HB2189 EnrolledLRB103 24836 BMS 51168 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. Short title. This Act may be cited as the Access
5to Affordable Insulin Act.
 
6    Section 5. Definitions. As used in this Act:
7    "Department" means the Department of Central Management
8Services.
9    "Director" means the Director of Central Management
10Services.
11    "Insulin" means a prescription drug that contains insulin.
12    "Manufacturer" means a manufacturer engaged in the
13manufacturing of insulin that is self-administered on an
14outpatient basis.
15    "Navigator" has the meaning described in Section 1311(i)
16of the Patient Protection and Affordable Care Act, Public Law
17111-148, and further defined through amendments to that Act
18and regulations issued under that Act.
19    "Pharmacy" means a pharmacy located in this State.
20    "Prescription drug" means a drug that is required by
21federal or State law or rule to be dispensed only by
22prescription or that is restricted to administration only by
23practitioners.
 

 

 

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1    Section 10. Insulin discount program.
2    (a) The Department shall offer a discount program that
3allows participants to purchase insulin at a discounted,
4post-rebate price.
5    (b) The discount program shall:
6        (1) provide a participant with a card or electronic
7    document that identifies the participant as eligible for
8    the discount;
9        (2) provide a participant with information about
10    pharmacies that will honor the discount;
11        (3) allow a participant to purchase insulin at a
12    discounted, post-rebate price; and
13        (4) provide a participant with instructions to pursue
14    a reimbursement of the purchase price from the
15    participant's health insurer.
16    (c) The discount program shall charge a price for insulin
17that allows the program to retain only enough of any rebate for
18the insulin to make the State risk pool whole for providing
19discounted insulin to participants.
 
20    Section 90. The Illinois Insurance Code is amended by
21changing Section 356z.41 as follows:
 
22    (215 ILCS 5/356z.41)
23    Sec. 356z.41. Cost sharing in prescription insulin drugs;

 

 

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1limits; confidentiality of rebate information.
2    (a) As used in this Section, "prescription insulin drug"
3means a prescription drug that contains insulin and is used to
4control blood glucose levels to treat diabetes but does not
5include an insulin drug that is administered to a patient
6intravenously.
7    (b) This Section applies to a group or individual policy
8of accident and health insurance amended, delivered, issued,
9or renewed on or after the effective date of this amendatory
10Act of the 101st General Assembly.
11    (c) An insurer that provides coverage for prescription
12insulin drugs pursuant to the terms of a health coverage plan
13the insurer offers shall limit the total amount that an
14insured is required to pay for a 30-day supply of covered
15prescription insulin drugs at an amount not to exceed $35
16$100, regardless of the quantity or type of covered
17prescription insulin drug used to fill the insured's
18prescription.
19    (d) Nothing in this Section prevents an insurer from
20reducing an insured's cost sharing by an amount greater than
21the amount specified in subsection (c).
22    (e) The Director may use any of the Director's enforcement
23powers to obtain an insurer's compliance with this Section.
24    (f) The Department may adopt rules as necessary to
25implement and administer this Section and to align it with
26federal requirements.

 

 

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1    (g) On January 1 of each year, the limit on the amount that
2an insured is required to pay for a 30-day supply of a covered
3prescription insulin drug shall increase by a percentage equal
4to the percentage change from the preceding year in the
5medical care component of the Consumer Price Index of the
6Bureau of Labor Statistics of the United States Department of
7Labor.
8(Source: P.A. 101-625, eff. 1-1-21.)
 
9    Section 99. Effective date. This Act takes effect July 1,
102025.