IL HB3631

Requires pharmacy benefit managers to update maximum allowable cost pricing at least every 7 calendar days and maintain processes to eliminate outdated drugs or modify prices based on current pricing data and product availability.

Mandates pharmacy benefit managers provide pharmacies access to maximum allowable cost lists via real-time website portals and establish appeal processes allowing contracted pharmacies 14 calendar days to challenge reimbursement rates with responses required within 14 days.

Prohibits pharmacy benefit managers from limiting pharmacists' ability to disclose whether patient cost-sharing exceeds retail price and to inform patients of more affordable alternative drugs.

Caps patient out-of-pocket payments at the lesser of the applicable cost-sharing amount or the retail price of the drug without prescription coverage.

Prohibits pharmacy benefit managers from discriminating against 340B drug program entities and pharmacies through unfavorable reimbursement rates, fees, exclusions from networks, or prevention of drug usage based on 340B program participation.

Protects pharmacists and pharmacies from retaliation for disclosing evidence of violations of state or federal law to courts, administrative hearings, legislative bodies, or government agencies.