
15prescription information, including prescriptions for 
16controlled substances, and personal information.
17 (t) (Blank). 
18 (u) "Medical device" or "device" means an instrument, 
19apparatus, implement, machine, contrivance, implant, in vitro 
20reagent, or other similar or related article, including any 
21component part or accessory, required under federal law to 
22bear the label "Caution: Federal law requires dispensing by or 
23on the order of a physician". A seller of goods and services 
24who, only for the purpose of retail sales, compounds, sells, 
25rents, or leases medical devices shall not, by reasons 
26thereof, be required to be a licensed pharmacy.
 
 
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1 (v) "Unique identifier" means an electronic signature, 
2handwritten signature or initials, thumb print, or other 
3acceptable biometric or electronic identification process as 
4approved by the Department.
5 (w) "Current usual and customary retail price" means the 
6price that a pharmacy charges to a non-third-party payor. 
7 (x) "Automated pharmacy system" means a mechanical system 
8located within the confines of the pharmacy or remote location 
9that performs operations or activities, other than compounding 
10or administration, relative to storage, packaging, dispensing, 
11or distribution of medication, and which collects, controls, 
12and maintains all transaction information.
13 (y) "Drug regimen review" means and includes the 
14evaluation of prescription drug orders and patient records for 
15(1) known allergies; (2) drug or potential therapy 
16contraindications; (3) reasonable dose, duration of use, and 
17route of administration, taking into consideration factors 
18such as age, gender, and contraindications; (4) reasonable 
19directions for use; (5) potential or actual adverse drug 
20reactions; (6) drug-drug interactions; (7) drug-food 
21interactions; (8) drug-disease contraindications; (9) 
22therapeutic duplication; (10) patient laboratory values when 
23authorized and available; (11) proper utilization (including 
24over or under utilization) and optimum therapeutic outcomes; 
25and (12) abuse and misuse. 
26 (z) "Electronically transmitted prescription" means a 
 
 
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1prescription that is created, recorded, or stored by 
2electronic means; issued and validated with an electronic 
3signature; and transmitted by electronic means directly from 
4the prescriber to a pharmacy. An electronic prescription is 
5not an image of a physical prescription that is transferred by 
6electronic means from computer to computer, facsimile to 
7facsimile, or facsimile to computer. 
8 (aa) "Medication therapy management services" means a 
9distinct service or group of services offered by licensed 
10pharmacists, physicians licensed to practice medicine in all 
11its branches, advanced practice registered nurses authorized 
12in a written agreement with a physician licensed to practice 
13medicine in all its branches, or physician assistants 
14authorized in guidelines by a supervising physician that 
15optimize therapeutic outcomes for individual patients through 
16improved medication use. In a retail or other non-hospital 
17pharmacy, medication therapy management services shall consist 
18of the evaluation of prescription drug orders and patient 
19medication records to resolve conflicts with the following:
20  (1) known allergies;
21  (2) drug or potential therapy contraindications;
22  (3) reasonable dose, duration of use, and route of 
23 administration, taking into consideration factors such as 
24 age, gender, and contraindications;
25  (4) reasonable directions for use;
26  (5) potential or actual adverse drug reactions;
 
 
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1  (6) drug-drug interactions;
2  (7) drug-food interactions;
3  (8) drug-disease contraindications;
4  (9) identification of therapeutic duplication;
5  (10) patient laboratory values when authorized and 
6 available;
7  (11) proper utilization (including over or under 
8 utilization) and optimum therapeutic outcomes; and
9  (12) drug abuse and misuse.
10 "Medication therapy management services" includes the 
11following:
12  (1) documenting the services delivered and 
13 communicating the information provided to patients' 
14 prescribers within an appropriate time frame, not to 
15 exceed 48 hours;
16  (2) providing patient counseling designed to enhance a 
17 patient's understanding and the appropriate use of his or 
18 her medications; and
19  (3) providing information, support services, and 
20 resources designed to enhance a patient's adherence with 
21 his or her prescribed therapeutic regimens.
22 "Medication therapy management services" may also include 
23patient care functions authorized by a physician licensed to 
24practice medicine in all its branches for his or her 
25identified patient or groups of patients under specified 
26conditions or limitations in a standing order from the 
 
 
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1physician.
2 "Medication therapy management services" in a licensed 
3hospital may also include the following:
4  (1) reviewing assessments of the patient's health 
5 status; and
6  (2) following protocols of a hospital pharmacy and 
7 therapeutics committee with respect to the fulfillment of 
8 medication orders. 
9 (bb) "Pharmacist care" means the provision by a pharmacist 
10of medication therapy management services, with or without the 
11dispensing of drugs or devices, intended to achieve outcomes 
12that improve patient health, quality of life, and comfort and 
13enhance patient safety. 
14 (cc) "Protected health information" means individually 
15identifiable health information that, except as otherwise 
16provided, is: 
17  (1) transmitted by electronic media;
18  (2) maintained in any medium set forth in the 
19 definition of "electronic media" in the federal Health 
20 Insurance Portability and Accountability Act; or
21  (3) transmitted or maintained in any other form or 
22 medium.
23 "Protected health information" does not include 
24individually identifiable health information found in:
25  (1) education records covered by the federal Family 
26 Educational Right and Privacy Act; or
 
 
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1  (2) employment records held by a licensee in its role 
2 as an employer.
3 (dd) "Standing order" means a specific order for a patient 
4or group of patients issued by a physician licensed to 
5practice medicine in all its branches in Illinois.
6 (ee) "Address of record" means the designated address 
7recorded by the Department in the applicant's application file 
8or licensee's license file maintained by the Department's 
9licensure maintenance unit.
10 (ff) "Home pharmacy" means the location of a pharmacy's 
11primary operations. 
12 (gg) "Email address of record" means the designated email 
13address recorded by the Department in the applicant's 
14application file or the licensee's license file, as maintained 
15by the Department's licensure maintenance unit. 
16(Source: P.A. 102-16, eff. 6-17-21; 102-103, eff. 1-1-22; 
17102-558, eff. 8-20-21; 102-813, eff. 5-13-22; 102-1051, eff. 
181-1-23; 103-1, eff. 4-27-23.)