Bill > HB1697

Introduced Session

Provides that the amendatory Act may be referred to as the Prescription Drug Affordability Act. Amends the Department of Commerce and Economic Opportunity Law of the Civil Administrative Code of Illinois. Provides that the Department of Insurance shall use moneys deposited into the DCEO Projects Fund pursuant to specified provisions of the Illinois Insurance Code to make a grant to a statewide retail association representing pharmacies to promote access to pharmacies and pharmacist services. Amends the Illinois Insurance Code. Makes changes to defined terms in provisions concerning pharmacy benefit manager contracts. Provides that a pharmacy benefit manager or an affiliate acting on its behalf shall not conduct spread pricing, steer a covered individual, or limit a covered individual's access to drugs from a pharmacy or pharmacist enrolled with the health benefit plan under the terms offered to all pharmacies in the plan coverage area by designating the covered drug as a specialty drug contrary to the specified definition. Provides that a pharmacy benefit manager or affiliated rebate aggregator must remit no less than 100% of any amounts paid by a pharmaceutical manufacturer, wholesaler, or other distributor of a drug. Provides that the contract between the pharmacy benefit manager and the insurer or health benefit plan sponsor must allow and provide for the pharmacy benefit manager's compliance with an audit at least once per calendar year of the rebate and fee records remitted from a pharmacy benefit manager or its affiliated party to a health benefit plan. Provides that the changes made to provisions concerning pharmacy benefit manager contracts by the Act shall apply with respect to any health benefit plan that provides coverage for drugs that is amended, delivered, issued, or renewed on or after January 1, 2026. Sets forth provisions concerning pharmacy benefit manager reporting requirements. In provisions concerning pharmacy benefit manager licensure requirements, provides that on or before August 1, 2025, the pharmacy benefit manager shall submit a report to the Department that lists the name of each health benefit plan it administers, provides the number of covered individuals for each health benefit plan as of the date of submission, and provides the total covered individuals across all health benefit plans the pharmacy benefit manager administers. Provides that on or before September 1, 2025, a registered pharmacy benefit manager, as a condition of its authority to transact business in the State, must submit to the Department an amount equal to $15 or an alternate amount as determined by the Director by rule per covered individual enrolled by the pharmacy benefit manager in the State. Provides that on or before September 1, 2026 and each September 1 thereafter, payments submitted in provisions concerning pharmacy benefit manager licensure requirements shall be based on the number of covered individuals reported to the Department in specified provisions of the Illinois Insurance Code. Makes changes to provisions concerning examinations of registered pharmacy benefit managers. Amends the Illinois Public Aid Code. Makes changes to provisions concerning critical access care pharmacies. In provisions concerning pharmacy benefits, provides that a pharmacy benefit manager must comply with all provisions of the Pharmacy Benefit Managers Article of the Illinois Insurance Code to the extent that the provisions do not prevent the application of any provision of the Article or applicable federal law. Amends the State Employees Group Insurance Act of 1971 and the School Code to require coverage from specified provisions of the Illinois Insurance Code under the provisions of those Acts. Amends the Juvenile Court Act of 1987, the Unified Code of Corrections, and the County Jail Act to require specified contracts and pharmacy benefit manager activities to be subject to the Pharmacy Benefit Managers Article of the Illinois Insurance Code and the authority of the Director of Insurance to enforce those provisions. Makes other changes. Effective January 1, 2026, except that certain provisions are effective immediately.

AI Summary

Committee Categories

Dave Koehler (D)*,  Natalie Manley (D)*,  Dee Avelar (D),  Christopher Belt (D),  Harry Benton (D),  Diane Blair-Sherlock (D),  Amy Briel (D),  Kam Buckner (D),  Jason Bunting (R),  John Cabello (R),  Mary Beth Canty (D),  Kelly Cassidy (D),  Sharon Chung (D),  Mike Coffey (R),  Margaret Croke (D),  C.D. Davidsmeyer (R),  William Davis (D),  Regan Deering (R),  Anthony DeLuca (D),  Martha Deuter (D),  Kimberly du Buclet (D),  Mary Edly-Allen (D),  Amy Elik (R),  Laura Ellman (D),  Marcus Evans (D),  Laura Faver Dias (D),  Sara Feigenholtz (D),  Laura Fine (D),  Dale Fowler (R),  Mary Gill (D),  Jen Gong-Gershowitz (D),  Jehan Gordon-Booth (D),  Nicolle Grasse (D),  Angelica Guerrero-Cuellar (D),  Graciela Guzmán (D),  Will Guzzardi (D),  Jackie Haas (R),  Mike Halpin (D),  Norine Hammond (R),  Matt Hanson (D),  Sonya Harper (D),  Napoleon Harris (D),  Erica Harriss (R),  Bill Hauter (R),  Norma Hernandez (D),  Maura Hirschauer (D),  Hoan Huynh (D),  Adriane Johnson (D),  Gregg Johnson (D),  Emil Jones (D),  Tracy Katz Muhl (D),  Michael Kelly (D),  Stephanie Kifowit (D),  Nicole La Ha (R),  Lindsey LaPointe (D),  Meg Loughran Cappel (D),  Joyce Mason (D),  Rita Mayfield (D),  Steve McClure (R),  Tony McCombie (R),  Charlie Meier (R),  Debbie Meyers-Martin (D),  Anna Moeller (D),  Kyle Moore (R),  Bob Morgan (D),  Yolonda Morris (D),  Julie Morrison (D),  Marty Moylan (D),  Laura Murphy (D),  Michelle Mussman (D),  Suzanne Ness (D),  Adam Niemerg (R),  Kevin Olickal (D),  Willie Preston (D),  Abdelnasser Rashid (D),  Steve Reick (R),  Bob Rita (D),  Wayne Rosenthal (R),  Rick Ryan (D),  Jennifer Sanalitro (R),  Sue Scherer (D),  Kevin Schmidt (R),  Brandun Schweizer (R),  Dave Severin (R),  Patrick Sheehan (R),  Mike Simmons (D),  Justin Slaughter (D),  Nick Smith (D),  Ryan Spain (R),  Steve Stadelman (D),  Brad Stephens (R),  Katie Stuart (D),  Dan Swanson (R),  Nabeela Syed (D),  Curtis Tarver (D),  Dennis Tipsword (R),  Doris Turner (D),  Sally Turner (R),  Dave Vella (D),  Rachel Ventura (D),  Karina Villa (D),  Celina Villanueva (D),  Tom Weber (R),  Chris Welch (D),  Maurice West (D),  Blaine Wilhour (R),  Omar Williams (D),  Patrick Windhorst (R),  Janet Yang Rohr (D), 

Public Act . . . . . . . . . 104-0027 (on 07/01/2025)

Official Document