Date	Chamber	Action
3/21/2025	House	Rule 19(a) / Re-referred to Rules Committee

Statutes Amended In Order of Appearance

215 ILCS 5/513b8 new

215 ILCS 5/513b9 new

Synopsis As Introduced
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.

Actions 

Date	Chamber	Action
2/3/2025	House	Filed with the Clerk by Rep. Mary Beth Canty
2/4/2025	House	First Reading
2/4/2025	House	Referred to Rules Committee
2/4/2025	House	Assigned to Insurance Committee
2/25/2025	House	To Insurance Main Subcommittee
3/21/2025	House	Rule 19(a) / Re-referred to Rules Committee

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