Illinois 2025-2026 Regular Session

Illinois Senate Bill SB1258

Introduced
1/28/25  
Refer
1/28/25  

Caption

PRIOR AUTH-PRESCRIPTION DRUGS

Impact

The implications of SB1258 on state laws could be significant, as it represents a shift towards greater patient access to necessary medications without the bureaucratic delay often associated with prior authorizations. By removing barriers to these vital prescriptions, the bill has the potential to improve health outcomes for patients who require ongoing treatment for conditions like diabetes or HIV. This regulatory change could also influence how health insurance plans structure their coverage and treatment protocols in Illinois.

Summary

SB1258, introduced by Senator Graciela Guzmán, amends the Prior Authorization Reform Act in Illinois. The bill aims to eliminate the requirement for prior authorization by health insurance issuers for specific prescription drugs. Notably, this applies to any prescription prescribed for six or more consecutive months by a healthcare professional, irrespective of whether the medication is considered non-preferred within the patient's health insurance plan. The proposed legislation specifically targets essential medications such as insulin and HIV-related drugs, thus seeking to enhance access to these critical therapies for patients managing chronic conditions.

Contention

While the intent of SB1258 is to facilitate easier access to medications, there may be concerns from health insurance issuers regarding the financial impacts of such changes. Opponents of the bill might argue that removing prior authorization requirements could lead to increased pharmaceutical costs and, subsequently, higher premiums for all insured individuals. Additionally, there may be discussions around the implications for patient safety and the appropriateness of prescribing practices without the checks that prior authorization processes may provide.

Companion Bills

No companion bills found.

Similar Bills

IL HB2584

INS-PRIOR AUTH HIV DRUG ACCESS

NV SB354

Revises provisions relating to health insurance coverage of prescription drugs. (BDR 57-1041)

TX HB2985

Relating to prior authorization for prescription drug benefits related to the prevention of human immunodeficiency virus infections.

TX HB1680

Relating to prior authorization for prescription drug benefits related to the prevention of human immunodeficiency virus infections.

TX SB1274

Relating to prior authorization for prescription drug benefits related to the prevention of human immunodeficiency virus infections.

MA H1245

To address barriers to HIV prevention medication

MA S717

To strengthen the control of contagious and infectious diseases in the Commonwealth

NV AB186

Revises provisions governing pharmacists. (BDR 54-344)