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Bill > SB0066


IL SB0066

IL SB0066
HEALTH CARE AVAILABILITY


summary

Introduced
01/13/2025
In Committee
03/03/2026
Crossed Over
Passed
Dead

Introduced Session

Potential new amendment
104th General Assembly

Bill Summary

Creates the Health Care Availability and Access Board Act. Establishes the Health Care Availability and Access Board to protect State residents, State and local governments, commercial health plans, health care providers, pharmacies licensed in the State, and other stakeholders within the health care system from the high costs of prescription drug products. Contains provisions concerning Board membership and terms; staff for the Board; Board meetings; circumstances under which Board members must recuse themselves; and other matters. Provides that the Board shall perform the following actions in open session: (i) deliberations on whether to subject a prescription drug product to a cost review; and (ii) any vote on whether to impose an upper payment limit on purchases, payments, and payor reimbursements of prescription drug products in the State. Permits the Board to adopt rules to implement the Act and to enter into a contract with a qualified, independent third party for any service necessary to carry out the powers and duties of the Board. Creates the Health Care Availability and Access Stakeholder Council to provide stakeholder input to assist the Board in making decisions as required by the Act. Contains provisions concerning Council membership, member terms, and other matters. Provides that the Board shall adopt the federal Medicare Maximum Fair Price as the upper payment limit for a prescription drug product intended for use by individuals in the State. Prohibits the Board from creating an upper payment limit that is different from the Medicare Maximum Fair Price for the prescription drug product that has a Medicare Maximum Fair Price. Requires the Board to implement an upper payment limit that is the same as the Medicare Maximum Fair Price no sooner than the Medicare implementation date. Provides that Medicare Part C and D plans are not required to reimburse at the upper payment limit. Provides that the Attorney General may enforce the Act and may pursue any available remedy under State law when enforcing the Act. Effective 180 days after becoming law.

AI Summary

This bill creates the Health Care Availability and Access Board, an independent state government body designed to address high prescription drug costs. The Board will have five members appointed by the Governor who have expertise in healthcare economics, pharmaceutical markets, and clinical medicine, and will be prohibited from having conflicts of interest with drug manufacturers. The Board's primary functions include conducting cost reviews for specific prescription drugs that meet certain price thresholds, such as brand name drugs costing $60,000 or more per year or generic drugs with significant price increases. When a drug is found to create affordability challenges, the Board can establish an upper payment limit that applies to all purchases and reimbursements in the state. Notably, the bill mandates that these upper payment limits will be based on the Medicare Maximum Fair Price, ensuring consistency with federal pricing. The bill also establishes a 15-member Stakeholder Council to provide input to the Board and requires annual reporting to the General Assembly about prescription drug pricing trends and market conditions. To support its operations, the Board will be funded by annual assessments on drug manufacturers, and it will have robust transparency requirements, including open meetings and public comment opportunities. The Attorney General is empowered to enforce the Act, and individuals can appeal Board decisions through an administrative and potentially judicial review process.

Committee Categories

Government Affairs

Sponsors (16)

Last Action

Senate Committee Amendment No. 1 Referred to Assignments (on 03/11/2026)

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