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91_HB4176
LRB9109951JSpc
1 AN ACT concerning prescription drug information cards.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 1. Short title. This Act may be cited as the
5 Uniform Prescription Drug Information Card Act.
6 Section 5. Legislative intent. It is the intent of the
7 legislature to lessen patients' waiting times, decrease
8 administrative burdens for pharmacies, and improve care to
9 patients by minimizing confusion, eliminating unnecessary
10 paperwork, and streamlining the dispensing of prescription
11 products paid for by third-party payors. This Act shall be
12 broadly applied and interpreted to effectuate this purpose.
13 Section 10. Definitions. As used in this Act, the
14 following terms have the meanings given in this Section.
15 "Department" means the Department of Insurance.
16 "Director" means the Director of Insurance.
17 "Health benefit plan" means an accident and health
18 insurance policy or certificate subject to the Illinois
19 Insurance Code, a voluntary health services plan subject to
20 the Voluntary Health Services Plans Act, a health maintenance
21 organization subscriber contract subject to the Health
22 Maintenance Organization Act, a plan provided by a multiple
23 employer welfare arrangement, or a plan provided by another
24 benefit arrangement, to the extent permitted by the federal
25 Employee Retirement Income Security Act of 1974, or by any
26 waiver of or other exception to that Act provided under
27 federal law or regulation. Without limitation, "health
28 benefit plan" does not mean any of the following types of
29 insurance:
30 (1) accident;
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1 (2) credit;
2 (3) disability income;
3 (4) long-term or nursing home care;
4 (5) specified disease;
5 (6) dental or vision;
6 (7) coverage issued as a supplement to liability
7 insurance;
8 (8) medical payments under automobile or
9 homeowners;
10 (9) insurance under which benefits are payable with
11 or without regard to fault as statutorily required to be
12 contained in any liability policy or equivalent
13 self-insurance;
14 (10) hospital income or indemnity.
15 Section 15. Uniform prescription drug information cards
16 required.
17 (a) A health benefit plan that provides coverage for
18 prescription drugs or devices and an administrator of such a
19 plan including, but not limited to, third-party
20 administrators for self-insured plans and state-administered
21 plans shall issue to its insureds a card or other technology
22 containing uniform prescription drug information. The uniform
23 prescription drug information card or technology shall be in
24 the format approved by the National Council for Prescription
25 Drug Programs (NCPDP) and shall include all of the required
26 and conditional or situational fields and conform to the most
27 recent pharmacy information card or technology implementation
28 guide produced by the NCPDP or conform to a national format
29 acceptable to the Director of Insurance.
30 (b) A new uniform prescription drug information card or
31 technology shall be issued by a health benefit plan upon
32 enrollment and reissued upon any change in the insured's
33 coverage that affects data contained on the card or upon any
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1 change in the NCPDP implementation guide. Newly issued cards
2 or technology shall be updated with the latest coverage
3 information and shall conform to the NCPDP standards then in
4 effect and to the implementation guide then in use.
5 Section 20. Applicability and enforcement.
6 (a) This Act applies to health benefit plans that are
7 amended, delivered, issued, or renewed on and after the
8 effective date of this amendatory Act of the 91st General
9 Assembly. For purposes of this Act, a renewal of a health
10 benefit plan is deemed to occur on each anniversary of the
11 date on which coverage was first effective for the person
12 covered by the health benefit plan.
13 (b) The Department shall enforce this Act. The
14 Department shall promulgate rules necessary to effectuate
15 this Act.
16 (c) A health benefit plan that is in violation of this
17 Act may not conduct business in this State.