Bill Status of HB3607 100th General Assembly
Short Description: INS CD-DRUG SYNCHRONIZATION
Rep. Marcus C. Evans, Jr.
| 1/8/2019||House||Session Sine Die|
Statutes Amended In Order of Appearance
Synopsis As Introduced
Amends the Illinois Insurance Code. Provides procedures for conducting pharmacy audits under the Third Party Prescription Programs Article. Prohibits an audit entity from using extrapolation to calculate penalties or amounts to be charged back, unless otherwise required by federal requirements. Defines terms. Contains provisions concerning notice of an audit, confidentiality, records, audit reporting, compensation, interest accrual, and appeal of a final audit report. Makes other changes. Provides that all entities providing prescription drug coverage shall permit and apply a prorated daily cost-sharing rate to prescriptions that are dispensed by a pharmacy for less than a 30-day supply if the prescriber or pharmacist indicates the fill or refill could be in the best interest of the patient or is for the purpose of synchronizing the patient's chronic medications. Provides that no entity providing prescription drug coverage shall deny coverage for the dispensing of any drug prescribed for the treatment of a chronic illness that is made in accordance with a plan among the insured, the prescriber, and a pharmacist to synchronize the refilling of multiple prescriptions for the insured. Provides that no entity providing prescription drug coverage shall use payment structures incorporating prorated dispensing fees determined by calculation of the days' supply of medication dispensed. Provides that dispensing fees shall be determined exclusively on the total number of prescriptions dispensed. Provides that the Department of Insurance and the Director shall have the authority to enforce the provisions of the Act and impose financial penalties. Effective immediately.