HB2464 Summary

• Creates new Illinois Insurance Code Section 356z.25 requiring government programs and health insurers to cover abuse-deterrent opioid analgesic drugs as preferred medications on formularies effective upon enactment of the 100th General Assembly.

• Prohibits cost sharing for abuse-deterrent opioid drugs that exceeds the lowest cost sharing level applied to other prescription drugs.

• Prohibits insurers from requiring patients to first use non-abuse-deterrent opioid products before covering abuse-deterrent versions and prohibits prior authorization requirements from mandating trial of non-abuse-deterrent opioids first.

• Allows insurers to apply prior authorization requirements to abuse-deterrent opioids provided the same requirements apply to non-abuse-deterrent versions of that opioid.

• Amends multiple Illinois codes (State Employees Group Insurance Act, Counties Code, Municipal Code, School Code, HMO Act, Limited Health Service Organization Act, Voluntary Health Services Plans Act, and Public Aid Code) to reference and incorporate the new abuse-deterrent opioid coverage requirements.