IL SB3498

Requires policy or plan sponsors to notify prescribing physicians and patients in writing at least 60 days before making formulary changes that alter or discontinue coverage for prescribed drugs patients are currently receiving.

Notification must disclose the formulary change, indicate the physician may appeal, and include information about the appeal process.

Allows electronic notification as an alternative only if the patient affirmatively elects to receive notices electronically.

Permits plan sponsors to provide written notification and a 60-day supply of the drug at the patient's refill request, maintaining the same terms as previously allowed.

Does not prohibit use of managed pharmacy care tools such as formulary tiers, generic substitution, prior authorization, or step therapy, provided an exception process exists allowing prescribers to petition for coverage of non-preferred drugs with sufficient clinical justification.