Full Text of HR0450 97th General Assembly
HR0450ham003 97TH GENERAL ASSEMBLY |
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| 1 | | AMENDMENT TO HOUSE RESOLUTION 450
| 2 | | AMENDMENT NO. ___. Amend House Resolution 450 by replacing | 3 | | everything after the title with the following:
| 4 | | "WHEREAS, In response to high costs for specialty-tier | 5 | | prescription drugs for chronically ill, insured patients, | 6 | | employer health plans and employer prescription drug plans have | 7 | | increased enrollee cost sharing amounts, instituted | 8 | | coinsurance, and implemented specialty tiers; and | 9 | | WHEREAS, The Medco 2011 Drug Trend Report showed that | 10 | | non-specialty medications grew at 1.1% in 2010 and specialty | 11 | | drugs grew at a pace of 17.4%; and | 12 | | WHEREAS, The price of specialty-tier drugs is often higher | 13 | | than traditional generics or branded medications and can create | 14 | | significant financial pressures on employer health plans, | 15 | | employer prescription drug plans, and individuals who purchase |
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| 1 | | an individual health insurance policy; and | 2 | | WHEREAS, The National Conference of State Legislatures | 3 | | reports that between the years 2000 and 2009, copayments for
| 4 | | insured workers have increased for specialty-tier drugs; and | 5 | | WHEREAS, Medicare has used specialty tiers since 2006 to
| 6 | | help control prescription drug costs on behalf of taxpayers;
| 7 | | and
| 8 | | WHEREAS, Nationally, 11% of employers utilize a | 9 | | coinsurance
or percentage of the cost of fourth-tier or | 10 | | specialty-tier
prescription medications to help control the | 11 | | cost of their
prescription drug benefit plans; and | 12 | | WHEREAS, Specialty-tier medications are often life-saving | 13 | | drugs and include medications for chronic diseases, including | 14 | | certain types of cancer, hemophilia, multiple sclerosis, | 15 | | myositis, neuropathy, arthritis, human immunodeficiency virus, | 16 | | and other diseases and disorders and do not have brand or | 17 | | generic alternatives; and | 18 | | WHEREAS, Step therapy is a strategy offered by employer | 19 | | health plans and employer prescription drug plans to | 20 | | incentivize plan participants to utilize lower cost generics or | 21 | | preferred brand alternatives when available; and
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| 1 | | WHEREAS, A specialty tier is a cost-sharing benefit | 2 | | structure utilized by employer health plans for prescription | 3 | | drugs that requires a consumer for any drug to pay a greater | 4 | | cost than that which applies for a non-preferred brand name | 5 | | drug; and | 6 | | WHEREAS, Specialty tier benefit structures may place | 7 | | financial burdens upon insured individuals with chronic health | 8 | | care issues requiring prescription medication, and may lead to | 9 | | decreased adherence or failure to take medications as | 10 | | prescribed, that may result in acute incidents and negative | 11 | | health outcomes such as doctor visits, emergency room visits, | 12 | | and hospital stays that can be much more expensive; therefore, | 13 | | be it
| 14 | | RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE
| 15 | | NINETY-SEVENTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that
| 16 | | the Department of Insurance shall (1) determine the impact a | 17 | | designed benefit plan that implements coinsurance for | 18 | | prescription medications has on individuals and employer | 19 | | health plans; (2) study the availability of manufacturer | 20 | | discounts and assistance plans to individuals and employers for | 21 | | specialty-tier medications; (3) determine the percentage of | 22 | | small group and large group health plans in this State | 23 | | providing prescription drug benefits and identify plan options |
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| 1 | | used by employer health plans and individuals to assist them to | 2 | | contain the costs of their specialty drug benefits; and (4) | 3 | | identify and evaluate options for reducing any negative impacts | 4 | | of cost sharing, coinsurance, and specialty-tier pricing; and | 5 | | be it further | 6 | | RESOLVED, That the Department of Insurance shall report to
| 7 | | the General Assembly on the first day of November, 2012 on its | 8 | | findings, conclusions, and recommendations; and be it further | 9 | | RESOLVED, That a suitable copy of this resolution be
| 10 | | delivered to the Director of Insurance.".
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