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305 ILCS 5/5-5.12d

    (305 ILCS 5/5-5.12d)
    (Text of Section from P.A. 102-103)
    Sec. 5-5.12d. Coverage for patient care services for hormonal contraceptives provided by a pharmacist.
    (a) Subject to approval by the federal Centers for Medicare and Medicaid Services, the medical assistance program, including both the fee-for-service and managed care medical assistance programs established under this Article, shall cover patient care services provided by a pharmacist for hormonal contraceptives assessment and consultation.
    (b) The Department shall establish a fee schedule for patient care services provided by a pharmacist for hormonal contraceptives assessment and consultation.
    (c) The rate of reimbursement for patient care services provided by a pharmacist for hormonal contraceptives assessment and consultation shall be at 85% of the fee schedule for physician services by the medical assistance program.
    (d) A pharmacist must be enrolled in the medical assistance program as an ordering and referring provider prior to providing hormonal contraceptives assessment and consultation that is submitted by a pharmacy or pharmacist provider for reimbursement pursuant to this Section.
    (e) The Department shall apply for any necessary federal waivers or approvals to implement this Section by January 1, 2022.
    (f) This Section does not restrict or prohibit any services currently provided by pharmacists as authorized by law, including, but not limited to, pharmacist services provided under this Code or authorized under the Illinois Title XIX State Plan.
    (g) The Department shall submit to the Joint Committee on Administrative Rules administrative rules for this Section as soon as practicable but no later than 6 months after federal approval is received.
(Source: P.A. 102-103, eff. 1-1-22.)
 
    (Text of Section from P.A. 102-409)
    Sec. 5-5.12d. Managed care organization prior authorization of health care services.
    (a) As used in this Section, "health care service" has the meaning given to that term in the Prior Authorization Reform Act.
    (b) Notwithstanding any other provision of law to the contrary, all managed care organizations shall comply with the requirements of the Prior Authorization Reform Act.
(Source: P.A. 102-409, eff. 1-1-22.)