HB 591 – IllinoisStatus: In Process
Year Introduced: 2021
Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to permit medical assistance recipients, including those enrolled in managed care, to obtain pharmacy services from the pharmacy of their choice if the pharmacy is licensed under the Pharmacy Practice Act and accepts the professional dispensing fee for pharmacy services as determined by the Department. Provides that no managed care organization that contracts with the Department to provide services to recipients may restrict a recipient’s access to pharmacy services to a selected group of pharmacies. Provides that if a managed care organization merges with or is acquired by another entity, the resulting entity may not restrict a recipient’s access to pharmacy services to a selected group of pharmacies. Permits the Department to renegotiate with the resulting entity the terms of the managed care contract the Department had with the original managed care organization prior to the merger or acquisition. Requires the Department to contract with an independent research organization to conduct a study and submit a report on those managed care organizations that are contracted to provide services to recipients. Requires the report to include an analysis of pharmacy access for medical assistance recipients with the aim of identifying “pharmacy deserts”; an analysis of the costs and benefits of having managed care organizations administer health care services, including pharmacy services, to recipients; and other matters. Prohibits the Department from entering into any new contract with a managed care organization before the report has been received and analyzed by the Department and posted on its website. Effective immediately.
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