IllinoisHB2440104th General Assembly (2025–2026)House

INS CD-PRESCRIPTION DRUG PRICE

Sponsored By: Mary Beth Canty (Democratic)

In Committee

Summary

Amends the Illinois Insurance Code. Requires any pharmacy benefit manager or health insurer to provide notice of a change in prescription drug coverage or pricing, including instructions on appeals and exceptions, to beneficiaries of health plans in the State who would be affected by the change. Provides that any pharmacy benefit manager or health insurer must, on or before July 30, 2026, submit to the Department for approval a plan by which beneficiaries may appeal, or request an exception to, a contemplated change in coverage. Provides that this process must allow beneficiaries to present evidence for their appeal or exception. Provides that if the Department of Insurance determines that the processes for requesting appeals or exceptions are insufficient, or do not adequately rely on medical necessity, the Department shall set forth required changes to the process within 90 days of receipt. Provides that if the pharmacy benefit manager or health insurer disputes the changes, a hearing may be requested within 10 days after receipt of the changes, and the Department shall enter a final written decision within 5 days of the hearing.

insurance

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Bill Overview

No Economic Impacts Identified for this Bill

Sponsors & Cosponsors

Sponsor

  • Mary Beth Canty

    Democratic • House

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

No roll call votes available for this bill.

Actions Timeline

  1. Rule 19(a) / Re-referred to Rules Committee

    3/21/2025House
  2. To Insurance Main Subcommittee

    2/25/2025House
  3. Assigned to Insurance Committee

    2/4/2025House
  4. Referred to Rules Committee

    2/4/2025House
  5. First Reading

    2/4/2025House
  6. Filed with the Clerk by Rep. Mary Beth Canty

    2/3/2025House

Bill Text

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