IL HB4146

Requires health care plans to allow enrollees to continue treatment with their physician for 90 days after the physician leaves the plan's network (unless terminated for patient safety or disciplinary reasons), provided the physician remains in the service area and agrees to accept existing reimbursement rates and plan policies.

Extends continuity of care through post-partum period for enrollees in their third trimester of pregnancy at the time of physician disaffiliation, including delivery-related care.

Permits new enrollees whose current physician is not in the plan's network to continue seeing that physician for 90 days from enrollment effective date, provided the physician accepts plan reimbursement rates and adheres to plan requirements.

Prohibits health care plans from removing drugs from formularies or negatively changing preferred or cost-tier sharing during a plan year without providing 60 days' notice to enrollees and prescribing providers, and requires plans to continue coverage if a prescribing provider certifies the drug is medically necessary.

Allows health care plans to continue removing drugs only if the FDA questions the drug's safety, the manufacturer discontinues it, or it is removed from market; permits pharmacist substitutions consistent with state pharmacy law.