IL HB4595

Amends the Illinois Insurance Code to designate violations of pharmacy benefit manager (PBM) contract requirements as unfair or deceptive acts in insurance business.

Requires PBMs contracting with health insurers to update maximum allowable cost pricing every 7 days, maintain accessible pricing lists, and establish pharmacy appeal processes with 14-day response deadlines.

Prohibits PBMs and third-party payers from discriminating against 340B drug discount program entities and pharmacies through unfavorable payment terms, excessive fees, network exclusions, or restrictions on using 340B-purchased drugs effective July 1, 2022.

Amends the Illinois Public Aid Code to require Medicaid providers eligible for the federal 340B drug discount program to enroll in it and prevent exclusion of fee-for-service Medicaid, while prohibiting similar discrimination by Medicaid managed care organizations and their PBMs.

Requires PBMs to disclose material contract changes to pharmacies 30 days in advance and prohibits contractual provisions that restrict pharmacists from informing patients about less costly medication alternatives.