HB5250 95TH GENERAL ASSEMBLY

LRB095 14905 RAS 40849 b

95TH GENERAL ASSEMBLY
State of Illinois
2007 and 2008
HB5250

Introduced , by Rep. Elaine Nekritz

SYNOPSIS AS INTRODUCED:

215 ILCS 5/512-4.5 new
225 ILCS 85/15.7 new
225 ILCS 120/53 new

Amends the Third Party Prescription Programs Article of the Insurance Code, the Pharmacy Practice Act of 1987, and the Wholesale Drug Distribution Licensing Act. Prohibits the licensure, transference, use, or sale of any records relative to prescription information containing patient-identifiable or prescriber-identifiable data by any licensee or registrant of the Acts for commercial purposes, except for limited purposes or under certain circumstances.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning regulation, which may be known as the Prescription Data Opt-in Act.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Illinois Insurance Code is amended by adding Section 512-4.5 as follows:

(215 ILCS 5/512-4.5 new)

Sec. 512-4.5. License, transfer, use, and sale of prescription information prohibited.

(a) In this Section, "commercial purpose" includes, without limitation, advertising, marketing, promotion, or any activity that could be used to (i) influence sales or market share of a pharmaceutical product, (ii) influence or evaluate the prescribing behavior of an individual health care professional, or (iii) evaluate the effectiveness of a professional pharmaceutical sales force.

(b) Except as provided in subsection (c) of this Section, records relative to prescription information containing patient-identifiable or prescriber-identifiable data may not be licensed, transferred, used, or sold by any registrant under this Act for any commercial purpose, except for any of the following limited purposes:

(1) Pharmacy reimbursement.

(2) Formulary compliance.

(3) Care management.

(4) Utilization review by a health care provider, the patient's insurance provider, or the agent of either.

(5) Health care research.

(6) Any purpose otherwise provided by law.

(c) A prescriber may authorize the transfer, use, or sale of his or her prescriber-identifiable data in writing or electronically if the prescriber has transmitted the authorization to an entity that (i) is involved in the transfer, sale, or use of prescriber-identifiable data, (ii) has designated an address, location, or system to which authorization may be transmitted electronically or in writing, and (iii) has established a process for prescribers to revoke their authorization in writing or electronically upon reasonable notice to the entity.

(d) Nothing in this Section shall prohibit the dispensing of prescription medications to a patient or to the patient's authorized representative; the transmission of prescription information between an authorized prescriber and a licensed pharmacy; the transfer of prescription information between licensed pharmacies; the transfer of prescription records that may occur in the event a pharmacy ownership is changed or transferred; or care management educational communications provided to a patient about the patient's health condition, adherence to a prescribed course of therapy, or other information about the drug being dispensed, treatment options, or clinical trials.

(e) Nothing in this Section shall prohibit the collection, use, transfer, or sale of patient and prescriber de-identified data by zip code, geographic region, or medical specialty for commercial purposes.

Section 10. The Pharmacy Practice Act of 1987 is amended by adding Section 15.7 as follows:

(225 ILCS 85/15.7 new)

Sec. 15.7. License, transfer, use, and sale of prescription information prohibited.

(a) In this Section, "commercial purpose" includes, without limitation, advertising, marketing, promotion, or any activity that could be used to (i) influence sales or market share of a pharmaceutical product, (ii) influence or evaluate the prescribing behavior of an individual health care professional, or (iii) evaluate the effectiveness of a professional pharmaceutical sales force.

(b) Except as provided in subsection (c) of this Section, records relative to prescription information containing patient-identifiable or prescriber-identifiable data may not be licensed, transferred, used, or sold by any licensee or registrant under this Act for any commercial purpose, except for any of the following limited purposes:

(1) Pharmacy reimbursement.

(2) Formulary compliance.

(3) Care management.

(4) Utilization review by a health care provider, the patient's insurance provider, or the agent of either.

(5) Health care research.

(6) Any purpose otherwise provided by law.

(c) A prescriber may authorize the transfer, use, or sale of his or her prescriber-identifiable data in writing or electronically if the prescriber has transmitted the authorization to an entity that (i) is involved in the transfer, sale, or use of prescriber-identifiable data, (ii) has designated an address, location, or system to which authorization may be transmitted electronically or in writing, and (iii) has established a process for prescribers to revoke their authorization in writing or electronically upon reasonable notice to the entity.

(d) Nothing in this Section shall prohibit the dispensing of prescription medications to a patient or to the patient's authorized representative; the transmission of prescription information between an authorized prescriber and a licensed pharmacy; the transfer of prescription information between licensed pharmacies; the transfer of prescription records that may occur in the event a pharmacy ownership is changed or transferred; or care management educational communications provided to a patient about the patient's health condition, adherence to a prescribed course of therapy, or other information about the drug being dispensed, treatment options, or clinical trials.

(e) Nothing in this Section shall prohibit the collection, use, transfer, or sale of patient and prescriber de-identified data by zip code, geographic region, or medical specialty for commercial purposes.

Section 15. The Wholesale Drug Distribution Licensing Act is amended by adding Section 53 as follows:

(225 ILCS 120/53 new)

Sec. 53. License, transfer, use, and sale of prescription information prohibited.

(a) In this Section, "commercial purpose" includes, without limitation, advertising, marketing, promotion, or any activity that could be used to (i) influence sales or market share of a pharmaceutical product, (ii) influence or evaluate the prescribing behavior of an individual health care professional, or (iii) evaluate the effectiveness of a professional pharmaceutical sales force.

(b) Except as provided in subsection (c) of this Section, records relative to prescription information containing patient-identifiable or prescriber-identifiable data may not be licensed, transferred, used, or sold by any licensee under this Act for any commercial purpose, except for any of the following limited purposes:

(1) Pharmacy reimbursement.

(2) Formulary compliance.

(3) Care management.

(4) Utilization review by a health care provider, the patient's insurance provider, or the agent of either.

(5) Health care research.

(6) Any purpose otherwise provided by law.

(c) A prescriber may authorize the transfer, use, or sale of his or her prescriber-identifiable data in writing or electronically if the prescriber has transmitted the authorization to an entity that (i) is involved in the transfer, sale, or use of prescriber-identifiable data, (ii) has designated an address, location, or system to which authorization may be transmitted electronically or in writing, and (iii) has established a process for prescribers to revoke their authorization in writing or electronically upon reasonable notice to the entity.

(d) Nothing in this Section shall prohibit the dispensing of prescription medications to a patient or to the patient's authorized representative; the transmission of prescription information between an authorized prescriber and a licensed pharmacy; the transfer of prescription information between licensed pharmacies; the transfer of prescription records that may occur in the event a pharmacy ownership is changed or transferred; or care management educational communications provided to a patient about the patient's health condition, adherence to a prescribed course of therapy, or other information about the drug being dispensed, treatment options, or clinical trials.

(e) Nothing in this Section shall prohibit the collection, use, transfer, or sale of patient and prescriber de-identified data by zip code, geographic region, or medical specialty for commercial purposes.