Illinois House Bill 1159

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Spectrum: Partisan Bill (Democrat 1-0)
Status: Introduced on January 9 2025 - 25% progression
Action: 2025-02-11 - Assigned to Health Care Availability & Accessibility Committee
Pending: House Health Care Availability & Accessibility Committee
Hearing: Feb 18 @ 4:00 pm in Room C-1 Stratton Building
Text: Latest bill text (Introduced) [HTML]

Amends the Illinois Insurance Code. Defines "health benefit plan" and other terms. Provides that a pharmacy benefit manager or an affiliate acting on the pharmacy benefit manager's behalf is prohibited from conducting spread pricing, from steering a covered individual, and from limiting a covered individual's access to prescription 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 unreasonably designating the covered prescription drugs as a specialty drug. Provides that a pharmacy benefit manager or an affiliate acting on the pharmacy benefit manager's behalf must remit 100% of rebates and fees to the health benefit plan sponsor, consumer, or employer. Provides that a pharmacy benefit manager may not reimburse a pharmacy or pharmacist for a prescription drug or pharmacy service in an amount less than the national average drug acquisition cost for the prescription drug or pharmacy service at the time the drug is administered or dispensed, plus a professional dispensing fee. Provides that a contract between a pharmacy benefit manager and an 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 records remitted from a pharmacy benefit manager or its contracted party to a health benefit plan. Provides that provisions concerning pharmacy benefit manager contracts apply to any health benefit plan (instead of 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. Requires a pharmacy benefit manager to submit an annual report that includes specified information concerning prescription drugs. Makes other changes. Amends the Freedom of Information Act to make a conforming change. Effective July 1, 2025.

INS-PHARMACY BENEFIT MANAGERS

Rep. Thaddeus Jones [D]

Date	Chamber	Action
2025-02-11	House	Assigned to Health Care Availability & Accessibility Committee
2025-01-09	House	Referred to Rules Committee
2025-01-09	House	First Reading
2025-01-06	House	Prefiled with Clerk by Rep. Thaddeus Jones

Chapter	Article	Section	Citation Type	Statute Text
215	5	513b1	Amended Code	Citation Text
215	5	513b1.5	New Code	See Bill Text
5	140	7	Amended Code	Citation Text

Type	Source
Summary	https://www.ilga.gov/legislation/BillStatus.asp?DocNum=1159&GAID=18&DocTypeID=HB&SessionID=114&GA=104
Text	https://www.ilga.gov/legislation/104/HB/10400HB1159.htm