COST LIST-PHRMCY BENEFITS MNGR
Summary
Amends the Illinois Insurance Code. Provides regulation for the creation of a list of drugs used to set the maximum allowable cost on which reimbursement to a pharmacy or pharmacist may be based. Provides that before a pharmacy benefits manager places or continues a particular drug on a maximum allowable cost list, the drug shall meet specified requirements. Provides for the duties of a pharmacy benefits manager in his or her use of a maximum allowable cost list. Provides for a reasonable administrative appeal procedure to allow pharmacies to challenge maximum allowable costs and reimbursements made under a maximum allowable cost for a specific drug. Provides that a pharmacy benefits manager shall not reimburse a pharmacy or pharmacist in this State in an amount less than the amount that the pharmacy benefits manager reimburses a pharmacy benefits manager affiliate for providing the same pharmacist services. Provides that a pharmacy or pharmacist may decline to provide pharmacist services to a patient or pharmacy benefits manager if, as a result of a maximum allowable cost list, a pharmacy or pharmacist is to be paid less than the pharmacy acquisition cost of the pharmacy providing pharmacist services. Provides that a violation of the provisions concerning maximum allowable cost lists and pharmacy benefits managers is a deceptive trade practice. Amends the Uniform Deceptive Trade Practices Act to make a conforming change. Defines terms.
Bill status
failed
1 of 4 stages cleared
Introduction
Feb 2017
Committee Review
Floor Vote
Governor
Introduced Feb 10, 2017
Last action Jan 9, 2019
Floor votes
How they voted
No floor votes recorded yet.
Full legislative history
Actions timeline
Total actions
9
Key actions
1
Committee
4
Apr 7, 2017
Committee
Rule 3-9(a) / Re-referred to Assignments
upper
Mar 17, 2017
Upper · Passed
Rule 2-10 Committee Deadline Established As April 7, 2017
upper
Feb 28, 2017
Committee
Assigned to Insurance
upper
Feb 10, 2017
Committee
Referred to Assignments
upper
0 primary · 1 co-sponsor
Sponsors
No sponsor information available.
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