IL HB4955

Prohibits state appropriations to managed care organizations contracted with the Department of Healthcare and Family Services unless they allow specialty pharmacies to provide prescription drug benefits on the same terms as any willing qualified provider

Specialty pharmacies must meet two requirements to qualify: certification in the Business Enterprise Program for Minorities, Women, and Persons with Disabilities, and accreditation by at least 2 different entities for specialty pharmacy services

Defines "specialty pharmacy" as an Illinois-licensed pharmacy that primarily provides oral, infusion, or injectable medications for serious health conditions including cancer, hepatitis C, HIV/AIDS, multiple sclerosis, organ transplantation, and bleeding disorders

Applies to all prescription drug benefits whether managed as part of overall healthcare packages, integrated medical-pharmacy benefits through MCOs, or pharmacy benefits separately administered through pharmacy benefits managers

Effective date: July 1, 2022