Illinois 2025-2026 Regular Session

Illinois House Bill HB0004 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB0004 Introduced , by Rep. La Shawn K. Ford SYNOPSIS AS INTRODUCED: 305 ILCS 5/5-5.12g new Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to conduct a study on managed care pharmacy access standards. Provides that the study shall review the current access standards, with a focus on disproportionately impacted areas. Requires the Department to seek input from consumers of pharmacy services. Requires the Department to report its findings to the Governor and the General Assembly by January 1, 2026 and to publish the report on the Department's website. Provides that any retail pharmacy that is enrolled as an eligible retail pharmacy provider in the medical assistance program and is not sanctioned under investigation for fraud, waste, or abuse shall provide retail pharmacy services to any medical assistance recipient who resides in the same zip code as the pharmacy, regardless of whether the retail pharmacy is contracted to provide pharmacy services for the managed care organization that the recipient is enrolled with. Requires the managed care organization to pay the retail pharmacy the managed care organization's standard contractual rate. Effective immediately. LRB104 03381 KTG 13403 b A BILL FOR 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB0004 Introduced , by Rep. La Shawn K. Ford SYNOPSIS AS INTRODUCED: 305 ILCS 5/5-5.12g new 305 ILCS 5/5-5.12g new Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to conduct a study on managed care pharmacy access standards. Provides that the study shall review the current access standards, with a focus on disproportionately impacted areas. Requires the Department to seek input from consumers of pharmacy services. Requires the Department to report its findings to the Governor and the General Assembly by January 1, 2026 and to publish the report on the Department's website. Provides that any retail pharmacy that is enrolled as an eligible retail pharmacy provider in the medical assistance program and is not sanctioned under investigation for fraud, waste, or abuse shall provide retail pharmacy services to any medical assistance recipient who resides in the same zip code as the pharmacy, regardless of whether the retail pharmacy is contracted to provide pharmacy services for the managed care organization that the recipient is enrolled with. Requires the managed care organization to pay the retail pharmacy the managed care organization's standard contractual rate. Effective immediately. LRB104 03381 KTG 13403 b LRB104 03381 KTG 13403 b A BILL FOR
2	2	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB0004 Introduced , by Rep. La Shawn K. Ford SYNOPSIS AS INTRODUCED:
3	3	305 ILCS 5/5-5.12g new 305 ILCS 5/5-5.12g new
4	4	305 ILCS 5/5-5.12g new
5	5	Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to conduct a study on managed care pharmacy access standards. Provides that the study shall review the current access standards, with a focus on disproportionately impacted areas. Requires the Department to seek input from consumers of pharmacy services. Requires the Department to report its findings to the Governor and the General Assembly by January 1, 2026 and to publish the report on the Department's website. Provides that any retail pharmacy that is enrolled as an eligible retail pharmacy provider in the medical assistance program and is not sanctioned under investigation for fraud, waste, or abuse shall provide retail pharmacy services to any medical assistance recipient who resides in the same zip code as the pharmacy, regardless of whether the retail pharmacy is contracted to provide pharmacy services for the managed care organization that the recipient is enrolled with. Requires the managed care organization to pay the retail pharmacy the managed care organization's standard contractual rate. Effective immediately.
6	6	LRB104 03381 KTG 13403 b LRB104 03381 KTG 13403 b
7	7	LRB104 03381 KTG 13403 b
8	8	A BILL FOR
9	9	HB0004LRB104 03381 KTG 13403 b HB0004 LRB104 03381 KTG 13403 b
10	10	HB0004 LRB104 03381 KTG 13403 b
11	11	1 AN ACT concerning public aid.
12	12	2 Be it enacted by the People of the State of Illinois,
13	13	3 represented in the General Assembly:
14	14	4 Section 5. The Illinois Public Aid Code is amended by
15	15	5 adding Section 5-5.12g as follows:
16	16	6 (305 ILCS 5/5-5.12g new)
17	17	7 Sec. 5-5.12g. Pharmacy services; report on access
18	18	8 standards.
19	19	9 (a) The Department shall conduct a study on managed care
20	20	10 pharmacy access standards. The study shall review the current
21	21	11 access standards, with a focus on disproportionately impacted
22	22	12 areas. The Department shall seek input from consumers of
23	23	13 pharmacy services. The Department shall report its findings to
24	24	14 the Governor and the General Assembly by January 1, 2026. The
25	25	15 Department shall post the report on its website.
26	26	16 (b) Any retail pharmacy that is enrolled as an eligible
27	27	17 retail pharmacy provider in the medical assistance program and
28	28	18 is not sanctioned under investigation for fraud, waste, or
29	29	19 abuse shall provide retail pharmacy services to any medical
30	30	20 assistance recipient who resides in the same zip code as the
31	31	21 pharmacy, regardless of whether the retail pharmacy is
32	32	22 contracted to provide pharmacy services for the managed care
33	33	23 organization that the recipient is enrolled with. The managed
34	34
35	35
36	36
37	37	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB0004 Introduced , by Rep. La Shawn K. Ford SYNOPSIS AS INTRODUCED:
38	38	305 ILCS 5/5-5.12g new 305 ILCS 5/5-5.12g new
39	39	305 ILCS 5/5-5.12g new
40	40	Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to conduct a study on managed care pharmacy access standards. Provides that the study shall review the current access standards, with a focus on disproportionately impacted areas. Requires the Department to seek input from consumers of pharmacy services. Requires the Department to report its findings to the Governor and the General Assembly by January 1, 2026 and to publish the report on the Department's website. Provides that any retail pharmacy that is enrolled as an eligible retail pharmacy provider in the medical assistance program and is not sanctioned under investigation for fraud, waste, or abuse shall provide retail pharmacy services to any medical assistance recipient who resides in the same zip code as the pharmacy, regardless of whether the retail pharmacy is contracted to provide pharmacy services for the managed care organization that the recipient is enrolled with. Requires the managed care organization to pay the retail pharmacy the managed care organization's standard contractual rate. Effective immediately.
41	41	LRB104 03381 KTG 13403 b LRB104 03381 KTG 13403 b
42	42	LRB104 03381 KTG 13403 b
43	43	A BILL FOR
44	44
45	45
46	46
47	47
48	48
49	49	305 ILCS 5/5-5.12g new
50	50
51	51
52	52
53	53	LRB104 03381 KTG 13403 b
54	54
55	55
56	56
57	57
58	58
59	59
60	60
61	61
62	62
63	63	HB0004 LRB104 03381 KTG 13403 b
64	64
65	65
66	66	HB0004- 2 -LRB104 03381 KTG 13403 b HB0004 - 2 - LRB104 03381 KTG 13403 b
67	67	HB0004 - 2 - LRB104 03381 KTG 13403 b
68	68	1 care organization shall pay such a retail pharmacy the managed
69	69	2 care organization's standard contractual rate.
70	70
71	71
72	72
73	73
74	74
75	75	HB0004 - 2 - LRB104 03381 KTG 13403 b