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

HB0135ham002 102ND GENERAL ASSEMBLY

Rep. Michelle Mussman

Filed: 4/20/2021

 

 


 

 


 
10200HB0135ham002LRB102 02749 BMS 25625 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 Department of Public Health Powers and
22Duties Law of the Civil Administrative Code of Illinois is
23amended by adding Section 2310-705 as follows:
 
24    (20 ILCS 2310/2310-705 new)

 

 

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1    Sec. 2310-705. Contraceptive drugs and products; Director
2standing order.
3    (a) As used in this Section:
4    "Hormonal contraceptive" means a prescribed
5medically-acceptable oral drug, transdermal patch, or vaginal
6ring that is approved by the United States Food and Drug
7Administration to prevent pregnancy.
8    "Standing order" has the meaning given to that term in the
9Pharmacy Practice Act.
10    (b) If the Director of Public Health is a physician
11licensed to practice medicine in all its branches in Illinois,
12the Director shall establish a standing order complete with
13the issuance of a prescription for a hormonal contraceptive in
14accordance with this Section. If the Director is not a
15physician licensed to practice medicine in all its branches in
16Illinois, then the Medical Director of the Department of
17Public Health shall establish a standing order in accordance
18with this Section.
19    (c) The standing order, at a minimum, shall comply with
20the following:
21        (1) A pharmacist may dispense a 12-month supply of
22    hormonal contraceptives to a patient.
23        (2) A pharmacist shall have the patient complete the
24    self-screening risk assessment tool. The self-screening
25    risk assessment tool is to be based on the most current
26    version of the United States Medical Eligibility Criteria

 

 

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1    for Contraceptive Use published by the federal Centers for
2    Disease Control and Prevention.
3        (3) Based upon the results of the self-screening risk
4    assessment and the patient assessment, the pharmacist
5    shall use his or her professional and clinical judgment as
6    to when a patient should be referred to the patient's
7    physician or another health care provider.
8        (4) The pharmacist shall provide, during the patient
9    assessment and consultation, counseling and education
10    about all methods of contraception, including methods not
11    covered under the standing order, and their proper use and
12    effectiveness.
13        (5) The patient consultation shall take place in a
14    private manner consistent with rules adopted by the
15    Department of Financial and Professional Regulation.
16        (6) The Department shall adopt rules under this
17    Section that require a pharmacist to:
18            (A) complete an educational training program
19        accredited by the Accreditation Council for Pharmacy
20        Education and approved by the Department that is
21        related to the patient self-screening risk assessment,
22        patient assessment, contraceptive counseling and
23        education, and dispensation of hormonal
24        contraceptives; and
25            (B) dispense the hormonal contraceptive to the
26        patient as soon as practicable after meeting the

 

 

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1        requirements of paragraph (2).
2        (7) All State and federal laws governing insurance
3    coverage of contraceptive drugs shall apply to hormonal
4    contraceptives dispensed by a pharmacist under this
5    Section.
 
6    Section 15. The Counties Code is amended by changing
7Section 5-1069.3 as follows:
 
8    (55 ILCS 5/5-1069.3)
9    Sec. 5-1069.3. Required health benefits. If a county,
10including a home rule county, is a self-insurer for purposes
11of providing health insurance coverage for its employees, the
12coverage shall include coverage for the post-mastectomy care
13benefits required to be covered by a policy of accident and
14health insurance under Section 356t and the coverage required
15under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x,
16356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
17356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
18356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41, and 356z.43
19of the Illinois Insurance Code. The coverage shall comply with
20Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
21Insurance Code. The Department of Insurance shall enforce the
22requirements of this Section. The requirement that health
23benefits be covered as provided in this Section is an
24exclusive power and function of the State and is a denial and

 

 

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1limitation under Article VII, Section 6, subsection (h) of the
2Illinois Constitution. A home rule county to which this
3Section applies must comply with every provision of this
4Section.
5    Rulemaking authority to implement Public Act 95-1045, if
6any, is conditioned on the rules being adopted in accordance
7with all provisions of the Illinois Administrative Procedure
8Act and all rules and procedures of the Joint Committee on
9Administrative Rules; any purported rule not so adopted, for
10whatever reason, is unauthorized.
11(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
12100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
131-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
14eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
15101-625, eff. 1-1-21.)
 
16    Section 20. The Illinois Municipal Code is amended by
17changing Section 10-4-2.3 as follows:
 
18    (65 ILCS 5/10-4-2.3)
19    Sec. 10-4-2.3. Required health benefits. If a
20municipality, including a home rule municipality, is a
21self-insurer for purposes of providing health insurance
22coverage for its employees, the coverage shall include
23coverage for the post-mastectomy care benefits required to be
24covered by a policy of accident and health insurance under

 

 

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1Section 356t and the coverage required under Sections 356g,
2356g.5, 356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9,
3356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
4356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
5356z.36, and 356z.41, and 356z.43 of the Illinois Insurance
6Code. The coverage shall comply with Sections 155.22a, 355b,
7356z.19, and 370c of the Illinois Insurance Code. The
8Department of Insurance shall enforce the requirements of this
9Section. The requirement that health benefits be covered as
10provided in this is an exclusive power and function of the
11State and is a denial and limitation under Article VII,
12Section 6, subsection (h) of the Illinois Constitution. A home
13rule municipality to which this Section applies must comply
14with every provision of this Section.
15    Rulemaking authority to implement Public Act 95-1045, if
16any, is conditioned on the rules being adopted in accordance
17with all provisions of the Illinois Administrative Procedure
18Act and all rules and procedures of the Joint Committee on
19Administrative Rules; any purported rule not so adopted, for
20whatever reason, is unauthorized.
21(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
22100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
231-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
24eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
25101-625, eff. 1-1-21.)
 

 

 

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1    Section 25. The School Code is amended by changing Section
210-22.3f as follows:
 
3    (105 ILCS 5/10-22.3f)
4    Sec. 10-22.3f. Required health benefits. Insurance
5protection and benefits for employees shall provide the
6post-mastectomy care benefits required to be covered by a
7policy of accident and health insurance under Section 356t and
8the coverage required under Sections 356g, 356g.5, 356g.5-1,
9356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.11, 356z.12,
10356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
11356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41, and 356z.43
12of the Illinois Insurance Code. Insurance policies shall
13comply with Section 356z.19 of the Illinois Insurance Code.
14The coverage shall comply with Sections 155.22a, 355b, and
15370c of the Illinois Insurance Code. The Department of
16Insurance shall enforce the requirements of this Section.
17    Rulemaking authority to implement Public Act 95-1045, if
18any, is conditioned on the rules being adopted in accordance
19with all provisions of the Illinois Administrative Procedure
20Act and all rules and procedures of the Joint Committee on
21Administrative Rules; any purported rule not so adopted, for
22whatever reason, is unauthorized.
23(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
24100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
251-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,

 

 

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1eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
2101-625, eff. 1-1-21.)
 
3    Section 30. The Illinois Insurance Code is amended by
4adding Section 356z.43 as follows:
 
5    (215 ILCS 5/356z.43 new)
6    Sec. 356z.43. Coverage for patient care services for
7hormonal contraceptives provided by a pharmacist. A group or
8individual policy of accident and health insurance or a
9managed care plan that is amended, delivered, issued, or
10renewed after the effective date of this amendatory Act of the
11102nd General Assembly shall provide coverage for patient care
12services provided by a pharmacist for hormonal contraceptives
13assessment and consultation.
 
14    Section 35. The Pharmacy Practice Act is amended by
15changing Section 3 and by adding Section 43 as follows:
 
16    (225 ILCS 85/3)
17    (Section scheduled to be repealed on January 1, 2023)
18    Sec. 3. Definitions. For the purpose of this Act, except
19where otherwise limited therein:
20    (a) "Pharmacy" or "drugstore" means and includes every
21store, shop, pharmacy department, or other place where
22pharmacist care is provided by a pharmacist (1) where drugs,

 

 

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1medicines, or poisons are dispensed, sold or offered for sale
2at retail, or displayed for sale at retail; or (2) where
3prescriptions of physicians, dentists, advanced practice
4registered nurses, physician assistants, veterinarians,
5podiatric physicians, or optometrists, within the limits of
6their licenses, are compounded, filled, or dispensed; or (3)
7which has upon it or displayed within it, or affixed to or used
8in connection with it, a sign bearing the word or words
9"Pharmacist", "Druggist", "Pharmacy", "Pharmaceutical Care",
10"Apothecary", "Drugstore", "Medicine Store", "Prescriptions",
11"Drugs", "Dispensary", "Medicines", or any word or words of
12similar or like import, either in the English language or any
13other language; or (4) where the characteristic prescription
14sign (Rx) or similar design is exhibited; or (5) any store, or
15shop, or other place with respect to which any of the above
16words, objects, signs or designs are used in any
17advertisement.
18    (b) "Drugs" means and includes (1) articles recognized in
19the official United States Pharmacopoeia/National Formulary
20(USP/NF), or any supplement thereto and being intended for and
21having for their main use the diagnosis, cure, mitigation,
22treatment or prevention of disease in man or other animals, as
23approved by the United States Food and Drug Administration,
24but does not include devices or their components, parts, or
25accessories; and (2) all other articles intended for and
26having for their main use the diagnosis, cure, mitigation,

 

 

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1treatment or prevention of disease in man or other animals, as
2approved by the United States Food and Drug Administration,
3but does not include devices or their components, parts, or
4accessories; and (3) articles (other than food) having for
5their main use and intended to affect the structure or any
6function of the body of man or other animals; and (4) articles
7having for their main use and intended for use as a component
8or any articles specified in clause (1), (2) or (3); but does
9not include devices or their components, parts or accessories.
10    (c) "Medicines" means and includes all drugs intended for
11human or veterinary use approved by the United States Food and
12Drug Administration.
13    (d) "Practice of pharmacy" means:
14        (1) the interpretation and the provision of assistance
15    in the monitoring, evaluation, and implementation of
16    prescription drug orders;
17        (2) the dispensing of prescription drug orders;
18        (3) participation in drug and device selection;
19        (4) drug administration limited to the administration
20    of oral, topical, injectable, and inhalation as follows:
21            (A) in the context of patient education on the
22        proper use or delivery of medications;
23            (B) vaccination of patients 14 years of age and
24        older pursuant to a valid prescription or standing
25        order, by a physician licensed to practice medicine in
26        all its branches, upon completion of appropriate

 

 

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

 

 

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

 

 

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1    reactions set forth by rule, with notification to the
2    patient's physician and appropriate record retention, or
3    pursuant to hospital pharmacy and therapeutics committee
4    policies and procedures;
5        (6) drug regimen review;
6        (7) drug or drug-related research;
7        (8) the provision of patient counseling;
8        (9) the practice of telepharmacy;
9        (10) the provision of those acts or services necessary
10    to provide pharmacist care;
11        (11) medication therapy management; and
12        (12) the responsibility for compounding and labeling
13    of drugs and devices (except labeling by a manufacturer,
14    repackager, or distributor of non-prescription drugs and
15    commercially packaged legend drugs and devices), proper
16    and safe storage of drugs and devices, and maintenance of
17    required records; and .
18        (13) the assessment and consultation of patients and
19    dispensing of hormonal contraceptives pursuant to the
20    standing order under Section 2310-705 of the Department of
21    Public Health Powers and Duties Law of the Civil
22    Administrative Code of Illinois.
23    A pharmacist who performs any of the acts defined as the
24practice of pharmacy in this State must be actively licensed
25as a pharmacist under this Act.
26    (e) "Prescription" means and includes any written, oral,

 

 

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1facsimile, or electronically transmitted order for drugs or
2medical devices, issued by a physician licensed to practice
3medicine in all its branches, dentist, veterinarian, podiatric
4physician, or optometrist, within the limits of his or her
5license, by a physician assistant in accordance with
6subsection (f) of Section 4, or by an advanced practice
7registered nurse in accordance with subsection (g) of Section
84, containing the following: (1) name of the patient; (2) date
9when prescription was issued; (3) name and strength of drug or
10description of the medical device prescribed; and (4)
11quantity; (5) directions for use; (6) prescriber's name,
12address, and signature; and (7) DEA registration number where
13required, for controlled substances. The prescription may, but
14is not required to, list the illness, disease, or condition
15for which the drug or device is being prescribed. DEA
16registration numbers shall not be required on inpatient drug
17orders. A prescription for medication other than controlled
18substances shall be valid for up to 15 months from the date
19issued for the purpose of refills, unless the prescription
20states otherwise.
21    (f) "Person" means and includes a natural person,
22partnership, association, corporation, government entity, or
23any other legal entity.
24    (g) "Department" means the Department of Financial and
25Professional Regulation.
26    (h) "Board of Pharmacy" or "Board" means the State Board

 

 

10200HB0135ham002- 16 -LRB102 02749 BMS 25625 a

1of Pharmacy of the Department of Financial and Professional
2Regulation.
3    (i) "Secretary" means the Secretary of Financial and
4Professional Regulation.
5    (j) "Drug product selection" means the interchange for a
6prescribed pharmaceutical product in accordance with Section
725 of this Act and Section 3.14 of the Illinois Food, Drug and
8Cosmetic Act.
9    (k) "Inpatient drug order" means an order issued by an
10authorized prescriber for a resident or patient of a facility
11licensed under the Nursing Home Care Act, the ID/DD Community
12Care Act, the MC/DD Act, the Specialized Mental Health
13Rehabilitation Act of 2013, the Hospital Licensing Act, or the
14University of Illinois Hospital Act, or a facility which is
15operated by the Department of Human Services (as successor to
16the Department of Mental Health and Developmental
17Disabilities) or the Department of Corrections.
18    (k-5) "Pharmacist" means an individual health care
19professional and provider currently licensed by this State to
20engage in the practice of pharmacy.
21    (l) "Pharmacist in charge" means the licensed pharmacist
22whose name appears on a pharmacy license and who is
23responsible for all aspects of the operation related to the
24practice of pharmacy.
25    (m) "Dispense" or "dispensing" means the interpretation,
26evaluation, and implementation of a prescription drug order,

 

 

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1including the preparation and delivery of a drug or device to a
2patient or patient's agent in a suitable container
3appropriately labeled for subsequent administration to or use
4by a patient in accordance with applicable State and federal
5laws and regulations. "Dispense" or "dispensing" does not mean
6the physical delivery to a patient or a patient's
7representative in a home or institution by a designee of a
8pharmacist or by common carrier. "Dispense" or "dispensing"
9also does not mean the physical delivery of a drug or medical
10device to a patient or patient's representative by a
11pharmacist's designee within a pharmacy or drugstore while the
12pharmacist is on duty and the pharmacy is open.
13    (n) "Nonresident pharmacy" means a pharmacy that is
14located in a state, commonwealth, or territory of the United
15States, other than Illinois, that delivers, dispenses, or
16distributes, through the United States Postal Service,
17commercially acceptable parcel delivery service, or other
18common carrier, to Illinois residents, any substance which
19requires a prescription.
20    (o) "Compounding" means the preparation and mixing of
21components, excluding flavorings, (1) as the result of a
22prescriber's prescription drug order or initiative based on
23the prescriber-patient-pharmacist relationship in the course
24of professional practice or (2) for the purpose of, or
25incident to, research, teaching, or chemical analysis and not
26for sale or dispensing. "Compounding" includes the preparation

 

 

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1of drugs or devices in anticipation of receiving prescription
2drug orders based on routine, regularly observed dispensing
3patterns. Commercially available products may be compounded
4for dispensing to individual patients only if all of the
5following conditions are met: (i) the commercial product is
6not reasonably available from normal distribution channels in
7a timely manner to meet the patient's needs and (ii) the
8prescribing practitioner has requested that the drug be
9compounded.
10    (p) (Blank).
11    (q) (Blank).
12    (r) "Patient counseling" means the communication between a
13pharmacist or a student pharmacist under the supervision of a
14pharmacist and a patient or the patient's representative about
15the patient's medication or device for the purpose of
16optimizing proper use of prescription medications or devices.
17"Patient counseling" may include without limitation (1)
18obtaining a medication history; (2) acquiring a patient's
19allergies and health conditions; (3) facilitation of the
20patient's understanding of the intended use of the medication;
21(4) proper directions for use; (5) significant potential
22adverse events; (6) potential food-drug interactions; and (7)
23the need to be compliant with the medication therapy. A
24pharmacy technician may only participate in the following
25aspects of patient counseling under the supervision of a
26pharmacist: (1) obtaining medication history; (2) providing

 

 

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1the offer for counseling by a pharmacist or student
2pharmacist; and (3) acquiring a patient's allergies and health
3conditions.
4    (s) "Patient profiles" or "patient drug therapy record"
5means the obtaining, recording, and maintenance of patient
6prescription information, including prescriptions for
7controlled substances, and personal information.
8    (t) (Blank).
9    (u) "Medical device" or "device" means an instrument,
10apparatus, implement, machine, contrivance, implant, in vitro
11reagent, or other similar or related article, including any
12component part or accessory, required under federal law to
13bear the label "Caution: Federal law requires dispensing by or
14on the order of a physician". A seller of goods and services
15who, only for the purpose of retail sales, compounds, sells,
16rents, or leases medical devices shall not, by reasons
17thereof, be required to be a licensed pharmacy.
18    (v) "Unique identifier" means an electronic signature,
19handwritten signature or initials, thumb print, or other
20acceptable biometric or electronic identification process as
21approved by the Department.
22    (w) "Current usual and customary retail price" means the
23price that a pharmacy charges to a non-third-party payor.
24    (x) "Automated pharmacy system" means a mechanical system
25located within the confines of the pharmacy or remote location
26that performs operations or activities, other than compounding

 

 

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1or administration, relative to storage, packaging, dispensing,
2or distribution of medication, and which collects, controls,
3and maintains all transaction information.
4    (y) "Drug regimen review" means and includes the
5evaluation of prescription drug orders and patient records for
6(1) known allergies; (2) drug or potential therapy
7contraindications; (3) reasonable dose, duration of use, and
8route of administration, taking into consideration factors
9such as age, gender, and contraindications; (4) reasonable
10directions for use; (5) potential or actual adverse drug
11reactions; (6) drug-drug interactions; (7) drug-food
12interactions; (8) drug-disease contraindications; (9)
13therapeutic duplication; (10) patient laboratory values when
14authorized and available; (11) proper utilization (including
15over or under utilization) and optimum therapeutic outcomes;
16and (12) abuse and misuse.
17    (z) "Electronically transmitted prescription" means a
18prescription that is created, recorded, or stored by
19electronic means; issued and validated with an electronic
20signature; and transmitted by electronic means directly from
21the prescriber to a pharmacy. An electronic prescription is
22not an image of a physical prescription that is transferred by
23electronic means from computer to computer, facsimile to
24facsimile, or facsimile to computer.
25    (aa) "Medication therapy management services" means a
26distinct service or group of services offered by licensed

 

 

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1pharmacists, physicians licensed to practice medicine in all
2its branches, advanced practice registered nurses authorized
3in a written agreement with a physician licensed to practice
4medicine in all its branches, or physician assistants
5authorized in guidelines by a supervising physician that
6optimize therapeutic outcomes for individual patients through
7improved medication use. In a retail or other non-hospital
8pharmacy, medication therapy management services shall consist
9of the evaluation of prescription drug orders and patient
10medication records to resolve conflicts with the following:
11        (1) known allergies;
12        (2) drug or potential therapy contraindications;
13        (3) reasonable dose, duration of use, and route of
14    administration, taking into consideration factors such as
15    age, gender, and contraindications;
16        (4) reasonable directions for use;
17        (5) potential or actual adverse drug reactions;
18        (6) drug-drug interactions;
19        (7) drug-food interactions;
20        (8) drug-disease contraindications;
21        (9) identification of therapeutic duplication;
22        (10) patient laboratory values when authorized and
23    available;
24        (11) proper utilization (including over or under
25    utilization) and optimum therapeutic outcomes; and
26        (12) drug abuse and misuse.

 

 

10200HB0135ham002- 22 -LRB102 02749 BMS 25625 a

1    "Medication therapy management services" includes the
2following:
3        (1) documenting the services delivered and
4    communicating the information provided to patients'
5    prescribers within an appropriate time frame, not to
6    exceed 48 hours;
7        (2) providing patient counseling designed to enhance a
8    patient's understanding and the appropriate use of his or
9    her medications; and
10        (3) providing information, support services, and
11    resources designed to enhance a patient's adherence with
12    his or her prescribed therapeutic regimens.
13    "Medication therapy management services" may also include
14patient care functions authorized by a physician licensed to
15practice medicine in all its branches for his or her
16identified patient or groups of patients under specified
17conditions or limitations in a standing order from the
18physician.
19    "Medication therapy management services" in a licensed
20hospital may also include the following:
21        (1) reviewing assessments of the patient's health
22    status; and
23        (2) following protocols of a hospital pharmacy and
24    therapeutics committee with respect to the fulfillment of
25    medication orders.
26    (bb) "Pharmacist care" means the provision by a pharmacist

 

 

10200HB0135ham002- 23 -LRB102 02749 BMS 25625 a

1of medication therapy management services, with or without the
2dispensing of drugs or devices, intended to achieve outcomes
3that improve patient health, quality of life, and comfort and
4enhance patient safety.
5    (cc) "Protected health information" means individually
6identifiable health information that, except as otherwise
7provided, is:
8        (1) transmitted by electronic media;
9        (2) maintained in any medium set forth in the
10    definition of "electronic media" in the federal Health
11    Insurance Portability and Accountability Act; or
12        (3) transmitted or maintained in any other form or
13    medium.
14    "Protected health information" does not include
15individually identifiable health information found in:
16        (1) education records covered by the federal Family
17    Educational Right and Privacy Act; or
18        (2) employment records held by a licensee in its role
19    as an employer.
20    (dd) "Standing order" means a specific order for a patient
21or group of patients issued by a physician licensed to
22practice medicine in all its branches in Illinois.
23    (ee) "Address of record" means the designated address
24recorded by the Department in the applicant's application file
25or licensee's license file maintained by the Department's
26licensure maintenance unit.

 

 

10200HB0135ham002- 24 -LRB102 02749 BMS 25625 a

1    (ff) "Home pharmacy" means the location of a pharmacy's
2primary operations.
3    (gg) "Email address of record" means the designated email
4address recorded by the Department in the applicant's
5application file or the licensee's license file, as maintained
6by the Department's licensure maintenance unit.
7(Source: P.A. 100-208, eff. 1-1-18; 100-497, eff. 9-8-17;
8100-513, eff. 1-1-18; 100-804, eff. 1-1-19; 100-863, eff.
98-14-18; 101-349, eff. 1-1-20; revised 8-21-20.)
 
10    (225 ILCS 85/43 new)
11    Sec. 43. Dispensation of hormonal contraceptives.
12    (a) The dispensing of hormonal contraceptives to a patient
13shall be pursuant to a valid prescription or standing order by
14a physician licensed to practice medicine in all its branches
15or the medical director of a local health department, pursuant
16to the following:
17        (1) a pharmacist may dispense no more than a 12-month
18    supply of hormonal contraceptives to a patient;
19        (2) a pharmacist must complete an educational training
20    program accredited by the Accreditation Council for
21    Pharmacy Education and approved by the Department that is
22    related to the patient self-screening risk assessment,
23    patient assessment contraceptive counseling and education,
24    and dispensation of hormonal contraceptives;
25        (3) a pharmacist shall have the patient complete the

 

 

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1    self-screening risk assessment tool; the self-screening
2    risk assessment tool is to be based on the most current
3    version of the United States Medical Eligibility Criteria
4    for Contraceptive Use published by the federal Centers for
5    Disease Control and Prevention;
6        (4) based upon the results of the self-screening risk
7    assessment and the patient assessment, the pharmacist
8    shall use his or her professional and clinical judgment as
9    to when a patient should be referred to the patient's
10    physician or another health care provider;
11        (5) a pharmacist shall provide, during the patient
12    assessment and consultation, counseling and education
13    about all methods of contraception, including methods not
14    covered under the standing order, and their proper use and
15    effectiveness;
16        (6) the patient consultation shall take place in a
17    private manner; and
18        (7) a pharmacist and pharmacy must maintain
19    appropriate records.
20    (b) The Department may adopt rules to implement this
21Section.
22    (c) Nothing in this Section shall be interpreted to
23require a pharmacist to dispense hormonal contraception under
24a standing order issued by the Director of Public Health or the
25Medical Director of the Department of Public Health.
 

 

 

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1    Section 40. The Illinois Public Aid Code is amended by
2adding Section 5-5.12d as follows:
 
3    (305 ILCS 5/5-5.12d new)
4    Sec. 5-5.12d. Coverage for patient care services for
5hormonal contraceptives provided by a pharmacist.
6    (a) Subject to approval by the federal Centers for
7Medicare and Medicaid Services, the medical assistance
8program, including both the fee-for-service and managed care
9medical assistance programs established under this Article,
10shall cover patient care services provided by a pharmacist for
11hormonal contraceptives assessment and consultation.
12    (b) The Department shall establish a fee schedule for
13patient care services provided by a pharmacist for hormonal
14contraceptives assessment and consultation.
15    (c) The rate of reimbursement for patient care services
16provided by a pharmacist for hormonal contraceptives
17assessment and consultation shall be at 85% of the fee
18schedule for physician services by the medical assistance
19program.
20    (d) A pharmacist must be enrolled in the medical
21assistance program as an ordering and referring provider prior
22to providing hormonal contraceptives assessment and
23consultation that is submitted by a pharmacy or pharmacist
24provider for reimbursement pursuant to this Section.
25    (e) The Department shall apply for any necessary federal

 

 

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1waivers or approvals to implement this Section by January 1,
22022.
3    (f) This Section does not restrict or prohibit any
4services currently provided by pharmacists as authorized by
5law, including, but not limited to, pharmacist services
6provided under this Code or authorized under the Illinois
7Title XIX State Plan.
8    (g) The Department shall submit to the Joint Committee on
9Administrative Rules administrative rules for this Section as
10soon as practicable but no later than 6 months after federal
11approval is received.
 
12    Section 99. Effective date. This Act takes effect January
131, 2022.".