Sen. Laura M. Murphy

Filed: 5/5/2023

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 2189

2    AMENDMENT NO. ______. Amend House Bill 2189 by replacing
3everything after the enacting clause with the following:
 
4    "Section 1. Short title. This Act may be cited as the
5Access to 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

 

 

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1111-148, and further defined through amendments to that Act
2and regulations issued under that Act.
3    "Pharmacy" means a pharmacy located in this State.
4    "Prescription drug" means a drug that is required by
5federal or State law or rule to be dispensed only by
6prescription or that is restricted to administration only by
7practitioners.
 
8    Section 10. Insulin discount program.
9    (a) The Department shall offer a discount program that
10allows participants to purchase insulin at a discounted,
11post-rebate price.
12    (b) The discount program shall:
13        (1) provide a participant with a card or electronic
14    document that identifies the participant as eligible for
15    the discount;
16        (2) provide a participant with information about
17    pharmacies that will honor the discount;
18        (3) allow a participant to purchase insulin at a
19    discounted, post-rebate price; and
20        (4) provide a participant with instructions to pursue
21    a reimbursement of the purchase price from the
22    participant's health insurer.
23    (c) The discount program shall charge a price for insulin
24that allows the program to retain only enough of any rebate for
25the insulin to make the State risk pool whole for providing

 

 

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1discounted insulin to participants.
 
2    Section 90. The Illinois Insurance Code is amended by
3changing Section 356z.41 as follows:
 
4    (215 ILCS 5/356z.41)
5    Sec. 356z.41. Cost sharing in prescription insulin drugs;
6limits; confidentiality of rebate information.
7    (a) As used in this Section, "prescription insulin drug"
8means a prescription drug that contains insulin and is used to
9control blood glucose levels to treat diabetes but does not
10include an insulin drug that is administered to a patient
11intravenously.
12    (b) This Section applies to a group or individual policy
13of accident and health insurance amended, delivered, issued,
14or renewed on or after the effective date of this amendatory
15Act of the 101st General Assembly.
16    (c) An insurer that provides coverage for prescription
17insulin drugs pursuant to the terms of a health coverage plan
18the insurer offers shall limit the total amount that an
19insured is required to pay for a 30-day supply of covered
20prescription insulin drugs at an amount not to exceed $35
21$100, regardless of the quantity or type of covered
22prescription insulin drug used to fill the insured's
23prescription.
24    (d) Nothing in this Section prevents an insurer from

 

 

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1reducing an insured's cost sharing by an amount greater than
2the amount specified in subsection (c).
3    (e) The Director may use any of the Director's enforcement
4powers to obtain an insurer's compliance with this Section.
5    (f) The Department may adopt rules as necessary to
6implement and administer this Section and to align it with
7federal requirements.
8    (g) On January 1 of each year, the limit on the amount that
9an insured is required to pay for a 30-day supply of a covered
10prescription insulin drug shall increase by a percentage equal
11to the percentage change from the preceding year in the
12medical care component of the Consumer Price Index of the
13Bureau of Labor Statistics of the United States Department of
14Labor.
15(Source: P.A. 101-625, eff. 1-1-21.)
 
16    Section 99. Effective date. This Act takes effect July 1,
172025.".