IL HB3266

Requires the Department of Healthcare and Family Services to transition pharmacy services for managed care enrollees from managed care back to the state's traditional fee-for-service program, with the Department assuming direct responsibility for all pharmacy services.

Transition to fee-for-service reimbursement for pharmacy services shall take effect upon expiration of existing managed care contracts with managed care organizations that are in place on the bill's effective date.

Department must take minimum steps to prevent service interruption during transition: hire an additional licensed pharmacist, stress-test existing claims processing systems, increase prior authorization capacity, and educate the public and help desk staff about the coverage change.

Department is granted rulemaking authority to implement the requirements of this Section.

Repeals the existing provision (Section 5-36) that permitted the Department to contract with a third party for pharmacy benefit administration using a fee-for-service model.