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Rep. Michelle Mussman
Filed: 4/20/2021
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1 | | AMENDMENT TO HOUSE BILL 135
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2 | | AMENDMENT NO. ______. Amend House Bill 135 by replacing |
3 | | everything after the enacting clause with the following:
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4 | | "Section 5. The State Employees Group Insurance Act of |
5 | | 1971 is amended by changing Section 6.11 as follows:
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6 | | (5 ILCS 375/6.11)
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7 | | Sec. 6.11. Required health benefits; Illinois Insurance |
8 | | Code
requirements. The program of health
benefits shall |
9 | | provide the post-mastectomy care benefits required to be |
10 | | covered
by a policy of accident and health insurance under |
11 | | Section 356t of the Illinois
Insurance Code. The program of |
12 | | health benefits shall provide the coverage
required under |
13 | | Sections 356g, 356g.5, 356g.5-1, 356m,
356u, 356w, 356x, |
14 | | 356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, |
15 | | 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22, |
16 | | 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, |
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1 | | 356z.36, and 356z.41 , and 356z.43 of the
Illinois Insurance |
2 | | Code.
The program of health benefits must comply with Sections |
3 | | 155.22a, 155.37, 355b, 356z.19, 370c, and 370c.1 and Article |
4 | | XXXIIB of the
Illinois Insurance Code. The Department of |
5 | | Insurance shall enforce the requirements of this Section with |
6 | | respect to Sections 370c and 370c.1 of the Illinois Insurance |
7 | | Code; all other requirements of this Section shall be enforced |
8 | | by the Department of Central Management Services.
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9 | | Rulemaking authority to implement Public Act 95-1045, if |
10 | | any, is conditioned on the rules being adopted in accordance |
11 | | with all provisions of the Illinois Administrative Procedure |
12 | | Act and all rules and procedures of the Joint Committee on |
13 | | Administrative Rules; any purported rule not so adopted, for |
14 | | whatever reason, is unauthorized. |
15 | | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; |
16 | | 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. |
17 | | 1-1-19; 100-1102, eff. 1-1-19; 100-1170, eff. 6-1-19; 101-13, |
18 | | eff. 6-12-19; 101-281, eff. 1-1-20; 101-393, eff. 1-1-20; |
19 | | 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff. |
20 | | 1-1-21 .) |
21 | | Section 10. The Department of Public Health Powers and |
22 | | Duties Law of the
Civil Administrative Code of Illinois is |
23 | | amended by adding Section 2310-705 as follows: |
24 | | (20 ILCS 2310/2310-705 new) |
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1 | | Sec. 2310-705. Contraceptive drugs and products; Director |
2 | | standing order. |
3 | | (a) As used in this Section: |
4 | | "Hormonal contraceptive" means a prescribed |
5 | | medically-acceptable oral drug, transdermal patch, or vaginal |
6 | | ring that is approved by the United States Food and Drug |
7 | | Administration to prevent pregnancy. |
8 | | "Standing order" has the meaning given to that term in the |
9 | | Pharmacy Practice Act. |
10 | | (b) If the Director of Public Health is a physician |
11 | | licensed to practice medicine in all its branches in Illinois, |
12 | | the Director shall establish a standing order complete with |
13 | | the issuance of a prescription for a hormonal contraceptive in |
14 | | accordance with this Section. If the Director is not a |
15 | | physician licensed to practice medicine in all its branches in |
16 | | Illinois, then the Medical Director of the Department of |
17 | | Public Health shall establish a standing order in accordance |
18 | | with this Section. |
19 | | (c) The standing order, at a minimum, shall comply with |
20 | | the following: |
21 | | (1) A pharmacist may dispense a 12-month supply of |
22 | | hormonal contraceptives to a patient. |
23 | | (2) A pharmacist shall have the patient complete the |
24 | | self-screening risk assessment tool. The self-screening |
25 | | risk assessment tool is to be based on the most current |
26 | | version of the United States Medical Eligibility Criteria |
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1 | | for Contraceptive Use published by the federal Centers for |
2 | | Disease Control and Prevention. |
3 | | (3) Based upon the results of the self-screening risk |
4 | | assessment and the patient assessment, the pharmacist |
5 | | shall use his or her professional and clinical judgment as |
6 | | to when a patient should be referred to the patient's |
7 | | physician or another health care provider. |
8 | | (4) The pharmacist shall provide, during the patient |
9 | | assessment and consultation, counseling and education |
10 | | about all methods of contraception, including methods not |
11 | | covered under the standing order, and their proper use and |
12 | | effectiveness. |
13 | | (5) The patient consultation shall take place in a |
14 | | private manner consistent with rules adopted by the |
15 | | Department of Financial and Professional Regulation. |
16 | | (6) The Department shall adopt rules under this |
17 | | Section that require a pharmacist to: |
18 | | (A) complete an educational training program |
19 | | accredited by the Accreditation Council for Pharmacy |
20 | | Education and approved by the Department that is |
21 | | related to the patient self-screening risk assessment, |
22 | | patient assessment, contraceptive counseling and |
23 | | education, and dispensation of hormonal |
24 | | contraceptives; and |
25 | | (B) dispense the hormonal contraceptive to the |
26 | | patient as soon as practicable after meeting the |
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1 | | requirements of paragraph (2). |
2 | | (7) All State and federal laws governing insurance |
3 | | coverage of contraceptive drugs shall apply to hormonal |
4 | | contraceptives dispensed by a pharmacist under this |
5 | | Section. |
6 | | Section 15. The Counties Code is amended by changing |
7 | | Section 5-1069.3 as follows: |
8 | | (55 ILCS 5/5-1069.3)
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9 | | Sec. 5-1069.3. Required health benefits. If a county, |
10 | | including a home
rule
county, is a self-insurer for purposes |
11 | | of providing health insurance coverage
for its employees, the |
12 | | coverage shall include coverage for the post-mastectomy
care |
13 | | benefits required to be covered by a policy of accident and |
14 | | health
insurance under Section 356t and the coverage required |
15 | | under Sections 356g, 356g.5, 356g.5-1, 356u,
356w, 356x, |
16 | | 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, |
17 | | 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, |
18 | | 356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41 , and 356z.43 |
19 | | of
the Illinois Insurance Code. The coverage shall comply with |
20 | | Sections 155.22a, 355b, 356z.19, and 370c of
the Illinois |
21 | | Insurance Code. The Department of Insurance shall enforce the |
22 | | requirements of this Section. The requirement that health |
23 | | benefits be covered
as provided in this Section is an
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24 | | exclusive power and function of the State and is a denial and |
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1 | | limitation under
Article VII, Section 6, subsection (h) of the |
2 | | Illinois Constitution. A home
rule county to which this |
3 | | Section applies must comply with every provision of
this |
4 | | Section.
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5 | | Rulemaking authority to implement Public Act 95-1045, if |
6 | | any, is conditioned on the rules being adopted in accordance |
7 | | with all provisions of the Illinois Administrative Procedure |
8 | | Act and all rules and procedures of the Joint Committee on |
9 | | Administrative Rules; any purported rule not so adopted, for |
10 | | whatever reason, is unauthorized. |
11 | | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; |
12 | | 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. |
13 | | 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281, |
14 | | eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; |
15 | | 101-625, eff. 1-1-21 .) |
16 | | Section 20. The Illinois Municipal Code is amended by |
17 | | changing Section 10-4-2.3 as follows: |
18 | | (65 ILCS 5/10-4-2.3)
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19 | | Sec. 10-4-2.3. Required health benefits. If a |
20 | | municipality, including a
home rule municipality, is a |
21 | | self-insurer for purposes of providing health
insurance |
22 | | coverage for its employees, the coverage shall include |
23 | | coverage for
the post-mastectomy care benefits required to be |
24 | | covered by a policy of
accident and health insurance under |
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1 | | Section 356t and the coverage required
under Sections 356g, |
2 | | 356g.5, 356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, |
3 | | 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, |
4 | | 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, |
5 | | 356z.36, and 356z.41 , and 356z.43 of the Illinois
Insurance
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6 | | Code. The coverage shall comply with Sections 155.22a, 355b, |
7 | | 356z.19, and 370c of
the Illinois Insurance Code. The |
8 | | Department of Insurance shall enforce the requirements of this |
9 | | Section. The requirement that health
benefits be covered as |
10 | | provided in this is an exclusive power and function of
the |
11 | | State and is a denial and limitation under Article VII, |
12 | | Section 6,
subsection (h) of the Illinois Constitution. A home |
13 | | rule municipality to which
this Section applies must comply |
14 | | with every provision of this Section.
|
15 | | Rulemaking authority to implement Public Act 95-1045, if |
16 | | any, is conditioned on the rules being adopted in accordance |
17 | | with all provisions of the Illinois Administrative Procedure |
18 | | Act and all rules and procedures of the Joint Committee on |
19 | | Administrative Rules; any purported rule not so adopted, for |
20 | | whatever reason, is unauthorized. |
21 | | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; |
22 | | 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. |
23 | | 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281, |
24 | | eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; |
25 | | 101-625, eff. 1-1-21 .) |
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1 | | Section 25. The School Code is amended by changing Section |
2 | | 10-22.3f as follows: |
3 | | (105 ILCS 5/10-22.3f)
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4 | | Sec. 10-22.3f. Required health benefits. Insurance |
5 | | protection and
benefits
for employees shall provide the |
6 | | post-mastectomy care benefits required to be
covered by a |
7 | | policy of accident and health insurance under Section 356t and |
8 | | the
coverage required under Sections 356g, 356g.5, 356g.5-1, |
9 | | 356u, 356w, 356x,
356z.6, 356z.8, 356z.9, 356z.11, 356z.12, |
10 | | 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, |
11 | | 356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41 , and 356z.43 |
12 | | of
the
Illinois Insurance Code.
Insurance policies shall |
13 | | comply with Section 356z.19 of the Illinois Insurance Code. |
14 | | The coverage shall comply with Sections 155.22a, 355b, and |
15 | | 370c of
the Illinois Insurance Code. The Department of |
16 | | Insurance shall enforce the requirements of this Section.
|
17 | | Rulemaking authority to implement Public Act 95-1045, if |
18 | | any, is conditioned on the rules being adopted in accordance |
19 | | with all provisions of the Illinois Administrative Procedure |
20 | | Act and all rules and procedures of the Joint Committee on |
21 | | Administrative Rules; any purported rule not so adopted, for |
22 | | whatever reason, is unauthorized. |
23 | | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; |
24 | | 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. |
25 | | 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281, |
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1 | | eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; |
2 | | 101-625, eff. 1-1-21 .) |
3 | | Section 30. The Illinois Insurance Code is amended by |
4 | | adding Section 356z.43 as follows: |
5 | | (215 ILCS 5/356z.43 new) |
6 | | Sec. 356z.43. Coverage for patient care services for |
7 | | hormonal contraceptives provided by a pharmacist. A group or |
8 | | individual policy of accident and health insurance or a |
9 | | managed care plan that is amended, delivered, issued, or |
10 | | renewed after the effective date of this amendatory Act of the |
11 | | 102nd General Assembly shall provide coverage for patient care |
12 | | services provided by a pharmacist for hormonal contraceptives |
13 | | assessment and consultation. |
14 | | Section 35. The Pharmacy Practice Act is amended by |
15 | | changing Section 3 and by adding Section 43 as follows:
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16 | | (225 ILCS 85/3)
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17 | | (Section scheduled to be repealed on January 1, 2023)
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18 | | Sec. 3. Definitions. For the purpose of this Act, except |
19 | | where otherwise
limited therein:
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20 | | (a) "Pharmacy" or "drugstore" means and includes every |
21 | | store, shop,
pharmacy department, or other place where |
22 | | pharmacist
care is
provided
by a pharmacist (1) where drugs, |
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1 | | medicines, or poisons are
dispensed, sold or
offered for sale |
2 | | at retail, or displayed for sale at retail; or
(2)
where
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3 | | prescriptions of physicians, dentists, advanced practice |
4 | | registered nurses, physician assistants, veterinarians, |
5 | | podiatric physicians, or
optometrists, within the limits of |
6 | | their
licenses, are
compounded, filled, or dispensed; or (3) |
7 | | which has upon it or
displayed within
it, or affixed to or used |
8 | | in connection with it, a sign bearing the word or
words |
9 | | "Pharmacist", "Druggist", "Pharmacy", "Pharmaceutical
Care", |
10 | | "Apothecary", "Drugstore",
"Medicine Store", "Prescriptions", |
11 | | "Drugs", "Dispensary", "Medicines", or any word
or words of |
12 | | similar or like import, either in the English language
or any |
13 | | other language; or (4) where the characteristic prescription
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14 | | sign (Rx) or similar design is exhibited; or (5) any store, or
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15 | | shop,
or other place with respect to which any of the above |
16 | | words, objects,
signs or designs are used in any |
17 | | advertisement.
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18 | | (b) "Drugs" means and includes (1) articles recognized
in |
19 | | the official United States Pharmacopoeia/National Formulary |
20 | | (USP/NF),
or any supplement thereto and being intended for and |
21 | | having for their
main use the diagnosis, cure, mitigation, |
22 | | treatment or prevention of
disease in man or other animals, as |
23 | | approved by the United States Food and
Drug Administration, |
24 | | but does not include devices or their components, parts,
or |
25 | | accessories; and (2) all other articles intended
for and |
26 | | having for their main use the diagnosis, cure, mitigation,
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1 | | treatment or prevention of disease in man or other animals, as |
2 | | approved
by the United States Food and Drug Administration, |
3 | | but does not include
devices or their components, parts, or |
4 | | accessories; and (3) articles
(other than food) having for |
5 | | their main use and intended
to affect the structure or any |
6 | | function of the body of man or other
animals; and (4) articles |
7 | | having for their main use and intended
for use as a component |
8 | | or any articles specified in clause (1), (2)
or (3); but does |
9 | | not include devices or their components, parts or
accessories.
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10 | | (c) "Medicines" means and includes all drugs intended for
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11 | | human or veterinary use approved by the United States Food and |
12 | | Drug
Administration.
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13 | | (d) "Practice of pharmacy" means: |
14 | | (1) the interpretation and the provision of assistance |
15 | | in the monitoring, evaluation, and implementation of |
16 | | prescription drug orders; |
17 | | (2) the dispensing of prescription drug orders; |
18 | | (3) participation in drug and device selection; |
19 | | (4) drug administration limited to the administration |
20 | | of oral, topical, injectable, and inhalation as follows: |
21 | | (A) in the context of patient education on the |
22 | | proper use or delivery of medications; |
23 | | (B) vaccination of patients 14 years of age and |
24 | | older pursuant to a valid prescription or standing |
25 | | order, by a physician licensed to practice medicine in |
26 | | all its branches, upon completion of appropriate |
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1 | | training, including how to address contraindications |
2 | | and adverse reactions set forth by rule, with |
3 | | notification to the patient's physician and |
4 | | appropriate record retention, or pursuant to hospital |
5 | | pharmacy and therapeutics committee policies and |
6 | | procedures; |
7 | | (B-5) following the initial administration of |
8 | | long-acting or extended-release extended release form |
9 | | opioid antagonists by a physician licensed to practice |
10 | | medicine in all its branches, administration of |
11 | | injections of long-acting or extended-release form |
12 | | opioid antagonists for the treatment of substance use |
13 | | disorder, pursuant to a valid prescription by a |
14 | | physician licensed to practice medicine in all its |
15 | | branches, upon completion of appropriate training, |
16 | | including how to address contraindications and adverse |
17 | | reactions, including, but not limited to, respiratory |
18 | | depression and the performance of cardiopulmonary |
19 | | resuscitation, set forth by rule, with notification to |
20 | | the patient's physician and appropriate record |
21 | | retention, or pursuant to hospital pharmacy and |
22 | | therapeutics committee policies and procedures; |
23 | | (C) administration of injections of |
24 | | alpha-hydroxyprogesterone caproate, pursuant to a |
25 | | valid prescription, by a physician licensed to |
26 | | practice medicine in all its branches, upon completion |
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1 | | of appropriate training, including how to address |
2 | | contraindications and adverse reactions set forth by |
3 | | rule, with notification to the patient's physician and |
4 | | appropriate record retention, or pursuant to hospital |
5 | | pharmacy and therapeutics committee policies and |
6 | | procedures; and |
7 | | (D) administration of injections of long-term |
8 | | antipsychotic medications pursuant to a valid |
9 | | prescription by a physician licensed to practice |
10 | | medicine in all its branches, upon completion of |
11 | | appropriate training conducted by an Accreditation |
12 | | Council of Pharmaceutical Education accredited |
13 | | provider, including how to address contraindications |
14 | | and adverse reactions set forth by rule, with |
15 | | notification to the patient's physician and |
16 | | appropriate record retention, or pursuant to hospital |
17 | | pharmacy and therapeutics committee policies and |
18 | | procedures. |
19 | | (5) vaccination of patients ages 10 through 13 limited |
20 | | to the Influenza (inactivated influenza vaccine and live |
21 | | attenuated influenza intranasal vaccine) and Tdap (defined |
22 | | as tetanus, diphtheria, acellular pertussis) vaccines, |
23 | | pursuant to a valid prescription or standing order, by a |
24 | | physician licensed to practice medicine in all its |
25 | | branches, upon completion of appropriate training, |
26 | | including how to address contraindications and adverse |
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1 | | reactions set forth by rule, with notification to the |
2 | | patient's physician and appropriate record retention, or |
3 | | pursuant to hospital pharmacy and therapeutics committee |
4 | | policies and procedures; |
5 | | (6) drug regimen review; |
6 | | (7) drug or drug-related research; |
7 | | (8) the provision of patient counseling; |
8 | | (9) the practice of telepharmacy; |
9 | | (10) the provision of those acts or services necessary |
10 | | to provide pharmacist care; |
11 | | (11) medication therapy management; and |
12 | | (12) the responsibility for compounding and labeling |
13 | | of drugs and devices (except labeling by a manufacturer, |
14 | | repackager, or distributor of non-prescription drugs and |
15 | | commercially packaged legend drugs and devices), proper |
16 | | and safe storage of drugs and devices, and maintenance of |
17 | | required records ; and . |
18 | | (13) the assessment and consultation of patients and |
19 | | dispensing of hormonal contraceptives pursuant to the |
20 | | standing order under Section 2310-705 of the Department of |
21 | | Public Health Powers and Duties Law of the Civil |
22 | | Administrative Code of Illinois. |
23 | | A pharmacist who performs any of the acts defined as the |
24 | | practice of pharmacy in this State must be actively licensed |
25 | | as a pharmacist under this Act.
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26 | | (e) "Prescription" means and includes any written, oral, |
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1 | | facsimile, or
electronically transmitted order for drugs
or |
2 | | medical devices, issued by a physician licensed to practice |
3 | | medicine in
all its branches, dentist, veterinarian, podiatric |
4 | | physician, or
optometrist, within the
limits of his or her |
5 | | license, by a physician assistant in accordance with
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6 | | subsection (f) of Section 4, or by an advanced practice |
7 | | registered nurse in
accordance with subsection (g) of Section |
8 | | 4, containing the
following: (1) name
of the patient; (2) date |
9 | | when prescription was issued; (3) name
and strength of drug or |
10 | | description of the medical device prescribed;
and (4) |
11 | | quantity; (5) directions for use; (6) prescriber's name,
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12 | | address,
and signature; and (7) DEA registration number where |
13 | | required, for controlled
substances.
The prescription may, but |
14 | | is not required to, list the illness, disease, or condition |
15 | | for which the drug or device is being prescribed. DEA |
16 | | registration numbers shall not be required on inpatient drug |
17 | | orders. A prescription for medication other than controlled |
18 | | substances shall be valid for up to 15 months from the date |
19 | | issued for the purpose of refills, unless the prescription |
20 | | states otherwise.
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21 | | (f) "Person" means and includes a natural person, |
22 | | partnership,
association, corporation, government entity, or |
23 | | any other legal
entity.
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24 | | (g) "Department" means the Department of Financial and
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25 | | Professional Regulation.
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26 | | (h) "Board of Pharmacy" or "Board" means the State Board
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1 | | of Pharmacy of the Department of Financial and Professional |
2 | | Regulation.
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3 | | (i) "Secretary"
means the Secretary
of Financial and |
4 | | Professional Regulation.
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5 | | (j) "Drug product selection" means the interchange for a
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6 | | prescribed pharmaceutical product in accordance with Section |
7 | | 25 of
this Act and Section 3.14 of the Illinois Food, Drug and |
8 | | Cosmetic Act.
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9 | | (k) "Inpatient drug order" means an order issued by an |
10 | | authorized
prescriber for a resident or patient of a facility |
11 | | licensed under the
Nursing Home Care Act, the ID/DD Community |
12 | | Care Act, the MC/DD Act, the Specialized Mental Health |
13 | | Rehabilitation Act of 2013, the Hospital Licensing Act, or the |
14 | | University of Illinois Hospital Act, or a facility which is |
15 | | operated by the Department of Human
Services (as successor to |
16 | | the Department of Mental Health
and Developmental |
17 | | Disabilities) or the Department of Corrections.
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18 | | (k-5) "Pharmacist" means an individual health care |
19 | | professional and
provider currently licensed by this State to |
20 | | engage in the practice of
pharmacy.
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21 | | (l) "Pharmacist in charge" means the licensed pharmacist |
22 | | whose name appears
on a pharmacy license and who is |
23 | | responsible for all aspects of the
operation related to the |
24 | | practice of pharmacy.
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25 | | (m) "Dispense" or "dispensing" means the interpretation, |
26 | | evaluation, and implementation of a prescription drug order, |
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1 | | including the preparation and delivery of a drug or device to a |
2 | | patient or patient's agent in a suitable container |
3 | | appropriately labeled for subsequent administration to or use |
4 | | by a patient in accordance with applicable State and federal |
5 | | laws and regulations.
"Dispense" or "dispensing" does not mean |
6 | | the physical delivery to a patient or a
patient's |
7 | | representative in a home or institution by a designee of a |
8 | | pharmacist
or by common carrier. "Dispense" or "dispensing" |
9 | | also does not mean the physical delivery
of a drug or medical |
10 | | device to a patient or patient's representative by a
|
11 | | pharmacist's designee within a pharmacy or drugstore while the |
12 | | pharmacist is
on duty and the pharmacy is open.
|
13 | | (n) "Nonresident pharmacy"
means a pharmacy that is |
14 | | located in a state, commonwealth, or territory
of the United |
15 | | States, other than Illinois, that delivers, dispenses, or
|
16 | | distributes, through the United States Postal Service, |
17 | | commercially acceptable parcel delivery service, or other |
18 | | common
carrier, to Illinois residents, any substance which |
19 | | requires a prescription.
|
20 | | (o) "Compounding" means the preparation and mixing of |
21 | | components, excluding flavorings, (1) as the result of a |
22 | | prescriber's prescription drug order or initiative based on |
23 | | the prescriber-patient-pharmacist relationship in the course |
24 | | of professional practice or (2) for the purpose of, or |
25 | | incident to, research, teaching, or chemical analysis and not |
26 | | for sale or dispensing. "Compounding" includes the preparation |
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1 | | of drugs or devices in anticipation of receiving prescription |
2 | | drug orders based on routine, regularly observed dispensing |
3 | | patterns. Commercially available products may be compounded |
4 | | for dispensing to individual patients only if all of the |
5 | | following conditions are met: (i) the commercial product is |
6 | | not reasonably available from normal distribution channels in |
7 | | a timely manner to meet the patient's needs and (ii) the |
8 | | prescribing practitioner has requested that the drug be |
9 | | compounded.
|
10 | | (p) (Blank).
|
11 | | (q) (Blank).
|
12 | | (r) "Patient counseling" means the communication between a |
13 | | pharmacist or a student pharmacist under the supervision of a |
14 | | pharmacist and a patient or the patient's representative about |
15 | | the patient's medication or device for the purpose of |
16 | | optimizing proper use of prescription medications or devices. |
17 | | "Patient counseling" may include without limitation (1) |
18 | | obtaining a medication history; (2) acquiring a patient's |
19 | | allergies and health conditions; (3) facilitation of the |
20 | | patient's understanding of the intended use of the medication; |
21 | | (4) proper directions for use; (5) significant potential |
22 | | adverse events; (6) potential food-drug interactions; and (7) |
23 | | the need to be compliant with the medication therapy. A |
24 | | pharmacy technician may only participate in the following |
25 | | aspects of patient counseling under the supervision of a |
26 | | pharmacist: (1) obtaining medication history; (2) providing |
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1 | | the offer for counseling by a pharmacist or student |
2 | | pharmacist; and (3) acquiring a patient's allergies and health |
3 | | conditions.
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4 | | (s) "Patient profiles" or "patient drug therapy record" |
5 | | means the
obtaining, recording, and maintenance of patient |
6 | | prescription
information, including prescriptions for |
7 | | controlled substances, and
personal information.
|
8 | | (t) (Blank).
|
9 | | (u) "Medical device" or "device" means an instrument, |
10 | | apparatus, implement, machine,
contrivance, implant, in vitro |
11 | | reagent, or other similar or related article,
including any |
12 | | component part or accessory, required under federal law to
|
13 | | bear the label "Caution: Federal law requires dispensing by or |
14 | | on the order
of a physician". A seller of goods and services |
15 | | who, only for the purpose of
retail sales, compounds, sells, |
16 | | rents, or leases medical devices shall not,
by reasons |
17 | | thereof, be required to be a licensed pharmacy.
|
18 | | (v) "Unique identifier" means an electronic signature, |
19 | | handwritten
signature or initials, thumb print, or other |
20 | | acceptable biometric
or electronic identification process as |
21 | | approved by the Department.
|
22 | | (w) "Current usual and customary retail price" means the |
23 | | price that a pharmacy charges to a non-third-party payor.
|
24 | | (x) "Automated pharmacy system" means a mechanical system |
25 | | located within the confines of the pharmacy or remote location |
26 | | that performs operations or activities, other than compounding |
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1 | | or administration, relative to storage, packaging, dispensing, |
2 | | or distribution of medication, and which collects, controls, |
3 | | and maintains all transaction information. |
4 | | (y) "Drug regimen review" means and includes the |
5 | | evaluation of prescription drug orders and patient records for |
6 | | (1)
known allergies; (2) drug or potential therapy |
7 | | contraindications;
(3) reasonable dose, duration of use, and |
8 | | route of administration, taking into consideration factors |
9 | | such as age, gender, and contraindications; (4) reasonable |
10 | | directions for use; (5) potential or actual adverse drug |
11 | | reactions; (6) drug-drug interactions; (7) drug-food |
12 | | interactions; (8) drug-disease contraindications; (9) |
13 | | therapeutic duplication; (10) patient laboratory values when |
14 | | authorized and available; (11) proper utilization (including |
15 | | over or under utilization) and optimum therapeutic outcomes; |
16 | | and (12) abuse and misuse.
|
17 | | (z) "Electronically transmitted prescription" means a |
18 | | prescription that is created, recorded, or stored by |
19 | | electronic means; issued and validated with an electronic |
20 | | signature; and transmitted by electronic means directly from |
21 | | the prescriber to a pharmacy. An electronic prescription is |
22 | | not an image of a physical prescription that is transferred by |
23 | | electronic means from computer to computer, facsimile to |
24 | | facsimile, or facsimile to computer.
|
25 | | (aa) "Medication therapy management services" means a |
26 | | distinct service or group of services offered by licensed |
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1 | | pharmacists, physicians licensed to practice medicine in all |
2 | | its branches, advanced practice registered nurses authorized |
3 | | in a written agreement with a physician licensed to practice |
4 | | medicine in all its branches, or physician assistants |
5 | | authorized in guidelines by a supervising physician that |
6 | | optimize therapeutic outcomes for individual patients through |
7 | | improved medication use. In a retail or other non-hospital |
8 | | pharmacy, medication therapy management services shall consist |
9 | | of the evaluation of prescription drug orders and patient |
10 | | medication records to resolve conflicts with the following: |
11 | | (1) known allergies; |
12 | | (2) drug or potential therapy contraindications; |
13 | | (3) reasonable dose, duration of use, and route of |
14 | | administration, taking into consideration factors such as |
15 | | age, gender, and contraindications; |
16 | | (4) reasonable directions for use; |
17 | | (5) potential or actual adverse drug reactions; |
18 | | (6) drug-drug interactions; |
19 | | (7) drug-food interactions; |
20 | | (8) drug-disease contraindications; |
21 | | (9) identification of therapeutic duplication; |
22 | | (10) patient laboratory values when authorized and |
23 | | available; |
24 | | (11) proper utilization (including over or under |
25 | | utilization) and optimum therapeutic outcomes; and |
26 | | (12) drug abuse and misuse. |
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1 | | "Medication therapy management services" includes the |
2 | | following: |
3 | | (1) documenting the services delivered and |
4 | | communicating the information provided to patients' |
5 | | prescribers within an appropriate time frame, not to |
6 | | exceed 48 hours; |
7 | | (2) providing patient counseling designed to enhance a |
8 | | patient's understanding and the appropriate use of his or |
9 | | her medications; and |
10 | | (3) providing information, support services, and |
11 | | resources designed to enhance a patient's adherence with |
12 | | his or her prescribed therapeutic regimens. |
13 | | "Medication therapy management services" may also include |
14 | | patient care functions authorized by a physician licensed to |
15 | | practice medicine in all its branches for his or her |
16 | | identified patient or groups of patients under specified |
17 | | conditions or limitations in a standing order from the |
18 | | physician. |
19 | | "Medication therapy management services" in a licensed |
20 | | hospital may also include the following: |
21 | | (1) reviewing assessments of the patient's health |
22 | | status; and |
23 | | (2) following protocols of a hospital pharmacy and |
24 | | therapeutics committee with respect to the fulfillment of |
25 | | medication orders.
|
26 | | (bb) "Pharmacist care" means the provision by a pharmacist |
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1 | | of medication therapy management services, with or without the |
2 | | dispensing of drugs or devices, intended to achieve outcomes |
3 | | that improve patient health, quality of life, and comfort and |
4 | | enhance patient safety.
|
5 | | (cc) "Protected health information" means individually |
6 | | identifiable health information that, except as otherwise |
7 | | provided, is:
|
8 | | (1) transmitted by electronic media; |
9 | | (2) maintained in any medium set forth in the |
10 | | definition of "electronic media" in the federal Health |
11 | | Insurance Portability and Accountability Act; or |
12 | | (3) transmitted or maintained in any other form or |
13 | | medium. |
14 | | "Protected health information" does not include |
15 | | individually identifiable health information found in: |
16 | | (1) education records covered by the federal Family |
17 | | Educational Right and Privacy Act; or |
18 | | (2) employment records held by a licensee in its role |
19 | | as an employer. |
20 | | (dd) "Standing order" means a specific order for a patient |
21 | | or group of patients issued by a physician licensed to |
22 | | practice medicine in all its branches in Illinois. |
23 | | (ee) "Address of record" means the designated address |
24 | | recorded by the Department in the applicant's application file |
25 | | or licensee's license file maintained by the Department's |
26 | | licensure maintenance unit. |
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1 | | (ff) "Home pharmacy" means the location of a pharmacy's |
2 | | primary operations.
|
3 | | (gg) "Email address of record" means the designated email |
4 | | address recorded by the Department in the applicant's |
5 | | application file or the licensee's license file, as maintained |
6 | | by the Department's licensure maintenance unit. |
7 | | (Source: P.A. 100-208, eff. 1-1-18; 100-497, eff. 9-8-17; |
8 | | 100-513, eff. 1-1-18; 100-804, eff. 1-1-19; 100-863, eff. |
9 | | 8-14-18; 101-349, eff. 1-1-20; revised 8-21-20.) |
10 | | (225 ILCS 85/43 new) |
11 | | Sec. 43. Dispensation of hormonal contraceptives. |
12 | | (a) The dispensing of hormonal contraceptives to a patient |
13 | | shall be pursuant to a valid prescription or standing order by |
14 | | a physician licensed to practice medicine in all its branches |
15 | | or the medical director of a local health department, pursuant |
16 | | to the following: |
17 | | (1) a pharmacist may dispense no more than a 12-month |
18 | | supply of hormonal contraceptives to a patient; |
19 | | (2) a pharmacist must complete an educational training |
20 | | program accredited by the Accreditation Council for |
21 | | Pharmacy Education and approved by the Department that is |
22 | | related to the patient self-screening risk assessment, |
23 | | patient assessment contraceptive counseling and education, |
24 | | and dispensation of hormonal contraceptives; |
25 | | (3) a pharmacist shall have the patient complete the |
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1 | | self-screening risk assessment tool; the self-screening |
2 | | risk assessment tool is to be based on the most current |
3 | | version of the United States Medical Eligibility Criteria |
4 | | for Contraceptive Use published by the federal Centers for |
5 | | Disease Control and Prevention; |
6 | | (4) based upon the results of the self-screening risk |
7 | | assessment and the patient assessment, the pharmacist |
8 | | shall use his or her professional and clinical judgment as |
9 | | to when a patient should be referred to the patient's |
10 | | physician or another health care provider; |
11 | | (5) a pharmacist shall provide, during the patient |
12 | | assessment and consultation, counseling and education |
13 | | about all methods of contraception, including methods not |
14 | | covered under the standing order, and their proper use and |
15 | | effectiveness; |
16 | | (6) the patient consultation shall take place in a |
17 | | private manner; and |
18 | | (7) a pharmacist and pharmacy must maintain |
19 | | appropriate records. |
20 | | (b) The Department may adopt rules to implement this |
21 | | Section. |
22 | | (c) Nothing in this Section shall be interpreted to |
23 | | require a pharmacist to dispense hormonal contraception under |
24 | | a standing order issued by the Director of Public Health or the |
25 | | Medical Director of the Department of Public Health. |
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1 | | Section 40. The Illinois Public Aid Code is amended by |
2 | | adding Section 5-5.12d as follows: |
3 | | (305 ILCS 5/5-5.12d new) |
4 | | Sec. 5-5.12d. Coverage for patient care services for |
5 | | hormonal contraceptives provided by a pharmacist. |
6 | | (a) Subject to approval by the federal Centers for |
7 | | Medicare and Medicaid Services, the medical assistance |
8 | | program, including both the fee-for-service and managed care |
9 | | medical assistance programs established under this Article, |
10 | | shall cover patient care services provided by a pharmacist for |
11 | | hormonal contraceptives assessment and consultation. |
12 | | (b) The Department shall establish a fee schedule for |
13 | | patient care services provided by a pharmacist for hormonal |
14 | | contraceptives assessment and consultation. |
15 | | (c) The rate of reimbursement for patient care services |
16 | | provided by a pharmacist for hormonal contraceptives |
17 | | assessment and consultation shall be at 85% of the fee |
18 | | schedule for physician services by the medical assistance |
19 | | program. |
20 | | (d) A pharmacist must be enrolled in the medical |
21 | | assistance program as an ordering and referring provider prior |
22 | | to providing hormonal contraceptives assessment and |
23 | | consultation that is submitted by a pharmacy or pharmacist |
24 | | provider for reimbursement pursuant to this Section. |
25 | | (e) The Department shall apply for any necessary federal |
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1 | | waivers or approvals to implement this Section by January 1, |
2 | | 2022. |
3 | | (f) This Section does not restrict or prohibit any |
4 | | services currently provided by pharmacists as authorized by |
5 | | law, including, but not limited to, pharmacist services |
6 | | provided under this Code or authorized under the Illinois |
7 | | Title XIX State Plan. |
8 | | (g) The Department shall submit to the Joint Committee on |
9 | | Administrative Rules administrative rules for this Section as |
10 | | soon as practicable but no later than 6 months after federal |
11 | | approval is received.
|
12 | | Section 99. Effective date. This Act takes effect January |
13 | | 1, 2022.".
|