HB2189 EnrolledLRB103 24836 BMS 51168 b HB2189 Enrolled LRB103 24836 BMS 51168 b
HB2189 Enrolled LRB103 24836 BMS 51168 b
1 AN ACT concerning regulation.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 1. Short title. This Act may be cited as the Access
5 to Affordable Insulin Act.
6 Section 5. Definitions. As used in this Act:
7 "Department" means the Department of Central Management
8 Services.
9 "Director" means the Director of Central Management
10 Services.
11 "Insulin" means a prescription drug that contains insulin.
12 "Manufacturer" means a manufacturer engaged in the
13 manufacturing of insulin that is self-administered on an
14 outpatient basis.
15 "Navigator" has the meaning described in Section 1311(i)
16 of the Patient Protection and Affordable Care Act, Public Law
17 111-148, and further defined through amendments to that Act
18 and regulations issued under that Act.
19 "Pharmacy" means a pharmacy located in this State.
20 "Prescription drug" means a drug that is required by
21 federal or State law or rule to be dispensed only by
22 prescription or that is restricted to administration only by
23 practitioners.
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1 Section 10. Insulin discount program.
2 (a) The Department shall offer a discount program that
3 allows participants to purchase insulin at a discounted,
4 post-rebate price.
5 (b) The discount program shall:
6 (1) provide a participant with a card or electronic
7 document that identifies the participant as eligible for
8 the discount;
9 (2) provide a participant with information about
10 pharmacies that will honor the discount;
11 (3) allow a participant to purchase insulin at a
12 discounted, post-rebate price; and
13 (4) provide a participant with instructions to pursue
14 a reimbursement of the purchase price from the
15 participant's health insurer.
16 (c) The discount program shall charge a price for insulin
17 that allows the program to retain only enough of any rebate for
18 the insulin to make the State risk pool whole for providing
19 discounted insulin to participants.
20 Section 90. The Illinois Insurance Code is amended by
21 changing Section 356z.41 as follows:
22 (215 ILCS 5/356z.41)
23 Sec. 356z.41. Cost sharing in prescription insulin drugs;
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1 limits; confidentiality of rebate information.
2 (a) As used in this Section, "prescription insulin drug"
3 means a prescription drug that contains insulin and is used to
4 control blood glucose levels to treat diabetes but does not
5 include an insulin drug that is administered to a patient
6 intravenously.
7 (b) This Section applies to a group or individual policy
8 of accident and health insurance amended, delivered, issued,
9 or renewed on or after the effective date of this amendatory
10 Act of the 101st General Assembly.
11 (c) An insurer that provides coverage for prescription
12 insulin drugs pursuant to the terms of a health coverage plan
13 the insurer offers shall limit the total amount that an
14 insured is required to pay for a 30-day supply of covered
15 prescription insulin drugs at an amount not to exceed $35
16 $100, regardless of the quantity or type of covered
17 prescription insulin drug used to fill the insured's
18 prescription.
19 (d) Nothing in this Section prevents an insurer from
20 reducing an insured's cost sharing by an amount greater than
21 the amount specified in subsection (c).
22 (e) The Director may use any of the Director's enforcement
23 powers to obtain an insurer's compliance with this Section.
24 (f) The Department may adopt rules as necessary to
25 implement and administer this Section and to align it with
26 federal requirements.
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1 (g) On January 1 of each year, the limit on the amount that
2 an insured is required to pay for a 30-day supply of a covered
3 prescription insulin drug shall increase by a percentage equal
4 to the percentage change from the preceding year in the
5 medical care component of the Consumer Price Index of the
6 Bureau of Labor Statistics of the United States Department of
7 Labor.
8 (Source: P.A. 101-625, eff. 1-1-21.)
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