Illinois House Bill HB4087

Illinois 2023-2024 Regular Session

• Introduced: 5/11/23
• Refer: 2/14/24
• Refer: 5/11/23
• Refer: 4/5/24

Caption

WORKERS COMP-COMPOUND DRUGS

Impact

The implementation of HB4087 is expected to significantly affect state law regarding workers' compensation by centralizing prescription standards and making the process of approving drugs more transparent and consistent. By limiting prescriptions to those on the closed formulary, the bill aims to mitigate unnecessary medical expenses and minimize the potential for over-prescription or misuse of certain medications. Additionally, the legislation is set to enforce standards for custom compound medications, requiring approval for any medications prescribed beyond a one-time 7-day supply unless they meet stringent criteria.

Summary

House Bill 4087 amends the Workers' Compensation Act in Illinois by establishing a requirement for an evidence-based drug formulary. The Illinois Workers' Compensation Commission, in consultation with the Workers' Compensation Medical Fee Advisory Board, is directed to adopt this formulary by September 1, 2023. The bill mandates that prescriptions made for workers' compensation cases only include drugs that are categorized as acceptable within the formulary. This move is anticipated to ensure that treatments are evidence-based and standardized across claims, which proponents argue will improve patient care while controlling costs.

Contention

Notably, there is contention surrounding the implications of the bill. Critics argue that the strict limitation on drug prescriptions could hinder access to necessary medications for injured workers who may not benefit from only those medications listed on the formulary. Additionally, concerns have been raised about the process of establishing the formulary itself and whether it adequately considers the diverse needs of patients with unique medical conditions. The balance between cost control and ensuring adequate medical care is a critical point in the discussions surrounding HB4087, with opinions varying significantly among stakeholders.