Public Act 103-0429
HB2189 EnrolledLRB103 24836 BMS 51168 b HB2189 Enrolled LRB103 24836 BMS 51168 b
HB2189 Enrolled LRB103 24836 BMS 51168 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 1. Short title. This Act may be cited as the Access
to Affordable Insulin Act.
Section 5. Definitions. As used in this Act:
"Department" means the Department of Central Management
Services.
"Director" means the Director of Central Management
Services.
"Insulin" means a prescription drug that contains insulin.
"Manufacturer" means a manufacturer engaged in the
manufacturing of insulin that is self-administered on an
outpatient basis.
"Navigator" has the meaning described in Section 1311(i)
of the Patient Protection and Affordable Care Act, Public Law
111-148, and further defined through amendments to that Act
and regulations issued under that Act.
"Pharmacy" means a pharmacy located in this State.
"Prescription drug" means a drug that is required by
federal or State law or rule to be dispensed only by
prescription or that is restricted to administration only by
practitioners.
HB2189 Enrolled LRB103 24836 BMS 51168 b
Section 10. Insulin discount program.
(a) The Department shall offer a discount program that
allows participants to purchase insulin at a discounted,
post-rebate price.
(b) The discount program shall:
(1) provide a participant with a card or electronic
document that identifies the participant as eligible for
the discount;
(2) provide a participant with information about
pharmacies that will honor the discount;
(3) allow a participant to purchase insulin at a
discounted, post-rebate price; and
(4) provide a participant with instructions to pursue
a reimbursement of the purchase price from the
participant's health insurer.
(c) The discount program shall charge a price for insulin
that allows the program to retain only enough of any rebate for
the insulin to make the State risk pool whole for providing
discounted insulin to participants.
Section 90. The Illinois Insurance Code is amended by
changing Section 356z.41 as follows:
(215 ILCS 5/356z.41)
Sec. 356z.41. Cost sharing in prescription insulin drugs;
limits; confidentiality of rebate information.
(a) As used in this Section, "prescription insulin drug"
means a prescription drug that contains insulin and is used to
control blood glucose levels to treat diabetes but does not
include an insulin drug that is administered to a patient
intravenously.
(b) This Section applies to a group or individual policy
of accident and health insurance amended, delivered, issued,
or renewed on or after the effective date of this amendatory
Act of the 101st General Assembly.
(c) An insurer that provides coverage for prescription
insulin drugs pursuant to the terms of a health coverage plan
the insurer offers shall limit the total amount that an
insured is required to pay for a 30-day supply of covered
prescription insulin drugs at an amount not to exceed $35
$100, regardless of the quantity or type of covered
prescription insulin drug used to fill the insured's
prescription.
(d) Nothing in this Section prevents an insurer from
reducing an insured's cost sharing by an amount greater than
the amount specified in subsection (c).
(e) The Director may use any of the Director's enforcement
powers to obtain an insurer's compliance with this Section.
(f) The Department may adopt rules as necessary to
implement and administer this Section and to align it with
federal requirements.
(g) On January 1 of each year, the limit on the amount that
an insured is required to pay for a 30-day supply of a covered
prescription insulin drug shall increase by a percentage equal
to the percentage change from the preceding year in the
medical care component of the Consumer Price Index of the
Bureau of Labor Statistics of the United States Department of
Labor.
(Source: P.A. 101-625, eff. 1-1-21.)