Bill Text: IL HB3811 | 2019-2020 | 101st General Assembly | Introduced

---

Bill Title: Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Provides that the Director of Public Health, if a physician licensed to practice medicine in all its branches in Illinois, shall establish a standing order complete with the issuance of a prescription for a hormonal contraceptive in accordance with the requirements of the provisions. Provides that if the Director is not a physician licensed to practice medicine in all its branches in Illinois, the Medical Director of the Department of Public Health shall establish the standing order. Provides that a pharmacist may dispense a 12-month supply of hormonal contraceptives to a patient who is age 17 or older. Amends the Illinois Insurance Code. Requires a group or individual policy of accident and health insurance or managed care plan to provide coverage for patient care services provided by a pharmacist. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, and the School Code. Amends the Pharmacy Practice Act. Provides that the definition of "practice of pharmacy" includes the dispensing of hormonal contraceptives pursuant to the standing order under provisions of the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Amends the Illinois Public Aid Code. Requires the medical assistance program to cover patient care services provided by a pharmacist for hormonal contraceptives assessment and consultation for patients who are age 17 or older. Effective January 1, 2020.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2019-03-19 - Referred to Rules Committee [HB3811 Detail]

Download: Illinois-2019-HB3811-Introduced.html

---

101ST GENERAL ASSEMBLY State of Illinois 2019 and 2020 HB3811 Introduced , by Rep. Mark Batinick SYNOPSIS AS INTRODUCED:
See Index
Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Provides that the Director of Public Health, if a physician licensed to practice medicine in all its branches in Illinois, shall establish a standing order complete with the issuance of a prescription for a hormonal contraceptive in accordance with the requirements of the provisions. Provides that if the Director is not a physician licensed to practice medicine in all its branches in Illinois, the Medical Director of the Department of Public Health shall establish the standing order. Provides that a pharmacist may dispense a 12-month supply of hormonal contraceptives to a patient who is age 17 or older. Amends the Illinois Insurance Code. Requires a group or individual policy of accident and health insurance or managed care plan to provide coverage for patient care services provided by a pharmacist. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, and the School Code. Amends the Pharmacy Practice Act. Provides that the definition of "practice of pharmacy" includes the dispensing of hormonal contraceptives pursuant to the standing order under provisions of the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Amends the Illinois Public Aid Code. Requires the medical assistance program to cover patient care services provided by a pharmacist for hormonal contraceptives assessment and consultation for patients who are age 17 or older. Effective January 1, 2020.
LRB101 11591 RAB 57590 b
FISCAL NOTE ACT MAY APPLY STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT
A BILL FOR
HB3811 LRB101 11591 RAB 57590 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The State Employees Group Insurance Act of 1971
is amended by changing Section 6.11 as follows:
(5 ILCS 375/6.11)
(Text of Section before amendment by P.A. 100-1170)
Sec. 6.11. Required health benefits; Illinois Insurance
Code requirements. The program of health benefits shall provide
the post-mastectomy care benefits required to be covered by a
policy of accident and health insurance under Section 356t of
the Illinois Insurance Code. The program of health benefits
shall provide the coverage required under Sections 356g,
356g.5, 356g.5-1, 356m, 356u, 356w, 356x, 356z.2, 356z.4,
356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
356z.14, 356z.15, 356z.17, 356z.22, 356z.25, and 356z.26, and
356z.29, 356z.32, and 356z.33 of the Illinois Insurance Code.
The program of health benefits must comply with Sections
155.22a, 155.37, 355b, 356z.19, 370c, and 370c.1 of the
Illinois Insurance Code. The Department of Insurance shall
enforce the requirements of this Section.
Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance

HB3811 - 2 - LRB101 11591 RAB 57590 b
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17;
100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1024, eff.
1-1-19; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; revised
1-8-19.)
(Text of Section after amendment by P.A. 100-1170)
Sec. 6.11. Required health benefits; Illinois Insurance
Code requirements. The program of health benefits shall provide
the post-mastectomy care benefits required to be covered by a
policy of accident and health insurance under Section 356t of
the Illinois Insurance Code. The program of health benefits
shall provide the coverage required under Sections 356g,
356g.5, 356g.5-1, 356m, 356u, 356w, 356x, 356z.2, 356z.4,
356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
356z.14, 356z.15, 356z.17, 356z.22, 356z.25, 356z.26, 356z.29,
and 356z.32, and 356z.33 of the Illinois Insurance Code. The
program of health benefits must comply with Sections 155.22a,
155.37, 355b, 356z.19, 370c, and 370c.1 of the Illinois
Insurance Code. The Department of Insurance shall enforce the
requirements of this Section with respect to Sections 370c and
370c.1 of the Illinois Insurance Code; all other requirements
of this Section shall be enforced by the Department of Central

HB3811 - 3 - LRB101 11591 RAB 57590 b
Management Services.
Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17;
100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1024, eff.
1-1-19; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19;
100-1170, eff. 6-1-19.)
Section 10. The Department of Public Health Powers and
Duties Law of the Civil Administrative Code of Illinois is
amended by adding Section 2310-705 as follows:
(20 ILCS 2310/2310-705 new)
Sec. 2310-705. Contraceptive drugs and products; Director
standing order.
(a) As used in this Section:
"Hormonal contraceptive" means a prescribed
medically-acceptable oral drug, transdermal patch, or vaginal
ring that is approved by the United States Food and Drug
Administration to prevent pregnancy.
"Standing order" has the meaning given to that term in the
Pharmacy Practice Act.

HB3811 - 4 - LRB101 11591 RAB 57590 b
(b) If the Director of Public Health is a physician
licensed to practice medicine in all its branches in Illinois,
the Director shall establish a standing order complete with the
issuance of a prescription for a hormonal contraceptive in
accordance with this Section. If the Director is not a
physician licensed to practice medicine in all its branches in
Illinois, then the Medical Director of the Department of Public
Health shall establish a standing order in accordance with this
Section.
(c) The standing order, at a minimum, shall comply with the
following:
(1) A pharmacist may dispense a 12-month supply of
hormonal contraceptives to a patient who is age 17 or
older.
(2) A pharmacist shall have the patient complete the
self-screening risk assessment tool. The self-screening
risk assessment tool is to be based on the most current
version of the United States Medical Eligibility Criteria
for Contraceptive Use published by the federal Centers for
Disease Control and Prevention.
(3) Based upon the results of the self-screening risk
assessment and the patient assessment, the pharmacist
shall use his or her professional and clinical judgment as
to when a patient should be referred to the patient's
physician or another health care provider.
(4) The pharmacist shall provide, during the patient

HB3811 - 5 - LRB101 11591 RAB 57590 b
assessment and consultation, counseling and education
about all methods of contraception, including methods not
covered under the standing order, and their proper use and
effectiveness.
(5) The patient consultation shall take place in a
private manner consistent with rules adopted by the
Department of Financial and Professional Regulation.
(6) The Department shall adopt rules under this Section
that require a pharmacist to:
(A) complete an educational training program
accredited by the Accreditation Council for Pharmacy
Education and approved by the Department that is
related to the patient self-screening risk assessment,
patient assessment, contraceptive counseling and
education, and dispensation of hormonal
contraceptives; and
(B) dispense the hormonal contraceptive to the
patient as soon as practicable after meeting the
requirements of paragraph (2).
(7) All State and federal laws governing insurance
coverage of contraceptive drugs shall apply to hormonal
contraceptives dispensed by a pharmacist under this
Section.
(8) Nothing in this Section shall apply to any contact
between a pharmacist and a patient who is under age 17.

HB3811 - 6 - LRB101 11591 RAB 57590 b
Section 15. The Counties Code is amended by changing
Section 5-1069.3 as follows:
(55 ILCS 5/5-1069.3)
Sec. 5-1069.3. Required health benefits. If a county,
including a home rule county, is a self-insurer for purposes of
providing health insurance coverage for its employees, the
coverage shall include coverage for the post-mastectomy care
benefits required to be covered by a policy of accident and
health insurance under Section 356t and the coverage required
under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x,
356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
356z.14, 356z.15, 356z.22, 356z.25, and 356z.26, and 356z.29,
356z.32, and 356z.33 of the Illinois Insurance Code. The
coverage shall comply with Sections 155.22a, 355b, 356z.19, and
370c of the Illinois Insurance Code. The Department of
Insurance shall enforce the requirements of this Section. The
requirement that health benefits be covered as provided in this
Section is an exclusive power and function of the State and is
a denial and limitation under Article VII, Section 6,
subsection (h) of the Illinois Constitution. A home rule county
to which this Section applies must comply with every provision
of this Section.
Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure

HB3811 - 7 - LRB101 11591 RAB 57590 b
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17;
100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1024, eff.
1-1-19; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; revised
10-3-18.)
Section 20. The Illinois Municipal Code is amended by
changing Section 10-4-2.3 as follows:
(65 ILCS 5/10-4-2.3)
Sec. 10-4-2.3. Required health benefits. If a
municipality, including a home rule municipality, is a
self-insurer for purposes of providing health insurance
coverage for its employees, the coverage shall include coverage
for the post-mastectomy care benefits required to be covered by
a policy of accident and health insurance under Section 356t
and the coverage required under Sections 356g, 356g.5,
356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.10,
356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25,
and 356z.26, and 356z.29, 356z.32, and 356z.33 of the Illinois
Insurance Code. The coverage shall comply with Sections
155.22a, 355b, 356z.19, and 370c of the Illinois Insurance
Code. The Department of Insurance shall enforce the
requirements of this Section. The requirement that health

HB3811 - 8 - LRB101 11591 RAB 57590 b
benefits be covered as provided in this is an exclusive power
and function of the State and is a denial and limitation under
Article VII, Section 6, subsection (h) of the Illinois
Constitution. A home rule municipality to which this Section
applies must comply with every provision of this Section.
Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17;
100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1024, eff.
1-1-19; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; revised
10-4-18.)
Section 25. The School Code is amended by changing Section
10-22.3f as follows:
(105 ILCS 5/10-22.3f)
Sec. 10-22.3f. Required health benefits. Insurance
protection and benefits for employees shall provide the
post-mastectomy care benefits required to be covered by a
policy of accident and health insurance under Section 356t and
the coverage required under Sections 356g, 356g.5, 356g.5-1,
356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.11, 356z.12,

HB3811 - 9 - LRB101 11591 RAB 57590 b
356z.13, 356z.14, 356z.15, 356z.22, 356z.25, and 356z.26, and
356z.29, 356z.32, and 356z.33 of the Illinois Insurance Code.
Insurance policies shall comply with Section 356z.19 of the
Illinois Insurance Code. The coverage shall comply with
Sections 155.22a, 355b, and 370c of the Illinois Insurance
Code. The Department of Insurance shall enforce the
requirements of this Section.
Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
1-1-19; 100-1102, eff. 1-1-19; revised 10-4-18.)
Section 30. The Illinois Insurance Code is amended by
adding Section 356z.33 as follows:
(215 ILCS 5/356z.33 new)
Sec. 356z.33. Coverage for patient care services for
hormonal contraceptives provided by a pharmacist. A group or
individual policy of accident and health insurance or a managed
care plan that is amended, delivered, issued, or renewed after
the effective date of this amendatory Act of the 101st General

HB3811 - 10 - LRB101 11591 RAB 57590 b
Assembly shall provide coverage for patient care services
provided by a pharmacist for hormonal contraceptives
assessment and consultation. Nothing in this Section shall
mandate the coverage of patient care services provided by a
pharmacist for hormonal contraceptives assessment and
consultation to a patient under age 17.
Section 35. The Pharmacy Practice Act is amended by
changing Section 3 as follows:
(225 ILCS 85/3)
(Section scheduled to be repealed on January 1, 2020)
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",

HB3811 - 11 - LRB101 11591 RAB 57590 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.
(c) "Medicines" means and includes all drugs intended for

HB3811 - 12 - LRB101 11591 RAB 57590 b
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, and inhalation as follows:
(A) in the context of patient education on the
proper use or delivery of medications;
(B) vaccination of patients 14 years of age and
older pursuant to a valid prescription or standing
order, 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 rule, with
notification to the patient's physician and
appropriate record retention, or pursuant to hospital
pharmacy and therapeutics committee policies and
procedures; and
(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

HB3811 - 13 - LRB101 11591 RAB 57590 b
of appropriate training, 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) vaccination of patients ages 10 through 13 limited
to the Influenza (inactivated influenza vaccine and live
attenuated influenza intranasal vaccine) and Tdap (defined
as tetanus, diphtheria, acellular pertussis) vaccines,
pursuant to a valid prescription or standing order, 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 rule, with notification to the
patient's physician and appropriate record retention, or
pursuant to hospital pharmacy and therapeutics committee
policies and procedures;
(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; and
(12) the responsibility for compounding and labeling

HB3811 - 14 - LRB101 11591 RAB 57590 b
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; and .
(13) the assessment and consultation of patients and
dispensing of hormonal contraceptives pursuant to the
standing order under Section 2310-705 of the Department of
Public Health Powers and Duties Law of the Civil
Administrative Code of Illinois.
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.

HB3811 - 15 - LRB101 11591 RAB 57590 b
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 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

HB3811 - 16 - LRB101 11591 RAB 57590 b
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.
(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

HB3811 - 17 - LRB101 11591 RAB 57590 b
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 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

HB3811 - 18 - LRB101 11591 RAB 57590 b
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)
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,

HB3811 - 19 - LRB101 11591 RAB 57590 b
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.
(v) "Unique identifier" means an electronic signature,
handwritten signature or initials, 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)

HB3811 - 20 - LRB101 11591 RAB 57590 b
and optimum therapeutic outcomes; and (12) abuse and misuse.
(z) "Electronically transmitted prescription" means a
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;

HB3811 - 21 - LRB101 11591 RAB 57590 b
(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) 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

HB3811 - 22 - LRB101 11591 RAB 57590 b
patient or groups of patients under specified conditions or
limitations in a standing order from the 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

HB3811 - 23 - LRB101 11591 RAB 57590 b
Educational Right and Privacy Act; or
(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. 99-180, eff. 7-29-15; 100-208, eff. 1-1-18;
100-497, eff. 9-8-17; 100-513, eff. 1-1-18; 100-804, eff.
1-1-19; 100-863, eff. 8-14-18.)
Section 40. The Illinois Public Aid Code is amended by
adding Section 5-5.12c as follows:
(305 ILCS 5/5-5.12c new)
Sec. 5-5.12c. Coverage for patient care services for
hormonal contraceptives provided by a pharmacist.

HB3811 - 24 - LRB101 11591 RAB 57590 b
(a) Subject to approval by the federal Centers for Medicare
and Medicaid Services, the medical assistance program,
including both the fee-for-service and managed care medical
assistance programs established under this Article, shall
cover patient care services provided by a pharmacist for
hormonal contraceptives assessment and consultation for
patients who are age 17 or older.
(b) The Department shall establish a fee schedule for
patient care services provided by a pharmacist for hormonal
contraceptives assessment and consultation.
(c) The rate of reimbursement for patient care services
provided by a pharmacist for hormonal contraceptives
assessment and consultation shall be at 85% of the fee schedule
for physician services by the medical assistance program.
(d) A pharmacist must be enrolled in the medical assistance
program as an ordering and referring provider prior to
providing hormonal contraceptives assessment and consultation
that is submitted by a pharmacy or pharmacist provider for
reimbursement pursuant to this Section.
(e) The Director shall seek any necessary federal waivers
or approvals to implement this Section. This Section shall not
be implemented until the receipt of all necessary federal
waivers or approvals or until January 1, 2022, whichever comes
first. If federal approval is not obtained by January 1, 2022,
the provisions of this Section shall be implemented using State
funds.

HB3811 - 25 - LRB101 11591 RAB 57590 b
(f) This Section does not restrict or prohibit any services
currently provided by pharmacists as authorized by law,
including, but not limited to, pharmacist services provided
under this Code or authorized under the Illinois Title XIX
State Plan.
(g) The Department shall adopt administrative rules for
this Section as soon as practicable but no later than May 1,
2020.
Section 95. No acceleration or delay. 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.
Section 99. Effective date. This Act takes effect January
1, 2020.
HB3811 - 26 - LRB101 11591 RAB 57590 b
INDEX
Statutes amended in order of appearance