Illinois General Assembly - Bill Status for HB4862

Amends the Illinois Insurance Code. Provides that a pharmacy benefit manager or health benefit plan issuer that covers prescription drugs shall provide certain information, including the issuer's patient-specific prescription benefit information, the enrollee's specific eligibility, and cost-sharing information, regarding a covered prescription drug to an enrollee or the enrollee's prescribing provider on request. Sets forth requirements for providing that information. Provides that a pharmacy benefit manager or health benefit plan issuer may not deny or delay a response to a request for that information for the purpose of blocking the release of the information; restrict a prescribing provider from communicating certain information to the enrollee; interfere with, prevent, or materially discourage access to or the exchange or use of the information; or penalize a prescribing provider for disclosing the information or prescribing, administering, or ordering a lower cost or clinically appropriate alternative drug. Amends the State Employees Group Insurance Act of 1971, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, and the Voluntary Health Services Plans Act to require plans issued under those Acts to comply with the requirements. Effective January 1, 2025.

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