IL SB1255

Prohibits health benefit plans amended, delivered, issued, or renewed on or after January 1, 2024 from requiring enrollees to obtain clinician-administered drugs from plan-selected pharmacies or steering enrollees to specific pharmacies through financial incentives.

Prevents health plans from denying, restricting, or limiting coverage and reimbursement for medically necessary clinician-administered drugs obtained from non-plan-selected providers or pharmacies, or imposing higher cost-sharing for such drugs.

Prohibits health plans from requiring use of home infusion pharmacies or specific sites of service for drug administration, and from including site of service in prior approval or medical necessity criteria.

Requires clinician-administered drugs to meet supply chain security controls and chain of distribution standards set by the federal Drug Supply Chain Security Act.

Applies requirements to health benefit plans, health maintenance organizations, and voluntary health services plans, with the Department of Insurance authorized to adopt implementing rules.