Illinois 2025-2026 Regular Session

Illinois House Bill HB2852 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 HB2852 Introduced , by Rep. Janet Yang Rohr SYNOPSIS AS INTRODUCED: 20 ILCS 2310/2310-735 new215 ILCS 5/370c.3 new305 ILCS 5/5-58 new Creates the Nonopioid Alternatives for Pain Act. Allows the Department of Public Health to develop and publish on its website a nonopioid alternatives pamphlet, with certain requirements. Prohibits a health insurance issuer to deny coverage of a nonopioid prescription drug in favor of an opioid prescription drug. Amends the Illinois Public Aid Code. Provides that coverage shall not be denied for a nonopioid prescription drug in favor of an opioid prescription drug. Requires that nonopioid drugs preferred on a specific list for the treatment or management of pain shall not be disadvantaged or discouraged with respect to coverage relative to any opioid or narcotic drug for the treatment or management of pain. Effective July 1, 2027. LRB104 09629 BDA 19694 b A BILL FOR 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB2852 Introduced , by Rep. Janet Yang Rohr SYNOPSIS AS INTRODUCED: 20 ILCS 2310/2310-735 new215 ILCS 5/370c.3 new305 ILCS 5/5-58 new 20 ILCS 2310/2310-735 new 215 ILCS 5/370c.3 new 305 ILCS 5/5-58 new Creates the Nonopioid Alternatives for Pain Act. Allows the Department of Public Health to develop and publish on its website a nonopioid alternatives pamphlet, with certain requirements. Prohibits a health insurance issuer to deny coverage of a nonopioid prescription drug in favor of an opioid prescription drug. Amends the Illinois Public Aid Code. Provides that coverage shall not be denied for a nonopioid prescription drug in favor of an opioid prescription drug. Requires that nonopioid drugs preferred on a specific list for the treatment or management of pain shall not be disadvantaged or discouraged with respect to coverage relative to any opioid or narcotic drug for the treatment or management of pain. Effective July 1, 2027. LRB104 09629 BDA 19694 b LRB104 09629 BDA 19694 b A BILL FOR
2	2	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB2852 Introduced , by Rep. Janet Yang Rohr SYNOPSIS AS INTRODUCED:
3	3	20 ILCS 2310/2310-735 new215 ILCS 5/370c.3 new305 ILCS 5/5-58 new 20 ILCS 2310/2310-735 new 215 ILCS 5/370c.3 new 305 ILCS 5/5-58 new
4	4	20 ILCS 2310/2310-735 new
5	5	215 ILCS 5/370c.3 new
6	6	305 ILCS 5/5-58 new
7	7	Creates the Nonopioid Alternatives for Pain Act. Allows the Department of Public Health to develop and publish on its website a nonopioid alternatives pamphlet, with certain requirements. Prohibits a health insurance issuer to deny coverage of a nonopioid prescription drug in favor of an opioid prescription drug. Amends the Illinois Public Aid Code. Provides that coverage shall not be denied for a nonopioid prescription drug in favor of an opioid prescription drug. Requires that nonopioid drugs preferred on a specific list for the treatment or management of pain shall not be disadvantaged or discouraged with respect to coverage relative to any opioid or narcotic drug for the treatment or management of pain. Effective July 1, 2027.
8	8	LRB104 09629 BDA 19694 b LRB104 09629 BDA 19694 b
9	9	LRB104 09629 BDA 19694 b
10	10	A BILL FOR
11	11	HB2852LRB104 09629 BDA 19694 b HB2852 LRB104 09629 BDA 19694 b
12	12	HB2852 LRB104 09629 BDA 19694 b
13	13	1 AN ACT concerning health.
14	14	2 Be it enacted by the People of the State of Illinois,
15	15	3 represented in the General Assembly:
16	16	4 Section 5. The Department of Public Health Powers and
17	17	5 Duties Law of the Civil Administrative Code of Illinois is
18	18	6 amended by adding Section 2310-735 as follows:
19	19	7 (20 ILCS 2310/2310-735 new)
20	20	8 Sec. 2310-735. Nonopioid alternatives pamphlet. The
21	21	9 Department of Public Health may develop and publish on its
22	22	10 website an educational pamphlet regarding the use of nonopioid
23	23	11 alternatives for the treatment of acute nonoperative, acute
24	24	12 perioperative, subacute, or chronic pain. The pamphlet may
25	25	13 conform with the United States Department of Health and Human
26	26	14 Services' Pain Management Best Practices Inter-Agency Task
27	27	15 Force recommendations and shall include:
28	28	16 (1) information on available nonopioid alternatives
29	29	17 for the treatment of pain, including available nonopioid
30	30	18 medicinal drugs or drug products and nonpharmacological
31	31	19 therapies; and
32	32	20 (2) the advantages and disadvantages of the use of
33	33	21 nonopioid alternatives.
34	34	22 Section 10. The Illinois Insurance Code is amended by
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38	38	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB2852 Introduced , by Rep. Janet Yang Rohr SYNOPSIS AS INTRODUCED:
39	39	20 ILCS 2310/2310-735 new215 ILCS 5/370c.3 new305 ILCS 5/5-58 new 20 ILCS 2310/2310-735 new 215 ILCS 5/370c.3 new 305 ILCS 5/5-58 new
40	40	20 ILCS 2310/2310-735 new
41	41	215 ILCS 5/370c.3 new
42	42	305 ILCS 5/5-58 new
43	43	Creates the Nonopioid Alternatives for Pain Act. Allows the Department of Public Health to develop and publish on its website a nonopioid alternatives pamphlet, with certain requirements. Prohibits a health insurance issuer to deny coverage of a nonopioid prescription drug in favor of an opioid prescription drug. Amends the Illinois Public Aid Code. Provides that coverage shall not be denied for a nonopioid prescription drug in favor of an opioid prescription drug. Requires that nonopioid drugs preferred on a specific list for the treatment or management of pain shall not be disadvantaged or discouraged with respect to coverage relative to any opioid or narcotic drug for the treatment or management of pain. Effective July 1, 2027.
44	44	LRB104 09629 BDA 19694 b LRB104 09629 BDA 19694 b
45	45	LRB104 09629 BDA 19694 b
46	46	A BILL FOR
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52	52	20 ILCS 2310/2310-735 new
53	53	215 ILCS 5/370c.3 new
54	54	305 ILCS 5/5-58 new
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58	58	LRB104 09629 BDA 19694 b
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68	68	HB2852 LRB104 09629 BDA 19694 b
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71	71	HB2852- 2 -LRB104 09629 BDA 19694 b HB2852 - 2 - LRB104 09629 BDA 19694 b
72	72	HB2852 - 2 - LRB104 09629 BDA 19694 b
73	73	1 adding Sections 370c.3 as follows:
74	74	2 (215 ILCS 5/370c.3 new)
75	75	3 Sec. 370c.3. Coverage for nonopioid medications; pain
76	76	4 relief parity.
77	77	5 (a) In this Section, "health insurance issuer" has the
78	78	6 meaning set forth in Section 5 of the Illinois Health
79	79	7 Insurance Portability and Accountability Act.
80	80	8 (b) Notwithstanding any provision of law to the contrary,
81	81	9 when a licensed health care practitioner prescribes a
82	82	10 nonopioid medication for the treatment of acute pain, it shall
83	83	11 be unlawful for a health insurance issuer to deny coverage of
84	84	12 the nonopioid prescription drug in favor of an opioid
85	85	13 prescription drug or to require the patient to try an opioid
86	86	14 prescription drug prior to providing coverage of the nonopioid
87	87	15 prescription drug.
88	88	16 (c) In establishing and maintaining its drug formulary, a
89	89	17 health insurance issuer shall ensure that no nonopioid drug
90	90	18 approved by the United States Food and Drug Administration for
91	91	19 the treatment or management of pain shall be disadvantaged or
92	92	20 discouraged, with respect to coverage or cost sharing,
93	93	21 relative to any opioid or narcotic drug for the treatment or
94	94	22 management of pain on the health insurance issuer's drug
95	95	23 formulary, where impermissible disadvantaging or
96	96	24 discouragement includes, without limitation: imposing more
97	97	25 restrictive coverage criteria on any such nonopioid drug than
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103	103	HB2852 - 2 - LRB104 09629 BDA 19694 b
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106	106	HB2852- 3 -LRB104 09629 BDA 19694 b HB2852 - 3 - LRB104 09629 BDA 19694 b
107	107	HB2852 - 3 - LRB104 09629 BDA 19694 b
108	108	1 the least restrictive coverage criteria imposed on an opioid
109	109	2 or narcotic drug; establishing more restrictive or more
110	110	3 extensive utilization controls, including, but not limited to,
111	111	4 more restrictive or more extensive prior authorization or step
112	112	5 therapy requirements, for such nonopioid drug than the least
113	113	6 restrictive or extensive utilization controls applicable to
114	114	7 any such opioid or narcotic drug; or, if the health insurance
115	115	8 issuer maintains a drug formulary grouped into tiers for the
116	116	9 purposes of determining cost sharing, placing any such
117	117	10 nonopioid drug on a tier that requires a cost-sharing
118	118	11 responsibility that exceeds the lowest cost-sharing
119	119	12 responsibility required for any opioid or narcotic drug on the
120	120	13 drug formulary. This subsection does not preclude opioid drugs
121	121	14 from being preferred over other opioid drugs or nonopioid
122	122	15 drugs from being preferred over other nonopioid drugs.
123	123	16 Section 15. The Illinois Public Aid Code is amended by
124	124	17 adding Section 5-58 as follows:
125	125	18 (305 ILCS 5/5-58 new)
126	126	19 Sec. 5-58. Coverage for nonopioid medications; pain relief
127	127	20 parity.
128	128	21 (a) Required coverage for nonopioid medications.
129	129	22 Notwithstanding any provision of law to the contrary, whenever
130	130	23 a licensed health care practitioner prescribes a nonopioid
131	131	24 medication for the treatment of acute pain, neither the
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137	137	HB2852 - 3 - LRB104 09629 BDA 19694 b
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141	141	HB2852 - 4 - LRB104 09629 BDA 19694 b
142	142	1 Department nor a managed care organization contracted with the
143	143	2 Department shall deny coverage of the nonopioid prescription
144	144	3 drug in favor of an opioid prescription drug or require a
145	145	4 patient to try an opioid prescription drug prior to providing
146	146	5 coverage of the nonopioid prescription drug.
147	147	6 (b) Pain relief parity. In establishing and maintaining
148	148	7 the Illinois Medicaid Preferred Drug List, the Department
149	149	8 shall ensure that nonopioid drugs preferred on the
150	150	9 Department's preferred drug list, and approved by the U.S.
151	151	10 Food and Drug Administration, for the treatment or management
152	152	11 of pain shall not be disadvantaged or discouraged with respect
153	153	12 to coverage relative to any opioid or narcotic drug for the
154	154	13 treatment or management of pain.
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160	160	HB2852 - 4 - LRB104 09629 BDA 19694 b