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IL HB0152
Bill
Status
8/28/2009
Primary Sponsor
Careen Gordon
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AI Summary
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Establishes the Organ Transplant Medication Notification Act, which applies to immunosuppressant drugs prescribed to prevent rejection of transplanted organs and tissues when marked "may not substitute" by the prescribing physician.
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Prohibits health insurance policies and health care service plans from requiring pharmacists to interchange immunosuppressant drugs without prior notification and documented consent from the prescribing physician, patient, parent/guardian, or authorized spouse.
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Requires insurance policies or plan sponsors to provide at least 60 days' written notice before making formulary changes that alter coverage terms or discontinue coverage for prescribed immunosuppressant drugs, with information on appeal procedures.
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Allows insurers and pharmacy benefit managers to use managed care tools such as formularies, generic substitution, prior authorization, and step therapy, provided an exception process exists for prescribers to petition for non-preferred drug coverage with sufficient clinical justification.
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Permits patient co-payments and deductibles for the prescribed drug to remain unchanged during the enrollment period when no drug interchange occurs.
Legislative Description
ORGAN TRANSPLANT MEDICATION
Last Action
Public Act . . . . . . . . . 96-0766
8/28/2009