Rep. Michelle Mussman

Filed: 4/20/2018

 

 


 

 


 
10000HB0274ham002LRB100 04385 SMS 39068 a

1
AMENDMENT TO HOUSE BILL 274

2    AMENDMENT NO. ______. Amend House Bill 274, AS AMENDED, by
3replacing everything after the enacting clause with the
4following:
 
5    "Section 5. The State Employees Group Insurance Act of 1971
6is amended by changing Section 6.11 as follows:
 
7    (5 ILCS 375/6.11)
8    Sec. 6.11. Required health benefits; Illinois Insurance
9Code requirements. The program of health benefits shall provide
10the post-mastectomy care benefits required to be covered by a
11policy of accident and health insurance under Section 356t of
12the Illinois Insurance Code. The program of health benefits
13shall provide the coverage required under Sections 356g,
14356g.5, 356g.5-1, 356m, 356u, 356w, 356x, 356z.2, 356z.4,
15356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
16356z.14, 356z.15, 356z.17, 356z.22, and 356z.25, 356z.26, and

 

 

10000HB0274ham002- 2 -LRB100 04385 SMS 39068 a

1356z.29 of the Illinois Insurance Code. The program of health
2benefits must comply with Sections 155.22a, 155.37, 355b,
3356z.19, 370c, and 370c.1 of the Illinois Insurance Code.
4    Rulemaking authority to implement Public Act 95-1045, if
5any, is conditioned on the rules being adopted in accordance
6with all provisions of the Illinois Administrative Procedure
7Act and all rules and procedures of the Joint Committee on
8Administrative Rules; any purported rule not so adopted, for
9whatever reason, is unauthorized.
10(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17;
11100-138, eff. 8-18-17; revised 10-3-17.)
 
12    Section 10. The Department of Public Health Powers and
13Duties Law of the Civil Administrative Code of Illinois is
14amended by adding Section 2310-700 as follows:
 
15    (20 ILCS 2310/2310-700 new)
16    Sec. 2310-700. Contraceptive drugs and products; Director
17standing order.
18    (a) As used in this Section:
19    "Hormonal contraceptive" means a prescribed
20medically-acceptable oral drug, transdermal patch, or vaginal
21ring that is approved by the United States Food and Drug
22Administration to prevent pregnancy.
23    "Standing order" has the meaning given to that term in the
24Pharmacy Practice Act.

 

 

10000HB0274ham002- 3 -LRB100 04385 SMS 39068 a

1    (b) If the Director of Public Health is a physician
2licensed to practice medicine in all its branches in Illinois,
3the Director shall establish a standing order complete with the
4issuance of a prescription for a hormonal contraceptive in
5accordance with this Section. If the Director is not a
6physician licensed to practice medicine in all its branches in
7Illinois, then the Medical Director of the Department of Public
8Health shall establish a standing order in accordance with this
9Section.
10    (c) The standing order, at a minimum, shall comply with the
11following:
12        (1) A pharmacist may dispense a 12-month supply of
13    hormonal contraceptives to a patient.
14        (2) A pharmacist shall have the patient complete the
15    self-screening risk assessment tool. The self-screening
16    risk assessment tool is to be based on the most current
17    version of the United States Medical Eligibility Criteria
18    for Contraceptive Use published by the federal Centers for
19    Disease Control and Prevention.
20        (3) Based upon the results of the self-screening risk
21    assessment and the patient assessment, the pharmacist
22    shall use his or her professional and clinical judgment as
23    to when a patient should be referred to the patient's
24    physician or another health care provider.
25        (4) The pharmacist shall provide, during the patient
26    assessment and consultation, counseling and education

 

 

10000HB0274ham002- 4 -LRB100 04385 SMS 39068 a

1    about all methods of contraception, including methods not
2    covered under the standing order, and their proper use and
3    effectiveness.
4        (5) The patient consultation shall take place in a
5    private manner consistent with rules adopted by the
6    Department of Financial and Professional Regulation.
7        (6) The Department shall adopt rules under this Section
8    that require a pharmacist to:
9            (A) complete an educational training program
10        accredited by the Accreditation Council for Pharmacy
11        Education and approved by the Department that is
12        related to the patient self-screening risk assessment,
13        patient assessment, contraceptive counseling and
14        education, and dispensation of hormonal
15        contraceptives; and
16            (B) dispense the hormonal contraceptive to the
17        patient as soon as practicable after meeting the
18        requirements of paragraph (2).
19        (7) All State and federal laws governing insurance
20    coverage of contraceptive drugs shall apply to hormonal
21    contraceptives dispensed by a pharmacist under this
22    Section.
 
23    Section 15. The Counties Code is amended by changing
24Section 5-1069.3 as follows:
 

 

 

10000HB0274ham002- 5 -LRB100 04385 SMS 39068 a

1    (55 ILCS 5/5-1069.3)
2    Sec. 5-1069.3. Required health benefits. If a county,
3including a home rule county, is a self-insurer for purposes of
4providing health insurance coverage for its employees, the
5coverage shall include coverage for the post-mastectomy care
6benefits required to be covered by a policy of accident and
7health insurance under Section 356t and the coverage required
8under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x,
9356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
10356z.14, 356z.15, 356z.22, and 356z.25, 356z.26, and 356z.29 of
11the Illinois Insurance Code. The coverage shall comply with
12Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
13Insurance Code. The requirement that health benefits be covered
14as provided in this Section is an exclusive power and function
15of the State and is a denial and limitation under Article VII,
16Section 6, subsection (h) of the Illinois Constitution. A home
17rule county to which this Section applies must comply with
18every provision of this Section.
19    Rulemaking authority to implement Public Act 95-1045, if
20any, is conditioned on the rules being adopted in accordance
21with all provisions of the Illinois Administrative Procedure
22Act and all rules and procedures of the Joint Committee on
23Administrative Rules; any purported rule not so adopted, for
24whatever reason, is unauthorized.
25(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17;
26100-138, eff. 8-18-17; revised 10-5-17.)
 

 

 

10000HB0274ham002- 6 -LRB100 04385 SMS 39068 a

1    Section 20. The Illinois Municipal Code is amended by
2changing Section 10-4-2.3 as follows:
 
3    (65 ILCS 5/10-4-2.3)
4    Sec. 10-4-2.3. Required health benefits. If a
5municipality, including a home rule municipality, is a
6self-insurer for purposes of providing health insurance
7coverage for its employees, the coverage shall include coverage
8for the post-mastectomy care benefits required to be covered by
9a policy of accident and health insurance under Section 356t
10and the coverage required under Sections 356g, 356g.5,
11356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.10,
12356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, and
13356z.25, 356z.26, and 356z.29 of the Illinois Insurance Code.
14The coverage shall comply with Sections 155.22a, 355b, 356z.19,
15and 370c of the Illinois Insurance Code. The requirement that
16health benefits be covered as provided in this is an exclusive
17power and function of the State and is a denial and limitation
18under Article VII, Section 6, subsection (h) of the Illinois
19Constitution. A home rule municipality to which this Section
20applies must comply with every provision of this Section.
21    Rulemaking authority to implement Public Act 95-1045, if
22any, is conditioned on the rules being adopted in accordance
23with all provisions of the Illinois Administrative Procedure
24Act and all rules and procedures of the Joint Committee on

 

 

10000HB0274ham002- 7 -LRB100 04385 SMS 39068 a

1Administrative Rules; any purported rule not so adopted, for
2whatever reason, is unauthorized.
3(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17;
4100-138, eff. 8-18-17; revised 10-5-17.)
 
5    Section 25. The School Code is amended by changing Section
610-22.3f as follows:
 
7    (105 ILCS 5/10-22.3f)
8    Sec. 10-22.3f. Required health benefits. Insurance
9protection and benefits for employees shall provide the
10post-mastectomy care benefits required to be covered by a
11policy of accident and health insurance under Section 356t and
12the coverage required under Sections 356g, 356g.5, 356g.5-1,
13356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.11, 356z.12,
14356z.13, 356z.14, 356z.15, 356z.22, and 356z.25, 356z.26, and
15356z.29 of the Illinois Insurance Code. Insurance policies
16shall comply with Section 356z.19 of the Illinois Insurance
17Code. The coverage shall comply with Sections 155.22a and 355b
18of the Illinois Insurance Code.
19    Rulemaking authority to implement Public Act 95-1045, if
20any, is conditioned on the rules being adopted in accordance
21with all provisions of the Illinois Administrative Procedure
22Act and all rules and procedures of the Joint Committee on
23Administrative Rules; any purported rule not so adopted, for
24whatever reason, is unauthorized.

 

 

10000HB0274ham002- 8 -LRB100 04385 SMS 39068 a

1(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
2revised 9-25-17.)
 
3    Section 30. The Illinois Insurance Code is amended by
4adding Section 356z.29 as follows:
 
5    (215 ILCS 5/356z.29 new)
6    Sec. 356z.29. Coverage for patient care services for
7hormonal contraceptives provided by a pharmacist. A group or
8individual policy of accident and health insurance or a managed
9care plan that is amended, delivered, issued, or renewed after
10the effective date of this amendatory Act of the 100th General
11Assembly shall provide coverage for patient care services
12provided by a pharmacist for hormonal contraceptives
13assessment and consultation.
 
14    Section 35. The Pharmacy Practice Act is amended by
15changing Section 3 as follows:
 
16    (225 ILCS 85/3)
17    (Section scheduled to be repealed on January 1, 2020)
18    Sec. 3. Definitions. For the purpose of this Act, except
19where otherwise limited therein:
20    (a) "Pharmacy" or "drugstore" means and includes every
21store, shop, pharmacy department, or other place where
22pharmacist care is provided by a pharmacist (1) where drugs,

 

 

10000HB0274ham002- 9 -LRB100 04385 SMS 39068 a

1medicines, or poisons are dispensed, sold or offered for sale
2at retail, or displayed for sale at retail; or (2) where
3prescriptions of physicians, dentists, advanced practice
4registered nurses, physician assistants, veterinarians,
5podiatric physicians, or optometrists, within the limits of
6their licenses, are compounded, filled, or dispensed; or (3)
7which has upon it or displayed within it, or affixed to or used
8in 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
12similar or like import, either in the English language or any
13other language; or (4) where the characteristic prescription
14sign (Rx) or similar design is exhibited; or (5) any store, or
15shop, or other place with respect to which any of the above
16words, objects, signs or designs are used in any advertisement.
17    (b) "Drugs" means and includes (1) articles recognized in
18the official United States Pharmacopoeia/National Formulary
19(USP/NF), or any supplement thereto and being intended for and
20having for their main use the diagnosis, cure, mitigation,
21treatment or prevention of disease in man or other animals, as
22approved by the United States Food and Drug Administration, but
23does not include devices or their components, parts, or
24accessories; and (2) all other articles intended for and having
25for their main use the diagnosis, cure, mitigation, treatment
26or prevention of disease in man or other animals, as approved

 

 

10000HB0274ham002- 10 -LRB100 04385 SMS 39068 a

1by the United States Food and Drug Administration, but does not
2include devices or their components, parts, or accessories; and
3(3) articles (other than food) having for their main use and
4intended to affect the structure or any function of the body of
5man or other animals; and (4) articles having for their main
6use and intended for use as a component or any articles
7specified in clause (1), (2) or (3); but does not include
8devices or their components, parts or accessories.
9    (c) "Medicines" means and includes all drugs intended for
10human or veterinary use approved by the United States Food and
11Drug Administration.
12    (d) "Practice of pharmacy" means:
13        (1) the interpretation and the provision of assistance
14    in the monitoring, evaluation, and implementation of
15    prescription drug orders;
16        (2) the dispensing of prescription drug orders;
17        (3) participation in drug and device selection;
18        (4) drug administration limited to the administration
19    of oral, topical, injectable, and inhalation as follows:
20            (A) in the context of patient education on the
21        proper use or delivery of medications;
22            (B) vaccination of patients 14 years of age and
23        older pursuant to a valid prescription or standing
24        order, by a physician licensed to practice medicine in
25        all its branches, upon completion of appropriate
26        training, including how to address contraindications

 

 

10000HB0274ham002- 11 -LRB100 04385 SMS 39068 a

1        and adverse reactions set forth by rule, with
2        notification to the patient's physician and
3        appropriate record retention, or pursuant to hospital
4        pharmacy and therapeutics committee policies and
5        procedures; and
6            (C) administration of injections of
7        alpha-hydroxyprogesterone caproate, pursuant to a
8        valid prescription, by a physician licensed to
9        practice medicine in all its branches, upon completion
10        of appropriate training, including how to address
11        contraindications and adverse reactions set forth by
12        rule, with notification to the patient's physician and
13        appropriate record retention, or pursuant to hospital
14        pharmacy and therapeutics committee policies and
15        procedures;
16        (5) vaccination of patients ages 10 through 13 limited
17    to the Influenza (inactivated influenza vaccine and live
18    attenuated influenza intranasal vaccine) and Tdap (defined
19    as tetanus, diphtheria, acellular pertussis) vaccines,
20    pursuant to a valid prescription or standing order, by a
21    physician licensed to practice medicine in all its
22    branches, upon completion of appropriate training,
23    including how to address contraindications and adverse
24    reactions set forth by rule, with notification to the
25    patient's physician and appropriate record retention, or
26    pursuant to hospital pharmacy and therapeutics committee

 

 

10000HB0274ham002- 12 -LRB100 04385 SMS 39068 a

1    policies and procedures;
2        (6) drug regimen review;
3        (7) drug or drug-related research;
4        (8) the provision of patient counseling;
5        (9) the practice of telepharmacy;
6        (10) the provision of those acts or services necessary
7    to provide pharmacist care;
8        (11) medication therapy management; and
9        (12) the responsibility for compounding and labeling
10    of drugs and devices (except labeling by a manufacturer,
11    repackager, or distributor of non-prescription drugs and
12    commercially packaged legend drugs and devices), proper
13    and safe storage of drugs and devices, and maintenance of
14    required records; and .
15        (13) the assessment and consultation of patients and
16    dispensing of hormonal contraceptives pursuant to the
17    standing order under Section 2310-700 of the Department of
18    Public Health Powers and Duties Law of the Civil
19    Administrative Code of Illinois.
20    A pharmacist who performs any of the acts defined as the
21practice of pharmacy in this State must be actively licensed as
22a pharmacist under this Act.
23    (e) "Prescription" means and includes any written, oral,
24facsimile, or electronically transmitted order for drugs or
25medical devices, issued by a physician licensed to practice
26medicine in all its branches, dentist, veterinarian, podiatric

 

 

10000HB0274ham002- 13 -LRB100 04385 SMS 39068 a

1physician, or optometrist, within the limits of his or her
2license their licenses, by a physician assistant in accordance
3with subsection (f) of Section 4, or by an advanced practice
4registered nurse in accordance with subsection (g) of Section
54, containing the following: (1) name of the patient; (2) date
6when prescription was issued; (3) name and strength of drug or
7description of the medical device prescribed; and (4) quantity;
8(5) directions for use; (6) prescriber's name, address, and
9signature; and (7) DEA registration number where required, for
10controlled substances. The prescription may, but is not
11required to, list the illness, disease, or condition for which
12the drug or device is being prescribed. DEA registration
13numbers shall not be required on inpatient drug orders.
14    (f) "Person" means and includes a natural person,
15partnership, association, corporation, government entity, or
16any other legal entity.
17    (g) "Department" means the Department of Financial and
18Professional Regulation.
19    (h) "Board of Pharmacy" or "Board" means the State Board of
20Pharmacy of the Department of Financial and Professional
21Regulation.
22    (i) "Secretary" means the Secretary of Financial and
23Professional Regulation.
24    (j) "Drug product selection" means the interchange for a
25prescribed pharmaceutical product in accordance with Section
2625 of this Act and Section 3.14 of the Illinois Food, Drug and

 

 

10000HB0274ham002- 14 -LRB100 04385 SMS 39068 a

1Cosmetic Act.
2    (k) "Inpatient drug order" means an order issued by an
3authorized prescriber for a resident or patient of a facility
4licensed under the Nursing Home Care Act, the ID/DD Community
5Care Act, the MC/DD Act, the Specialized Mental Health
6Rehabilitation Act of 2013, the Hospital Licensing Act, or the
7University of Illinois Hospital Act "An Act in relation to the
8founding and operation of the University of Illinois Hospital
9and the conduct of University of Illinois health care
10programs", approved July 3, 1931, as amended, or a facility
11which is operated by the Department of Human Services (as
12successor to the Department of Mental Health and Developmental
13Disabilities) or the Department of Corrections.
14    (k-5) "Pharmacist" means an individual health care
15professional and provider currently licensed by this State to
16engage in the practice of pharmacy.
17    (l) "Pharmacist in charge" means the licensed pharmacist
18whose name appears on a pharmacy license and who is responsible
19for all aspects of the operation related to the practice of
20pharmacy.
21    (m) "Dispense" or "dispensing" means the interpretation,
22evaluation, and implementation of a prescription drug order,
23including the preparation and delivery of a drug or device to a
24patient or patient's agent in a suitable container
25appropriately labeled for subsequent administration to or use
26by a patient in accordance with applicable State and federal

 

 

10000HB0274ham002- 15 -LRB100 04385 SMS 39068 a

1laws and regulations. "Dispense" or "dispensing" does not mean
2the physical delivery to a patient or a patient's
3representative in a home or institution by a designee of a
4pharmacist or by common carrier. "Dispense" or "dispensing"
5also does not mean the physical delivery of a drug or medical
6device to a patient or patient's representative by a
7pharmacist's designee within a pharmacy or drugstore while the
8pharmacist is on duty and the pharmacy is open.
9    (n) "Nonresident pharmacy" means a pharmacy that is located
10in a state, commonwealth, or territory of the United States,
11other than Illinois, that delivers, dispenses, or distributes,
12through the United States Postal Service, commercially
13acceptable parcel delivery service, or other common carrier, to
14Illinois residents, any substance which requires a
15prescription.
16    (o) "Compounding" means the preparation and mixing of
17components, excluding flavorings, (1) as the result of a
18prescriber's prescription drug order or initiative based on the
19prescriber-patient-pharmacist relationship in the course of
20professional practice or (2) for the purpose of, or incident
21to, research, teaching, or chemical analysis and not for sale
22or dispensing. "Compounding" includes the preparation of drugs
23or devices in anticipation of receiving prescription drug
24orders based on routine, regularly observed dispensing
25patterns. Commercially available products may be compounded
26for dispensing to individual patients only if all of the

 

 

10000HB0274ham002- 16 -LRB100 04385 SMS 39068 a

1following conditions are met: (i) the commercial product is not
2reasonably available from normal distribution channels in a
3timely manner to meet the patient's needs and (ii) the
4prescribing practitioner has requested that the drug be
5compounded.
6    (p) (Blank).
7    (q) (Blank).
8    (r) "Patient counseling" means the communication between a
9pharmacist or a student pharmacist under the supervision of a
10pharmacist and a patient or the patient's representative about
11the patient's medication or device for the purpose of
12optimizing proper use of prescription medications or devices.
13"Patient counseling" may include without limitation (1)
14obtaining a medication history; (2) acquiring a patient's
15allergies and health conditions; (3) facilitation of the
16patient's understanding of the intended use of the medication;
17(4) proper directions for use; (5) significant potential
18adverse events; (6) potential food-drug interactions; and (7)
19the need to be compliant with the medication therapy. A
20pharmacy technician may only participate in the following
21aspects of patient counseling under the supervision of a
22pharmacist: (1) obtaining medication history; (2) providing
23the offer for counseling by a pharmacist or student pharmacist;
24and (3) acquiring a patient's allergies and health conditions.
25    (s) "Patient profiles" or "patient drug therapy record"
26means the obtaining, recording, and maintenance of patient

 

 

10000HB0274ham002- 17 -LRB100 04385 SMS 39068 a

1prescription information, including prescriptions for
2controlled substances, and personal information.
3    (t) (Blank).
4    (u) "Medical device" or "device" means an instrument,
5apparatus, implement, machine, contrivance, implant, in vitro
6reagent, or other similar or related article, including any
7component part or accessory, required under federal law to bear
8the label "Caution: Federal law requires dispensing by or on
9the order of a physician". A seller of goods and services who,
10only for the purpose of retail sales, compounds, sells, rents,
11or leases medical devices shall not, by reasons thereof, be
12required to be a licensed pharmacy.
13    (v) "Unique identifier" means an electronic signature,
14handwritten signature or initials, thumb print, or other
15acceptable biometric or electronic identification process as
16approved by the Department.
17    (w) "Current usual and customary retail price" means the
18price that a pharmacy charges to a non-third-party payor.
19    (x) "Automated pharmacy system" means a mechanical system
20located within the confines of the pharmacy or remote location
21that performs operations or activities, other than compounding
22or administration, relative to storage, packaging, dispensing,
23or distribution of medication, and which collects, controls,
24and maintains all transaction information.
25    (y) "Drug regimen review" means and includes the evaluation
26of prescription drug orders and patient records for (1) known

 

 

10000HB0274ham002- 18 -LRB100 04385 SMS 39068 a

1allergies; (2) drug or potential therapy contraindications;
2(3) reasonable dose, duration of use, and route of
3administration, taking into consideration factors such as age,
4gender, and contraindications; (4) reasonable directions for
5use; (5) potential or actual adverse drug reactions; (6)
6drug-drug interactions; (7) drug-food interactions; (8)
7drug-disease contraindications; (9) therapeutic duplication;
8(10) patient laboratory values when authorized and available;
9(11) proper utilization (including over or under utilization)
10and optimum therapeutic outcomes; and (12) abuse and misuse.
11    (z) "Electronically transmitted prescription" means a
12prescription that is created, recorded, or stored by electronic
13means; issued and validated with an electronic signature; and
14transmitted by electronic means directly from the prescriber to
15a pharmacy. An electronic prescription is not an image of a
16physical prescription that is transferred by electronic means
17from computer to computer, facsimile to facsimile, or facsimile
18to computer.
19    (aa) "Medication therapy management services" means a
20distinct service or group of services offered by licensed
21pharmacists, physicians licensed to practice medicine in all
22its branches, advanced practice registered nurses authorized
23in a written agreement with a physician licensed to practice
24medicine in all its branches, or physician assistants
25authorized in guidelines by a supervising physician that
26optimize therapeutic outcomes for individual patients through

 

 

10000HB0274ham002- 19 -LRB100 04385 SMS 39068 a

1improved medication use. In a retail or other non-hospital
2pharmacy, medication therapy management services shall consist
3of the evaluation of prescription drug orders and patient
4medication records to resolve conflicts with the following:
5        (1) known allergies;
6        (2) drug or potential therapy contraindications;
7        (3) reasonable dose, duration of use, and route of
8    administration, taking into consideration factors such as
9    age, gender, and contraindications;
10        (4) reasonable directions for use;
11        (5) potential or actual adverse drug reactions;
12        (6) drug-drug interactions;
13        (7) drug-food interactions;
14        (8) drug-disease contraindications;
15        (9) identification of therapeutic duplication;
16        (10) patient laboratory values when authorized and
17    available;
18        (11) proper utilization (including over or under
19    utilization) and optimum therapeutic outcomes; and
20        (12) drug abuse and misuse.
21    "Medication therapy management services" includes the
22following:
23        (1) documenting the services delivered and
24    communicating the information provided to patients'
25    prescribers within an appropriate time frame, not to exceed
26    48 hours;

 

 

10000HB0274ham002- 20 -LRB100 04385 SMS 39068 a

1        (2) providing patient counseling designed to enhance a
2    patient's understanding and the appropriate use of his or
3    her medications; and
4        (3) providing information, support services, and
5    resources designed to enhance a patient's adherence with
6    his or her prescribed therapeutic regimens.
7    "Medication therapy management services" may also include
8patient care functions authorized by a physician licensed to
9practice medicine in all its branches for his or her identified
10patient or groups of patients under specified conditions or
11limitations in a standing order from the physician.
12    "Medication therapy management services" in a licensed
13hospital may also include the following:
14        (1) reviewing assessments of the patient's health
15    status; and
16        (2) following protocols of a hospital pharmacy and
17    therapeutics committee with respect to the fulfillment of
18    medication orders.
19    (bb) "Pharmacist care" means the provision by a pharmacist
20of medication therapy management services, with or without the
21dispensing of drugs or devices, intended to achieve outcomes
22that improve patient health, quality of life, and comfort and
23enhance patient safety.
24    (cc) "Protected health information" means individually
25identifiable health information that, except as otherwise
26provided, is:

 

 

10000HB0274ham002- 21 -LRB100 04385 SMS 39068 a

1        (1) transmitted by electronic media;
2        (2) maintained in any medium set forth in the
3    definition of "electronic media" in the federal Health
4    Insurance Portability and Accountability Act; or
5        (3) transmitted or maintained in any other form or
6    medium.
7    "Protected health information" does not include
8individually identifiable health information found in:
9        (1) education records covered by the federal Family
10    Educational Right and Privacy Act; or
11        (2) employment records held by a licensee in its role
12    as an employer.
13    (dd) "Standing order" means a specific order for a patient
14or group of patients issued by a physician licensed to practice
15medicine in all its branches in Illinois.
16    (ee) "Address of record" means the designated address
17recorded by the Department in the applicant's application file
18or licensee's license file maintained by the Department's
19licensure maintenance unit.
20    (ff) "Home pharmacy" means the location of a pharmacy's
21primary operations.
22    (gg) "Email address of record" means the designated email
23address recorded by the Department in the applicant's
24application file or the licensee's license file, as maintained
25by the Department's licensure maintenance unit.
26(Source: P.A. 99-180, eff. 7-29-15; 100-208, eff. 1-1-18;

 

 

10000HB0274ham002- 22 -LRB100 04385 SMS 39068 a

1100-497, eff. 9-8-17; 100-513, eff. 1-1-18; revised 9-29-17.)
 
2    Section 40. The Illinois Public Aid Code is amended by
3adding Section 5-5.12b as follows:
 
4    (305 ILCS 5/5-5.12b new)
5    Sec. 5-5.12b. Coverage for patient care services for
6hormonal contraceptives provided by a pharmacist.
7    (a) Subject to approval by the federal Centers for Medicare
8and Medicaid Services, the medical assistance program,
9including both the fee-for-service and managed care medical
10assistance programs established under this Article, shall
11cover patient care services provided by a pharmacist for
12hormonal contraceptives assessment and consultation.
13    (b) The Department shall establish a fee schedule for
14patient care services provided by a pharmacist for hormonal
15contraceptives assessment and consultation.
16    (c) The rate of reimbursement for patient care services
17provided by a pharmacist for hormonal contraceptives
18assessment and consultation shall be at 85% of the fee schedule
19for physician services by the medical assistance program.
20    (d) A pharmacist must be enrolled in the medical assistance
21program as an ordering and referring provider prior to
22providing hormonal contraceptives assessment and consultation
23that is submitted by a pharmacy or pharmacist provider for
24reimbursement pursuant to this Section.

 

 

10000HB0274ham002- 23 -LRB100 04385 SMS 39068 a

1    (e) The Director shall seek any necessary federal waivers
2or approvals to implement this Section. This Section shall not
3be implemented until the receipt of all necessary federal
4waivers or approvals or until January 1, 2021, whichever comes
5first. If federal approval is not obtained by January 1, 2021,
6the provisions of this Section shall be implemented using State
7funds.
8    (f) This Section does not restrict or prohibit any services
9currently provided by pharmacists as authorized by law,
10including, but not limited to, pharmacist services provided
11under this Code or authorized under the Illinois Title XIX
12State Plan.
13    (g) The Department shall adopt administrative rules for
14this Section as soon as practicable but no later than May 1,
152019.
 
16    Section 99. Effective date. This Act takes effect January
171, 2019.".