IL HB1159

Prohibits pharmacy benefit managers (PBMs) from engaging in spread pricing, where they charge health plans more for drugs than they pay pharmacies, and from steering patients to PBM-owned pharmacies through unfavorable plan designs or lower reimbursement rates to competing pharmacies

Requires PBMs to remit 100% of rebates and fees from drug manufacturers to health benefit plan sponsors, consumers, or employers, with records retained for 7 years and subject to annual audits

Establishes minimum pharmacy reimbursement at the national average drug acquisition cost plus a $10.49 professional dispensing fee, preventing PBMs from paying pharmacies below acquisition cost

Mandates PBMs submit annual reports to health plan sponsors and the Department of Insurance by September 1 each year, including detailed drug cost data, rebate information, broker compensation, and affiliated pharmacy utilization, with fines up to $1,000 per day for non-compliance

Applies to health benefit plans providing prescription drug coverage (excluding Medicaid managed care and ERISA plans), effective July 1, 2025