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Amends the Pharmacy Benefit Manager Article of the Illinois Insurance Code. Provides that a covered individual's defined cost sharing for each prescription drug shall be calculated at the point of sale based on a price that is reduced by an amount equal to at least 80% of all rebates received, or to be received, or to be received, in connection with the dispensing or administration of the prescription drug. Provides that a health insurer or its agents shall not publish or otherwise reveal information regarding the actual amount of rebates a health insurer receives on a product or therapeutic class of products, manufacturer-specific basis, or pharmacy-specific basis and that the information is confidential. Defines terms. Amends the Freedom of Information Act to make a conforming change. Amends the Pharmacy Practice Act. Provides that a pharmacist may substitute a biological product (instead of an interchangeable biological product) if, among other requirements, the product being considered for substitution is either the reference product or a product approved by the United States Food and Drug Administration as a biosimilar of the prescribed biological product (instead of if the substituted product has been determined by the United States Food and Drug Administration to be interchangeable with the prescribed biological product). Makes conforming changes.
Introduced
Feb 18, 2025
Last Action
Mar 21, 2025
Session
IL 104th
Sponsors
1 primary · 0 co
Rule 19(a) / Re-referred to Rules Committee
Assigned to Health Care Availability & Accessibility Committee
First Reading
Referred to Rules Committee
Filed with the Clerk by Rep. Ryan Spain
Get a plain-English explanation of what this bill does, who it affects, and why it matters.
Rule 19(a) / Re-referred to Rules Committee