Illinois HB 2440: INS CD-PRESCRIPTION DRUG PRICE

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104TH GENERAL ASSEMBLY 
State of Illinois 
2025 and 2026
HB2440

Introduced 2/4/2025, by Rep. Mary Beth Canty 

SYNOPSIS AS INTRODUCED:

215 ILCS 5/513b8 new

215 ILCS 5/513b9 new

 Amends the Illinois Insurance Code. Requires any pharmacy benefit manager or health insurer to provide notice of a change in prescription drug coverage or pricing, including instructions on appeals and exceptions, to beneficiaries of health plans in the State who would be affected by the change. Provides that any pharmacy benefit manager or health insurer must, on or before July 30, 2026, submit to the Department for approval a plan by which beneficiaries may appeal, or request an exception to, a contemplated change in coverage. Provides that this process must allow beneficiaries to present evidence for their appeal or exception. Provides that if the Department of Insurance determines that the processes for requesting appeals or exceptions are insufficient, or do not adequately rely on medical necessity, the Department shall set forth required changes to the process within 90 days of receipt. Provides that if the pharmacy benefit manager or health insurer disputes the changes, a hearing may be requested within 10 days after receipt of the changes, and the Department shall enter a final written decision within 5 days of the hearing.

LRB104 06171 BAB 16205 b

A BILL FOR

HB2440LRB104 06171 BAB 16205 b

1 AN ACT concerning regulation.

2 Be it enacted by the People of the State of Illinois, 

3represented in the General Assembly:

4 Section 5. The Illinois Insurance Code is amended by 

5adding Sections 513b8 and 513b9 as follows:

6 (215 ILCS 5/513b8 new)

7 Sec. 513b8. Prescription drug pricing transparency.

8 (a) As used in this Section:

9 "Cost-shari