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IL HB5421

IL HB5421
340B INTEGRITY ACT


summary

Introduced
02/06/2026
In Committee
02/13/2026
Crossed Over
Passed
Dead

Introduced Session

104th General Assembly

Bill Summary

Creates the 340B Integrity Act. Defines terms. Provides that, beginning January 1, 2027, 340B covered entities shall not bill any medical assistance fee-for-service or medical assistance managed care programs under the Illinois Public Aid Code for 340B drugs. Provides that, beginning July 1, 2026 a 340B covered entity shall use 80% of 340B profits from the prior year to decrease at the point of sale, including at the 340B contract pharmacy, the out-of-pocket costs paid for 340B drugs that are dispensed or administered to low-income patients of the 340B covered entity. Provides that, on or before September 1, 2026, and on or before September 1 of each year thereafter, each 340B covered entity shall annually report to the Department of Insurance, with respect to the 340B covered entity and separately for each offsite outpatient facility associated with the 340B covered entity, the specified information about the prior year. Provides that, on or before December 31, 2026, the Department of Central Management Services shall submit a report to the General Assembly on any impact to the State employee health plan arising from 340B covered entity purchases, 340B contract pharmacy arrangements, and general practices related to 340B drugs, regardless of whether the 340B drugs were self-administered or provider-administered. Provides that the report shall include, but not be limited to, an analysis of foregone rebates, the impact on premiums, and the impact to State employee out-of-pocket costs. Provides that, on or before December 31, 2026, the Department of Healthcare and Family Services shall report to the General Assembly on certain items for total aggregated covered outpatient drug units dispensed or administered in the State for the prior calendar year in connection with the medical assistance program under the Illinois Public Aid Code, broken out by fee-for-service and by each managed care plan. Makes other changes. Effective immediately.

AI Summary

This bill, titled the 340B Integrity Act, introduces several changes related to the 340B drug discount program, a federal program that allows certain healthcare facilities (known as "340B covered entities") to purchase outpatient drugs at significantly reduced prices. Starting January 1, 2027, these entities will no longer be able to bill state medical assistance programs, including fee-for-service and managed care plans, for 340B drugs. Furthermore, beginning July 1, 2026, 340B covered entities must use 80% of their profits from 340B drugs from the previous year to reduce the out-of-pocket costs for low-income patients who receive these medications, including those dispensed by a "340B contract pharmacy," which is a pharmacy that contracts with a 340B covered entity to dispense drugs. The bill also mandates annual reporting to the Department of Insurance by 340B covered entities detailing their 340B drug acquisition costs, payments received, patient costs, and payments to contract pharmacies, with these reports to be made public. Additionally, the Department of Central Management Services will study the impact of 340B practices on the State employee health plan, including foregone rebates and effects on premiums and employee costs, and the Department of Healthcare and Family Services will report on drug dispensing and pricing within the state's medical assistance program. The bill takes effect immediately.

Sponsors (1)

Last Action

Referred to Rules Committee (on 02/13/2026)

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