State of Illinois
91st General Assembly
Legislation

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91_HB4176eng

 
HB4176 Engrossed                               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;
 
HB4176 Engrossed            -2-                LRB9109951JSpc
 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 most recently adopted by the National Council for
25    Prescription Drug Programs (NCPDP) and shall include  all  of
26    the required and conditional or situational fields as defined
27    in  the  NCPDP  Pharmacy  ID  Card  Implementation  Guide  or
28    successor document.
29        (b)  A  new uniform prescription drug information card or
30    technology shall be issued by  a  health  benefit  plan  upon
31    enrollment  and  reissued  upon  any  change in the insured's
32    coverage that affects data elements contained on the card  or
33    upon   any  change  in  the  NCPDP  implementation  guide  or
 
HB4176 Engrossed            -3-                LRB9109951JSpc
 1    successor  document,  provided  that  change   affects   data
 2    elements  contained  on  the  card.   Newly  issued  cards or
 3    technology  shall  be  updated  with  the   latest   coverage
 4    information  and shall conform to the NCPDP standards then in
 5    effect and to the implementation guide then in use.

 6        Section 20.  Applicability and enforcement.
 7        (a)  This Act applies to health benefit  plans  that  are
 8    amended,  delivered,  issued,  or  renewed  on  and after the
 9    effective date of this amendatory Act  of  the  91st  General
10    Assembly.   For  purposes  of this Act, a renewal of a health
11    benefit plan is deemed to occur on the  anniversary  date  of
12    the contract with the health benefit plan.
13        (b)  The  Director may adopt rules necessary to implement
14    the Department's responsibilities under this Act.  To enforce
15    the provisions of this Act, the Director may  issue  a  cease
16    and desist order or require a health benefit plan to submit a
17    plan  of  correction  for  violations  of  this Act, or both.
18    Subject to the  provisions  of  the  Illinois  Administrative
19    Procedure  Act, the Director may, pursuant to Section 403A of
20    the Illinois Insurance Code, impose  upon  a  health  benefit
21    plan  an  administrative  fine  not  to  exceed  $250,000 for
22    failure to submit a requested plan of correction, failure  to
23    comply with its plan or correction, or repeated violations of
24    this Act.

25        Section  99.  Effective  date.   This Act takes effect on
26    January 1, 2001.

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