IllinoisHB5804104th General Assembly (2025–2026)House

MEDICAID-MCO RX PAYMENTS

Sponsored By: Dave Vella (Democratic)

Filed

Summary

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires a Medicaid managed care organization to reimburse a pharmacy provider that is not a critical access care pharmacy for dispensing fees and acquisition costs at no less than the amounts established under the fee-for-service program whether the Medicaid managed care organization directly reimburses those pharmacy providers or contracts with a pharmacy benefit manager to reimburse those pharmacy providers. Provides that the reimbursement requirement applies to all pharmacy services for persons receiving benefits under the Code including other specified pharmacy services.

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Bill Overview

No Economic Impacts Identified for this Bill

Sponsors & Cosponsors

Sponsor

  • Dave Vella

    Democratic • House

Cosponsors

  • Maurice A. West, II

    Democratic • House

  • Theresa Mah

    Democratic • House

Roll Call Votes

No roll call votes available for this bill.

Actions Timeline

  1. Added Co-Sponsor Rep. Theresa Mah

    9/4/2026House
  2. Added Co-Sponsor Rep. Maurice A. West, II

    9/4/2026House
  3. Filed with the Clerk by Rep. Dave Vella

    7/22/2026House

Bill Text

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