HB4087 Summary

• By September 1, 2023, the Illinois Workers' Compensation Commission must adopt an evidence-based drug formulary in consultation with the Workers' Compensation Medical Fee Advisory Board, limiting prescriptions to drugs and doses on the closed formulary.

• Prescriptions not on the closed formulary are subject to review under Section 8.7 of the Act.

• Custom compound medications exceeding a one-time 7-day supply require approval only if they meet five specified standards: no commercial equivalent exists, no FDA-approved alternative is appropriate, active ingredients have National Drug Code numbers and FDA approval, the drug has not been withdrawn for safety reasons, and the prescriber demonstrates clinical appropriateness.

• Custom compound medications are charged based on the average wholesale price of component drugs prorated by amount used, plus a single dispensing fee determined by the Commission; prescriptions over 7 days require employer preauthorization.

• The Act takes effect immediately upon becoming law.