For months following the Address, both bills would be “negotiated”. The Healthcare Protection Act expansion, originally on SB 708 (Fine), mellowed over time. The major components, like increasing the MLR and setting per diem rates for travel associated with care, were removed, and what was left was agreed to between all stakeholders. The Prescription Drug Affordability Act (PDAA), SB 709 (Koehler), talks broke down and eventu- ally turned into sending draft requests, while months of session went by without any hearing. After months of rumor and conjecture about hearings and votes on SB 708 (Fine) and SB 709 (Koehler), neither would turn out to be the vehicles for the proposals, which would go on to pass both chambers in the waning hours of May 31. The Prescription Drug Affordability Act or “the big PBM bill” as Rep Manley refers to it, was attached to HB 1697 (Manley/Koehler) on May 28 and would go on to pass the Senate the following day, May 29, 56-1-0 and then the House on May 31, on a concurrence vote of 115-1-0. The bill has Passed Both Houses but has yet to be sent to the Governor for his signature. The bill, among other things, does the following: • Prohibits the practice known as “steering” in which a PBM can direct pharmaceutical prescriptions to certain pharmacies at a discounted rate • Prohibits “spread pricing” in PBM negotiations over formularies • Institutes a $15/per covered individual tax on PBMs, first $25 million collected is directed to the DCEO to be administered as grant program for pharmacies, the remaining sum (estimated to be around $145 million) is directed to GRF • Requires expanded PBM reporting • Provides for a $10,000 per violation per day fine for noncompliance • Includes all covered individuals, including ERISA plans, in the State with the exception for Taft-Hartley plans (union healthcare plans) The Healthcare Protection Act expansion language was attached to HB 3019 (LaPointe/Fine) on May 29 after SB 708 (Fine) was no longer a viable option for passage before adjournment. The bill was negotiated between all stakeholders, and as a result, insurers did not take a position on the final product. As Passed Both Houses, the bill does not change the medical loss ratio, as intended in the introduced version, but does prohibit prior authorization for most behavioral and mental health and substance use treatments. The bill also provides for guidelines on travel, lodging, and food reimbursement for out-of-network coverage when no in-network coverage can be reasonably accommodated. The bill passed the Senate 45-11-0 and the House on a concurrence vote 84-32-0. The bill has yet to be sent to the Governor. Late Session Movement 340B legislation was amended onto HB 2371 (Moeller/Koehler) in the Senate on May 28. Senate Executive Committee recommended do adopt SFA2 13-0-0 before the entire body would pass the bill 55-0-0 over to the House. In the House, the Executive committee took up the concurrence motion on May 30 and passed RBA 12-0-0. The motion failed to be called on the House Floor before adjournment after a day and a half of mixed rumors about the sponsor having the “requisite” 60 Democratic votes. The Medicaid omnibus, SB 2437 (Aquino/Moeller,) Passed Both Houses; 76-39-0 in the House and 36-19-0 in the Senate. HB 1085 (LaPointe/Villa), the “mental health parity” legislation, saw a last-minute resurgence after lan- guishing in the Senate since early April. The Illinois Chamber opposed every iteration of the bill, slipping that position in the Committee and sharing our concerns with the sponsors. The bill was amended to require set reimbursement rates for mental and behavioral health and substance use treatments. The Senate Executive Committee recommend do adopt SCA1 10-0-2, but no further action was taken on the legislation before ad- journment. 12 | END OF SESSION REPORT
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