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The Illinois House is considering a new pharmacy benefit manager regulation bill.
Rep. Thaddeus Jones, D-South Holland, Illinois, introduced the bill earlier this week.
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The bill could prohibit a PBM from:
- Steering patients toward its own pharmacy.
- Requiring a patient to use an in-network pharmacy.
- Paying a pharmacy an amount less than the national average drug acquisition cost for the drug dispensed.
Jones wants the bill to apply to PBMs that work with self-insured employer health plans as well as to PBMs contracting with issuers of fully insured individual and group health insurance. The bill would apply to "any health benefit plan," not simply to "any group or individual policy of accident and health insurance or managed care plan," according to the bill synopsis.
Jones has started in the Illinois House since 2011. He is a member of the House Prescription Drug Affordability Committee.
The Illinois House is also considering a narrower PBM bill that was prefiled in December by Rep. John Cabello, R-Machesney Park, Ill. Cabello's bill focuses on prohibiting a PBM from steering patients to its own pharmacies. The bill would also prohibit a PBM from paying outside pharmacies less than it pays its own pharmacies.
Pennsylvania Gov. Josh Shapiro, a Democrat, signed a bill similar to Jones' bill into law in July.
Gov. Maura Healey, also a Democrat, signed a somewhat different PBM regulation bill Wednesday.
Related: Pennsylvania governor signs pharmacy benefit manager bill
California Gov. Gavin Newsom, a Democrat, vetoed a PBM regulation bill in September., in part because of concerns about how the PBM licensing provisions in the bill would work.
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Allison Bell
Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.
