IL HB5421

340B covered entities prohibited from billing Illinois Medicaid fee-for-service or managed care programs for 340B drugs beginning January 1, 2027, including drugs dispensed at contract pharmacies.

Beginning July 1, 2026, 340B covered entities must use 80% of their prior year 340B profits to reduce out-of-pocket drug costs at the point of sale for low-income patients (those with family income below 200% of federal poverty guidelines).

Annual reporting to the Department of Insurance required by September 1, 2026 and each year thereafter, detailing 340B drug acquisition costs, payments received, prescription volumes by payor type, contract pharmacy arrangements, and charity care expenditures.

Department of Central Management Services must report to the General Assembly by December 31, 2026 on 340B program impacts to the State employee health plan, including foregone rebates, premium effects, and employee out-of-pocket costs.

Department of Healthcare and Family Services must report by December 31, 2026 on Medicaid-related 340B drug dispensing data and estimated net costs or savings to the state medical assistance program.