Prescription drug plan control bill hits Rauner's desk

In Illinois, legislation that would prevent an insurance provider from changing a customer's coverage of a medication during the plan year if the drug was already approved for coverage in certain situations is now awaiting the signature of Gov. Bruce Rauner.

In Illinois, legislation that would prevent an insurance provider from changing a customer's coverage of a medication during the plan year if the drug was already approved for coverage in certain situations is now awaiting the signature of Gov. Bruce Rauner. If the insurance company removes a medication, the bill would establish an appeals process for providers to obtain exemptions for their patients from plan changes. While supporters say the measure provides continuity of medical care for the prescription drug benefits, opponents claim the bill would permit a medication's price to soar with little recourse for insurers once it is accepted into a coverage plan. "It allows a pharmaceutical manufacturer to increase its price over and over again within a year with no consequence," said pharmacist Abigail Stoddard with Prime Therapeutics. Under the measure, insurers would be able to add new medications to a formulary and also remove them if FDA deems them unsafe or if they are taken off the market. The plan would impact about 17% of the Illinois health care market, not including those enrolled in Medicaid. Rauner has 60 days from June 29 to make a decision on the bill.