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IL SB2420
Bill
Status
2/26/2021
Primary Sponsor
Napoleon Harris
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AI Summary
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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.
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Applies reimbursement requirements to all pharmacy services for Medicaid recipients, including services under Section 5-36 covering covered entities and specialty pharmacies.
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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.
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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.
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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