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IL SB2420

Bill

Status

Introduced

2/26/2021

Primary Sponsor

Napoleon Harris

Click for details

Origin

Senate

102nd General Assembly

AI Summary

  • Requires all Medicaid managed care organizations to reimburse pharmacy providers at no less than the fee-for-service program rates for dispensing fees and acquisition costs, whether they reimburse directly or through a pharmacy benefit manager.

  • Applies reimbursement requirements to all pharmacy services for Medicaid recipients, including services under Section 5-36 covering covered entities and specialty pharmacies.

  • Mandates pharmacy benefit managers disclose conflicts of interest, contracts with pharmaceutical manufacturers, claims payments to affiliated pharmacies, fees imposed on providers, and revenue percentages to the Department upon request.

  • Requires pharmacy benefit managers to provide 30 days' written notice to pharmacy providers before implementing material changes to contract provisions affecting reimbursement, benefit verification, dispute resolution, or formulary procedures.

  • Takes effect immediately upon becoming law.

Legislative Description

MEDICAID-MCO-PHARMACY FEE

Last Action

Rule 3-9(a) / Re-referred to Assignments

5/21/2021

Committee Referrals

Assignments5/21/2021
Managed Care Organizations3/31/2021
Health3/23/2021
Assignments2/26/2021

Full Bill Text

No bill text available