Bill Status of HB1029  103rd General Assembly


Short Description:  MEDICAID-PHARMACY SERVICES

House Sponsors
Rep. Mary E. Flowers

Last Action
DateChamber Action
  5/19/2023HouseRule 19(a) / Re-referred to Rules Committee

Statutes Amended In Order of Appearance
305 ILCS 5/5-36.3 new
305 ILCS 5/5-36 rep.


Synopsis As Introduced
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services shall transition pharmacy services for managed care enrollees from the State's managed care medical assistance program back to the State's traditional fee-for-service program, thereby assuming direct responsibility for all pharmacy services provided under the Article. Provides that the transition back to a fee-for-service reimbursement model for pharmacy services shall be implemented by the Department upon the expiration of any managed care contracts the Department has with managed care organizations on the effective date of the amendatory Act. Provides that, to ensure managed care enrollees do not experience an interruption in pharmacy services during the transition from managed care to fee-for-service coverage, the Department must, at a minimum, do the following: add an additional pharmacist to its staff; stress-test its existing claims processing system; increase its capacity for prior authorizations; and educate the public and its help desk staff about the change in coverage for pharmacy services. Grants the Department rulemaking authority. Repeals a provision that permits the Department to enter into a contract with a third party on a fee-for-service reimbursement model for the purpose of administering pharmacy benefits for recipients not enrolled in a Medicaid managed care organization. Effective immediately.

Actions 
DateChamber Action
  12/19/2022HousePrefiled with Clerk by Rep. Mary E. Flowers
  1/12/2023HouseFirst Reading
  1/12/2023HouseReferred to Rules Committee
  2/21/2023HouseAssigned to Appropriations-Health & Human Services Committee
  3/9/2023HouseTo Medicaid & Managed Care Subcommittee
  3/10/2023HouseCommittee/3rd Reading Deadline Extended-Rule May 19, 2023
  5/19/2023HouseRule 19(a) / Re-referred to Rules Committee