Illinois General Assembly - Bill Status for HB5614
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 Bill Status of HB5614  95th General Assembly

Short Description:  PHARMACY BENEFIT MANAGER LIC

House Sponsors
Rep. Dan Reitz - Thomas Holbrook - Brandon W. Phelps - Patrick J Verschoore - Robert W. Pritchard, Gary Hannig, Robert Rita, David E. Miller, Linda Chapa LaVia, Franco Coladipietro, David Reis, Harry R. Ramey, Jr. and Jim Watson

Senate Sponsors
(Sen. John J. Cullerton)

Last Action
DateChamber Action
  1/13/2009HouseSession Sine Die

Statutes Amended In Order of Appearance
215 ILCS 5/Art. XXXI.5 heading
215 ILCS 5/512-1from Ch. 73, par. 1065.59-1
215 ILCS 5/512-2from Ch. 73, par. 1065.59-2
215 ILCS 5/512-3from Ch. 73, par. 1065.59-3
215 ILCS 5/512-4from Ch. 73, par. 1065.59-4
215 ILCS 5/512-4.5 new
215 ILCS 5/512-5from Ch. 73, par. 1065.59-5
215 ILCS 5/512-6from Ch. 73, par. 1065.59-6
215 ILCS 5/512-7from Ch. 73, par. 1065.59-7
215 ILCS 5/512-8from Ch. 73, par. 1065.59-8
215 ILCS 5/512-9from Ch. 73, par. 1065.59-9
215 ILCS 5/512-10from Ch. 73, par. 1065.59-10
215 ILCS 5/512-11 new
215 ILCS 5/512-12 new
215 ILCS 5/512-13 new
215 ILCS 5/512-14 new
215 ILCS 5/512-15 new
215 ILCS 5/512-16 new
215 ILCS 5/512-17 new


Synopsis As Introduced
Amends the Third Party Prescription Programs Article of the Insurance Code to change the name of the Article to the Pharmacy Benefits Management Programs Law. Provides for the registration of all pharmacy benefits management programs and pharmacy benefits managers (PBMs) doing business in the State with the Director of the Division of Insurance of the Department of Financial and Professional Regulation. Creates the Advisory Council on Pharmacy Benefits Managers. Makes changes concerning fiduciary and bonding, notice, and contractual requirements, cancellation procedures, denial of payment, and failure to register. Sets forth provisions concerning drug substitution, pricing, claims, maximum allowable cost (MAC) adjustments, audit standards, contact of covered persons, record keeping, information sharing with out-of-network pharmacies, prohibitions, the collection and payment of taxes and fees, and failure to comply. Grants rulemaking authority to the Director of the Division of Insurance. Effective immediately.

House Committee Amendment No. 1
Deletes reference to:
215 ILCS 5/Art. XXXI.5 heading
215 ILCS 5/512-1from Ch. 73, par. 1065.59-1
215 ILCS 5/512-2from Ch. 73, par. 1065.59-2
215 ILCS 5/512-4.5 new
215 ILCS 5/512-6from Ch. 73, par. 1065.59-6
215 ILCS 5/512-7from Ch. 73, par. 1065.59-7
215 ILCS 5/512-8from Ch. 73, par. 1065.59-8
215 ILCS 5/512-9from Ch. 73, par. 1065.59-9
215 ILCS 5/512-10from Ch. 73, par. 1065.59-10
215 ILCS 5/512-11 new
215 ILCS 5/512-12 new
215 ILCS 5/512-13 new
215 ILCS 5/512-14 new
215 ILCS 5/512-15 new
215 ILCS 5/512-16 new
215 ILCS 5/512-17 new

Deletes everything after the enacting clause. Amends the Third Party Prescription Programs Article of the Illinois Insurance Code. Provides that references throughout the Article to "Director" mean the Director of the Division of Insurance of the Department of Financial and Professional Regulation and that references to "Division" mean the Division of Insurance of the Department.

Senate Committee Amendment No. 1
Adds reference to:
215 ILCS 5/Art. XXXI.5 heading
215 ILCS 5/512-1from Ch. 73, par. 1065.59-1
215 ILCS 5/512-2from Ch. 73, par. 1065.59-2
215 ILCS 5/512-6from Ch. 73, par. 1065.59-6
215 ILCS 5/512-7from Ch. 73, par. 1065.59-7
215 ILCS 5/512-7.5 new
215 ILCS 5/512-7.10 new
215 ILCS 5/512-8from Ch. 73, par. 1065.59-8
215 ILCS 5/512-9from Ch. 73, par. 1065.59-9
215 ILCS 5/512-10from Ch. 73, par. 1065.59-10
215 ILCS 5/512-11 new
215 ILCS 5/512-12 new

Deletes everything after the enacting clause. Amends the Third Party Prescription Programs Article of the Insurance Code to change the name of the Article to the Pharmacy Benefits Management Programs Law. Provides for the licensure of all pharmacy benefits management programs and pharmacy benefits managers (PBMs) doing business in the State with the Director of the Division of Insurance of the Department of Financial and Professional Regulation. Removes certain fiduciary and bonding requirements. Makes changes concerning contractual provisions, cancellation procedures, and denial of payment. Adds provisions concerning disclosures, recoupment and audits, and the examination of business and affairs. Provides that certain provisions of the Law do not apply to licensed insurance companies, Health Maintenance Organizations, Limited Health Services Organizations, and Voluntary Health Services Plans.

Actions 
DateChamber Action
  2/15/2008HouseFiled with the Clerk by Rep. Dan Reitz
  2/15/2008HouseFirst Reading
  2/15/2008HouseReferred to Rules Committee
  2/20/2008HouseAssigned to State Government Administration Committee
  2/26/2008HouseAdded Chief Co-Sponsor Rep. Thomas Holbrook
  2/27/2008HouseAdded Chief Co-Sponsor Rep. Brandon W. Phelps
  2/27/2008HouseAdded Chief Co-Sponsor Rep. Patrick J Verschoore
  2/27/2008HouseAdded Chief Co-Sponsor Rep. Robert W. Pritchard
  2/27/2008HouseAdded Co-Sponsor Rep. Gary Hannig
  2/28/2008HouseAdded Co-Sponsor Rep. Robert Rita
  2/28/2008HouseAdded Co-Sponsor Rep. David E. Miller
  2/28/2008HouseAdded Co-Sponsor Rep. Linda Chapa LaVia
  3/5/2008HouseHouse Committee Amendment No. 1 Filed with Clerk by State Government Administration Committee
  3/5/2008HouseHouse Committee Amendment No. 1 Adopted in State Government Administration Committee; by Voice Vote
  3/5/2008HouseDo Pass as Amended / Short Debate State Government Administration Committee; 013-000-000
  3/6/2008HousePlaced on Calendar 2nd Reading - Short Debate
  3/6/2008HouseAdded Co-Sponsor Rep. Franco Coladipietro
  3/6/2008HouseAdded Co-Sponsor Rep. David Reis
  3/6/2008HouseAdded Co-Sponsor Rep. Harry R. Ramey, Jr.
  3/13/2008HouseSecond Reading - Short Debate
  3/13/2008HousePlaced on Calendar Order of 3rd Reading - Short Debate
  3/17/2008HouseAdded Co-Sponsor Rep. Jim Watson
  4/1/2008HouseThird Reading - Short Debate - Passed 106-000-002
  4/2/2008SenateArrive in Senate
  4/2/2008SenatePlaced on Calendar Order of First Reading
  4/3/2008SenateChief Senate Sponsor Sen. John J. Cullerton
  4/3/2008SenateFirst Reading
  4/3/2008SenateReferred to Rules
  4/17/2008SenateAssigned to Licensed Activities
  5/8/2008SenatePostponed - Licensed Activities
  5/13/2008SenateSenate Committee Amendment No. 1 Filed with Secretary by Sen. John J. Cullerton
  5/13/2008SenateSenate Committee Amendment No. 1 Referred to Rules
  5/14/2008SenateSenate Committee Amendment No. 1 Rules Refers to Licensed Activities
  5/14/2008SenateSenate Committee Amendment No. 1 Adopted
  5/15/2008SenateHeld in Licensed Activities
  5/15/2008SenateRule 2-10 Committee Deadline Established As May 22, 2008; Substantive House Bills Out of Committee
  7/1/2008SenatePursuant to Senate Rule 3-9(b) / Referred to Rules
  1/13/2009HouseSession Sine Die

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