Bill > HB1018

This bill amends the Illinois Insurance Code to prohibit pharmacy benefit managers (PBMs) from "steering" covered individuals, which is defined to include several specific practices. These practices include requiring individuals to use only pharmacies in which the PBM has an ownership interest, implementing plan designs that increase costs for individuals who choose not to use PBM-owned pharmacies, reimbursing pharmacies at lower rates than the PBM reimburses itself for the same services, and any other actions the Department may determine constitute steering. The bill defines "steer" broadly to prevent PBMs from manipulating patients' pharmacy choices for their own financial benefit. Specifically, the bill prohibits PBMs from creating barriers or financial disincentives that would push patients toward using specific pharmacies that benefit the PBM, such as mail-order pharmacies or pharmacies the PBM owns. The legislation aims to protect patients' freedom to choose their preferred pharmacy and prevent PBMs from engaging in practices that could increase patient costs or limit access to pharmaceutical services. The bill is set to become effective on July 1, 2025, and represents an effort to increase transparency and fairness in pharmacy benefit management practices in Illinois.

Health and Social Services

https://www.ilga.gov/legislation/BillStatus.asp?DocNum=1018&GAID=18&DocTypeID=HB&SessionID=114&GA=104