Illinois General Assembly - Full Text of HB0135
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Full Text of HB0135  102nd General Assembly

HB0135ham001 102ND GENERAL ASSEMBLY

Rep. Michelle Mussman

Filed: 4/20/2021

 

 


 

 


 
10200HB0135ham001LRB102 02749 BMS 25698 a

1
AMENDMENT TO HOUSE BILL 135

2    AMENDMENT NO. ______. Amend House Bill 135 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The State Employees Group Insurance Act of
51971 is 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,

 

 

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1356z.36, and 356z.41, and 356z.43 of the Illinois Insurance
2Code. The program of health benefits must comply with Sections
3155.22a, 155.37, 355b, 356z.19, 370c, and 370c.1 and Article
4XXXIIB of the Illinois Insurance Code. The Department of
5Insurance shall enforce the requirements of this Section with
6respect to Sections 370c and 370c.1 of the Illinois Insurance
7Code; all other requirements of this Section shall be enforced
8by the Department of Central Management Services.
9    Rulemaking authority to implement Public Act 95-1045, if
10any, is conditioned on the rules being adopted in accordance
11with all provisions of the Illinois Administrative Procedure
12Act and all rules and procedures of the Joint Committee on
13Administrative Rules; any purported rule not so adopted, for
14whatever reason, is unauthorized.
15(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
16100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
171-1-19; 100-1102, eff. 1-1-19; 100-1170, eff. 6-1-19; 101-13,
18eff. 6-12-19; 101-281, eff. 1-1-20; 101-393, eff. 1-1-20;
19101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
201-1-21.)
 
21    Section 10. The Counties Code is amended by changing
22Section 5-1069.3 as follows:
 
23    (55 ILCS 5/5-1069.3)
24    Sec. 5-1069.3. Required health benefits. If a county,

 

 

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1including a home rule county, is a self-insurer for purposes
2of providing health insurance coverage for its employees, the
3coverage shall include coverage for the post-mastectomy care
4benefits required to be covered by a policy of accident and
5health insurance under Section 356t and the coverage required
6under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x,
7356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
8356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
9356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41, and 356z.43
10of the Illinois Insurance Code. The coverage shall comply with
11Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
12Insurance Code. The Department of Insurance shall enforce the
13requirements of this Section. The requirement that health
14benefits be covered as provided in this Section is an
15exclusive power and function of the State and is a denial and
16limitation under Article VII, Section 6, subsection (h) of the
17Illinois Constitution. A home rule county to which this
18Section applies must comply with every provision of this
19Section.
20    Rulemaking authority to implement Public Act 95-1045, if
21any, is conditioned on the rules being adopted in accordance
22with all provisions of the Illinois Administrative Procedure
23Act and all rules and procedures of the Joint Committee on
24Administrative Rules; any purported rule not so adopted, for
25whatever reason, is unauthorized.
26(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;

 

 

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1100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
21-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
3eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
4101-625, eff. 1-1-21.)
 
5    Section 15. The Illinois Municipal Code is amended by
6changing Section 10-4-2.3 as follows:
 
7    (65 ILCS 5/10-4-2.3)
8    Sec. 10-4-2.3. Required health benefits. If a
9municipality, including a home rule municipality, is a
10self-insurer for purposes of providing health insurance
11coverage for its employees, the coverage shall include
12coverage for the post-mastectomy care benefits required to be
13covered by a policy of accident and health insurance under
14Section 356t and the coverage required under Sections 356g,
15356g.5, 356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9,
16356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
17356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
18356z.36, and 356z.41, and 356z.43 of the Illinois Insurance
19Code. The coverage shall comply with Sections 155.22a, 355b,
20356z.19, and 370c of the Illinois Insurance Code. The
21Department of Insurance shall enforce the requirements of this
22Section. The requirement that health benefits be covered as
23provided in this is an exclusive power and function of the
24State and is a denial and limitation under Article VII,

 

 

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1Section 6, subsection (h) of the Illinois Constitution. A home
2rule municipality to which this Section applies must comply
3with every provision of this Section.
4    Rulemaking authority to implement Public Act 95-1045, if
5any, is conditioned on the rules being adopted in accordance
6with all provisions of the Illinois Administrative Procedure
7Act and all rules and procedures of the Joint Committee on
8Administrative Rules; any purported rule not so adopted, for
9whatever reason, is unauthorized.
10(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
11100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
121-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
13eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
14101-625, eff. 1-1-21.)
 
15    Section 20. The School Code is amended by changing Section
1610-22.3f as follows:
 
17    (105 ILCS 5/10-22.3f)
18    Sec. 10-22.3f. Required health benefits. Insurance
19protection and benefits for employees shall provide the
20post-mastectomy care benefits required to be covered by a
21policy of accident and health insurance under Section 356t and
22the coverage required under Sections 356g, 356g.5, 356g.5-1,
23356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.11, 356z.12,
24356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,

 

 

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1356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41, and 356z.43
2of the Illinois Insurance Code. Insurance policies shall
3comply with Section 356z.19 of the Illinois Insurance Code.
4The coverage shall comply with Sections 155.22a, 355b, and
5370c of the Illinois Insurance Code. The Department of
6Insurance shall enforce the requirements of this Section.
7    Rulemaking authority to implement Public Act 95-1045, if
8any, is conditioned on the rules being adopted in accordance
9with all provisions of the Illinois Administrative Procedure
10Act and all rules and procedures of the Joint Committee on
11Administrative Rules; any purported rule not so adopted, for
12whatever reason, is unauthorized.
13(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
14100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
151-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
16eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
17101-625, eff. 1-1-21.)
 
18    Section 25. The Illinois Insurance Code is amended by
19adding Section 356z.43 as follows:
 
20    (215 ILCS 5/356z.43 new)
21    Sec. 356z.43. Coverage for patient care services for
22hormonal contraceptives provided by a pharmacist. A group or
23individual policy of accident and health insurance or a
24managed care plan that is amended, delivered, issued, or

 

 

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1renewed after the effective date of this amendatory Act of the
2102nd General Assembly shall provide coverage for patient care
3services provided by a pharmacist for hormonal contraceptives
4assessment and consultation.
 
5    Section 30. The Pharmacy Practice Act is amended by
6changing Section 3 and by adding Section 43 as follows:
 
7    (225 ILCS 85/3)
8    (Section scheduled to be repealed on January 1, 2023)
9    Sec. 3. Definitions. For the purpose of this Act, except
10where otherwise limited therein:
11    (a) "Pharmacy" or "drugstore" means and includes every
12store, shop, pharmacy department, or other place where
13pharmacist care is provided by a pharmacist (1) where drugs,
14medicines, or poisons are dispensed, sold or offered for sale
15at retail, or displayed for sale at retail; or (2) where
16prescriptions of physicians, dentists, advanced practice
17registered nurses, physician assistants, veterinarians,
18podiatric physicians, or optometrists, within the limits of
19their licenses, are compounded, filled, or dispensed; or (3)
20which has upon it or displayed within it, or affixed to or used
21in connection with it, a sign bearing the word or words
22"Pharmacist", "Druggist", "Pharmacy", "Pharmaceutical Care",
23"Apothecary", "Drugstore", "Medicine Store", "Prescriptions",
24"Drugs", "Dispensary", "Medicines", or any word or words of

 

 

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

 

 

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1Drug Administration.
2    (d) "Practice of pharmacy" means:
3        (1) the interpretation and the provision of assistance
4    in the monitoring, evaluation, and implementation of
5    prescription drug orders;
6        (2) the dispensing of prescription drug orders;
7        (3) participation in drug and device selection;
8        (4) drug administration limited to the administration
9    of oral, topical, injectable, and inhalation as follows:
10            (A) in the context of patient education on the
11        proper use or delivery of medications;
12            (B) vaccination of patients 14 years of age and
13        older pursuant to a valid prescription or standing
14        order, by a physician licensed to practice medicine in
15        all its branches, upon completion of appropriate
16        training, including how to address contraindications
17        and adverse reactions set forth by rule, with
18        notification to the patient's physician and
19        appropriate record retention, or pursuant to hospital
20        pharmacy and therapeutics committee policies and
21        procedures;
22            (B-5) following the initial administration of
23        long-acting or extended-release extended release form
24        opioid antagonists by a physician licensed to practice
25        medicine in all its branches, administration of
26        injections of long-acting or extended-release form

 

 

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

 

 

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

 

 

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

 

 

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1address, and signature; and (7) DEA registration number where
2required, for controlled substances. The prescription may, but
3is not required to, list the illness, disease, or condition
4for which the drug or device is being prescribed. DEA
5registration numbers shall not be required on inpatient drug
6orders. A prescription for medication other than controlled
7substances shall be valid for up to 15 months from the date
8issued for the purpose of refills, unless the prescription
9states otherwise.
10    (f) "Person" means and includes a natural person,
11partnership, association, corporation, government entity, or
12any other legal entity.
13    (g) "Department" means the Department of Financial and
14Professional Regulation.
15    (h) "Board of Pharmacy" or "Board" means the State Board
16of Pharmacy of the Department of Financial and Professional
17Regulation.
18    (i) "Secretary" means the Secretary of Financial and
19Professional Regulation.
20    (j) "Drug product selection" means the interchange for a
21prescribed pharmaceutical product in accordance with Section
2225 of this Act and Section 3.14 of the Illinois Food, Drug and
23Cosmetic Act.
24    (k) "Inpatient drug order" means an order issued by an
25authorized prescriber for a resident or patient of a facility
26licensed under the Nursing Home Care Act, the ID/DD Community

 

 

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

 

 

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

 

 

10200HB0135ham001- 16 -LRB102 02749 BMS 25698 a

1    (r) "Patient counseling" means the communication between a
2pharmacist or a student pharmacist under the supervision of a
3pharmacist and a patient or the patient's representative about
4the patient's medication or device for the purpose of
5optimizing proper use of prescription medications or devices.
6"Patient counseling" may include without limitation (1)
7obtaining a medication history; (2) acquiring a patient's
8allergies and health conditions; (3) facilitation of the
9patient's understanding of the intended use of the medication;
10(4) proper directions for use; (5) significant potential
11adverse events; (6) potential food-drug interactions; and (7)
12the need to be compliant with the medication therapy. A
13pharmacy technician may only participate in the following
14aspects of patient counseling under the supervision of a
15pharmacist: (1) obtaining medication history; (2) providing
16the offer for counseling by a pharmacist or student
17pharmacist; and (3) acquiring a patient's allergies and health
18conditions.
19    (s) "Patient profiles" or "patient drug therapy record"
20means the obtaining, recording, and maintenance of patient
21prescription information, including prescriptions for
22controlled substances, and personal information.
23    (t) (Blank).
24    (u) "Medical device" or "device" means an instrument,
25apparatus, implement, machine, contrivance, implant, in vitro
26reagent, or other similar or related article, including any

 

 

10200HB0135ham001- 17 -LRB102 02749 BMS 25698 a

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

 

 

10200HB0135ham001- 18 -LRB102 02749 BMS 25698 a

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

 

 

10200HB0135ham001- 19 -LRB102 02749 BMS 25698 a

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

 

 

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

 

 

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1        (3) transmitted or maintained in any other form or
2    medium.
3    "Protected health information" does not include
4individually identifiable health information found in:
5        (1) education records covered by the federal Family
6    Educational Right and Privacy Act; or
7        (2) employment records held by a licensee in its role
8    as an employer.
9    (dd) "Standing order" means a specific order for a patient
10or group of patients issued by a physician licensed to
11practice medicine in all its branches in Illinois.
12    (ee) "Address of record" means the designated address
13recorded by the Department in the applicant's application file
14or licensee's license file maintained by the Department's
15licensure maintenance unit.
16    (ff) "Home pharmacy" means the location of a pharmacy's
17primary operations.
18    (gg) "Email address of record" means the designated email
19address recorded by the Department in the applicant's
20application file or the licensee's license file, as maintained
21by the Department's licensure maintenance unit.
22(Source: P.A. 100-208, eff. 1-1-18; 100-497, eff. 9-8-17;
23100-513, eff. 1-1-18; 100-804, eff. 1-1-19; 100-863, eff.
248-14-18; 101-349, eff. 1-1-20; revised 8-21-20.)
 
25    (225 ILCS 85/43 new)

 

 

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1    Sec. 43. Dispensation of hormonal contraceptives.
2    (a) The dispensing of hormonal contraceptives to a patient
3shall be pursuant to a valid prescription or standing order by
4a physician licensed to practice medicine in all its branches
5or the medical director of a local health department, pursuant
6to the following:
7        (1) a pharmacist may dispense no more than a 12-month
8    supply of hormonal contraceptives to a patient;
9        (2) a pharmacist must complete an educational training
10    program accredited by the Accreditation Council for
11    Pharmacy Education and approved by the Department that is
12    related to the patient self-screening risk assessment,
13    patient assessment contraceptive counseling and education,
14    and dispensation of hormonal contraceptives;
15        (3) a pharmacist shall have the patient complete the
16    self-screening risk assessment tool; the self-screening
17    risk assessment tool is to be based on the most current
18    version of the United States Medical Eligibility Criteria
19    for Contraceptive Use published by the federal Centers for
20    Disease Control and Prevention;
21        (4) based upon the results of the self-screening risk
22    assessment and the patient assessment, the pharmacist
23    shall use his or her professional and clinical judgment as
24    to when a patient should be referred to the patient's
25    physician or another health care provider;
26        (5) a pharmacist shall provide, during the patient

 

 

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1    assessment and consultation, counseling and education
2    about all methods of contraception, including methods not
3    covered under the standing order, and their proper use and
4    effectiveness;
5        (6) the patient consultation shall take place in a
6    private manner; and
7        (7) a pharmacist and pharmacy must maintain
8    appropriate records.
9    (b) The Department may adopt rules to implement this
10Section.
11    (c) Nothing in this Section shall be interpreted to
12require a pharmacist to dispense hormonal contraception under
13a standing order issued by a physician licensed to practice
14medicine in all its branches, the medical director of a local
15health department, or the Medical Director of the Department
16of Public Health.
 
17    Section 35. The Illinois Public Aid Code is amended by
18adding Section 5-5.12d as follows:
 
19    (305 ILCS 5/5-5.12d new)
20    Sec. 5-5.12d. Coverage for patient care services for
21hormonal contraceptives provided by a pharmacist.
22    (a) Subject to approval by the federal Centers for
23Medicare and Medicaid Services, the medical assistance
24program, including both the fee-for-service and managed care

 

 

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1medical assistance programs established under this Article,
2shall cover patient care services provided by a pharmacist for
3hormonal contraceptives assessment and consultation.
4    (b) The Department shall establish a fee schedule for
5patient care services provided by a pharmacist for hormonal
6contraceptives assessment and consultation.
7    (c) The rate of reimbursement for patient care services
8provided by a pharmacist for hormonal contraceptives
9assessment and consultation shall be at 85% of the fee
10schedule for physician services by the medical assistance
11program.
12    (d) A pharmacist must be enrolled in the medical
13assistance program as an ordering and referring provider prior
14to providing hormonal contraceptives assessment and
15consultation that is submitted by a pharmacy or pharmacist
16provider for reimbursement pursuant to this Section.
17    (e) The Department shall apply for any necessary federal
18waivers or approvals to implement this Section by January 1,
192022.
20    (f) This Section does not restrict or prohibit any
21services currently provided by pharmacists as authorized by
22law, including, but not limited to, pharmacist services
23provided under this Code or authorized under the Illinois
24Title XIX State Plan.
25    (g) The Department shall submit to the Joint Committee on
26Administrative Rules administrative rules for this Section as

 

 

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1soon as practicable but no later than 6 months after federal
2approval is received.
 
3    Section 99. Effective date. This Act takes effect January
41, 2022.".