Coverage for treatments to slow the progression of Alzheimer's disease and related dementias

(215 ILCS 5/356z.79)     Sec. 356z.79. Coverage for treatments to slow the progression of Alzheimer's disease and related dementias.     (a) A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2027 shall provide coverage for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia, in accordance with the U.S. Food and Drug Administration label, as determined by a physician licensed to practice medicine in all its branches. Coverage of U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia pursuant to this Section shall not be subject to step therapy.     (b) Nothing in this Section prohibits a group or individual policy of accident and health insurance or managed care plan, by contract, written policy, procedure, or any other agreement or course of conduct, from requiring a pharmacist to effect substitutions of prescription drugs consistent with Section 19.5 of the Pharmacy Practice Act, under which a pharmacist may substitute an interchangeable biologic for a prescribed biologic product, and Section 25 of the Pharmacy Practice Act, under which a pharmacist may select a generic drug determined to be therapeutically equivalent by the United States Food and Drug Administration and in accordance with the Illinois Food, Drug and Cosmetic Act.     (c) The coverage required under this Section shall not apply to managed care plans that are under contract with the Department of Healthcare and Family Services. (Source: P.A. 104-1, eff. 6-9-25; 104-852, eff. 8-21-26.)