Illinois General Assembly - Full Text of HB0135
Illinois General Assembly

  Bills & Resolutions  
  Compiled Statutes  
  Public Acts  
  Legislative Reports  
  IL Constitution  
  Legislative Guide  
  Legislative Glossary  

 Search By Number
 (example: HB0001)
Search Tips

Search By Keyword

Full Text of HB0135  102nd General Assembly

HB0135 102ND GENERAL ASSEMBLY

  
  

 


 
102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB0135

 

Introduced 1/14/2021, by Rep. Michelle Mussman

 

SYNOPSIS AS INTRODUCED:
 
See Index

    Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Provides that the Director of Public Health, if a physician licensed to practice medicine in all its branches in Illinois, shall establish a standing order complete with the issuance of a prescription for a hormonal contraceptive in accordance with the requirements of the provisions. Provides that if the Director is not a physician licensed to practice medicine in all its branches in Illinois, the Medical Director of the Department of Public Health shall establish the standing order. Amends the Illinois Insurance Code. Requires a group or individual policy of accident and health insurance or managed care plan to provide coverage for patient care services provided by a pharmacist. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, and the School Code. Amends the Pharmacy Practice Act. Provides that the definition of "practice of pharmacy" includes the dispensing of hormonal contraceptives pursuant to the standing order under provisions of the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Amends the Illinois Public Aid Code. Requires the medical assistance program to cover patient care services provided by a pharmacist for hormonal contraceptives assessment and consultation. Effective January 1, 2022.


LRB102 02749 BMS 12752 b

FISCAL NOTE ACT MAY APPLY
STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT

 

 

A BILL FOR

 

HB0135LRB102 02749 BMS 12752 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The State Employees Group Insurance Act of 1971
5is amended by changing Section 6.11 as follows:
 
6    (5 ILCS 375/6.11)
7    Sec. 6.11. Required health benefits; Illinois Insurance
8Code requirements. The program of health benefits shall
9provide the post-mastectomy care benefits required to be
10covered by a policy of accident and health insurance under
11Section 356t of the Illinois Insurance Code. The program of
12health benefits shall provide the coverage required under
13Sections 356g, 356g.5, 356g.5-1, 356m, 356u, 356w, 356x,
14356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
15356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
16356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
17356z.36, and 356z.41, and 356z.43 of the Illinois Insurance
18Code. The program of health benefits must comply with Sections
19155.22a, 155.37, 355b, 356z.19, 370c, and 370c.1 and Article
20XXXIIB of the Illinois Insurance Code. The Department of
21Insurance shall enforce the requirements of this Section with
22respect to Sections 370c and 370c.1 of the Illinois Insurance
23Code; all other requirements of this Section shall be enforced

 

 

HB0135- 2 -LRB102 02749 BMS 12752 b

1by the Department of Central Management Services.
2    Rulemaking authority to implement Public Act 95-1045, if
3any, is conditioned on the rules being adopted in accordance
4with all provisions of the Illinois Administrative Procedure
5Act and all rules and procedures of the Joint Committee on
6Administrative Rules; any purported rule not so adopted, for
7whatever reason, is unauthorized.
8(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
9100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
101-1-19; 100-1102, eff. 1-1-19; 100-1170, eff. 6-1-19; 101-13,
11eff. 6-12-19; 101-281, eff. 1-1-20; 101-393, eff. 1-1-20;
12101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
131-1-21.)
 
14    Section 10. The Department of Public Health Powers and
15Duties Law of the Civil Administrative Code of Illinois is
16amended by adding Section 2310-705 as follows:
 
17    (20 ILCS 2310/2310-705 new)
18    Sec. 2310-705. Contraceptive drugs and products; Director
19standing order.
20    (a) As used in this Section:
21    "Hormonal contraceptive" means a prescribed
22medically-acceptable oral drug, transdermal patch, or vaginal
23ring that is approved by the United States Food and Drug
24Administration to prevent pregnancy.

 

 

HB0135- 3 -LRB102 02749 BMS 12752 b

1    "Standing order" has the meaning given to that term in the
2Pharmacy Practice Act.
3    (b) If the Director of Public Health is a physician
4licensed to practice medicine in all its branches in Illinois,
5the Director shall establish a standing order complete with
6the issuance of a prescription for a hormonal contraceptive in
7accordance with this Section. If the Director is not a
8physician licensed to practice medicine in all its branches in
9Illinois, then the Medical Director of the Department of
10Public Health shall establish a standing order in accordance
11with this Section.
12    (c) The standing order, at a minimum, shall comply with
13the following:
14        (1) A pharmacist may dispense a 12-month supply of
15    hormonal contraceptives to a patient.
16        (2) A pharmacist shall have the patient complete the
17    self-screening risk assessment tool. The self-screening
18    risk assessment tool is to be based on the most current
19    version of the United States Medical Eligibility Criteria
20    for Contraceptive Use published by the federal Centers for
21    Disease Control and Prevention.
22        (3) Based upon the results of the self-screening risk
23    assessment and the patient assessment, the pharmacist
24    shall use his or her professional and clinical judgment as
25    to when a patient should be referred to the patient's
26    physician or another health care provider.

 

 

HB0135- 4 -LRB102 02749 BMS 12752 b

1        (4) The pharmacist shall provide, during the patient
2    assessment and consultation, counseling and education
3    about all methods of contraception, including methods not
4    covered under the standing order, and their proper use and
5    effectiveness.
6        (5) The patient consultation shall take place in a
7    private manner consistent with rules adopted by the
8    Department of Financial and Professional Regulation.
9        (6) The Department shall adopt rules under this
10    Section that require a pharmacist to:
11            (A) complete an educational training program
12        accredited by the Accreditation Council for Pharmacy
13        Education and approved by the Department that is
14        related to the patient self-screening risk assessment,
15        patient assessment, contraceptive counseling and
16        education, and dispensation of hormonal
17        contraceptives; and
18            (B) dispense the hormonal contraceptive to the
19        patient as soon as practicable after meeting the
20        requirements of paragraph (2).
21        (7) All State and federal laws governing insurance
22    coverage of contraceptive drugs shall apply to hormonal
23    contraceptives dispensed by a pharmacist under this
24    Section.
 
25    Section 15. The Counties Code is amended by changing

 

 

HB0135- 5 -LRB102 02749 BMS 12752 b

1Section 5-1069.3 as follows:
 
2    (55 ILCS 5/5-1069.3)
3    Sec. 5-1069.3. Required health benefits. If a county,
4including a home rule county, is a self-insurer for purposes
5of providing health insurance coverage for its employees, the
6coverage shall include coverage for the post-mastectomy care
7benefits required to be covered by a policy of accident and
8health insurance under Section 356t and the coverage required
9under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x,
10356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
11356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
12356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41, and 356z.43
13of the Illinois Insurance Code. The coverage shall comply with
14Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
15Insurance Code. The Department of Insurance shall enforce the
16requirements of this Section. The requirement that health
17benefits be covered as provided in this Section is an
18exclusive power and function of the State and is a denial and
19limitation under Article VII, Section 6, subsection (h) of the
20Illinois Constitution. A home rule county to which this
21Section applies must comply with every provision of this
22Section.
23    Rulemaking authority to implement Public Act 95-1045, if
24any, is conditioned on the rules being adopted in accordance
25with all provisions of the Illinois Administrative Procedure

 

 

HB0135- 6 -LRB102 02749 BMS 12752 b

1Act and all rules and procedures of the Joint Committee on
2Administrative Rules; any purported rule not so adopted, for
3whatever reason, is unauthorized.
4(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
5100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
61-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
7eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
8101-625, eff. 1-1-21.)
 
9    Section 20. The Illinois Municipal Code is amended by
10changing Section 10-4-2.3 as follows:
 
11    (65 ILCS 5/10-4-2.3)
12    Sec. 10-4-2.3. Required health benefits. If a
13municipality, including a home rule municipality, is a
14self-insurer for purposes of providing health insurance
15coverage for its employees, the coverage shall include
16coverage for the post-mastectomy care benefits required to be
17covered by a policy of accident and health insurance under
18Section 356t and the coverage required under Sections 356g,
19356g.5, 356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9,
20356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
21356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
22356z.36, and 356z.41, and 356z.43 of the Illinois Insurance
23Code. The coverage shall comply with Sections 155.22a, 355b,
24356z.19, and 370c of the Illinois Insurance Code. The

 

 

HB0135- 7 -LRB102 02749 BMS 12752 b

1Department of Insurance shall enforce the requirements of this
2Section. The requirement that health benefits be covered as
3provided in this is an exclusive power and function of the
4State and is a denial and limitation under Article VII,
5Section 6, subsection (h) of the Illinois Constitution. A home
6rule municipality to which this Section applies must comply
7with every provision of this Section.
8    Rulemaking authority to implement Public Act 95-1045, if
9any, is conditioned on the rules being adopted in accordance
10with all provisions of the Illinois Administrative Procedure
11Act and all rules and procedures of the Joint Committee on
12Administrative Rules; any purported rule not so adopted, for
13whatever reason, is unauthorized.
14(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
15100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
161-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
17eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
18101-625, eff. 1-1-21.)
 
19    Section 25. The School Code is amended by changing Section
2010-22.3f as follows:
 
21    (105 ILCS 5/10-22.3f)
22    Sec. 10-22.3f. Required health benefits. Insurance
23protection and benefits for employees shall provide the
24post-mastectomy care benefits required to be covered by a

 

 

HB0135- 8 -LRB102 02749 BMS 12752 b

1policy of accident and health insurance under Section 356t and
2the coverage required under Sections 356g, 356g.5, 356g.5-1,
3356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.11, 356z.12,
4356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
5356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41, and 356z.43
6of the Illinois Insurance Code. Insurance policies shall
7comply with Section 356z.19 of the Illinois Insurance Code.
8The coverage shall comply with Sections 155.22a, 355b, and
9370c of the Illinois Insurance Code. The Department of
10Insurance shall enforce the requirements of this Section.
11    Rulemaking authority to implement Public Act 95-1045, if
12any, is conditioned on the rules being adopted in accordance
13with all provisions of the Illinois Administrative Procedure
14Act and all rules and procedures of the Joint Committee on
15Administrative Rules; any purported rule not so adopted, for
16whatever reason, is unauthorized.
17(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
18100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
191-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
20eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
21101-625, eff. 1-1-21.)
 
22    Section 30. The Illinois Insurance Code is amended by
23adding Section 356z.43 as follows:
 
24    (215 ILCS 5/356z.43 new)

 

 

HB0135- 9 -LRB102 02749 BMS 12752 b

1    Sec. 356z.43. Coverage for patient care services for
2hormonal contraceptives provided by a pharmacist. A group or
3individual policy of accident and health insurance or a
4managed care plan that is amended, delivered, issued, or
5renewed after the effective date of this amendatory Act of the
6102nd General Assembly shall provide coverage for patient care
7services provided by a pharmacist for hormonal contraceptives
8assessment and consultation.
 
9    Section 35. The Pharmacy Practice Act is amended by
10changing Section 3 as follows:
 
11    (225 ILCS 85/3)
12    (Section scheduled to be repealed on January 1, 2023)
13    Sec. 3. Definitions. For the purpose of this Act, except
14where otherwise limited therein:
15    (a) "Pharmacy" or "drugstore" means and includes every
16store, shop, pharmacy department, or other place where
17pharmacist care is provided by a pharmacist (1) where drugs,
18medicines, or poisons are dispensed, sold or offered for sale
19at retail, or displayed for sale at retail; or (2) where
20prescriptions of physicians, dentists, advanced practice
21registered nurses, physician assistants, veterinarians,
22podiatric physicians, or optometrists, within the limits of
23their licenses, are compounded, filled, or dispensed; or (3)
24which has upon it or displayed within it, or affixed to or used

 

 

HB0135- 10 -LRB102 02749 BMS 12752 b

1in connection with it, a sign bearing the word or words
2"Pharmacist", "Druggist", "Pharmacy", "Pharmaceutical Care",
3"Apothecary", "Drugstore", "Medicine Store", "Prescriptions",
4"Drugs", "Dispensary", "Medicines", or any word or words of
5similar or like import, either in the English language or any
6other language; or (4) where the characteristic prescription
7sign (Rx) or similar design is exhibited; or (5) any store, or
8shop, or other place with respect to which any of the above
9words, objects, signs or designs are used in any
10advertisement.
11    (b) "Drugs" means and includes (1) articles recognized in
12the official United States Pharmacopoeia/National Formulary
13(USP/NF), or any supplement thereto and being intended for and
14having for their main use the diagnosis, cure, mitigation,
15treatment or prevention of disease in man or other animals, as
16approved by the United States Food and Drug Administration,
17but does not include devices or their components, parts, or
18accessories; and (2) all other articles intended for and
19having for their main use the diagnosis, cure, mitigation,
20treatment or prevention of disease in man or other animals, as
21approved by the United States Food and Drug Administration,
22but does not include devices or their components, parts, or
23accessories; and (3) articles (other than food) having for
24their main use and intended to affect the structure or any
25function of the body of man or other animals; and (4) articles
26having for their main use and intended for use as a component

 

 

HB0135- 11 -LRB102 02749 BMS 12752 b

1or any articles specified in clause (1), (2) or (3); but does
2not include devices or their components, parts or accessories.
3    (c) "Medicines" means and includes all drugs intended for
4human or veterinary use approved by the United States Food and
5Drug Administration.
6    (d) "Practice of pharmacy" means:
7        (1) the interpretation and the provision of assistance
8    in the monitoring, evaluation, and implementation of
9    prescription drug orders;
10        (2) the dispensing of prescription drug orders;
11        (3) participation in drug and device selection;
12        (4) drug administration limited to the administration
13    of oral, topical, injectable, and inhalation as follows:
14            (A) in the context of patient education on the
15        proper use or delivery of medications;
16            (B) vaccination of patients 14 years of age and
17        older pursuant to a valid prescription or standing
18        order, by a physician licensed to practice medicine in
19        all its branches, upon completion of appropriate
20        training, including how to address contraindications
21        and adverse reactions set forth by rule, with
22        notification to the patient's physician and
23        appropriate record retention, or pursuant to hospital
24        pharmacy and therapeutics committee policies and
25        procedures;
26            (B-5) following the initial administration of

 

 

HB0135- 12 -LRB102 02749 BMS 12752 b

1        long-acting or extended-release extended release form
2        opioid antagonists by a physician licensed to practice
3        medicine in all its branches, administration of
4        injections of long-acting or extended-release form
5        opioid antagonists for the treatment of substance use
6        disorder, pursuant to a valid prescription by a
7        physician licensed to practice medicine in all its
8        branches, upon completion of appropriate training,
9        including how to address contraindications and adverse
10        reactions, including, but not limited to, respiratory
11        depression and the performance of cardiopulmonary
12        resuscitation, set forth by rule, with notification to
13        the patient's physician and appropriate record
14        retention, or pursuant to hospital pharmacy and
15        therapeutics committee policies and procedures;
16            (C) administration of injections of
17        alpha-hydroxyprogesterone caproate, pursuant to a
18        valid prescription, by a physician licensed to
19        practice medicine in all its branches, upon completion
20        of appropriate training, including how to address
21        contraindications and adverse reactions set forth by
22        rule, with notification to the patient's physician and
23        appropriate record retention, or pursuant to hospital
24        pharmacy and therapeutics committee policies and
25        procedures; and
26            (D) administration of injections of long-term

 

 

HB0135- 13 -LRB102 02749 BMS 12752 b

1        antipsychotic medications pursuant to a valid
2        prescription by a physician licensed to practice
3        medicine in all its branches, upon completion of
4        appropriate training conducted by an Accreditation
5        Council of Pharmaceutical Education accredited
6        provider, including how to address contraindications
7        and adverse reactions set forth by rule, with
8        notification to the patient's physician and
9        appropriate record retention, or pursuant to hospital
10        pharmacy and therapeutics committee policies and
11        procedures.
12        (5) vaccination of patients ages 10 through 13 limited
13    to the Influenza (inactivated influenza vaccine and live
14    attenuated influenza intranasal vaccine) and Tdap (defined
15    as tetanus, diphtheria, acellular pertussis) vaccines,
16    pursuant to a valid prescription or standing order, by a
17    physician licensed to practice medicine in all its
18    branches, upon completion of appropriate training,
19    including how to address contraindications and adverse
20    reactions set forth by rule, with notification to the
21    patient's physician and appropriate record retention, or
22    pursuant to hospital pharmacy and therapeutics committee
23    policies and procedures;
24        (6) drug regimen review;
25        (7) drug or drug-related research;
26        (8) the provision of patient counseling;

 

 

HB0135- 14 -LRB102 02749 BMS 12752 b

1        (9) the practice of telepharmacy;
2        (10) the provision of those acts or services necessary
3    to provide pharmacist care;
4        (11) medication therapy management; and
5        (12) the responsibility for compounding and labeling
6    of drugs and devices (except labeling by a manufacturer,
7    repackager, or distributor of non-prescription drugs and
8    commercially packaged legend drugs and devices), proper
9    and safe storage of drugs and devices, and maintenance of
10    required records; and .
11        (13) the assessment and consultation of patients and
12    dispensing of hormonal contraceptives pursuant to the
13    standing order under Section 2310-705 of the Department of
14    Public Health Powers and Duties Law of the Civil
15    Administrative Code of Illinois.
16    A pharmacist who performs any of the acts defined as the
17practice of pharmacy in this State must be actively licensed
18as a pharmacist under this Act.
19    (e) "Prescription" means and includes any written, oral,
20facsimile, or electronically transmitted order for drugs or
21medical devices, issued by a physician licensed to practice
22medicine in all its branches, dentist, veterinarian, podiatric
23physician, or optometrist, within the limits of his or her
24license, by a physician assistant in accordance with
25subsection (f) of Section 4, or by an advanced practice
26registered nurse in accordance with subsection (g) of Section

 

 

HB0135- 15 -LRB102 02749 BMS 12752 b

14, containing the following: (1) name of the patient; (2) date
2when prescription was issued; (3) name and strength of drug or
3description of the medical device prescribed; and (4)
4quantity; (5) directions for use; (6) prescriber's name,
5address, and signature; and (7) DEA registration number where
6required, for controlled substances. The prescription may, but
7is not required to, list the illness, disease, or condition
8for which the drug or device is being prescribed. DEA
9registration numbers shall not be required on inpatient drug
10orders. A prescription for medication other than controlled
11substances shall be valid for up to 15 months from the date
12issued for the purpose of refills, unless the prescription
13states otherwise.
14    (f) "Person" means and includes a natural person,
15partnership, association, corporation, government entity, or
16any other legal entity.
17    (g) "Department" means the Department of Financial and
18Professional Regulation.
19    (h) "Board of Pharmacy" or "Board" means the State Board
20of Pharmacy of the Department of Financial and Professional
21Regulation.
22    (i) "Secretary" means the Secretary of Financial and
23Professional Regulation.
24    (j) "Drug product selection" means the interchange for a
25prescribed pharmaceutical product in accordance with Section
2625 of this Act and Section 3.14 of the Illinois Food, Drug and

 

 

HB0135- 16 -LRB102 02749 BMS 12752 b

1Cosmetic Act.
2    (k) "Inpatient drug order" means an order issued by an
3authorized prescriber for a resident or patient of a facility
4licensed under the Nursing Home Care Act, the ID/DD Community
5Care Act, the MC/DD Act, the Specialized Mental Health
6Rehabilitation Act of 2013, the Hospital Licensing Act, or the
7University of Illinois Hospital Act, or a facility which is
8operated by the Department of Human Services (as successor to
9the Department of Mental Health and Developmental
10Disabilities) or the Department of Corrections.
11    (k-5) "Pharmacist" means an individual health care
12professional and provider currently licensed by this State to
13engage in the practice of pharmacy.
14    (l) "Pharmacist in charge" means the licensed pharmacist
15whose name appears on a pharmacy license and who is
16responsible for all aspects of the operation related to the
17practice of pharmacy.
18    (m) "Dispense" or "dispensing" means the interpretation,
19evaluation, and implementation of a prescription drug order,
20including the preparation and delivery of a drug or device to a
21patient or patient's agent in a suitable container
22appropriately labeled for subsequent administration to or use
23by a patient in accordance with applicable State and federal
24laws and regulations. "Dispense" or "dispensing" does not mean
25the physical delivery to a patient or a patient's
26representative in a home or institution by a designee of a

 

 

HB0135- 17 -LRB102 02749 BMS 12752 b

1pharmacist or by common carrier. "Dispense" or "dispensing"
2also does not mean the physical delivery of a drug or medical
3device to a patient or patient's representative by a
4pharmacist's designee within a pharmacy or drugstore while the
5pharmacist is on duty and the pharmacy is open.
6    (n) "Nonresident pharmacy" means a pharmacy that is
7located in a state, commonwealth, or territory of the United
8States, other than Illinois, that delivers, dispenses, or
9distributes, through the United States Postal Service,
10commercially acceptable parcel delivery service, or other
11common carrier, to Illinois residents, any substance which
12requires a prescription.
13    (o) "Compounding" means the preparation and mixing of
14components, excluding flavorings, (1) as the result of a
15prescriber's prescription drug order or initiative based on
16the prescriber-patient-pharmacist relationship in the course
17of professional practice or (2) for the purpose of, or
18incident to, research, teaching, or chemical analysis and not
19for sale or dispensing. "Compounding" includes the preparation
20of drugs or devices in anticipation of receiving prescription
21drug orders based on routine, regularly observed dispensing
22patterns. Commercially available products may be compounded
23for dispensing to individual patients only if all of the
24following conditions are met: (i) the commercial product is
25not reasonably available from normal distribution channels in
26a timely manner to meet the patient's needs and (ii) the

 

 

HB0135- 18 -LRB102 02749 BMS 12752 b

1prescribing practitioner has requested that the drug be
2compounded.
3    (p) (Blank).
4    (q) (Blank).
5    (r) "Patient counseling" means the communication between a
6pharmacist or a student pharmacist under the supervision of a
7pharmacist and a patient or the patient's representative about
8the patient's medication or device for the purpose of
9optimizing proper use of prescription medications or devices.
10"Patient counseling" may include without limitation (1)
11obtaining a medication history; (2) acquiring a patient's
12allergies and health conditions; (3) facilitation of the
13patient's understanding of the intended use of the medication;
14(4) proper directions for use; (5) significant potential
15adverse events; (6) potential food-drug interactions; and (7)
16the need to be compliant with the medication therapy. A
17pharmacy technician may only participate in the following
18aspects of patient counseling under the supervision of a
19pharmacist: (1) obtaining medication history; (2) providing
20the offer for counseling by a pharmacist or student
21pharmacist; and (3) acquiring a patient's allergies and health
22conditions.
23    (s) "Patient profiles" or "patient drug therapy record"
24means the obtaining, recording, and maintenance of patient
25prescription information, including prescriptions for
26controlled substances, and personal information.

 

 

HB0135- 19 -LRB102 02749 BMS 12752 b

1    (t) (Blank).
2    (u) "Medical device" or "device" means an instrument,
3apparatus, implement, machine, contrivance, implant, in vitro
4reagent, or other similar or related article, including any
5component part or accessory, required under federal law to
6bear the label "Caution: Federal law requires dispensing by or
7on the order of a physician". A seller of goods and services
8who, only for the purpose of retail sales, compounds, sells,
9rents, or leases medical devices shall not, by reasons
10thereof, be required to be a licensed pharmacy.
11    (v) "Unique identifier" means an electronic signature,
12handwritten signature or initials, thumb print, or other
13acceptable biometric or electronic identification process as
14approved by the Department.
15    (w) "Current usual and customary retail price" means the
16price that a pharmacy charges to a non-third-party payor.
17    (x) "Automated pharmacy system" means a mechanical system
18located within the confines of the pharmacy or remote location
19that performs operations or activities, other than compounding
20or administration, relative to storage, packaging, dispensing,
21or distribution of medication, and which collects, controls,
22and maintains all transaction information.
23    (y) "Drug regimen review" means and includes the
24evaluation of prescription drug orders and patient records for
25(1) known allergies; (2) drug or potential therapy
26contraindications; (3) reasonable dose, duration of use, and

 

 

HB0135- 20 -LRB102 02749 BMS 12752 b

1route of administration, taking into consideration factors
2such as age, gender, and contraindications; (4) reasonable
3directions for use; (5) potential or actual adverse drug
4reactions; (6) drug-drug interactions; (7) drug-food
5interactions; (8) drug-disease contraindications; (9)
6therapeutic duplication; (10) patient laboratory values when
7authorized and available; (11) proper utilization (including
8over or under utilization) and optimum therapeutic outcomes;
9and (12) abuse and misuse.
10    (z) "Electronically transmitted prescription" means a
11prescription that is created, recorded, or stored by
12electronic means; issued and validated with an electronic
13signature; and transmitted by electronic means directly from
14the prescriber to a pharmacy. An electronic prescription is
15not an image of a physical prescription that is transferred by
16electronic means from computer to computer, facsimile to
17facsimile, or facsimile to computer.
18    (aa) "Medication therapy management services" means a
19distinct service or group of services offered by licensed
20pharmacists, physicians licensed to practice medicine in all
21its branches, advanced practice registered nurses authorized
22in a written agreement with a physician licensed to practice
23medicine in all its branches, or physician assistants
24authorized in guidelines by a supervising physician that
25optimize therapeutic outcomes for individual patients through
26improved medication use. In a retail or other non-hospital

 

 

HB0135- 21 -LRB102 02749 BMS 12752 b

1pharmacy, medication therapy management services shall consist
2of the evaluation of prescription drug orders and patient
3medication records to resolve conflicts with the following:
4        (1) known allergies;
5        (2) drug or potential therapy contraindications;
6        (3) reasonable dose, duration of use, and route of
7    administration, taking into consideration factors such as
8    age, gender, and contraindications;
9        (4) reasonable directions for use;
10        (5) potential or actual adverse drug reactions;
11        (6) drug-drug interactions;
12        (7) drug-food interactions;
13        (8) drug-disease contraindications;
14        (9) identification of therapeutic duplication;
15        (10) patient laboratory values when authorized and
16    available;
17        (11) proper utilization (including over or under
18    utilization) and optimum therapeutic outcomes; and
19        (12) drug abuse and misuse.
20    "Medication therapy management services" includes the
21following:
22        (1) documenting the services delivered and
23    communicating the information provided to patients'
24    prescribers within an appropriate time frame, not to
25    exceed 48 hours;
26        (2) providing patient counseling designed to enhance a

 

 

HB0135- 22 -LRB102 02749 BMS 12752 b

1    patient's understanding and the appropriate use of his or
2    her medications; and
3        (3) providing information, support services, and
4    resources designed to enhance a patient's adherence with
5    his or her prescribed therapeutic regimens.
6    "Medication therapy management services" may also include
7patient care functions authorized by a physician licensed to
8practice medicine in all its branches for his or her
9identified patient or groups of patients under specified
10conditions or limitations in a standing order from the
11physician.
12    "Medication therapy management services" in a licensed
13hospital may also include the following:
14        (1) reviewing assessments of the patient's health
15    status; and
16        (2) following protocols of a hospital pharmacy and
17    therapeutics committee with respect to the fulfillment of
18    medication orders.
19    (bb) "Pharmacist care" means the provision by a pharmacist
20of medication therapy management services, with or without the
21dispensing of drugs or devices, intended to achieve outcomes
22that improve patient health, quality of life, and comfort and
23enhance patient safety.
24    (cc) "Protected health information" means individually
25identifiable health information that, except as otherwise
26provided, is:

 

 

HB0135- 23 -LRB102 02749 BMS 12752 b

1        (1) transmitted by electronic media;
2        (2) maintained in any medium set forth in the
3    definition of "electronic media" in the federal Health
4    Insurance Portability and Accountability Act; or
5        (3) transmitted or maintained in any other form or
6    medium.
7    "Protected health information" does not include
8individually identifiable health information found in:
9        (1) education records covered by the federal Family
10    Educational Right and Privacy Act; or
11        (2) employment records held by a licensee in its role
12    as an employer.
13    (dd) "Standing order" means a specific order for a patient
14or group of patients issued by a physician licensed to
15practice medicine in all its branches in Illinois.
16    (ee) "Address of record" means the designated address
17recorded by the Department in the applicant's application file
18or licensee's license file maintained by the Department's
19licensure maintenance unit.
20    (ff) "Home pharmacy" means the location of a pharmacy's
21primary operations.
22    (gg) "Email address of record" means the designated email
23address recorded by the Department in the applicant's
24application file or the licensee's license file, as maintained
25by the Department's licensure maintenance unit.
26(Source: P.A. 100-208, eff. 1-1-18; 100-497, eff. 9-8-17;

 

 

HB0135- 24 -LRB102 02749 BMS 12752 b

1100-513, eff. 1-1-18; 100-804, eff. 1-1-19; 100-863, eff.
28-14-18; 101-349, eff. 1-1-20; revised 8-21-20.)
 
3    Section 40. The Illinois Public Aid Code is amended by
4adding Section 5-5.12d as follows:
 
5    (305 ILCS 5/5-5.12d new)
6    Sec. 5-5.12d. Coverage for patient care services for
7hormonal contraceptives provided by a pharmacist.
8    (a) Subject to approval by the federal Centers for
9Medicare and Medicaid Services, the medical assistance
10program, including both the fee-for-service and managed care
11medical assistance programs established under this Article,
12shall cover patient care services provided by a pharmacist for
13hormonal contraceptives assessment and consultation.
14    (b) The Department shall establish a fee schedule for
15patient care services provided by a pharmacist for hormonal
16contraceptives assessment and consultation.
17    (c) The rate of reimbursement for patient care services
18provided by a pharmacist for hormonal contraceptives
19assessment and consultation shall be at 85% of the fee
20schedule for physician services by the medical assistance
21program.
22    (d) A pharmacist must be enrolled in the medical
23assistance program as an ordering and referring provider prior
24to providing hormonal contraceptives assessment and

 

 

HB0135- 25 -LRB102 02749 BMS 12752 b

1consultation that is submitted by a pharmacy or pharmacist
2provider for reimbursement pursuant to this Section.
3    (e) The Director shall seek any necessary federal waivers
4or approvals to implement this Section. This Section shall not
5be implemented until the receipt of all necessary federal
6waivers or approvals or until January 1, 2024, whichever comes
7first. If federal approval is not obtained by January 1, 2024,
8the provisions of this Section shall be implemented using
9State funds.
10    (f) This Section does not restrict or prohibit any
11services currently provided by pharmacists as authorized by
12law, including, but not limited to, pharmacist services
13provided under this Code or authorized under the Illinois
14Title XIX State Plan.
15    (g) The Department shall adopt administrative rules for
16this Section as soon as practicable but no later than May 1,
172022.
 
18    Section 99. Effective date. This Act takes effect January
191, 2022.

 

 

HB0135- 26 -LRB102 02749 BMS 12752 b

1 INDEX
2 Statutes amended in order of appearance
3    5 ILCS 375/6.11
4    20 ILCS 2310/2310-705 new
5    55 ILCS 5/5-1069.3
6    65 ILCS 5/10-4-2.3
7    105 ILCS 5/10-22.3f
8    215 ILCS 5/356z.43 new
9    225 ILCS 85/3
10    305 ILCS 5/5-5.12d new