In Review: House Bill 4548 (Jones-D) was introduced and supported by the Department of Insurance (DOI) and the Governor’s office but was not called for a vote in the Illinois House this year, largely due to the Governor’s office’s focus on HB 5395, the omnibus health insurance bill, which included a ban on step therapy for drugs, a medical exceptions process for off-formulary drugs, and mandated published formularies and prior authorization services/medication.

Up Next: The Governor’s office is now taking an even more prominent lead in working to pass HB 4548, or a bill with the same language, in either the fall Veto Session (November 12-14 and 19-21), the lame duck session (January 2-7, 2025), or during the Spring 2025 session. We have heard that the Governor’s office will be requesting the House Health Care Availability and Accessibility Committee to continue to hold subject matter hearings on both PBM and PDAB issues this summer, likely in July and August. PCMA did share language redlines to HB 4548 along with reasons for changes with the DOI in April, but the DOI never responded to the language requests, taking their lead from the Governor’s office, which was not prepared to negotiate. We will work again to open those discussions.

If you have any questions, please contact Melodie Shrader at mshrader@pcmanet.org.