Rep. Jenn Ladisch Douglass
Filed: 3/20/2024
 
 

 
 

 
10300HB5051ham001LRB103 38175 RPS 71283 a

1
AMENDMENT TO HOUSE BILL 5051

2    AMENDMENT NO. ______. Amend House Bill 5051 by replacing 
3everything after the enacting clause with the following:
 
4    "Section 5. The Prior Authorization Reform Act is amended 
5by adding Section 52 as follows:
 
6    (215 ILCS 200/52 new)
7    Sec. 52. Prior authorization for certain prescription 
8drugs; prohibited. A health insurance issuer may not require 
9prior authorization for:
10        (1) a prescription drug prescribed to a patient by a 
11    health care professional for 6 or more consecutive months, 
12    regardless of whether the prescription drug is a 
13    non-preferred medication pursuant to the patient's health 
14    insurance coverage; and
15        (2) the following prescription drug types and their 
16    therapeutic equivalents approved by the United States Food 
 
 
10300HB5051ham001- 2 -LRB103 38175 RPS 71283 a

1    and Drug Administration that are on the formulary: 
2    insulin; human immunodeficiency virus pre-exposure 
3    prophylaxis and post-exposure prophylaxis medication; 
4    human immunodeficiency virus treatment medication; viral 
5    hepatitis medication; or hormone therapy medication, 
6    including, but not limited to, estrogen, progesterone, and 
7    testosterone.
 
8    Section 10. The Illinois Public Aid Code is amended by 
9adding Section 5-52 as follows:
 
10    (305 ILCS 5/5-52 new)
11    Sec. 5-52. Prior authorization for certain prescription 
12drugs; prohibited. The fee-for-service medical assistance 
13program and a Medicaid managed care organization may not 
14require prior authorization for:
15        (1) a prescription drug prescribed to a patient by a 
16    health care professional for 6 or more consecutive months, 
17    regardless of whether the prescription drug is a 
18    non-preferred medication under the medical assistance 
19    program; and
20        (2) the following prescription drug types and their 
21    therapeutic equivalents approved by the United States Food 
22    and Drug Administration that are on the formulary: 
23    insulin; human immunodeficiency virus pre-exposure 
24    prophylaxis and post-exposure prophylaxis medication; 
 
 
10300HB5051ham001- 3 -LRB103 38175 RPS 71283 a

1    human immunodeficiency virus treatment medication; viral 
2    hepatitis medication; or hormone therapy medication, 
3    including, but not limited to, estrogen, progesterone, and 
4    testosterone.
 
5    Section 99. Effective date. This Act takes effect January 
61, 2026.".