IL HB3761

Prohibits pharmacy benefit managers from conducting spread pricing in Illinois and from preventing pharmacies from selling more affordable alternatives to covered persons.

Requires pharmacy benefit managers to reimburse Illinois pharmacies at amounts no less than what they reimburse their own affiliated pharmacies for the same pharmaceutical products.

Establishes pharmacy network participation requirements prohibiting PBMs from restricting patient choice of pharmacy, requiring unnecessary accreditations beyond state law, or mandating exclusive use of mail-order or affiliated pharmacies.

Requires PBMs to report quarterly to the Director on rebates received and distributed, amounts paid to pharmacies, and rebates passed to enrollees at point of sale; reports are confidential and exempt from public disclosure.

Sets pharmacy network adequacy standards requiring at least 90% of covered individuals in urban areas live within 2-5 miles of a participating pharmacy and 70% in rural areas live within 15-18 miles; applies to contracts entered into or renewed on or after July 1, 2023.