IL HB1697

Establishes the Prescription Drug Affordability Act, creating new requirements for pharmacy benefit managers (PBMs) including prohibitions on spread pricing, steering patients to PBM-affiliated pharmacies, and requirements to pass through 100% of manufacturer rebates to health benefit plans

Requires PBMs to submit annual reports to the Department of Insurance detailing drug costs, rebates received, amounts paid to pharmacies, and compensation to brokers, with the three largest PBMs subject to examination at least every 5 years

Imposes a $15 per covered individual fee on PBMs, depositing funds into a new Prescription Drug Affordability Fund, with the first $25 million annually transferred to support pharmacy access grants for critical access pharmacies and underserved areas

Expands the critical access care pharmacy program from $10 million to $45 million annually and broadens eligibility to include pharmacies in Medically Underserved Areas, not just counties under 50,000 residents

Extends PBM regulations to Medicaid managed care organizations beginning January 1, 2026, and applies pharmacy benefit manager oversight provisions to contracts with county jails, juvenile detention facilities, and the Department of Corrections