Amendment vs bill House Amendment 001 vs Enrolled

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HB4327 Enrolled LRB104 17027 BAB 30442 b AN ACT concerning auditing.
*LRB10417027BAB38183a* Rep.
Be it enacted by the People of the State of Illinois, represented in the General Assembly:
Camille Y.
Section 1.
Lilly Filed:
5/22/2026 10400HB4327ham001 LRB104 17027 BAB 38183 a AMENDMENT TO HOUSE BILL 4327 AMENDMENT NO.
______.
Amend House Bill 4327 by replacing everything after the enacting clause with the following:
"Section 1.
(1) The intent of the 340B Drug Discount Program is to provide resources to reach more eligible patients and provide more comprehensive services.
(1) The intent of the 340B Drug Discount Program is to provide discounted medicines to eligible healthcare organizations for the purpose of improving access to affordable medications for low-income, underinsured, uninsured, or otherwise vulnerable patients being treated at eligible hospitals, clinics, federally qualified health centers (FQHC), and safety-net hospitals in or adjacent to vulnerable communities.
In doing so, 340B covered entities provide discounted medicines to eligible health care organizations for the purpose of improving access to affordable medications and health care services for low-income, underinsured, uninsured, or otherwise vulnerable patients being treated at eligible hospitals, clinics, federally qualified health centers (FQHC), and safety-net hospitals in or adjacent to vulnerable communities.
(2) Congress intended the 340B Drug Discount Program to provide discounts only to federally-funded clinics and 10400HB4327ham001 -2- LRB104 17027 BAB 38183 a qualified hospitals that provide direct clinical care to uninsured Americans who meet the definitions of vulnerable communities and vulnerable patients.
(2) Congress intended the 340B Drug Discount Program to provide discounts to 340B covered entities that provide direct health care to uninsured and underinsured vulnerable patients.
(3) The appropriate and effective use of the 340B Drug Discount Program is essential for improving health outcomes, particularly for vulnerable and underserved communities in rural, suburban, and urban areas throughout Illinois meeting the definitions of vulnerable communities and vulnerable patients.
(3) The appropriate and effective use of the 340B Drug Discount Program is essential for improving health HB4327 Enrolled - 2 - LRB104 17027 BAB 30442 b outcomes, particularly for vulnerable and underserved communities in rural, suburban, and urban areas throughout Illinois meeting the definitions of vulnerable communities.
(4) There is a need for increased, consistent, statewide data to evaluate program utilization, financial impact, and patient benefits.
(4) There is a need for statewide data to evaluate the ways in which 340B Drug Discount Program utilization, financial impact, and patient benefits enable vulnerable Illinoisans to access care and fit into the overall health care safety net framework.
Increased transparency in aggregate financial and operational reporting enhances legislative oversight without interfering with federal law.
Additional transparency in aggregate financial and operational reporting enhances legislative oversight without interfering with federal law.
(D) the Behavioral and Mental Health (BMH) Access and Expansion Fund;
10400HB4327ham001 -3- LRB104 17027 BAB 38183 a (D) the Behavioral and Mental Health (BMH) Access and Expansion Fund;
(E) the Stabilization and Sustainability HB4327 Enrolled - 3 - LRB104 17027 BAB 30442 b Operational Funding Program;
(E) the Stabilization and Sustainability Operational Funding Program;
(6) Savings associated with the federal 340B Drug Discount Program may support the financial stability of hospitals, FQHCs, Ryan White providers, rural providers, and other historical safety-net institutions serving vulnerable communities experiencing health care access shortages, provider scarcity, or risk of service reduction or closure.
(6) Revenues associated with the federal 340B Drug Discount Program may support the financial stability of hospitals, federally qualified health centers, Ryan White providers, rural providers, and other historical safety-net institutions serving vulnerable communities experiencing health care access shortages, provider scarcity, or risk of service reduction or closure.
These communities are characterized by elevated health disparities, limited access to health care services, and increased exposure to risk factors, such as poverty, inadequate insurance coverage, geographic isolation, systemic discrimination, and unmet social determinants of health, including housing, transportation, food security, and environmental conditions, and who, as a result of these conditions, experience reduced access to timely, HB4327 Enrolled - 4 - LRB104 17027 BAB 30442 b culturally competent, and geographically proximate community-based hospital and health care services.
These communities are characterized by elevated health disparities, limited access to health care services, and increased exposure to risk factors, such as poverty, inadequate insurance coverage, geographic isolation, systemic discrimination, and unmet social determinants of 10400HB4327ham001 -4- LRB104 17027 BAB 38183 a health, including housing, transportation, food security, and environmental conditions, and who, as a result of these conditions, experience reduced access to timely, culturally competent, and geographically proximate community-based hospital and health care services.
(8) This Act is intended solely to establish a State-level reporting and transparency framework to allow the 340B program to be evaluated, and shall not regulate pricing, reimbursement, or participation in the federal 340B Program.
(8) This Act is intended solely to establish a state-level reporting and transparency framework and shall not regulate pricing, reimbursement, or participation in the federal 340B Program.
(9) This Act is intended as a step toward either annual or biennial 340B covered entity reporting.
"340B covered entity" or "covered entity" means an entity in Illinois that qualifies as a covered entity under Section 340B of the federal Public Health Service Act, 42 U.S.C.
"340B covered entity" or "covered entity" means a covered entity as defined in 42 U.S.C.
256b(a)(4).
256b(a)(4), with a service address in Illinois as of January 1 of the reporting year.
"340B contract pharmacy" means any pharmacy that is under contract with a 340B covered entity to dispense 340B drugs on behalf of the 340B covered entity and is either (i) located in HB4327 Enrolled - 5 - LRB104 17027 BAB 30442 b Illinois and qualifies as a pharmacy under Section 3 of the Pharmacy Practice Act;
10400HB4327ham001 -5- LRB104 17027 BAB 38183 a "Contract pharmacy" means a pharmacy that enters into a contract with a 340B covered entity to provide services to the 340B covered entity's patients, including dispensing entity-owned 340B drugs.
or (ii) is located in a state, commonwealth, or territory of the United States, other than Illinois, and dispenses 340B drugs on behalf of the 340B covered entity.
"340B grantee" means an entity in Illinois that qualifies as a covered entity under subparagraphs (A)-(K) of paragraph (4) of subsection (a) of Section 340B of the federal Public Health Service Act, 42 U.S.C.
256b(a)(4)(A)-(K).
"Critical Access Hospital" has the meaning given to that term in paragraph (4) of subsection (b) of Section 5-5e of the Illinois Public Aid Code.
"Hospital" means a hospital licensed under the Hospital Licensing Act or University of Illinois Hospital Act.
"Pharmaceutical manufacturer" has the meaning given to the term "manufacturer" in the Wholesale Drug Distribution Licensing Act.
"Safety-Net Hospital" has the meaning given to that term Section 5-5e.1 of the Illinois Public Aid Code.
"Pharmaceutical manufacturer" means an entity that is engaged in:
(1) the production, preparation, propagation, compounding, conversion, or processing of prescription drug products, either directly or indirectly by extraction from substances of natural origin, independently by means of chemical synthesis, or by a combination of extraction and chemical synthesis;
or (2) the packaging, repackaging, labeling, relabeling, or distribution of prescription drug products.
"Pharmaceutical manufacturer" does not include a wholesale distributor of drugs or a retail pharmacy licensed under State law.
HB4327 Enrolled - 6 - LRB104 17027 BAB 30442 b (2) racial and ethnic minority populations and historically marginalized groups experiencing systemic inequities;
(2) racial and ethnic minority populations and historically marginalized groups experiencing systemic 10400HB4327ham001 -6- LRB104 17027 BAB 38183 a inequities;
(a) As soon as practical after the effective date of this Act, the Department of Insurance shall conduct a comprehensive study of how 340B covered entities and pharmaceutical manufacturers within Illinois participate in the 340B Drug Discount Program.
(a) As soon as practical after the effective date of this Act, the Department of Insurance shall conduct a comprehensive study of how 340B covered entities within Illinois participate in the 340B Drug Discount Program.
HB4327 Enrolled - 7 - LRB104 17027 BAB 30442 b (A) name;
(A) name;
and (D) 340B designation, as specified in 42 U.S.C 256b(a)(4);
and 10400HB4327ham001 -7- LRB104 17027 BAB 38183 a (D) designation of entity type, as specified in 42 U.S.C 256b(a)(4);
(2) the aggregate amount, by 340B entity type, spent on third-party administrators for the management of the 340B Drug Discount Program;
(2) the amount of 340B revenue, defined as the total patient and payer reimbursement less the total 340B acquisition cost, generated by 340B covered entities from both self-administered and physician-administered drugs;
(3) the average difference between the cost imposed by each covered entity on 340B-priced drugs and the reimbursement rate for 340B drugs, organized by therapeutic class;
(3) the amount spent on third-party administrators for the management of the 340B Drug Discount Program;
(4) the aggregate and transaction-level acquisition cost paid by a 340B covered entity for all prescription drugs organized by therapeutic class obtained under the 340B Drug Discount Program and dispensed or administered to patients;
(4) the amount paid to pharmacy benefit managers, as defined in subsection (a) of Section 513b1 of the Illinois Insurance Code, in contract pharmacy arrangements;
(5) the aggregate and transaction-level payment amount received by a 340B covered entity for all drugs organized by therapeutic class obtained under the 340B Drug Discount Program and dispensed or administered to patients;
(5) the amount paid to contract pharmacies;
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(6) with respect to 340B covered entities, a list of contract pharmacies contracted with the 340B covered entity to dispense 340B covered drugs;
(6) whether each covered entity maintains title to 340B drugs in contract pharmacy locations;
(7) the aggregate and transaction-level payment made to contract pharmacies to dispense drugs obtained under HB4327 Enrolled - 8 - LRB104 17027 BAB 30442 b the 340B Drug Discount Program;
(7) the average markup imposed by each covered entity on 340B-priced drugs;
(8) how the 340B covered entity uses any savings from participating in the 340B Drug Discount Program, including the total amount of 340B savings used for the provision of charity care, community benefits (including identification of the benefit program), any similar program of providing unreimbursed or subsidized health care, and any remaining savings for other purposes;
(8) the aggregate and transaction-level dollar amount of discounts that each 340B covered entity passes to patients at the point of sale for both in-house and contracted pharmacies, as defined by the difference between the total reimbursement amount to the 340B covered entity and the 340B price;
(9) to the extent the information is available, the percentage of total patients of the 340B covered entity that were:
(9) the aggregate and transaction-level acquisition cost paid by a 340B covered entity for all prescription drugs organized by therapeutic class obtained under the 340B Drug Discount Program and dispensed or administered 10400HB4327ham001 -8- LRB104 17027 BAB 38183 a to patients;
(A) served by a sliding fee scale for a prescription drug dispensed or administered under the 340B Drug Discount Program;
(10) the aggregate and transaction-level payment amount received by a 340B covered entity for all drugs organized by therapeutic class obtained under the 340B Drug Discount Program and dispensed or administered to patients;
(11) the aggregate and transaction-level payment made to contract pharmacies to dispense drugs obtained under the 340B Drug Discount Program;
(12) the number of claims for prescription drugs described in paragraph (10) organized by therapeutic class of drug;
(13) how the 340B covered entity uses any savings from participating in the 340B Drug Discount Program, including the amount of savings used for the provision of charity care, community benefits (including identification of the benefit program), and any similar program of providing unreimbursed or subsidized health care;
(14) the aggregate and transaction-level payment made for any other administering expense for the 340B Drug Discount Program;
(15) the percentage of the 340B covered entity's claims that were for prescription drugs obtained under the 340B Drug Discount Program;
(16) the percentage of total patients of the 340B covered entity that were:
10400HB4327ham001 -9- LRB104 17027 BAB 38183 a (A) served by a sliding fee scale for a prescription drug dispensed or administered under the 340B Drug Discount Program;
and (F) individuals with disabilities, older adults, HB4327 Enrolled - 9 - LRB104 17027 BAB 30442 b LGBTQ+ populations, and justice-involved individuals;
and (F) individuals with disabilities, older adults, LGBTQ+ populations, and justice-involved individuals;
(10) with respect to covered entities, the 340B covered entity's total operating costs;
(17) the 340B covered entity's total operating costs;
(11) with respect to covered entities, a copy of the 340B covered entity's financial assistance policy for the reporting year;
(18) the 340B covered entity's total costs for charity care;
(12) identification of the parties involved in the 340B procurement and dispensing process for each covered facility;
(19) a copy of the 340B covered entity's financial assistance policy for the reporting year;
(13) the aggregate and transaction-level payment made to a pharmacy services administrative organization that provides pharmacy services for a 340B contract pharmacy;
(20) identification of the parties involved in the 340B procurement and dispensing process for each covered facility;
(14) the aggregate and transaction-level payment made to a pharmacy benefit manager that provides pharmacy benefit management services for a 340B covered entity, if the information has not already been submitted in a pharmaceutical manufacturer 340B audit;
(21) the aggregate and transaction-level payment made to a pharmacy services administrative organization that 10400HB4327ham001 -10- LRB104 17027 BAB 38183 a provides pharmacy services for a 340B contract pharmacy;
(15) the total cost and number of hours spent preparing the data in response to the study;
and (22) the aggregate and transaction-level payment made to a pharmacy benefit manager that provides pharmacy benefit management services for a 340B covered entity organized by therapeutic class of drug.
(16) with respect to pharmaceutical manufacturers, copies of any 340B audits conducted during the previous calendar year;
(17) the specific pharmaceutical manufacturers that are participating in the 340B Drug Discount Program in Illinois;
(18) with respect to pharmaceutical manufacturers, any HB4327 Enrolled - 10 - LRB104 17027 BAB 30442 b restrictions placed by that manufacturer on participation in the 340B Drug Discount Program, any accompanying data supporting those restrictions, and the reasoning;
(19) a description of the impact of the 340B Drug Discount Program on the patients and the community served by each 340B covered entity;
(20) with respect to pharmaceutical manufacturers, and for the purpose of analyzing the impact of the 340B Drug Discount Program, the aggregate amount of all 340B discounts provided for each calendar year beginning in 2020;
and (21) with respect to pharmaceutical manufacturers, the aggregate amount of all 340B discounts provided for each calendar year beginning in 2020, stated as a percentage of the manufacturer's total annual revenues.
(c) The Department of Insurance shall request the information described in subsection (a) in a format designated by the Department.
(c) The Department of Insurance shall request the information described in subsection (a).
All 340B covered entities, and pharmaceutical manufacturers doing business in the State of Illinois, shall comply with requests for information relevant to subsection (a) from the Department of Insurance in the format prescribed and within the timeframe specified.
All 340B covered entities, insurers as defined in subsection (a-5) of Section 513b1 of the Illinois Insurance Code, pharmacy benefit managers, third-party administrators, and administrative service organizations of the State Employees Group Insurance Program shall comply with requests for information relevant to subsection (a) from the Department of Insurance in the format prescribed and within the timeframe specified.
Failure by a covered entity or pharmaceutical manufacturer to submit all requested information described in subsection (a) within HB4327 Enrolled - 11 - LRB104 17027 BAB 30442 b 30 calendar days from the time frame specified by the Department shall result in a fine levied by the Director of:
The Department of Insurance is hereby granted specific authority to fine any 340B covered entity, insurer, pharmacy benefit manager, third-party administrator, or administrative services organization that fails to comply with this Section within 14 calendar days after the due date specified by the Department of Insurance, at a rate of $100 per day for each day beyond 14 calendar days for federally qualified health centers and historical safety-net hospitals, and at a rate of $1,000 per day for each day beyond 14 calendar days for all other 10400HB4327ham001 -11- LRB104 17027 BAB 38183 a entities, that the information is past due.
(1) $500 per day the information is past due;
or (2) $100 per day the information is past due for hospitals with fewer than 100 licensed beds, Critical Access Hospitals, Safety-Net Hospitals, and 340B grantees.
All moneys in the Vulnerable Community Hospital Capital Investment Fund shall be used to support the health equity framework for supporting access to health care, creating sustainability, and supporting the implementation of the 340B Drug Discount Program.
HB4327 Enrolled - 12 - LRB104 17027 BAB 30442 b Nothing in this Section shall prevent the Department of Insurance from furnishing information collected from 340B covered entities or pharmaceutical manufacturers to State or federal authorities that may investigate, prosecute, or pursue other legal action against a 340B covered entity or pharmaceutical manufacturer for violations of 42 U.S.C.
Nothing in this Section shall prevent the Department of Insurance from furnishing information collected from 340B covered entities to State or federal authorities that may investigate, prosecute, or pursue other legal action against a 340B covered entity for violations of 42 U.S.C.
The report shall provide findings aggregated across 340B covered entities and pharmaceutical manufacturers and shall not disclose information or data attributed to any specific 340B covered entity or pharmaceutical manufacturer.
The report shall provide findings 10400HB4327ham001 -12- LRB104 17027 BAB 38183 a aggregated across 340B covered entities and shall not disclose information or data attributed to any specific 340B covered entity.
The report shall note any requests for information from the Department of Insurance where the requested information was never submitted.
The report may include any aggregated findings related to the populations identified in paragraph (9) of subsection (a).
The report may include any aggregated findings related to the populations identified in paragraph (16) of subsection (a).
The report shall address whether the data collected by the Department indicates a need for biennial reporting by 340B covered entities.
Section 20.
Severability.
If any provision of this Act or the Patient Access to Pharmacy Act is held invalid by a court, HB4327 Enrolled - 13 - LRB104 17027 BAB 30442 b the validity of the remainder of this Act and the Patient Access to Pharmacy Act shall not be affected by that determination of invalidity.
If the applicability of any provision of this Act or the Patient Access to Pharmacy Act to any person or circumstance is held invalid by a court, the applicability of that provision to other persons or circumstances shall not be affected by that determination of invalidity.
This Act is repealed on July 1, 2032.
This Act is repealed on July 1, 2029.
If and only if House Bill 2371 of the 104th General Assembly becomes law, then the Patient Access to Pharmacy Protection Act is amended by changing Section 40 and Section 99 as follows:
If and only if House Bill 2371 of the 104th General Assembly becomes law, then the Patient Access to Pharmacy Protection Act is amended by changing Section 40 as follows:
(b) Upon finding a violation of Section 15 of this Act, a HB4327 Enrolled - 14 - LRB104 17027 BAB 30442 b court may order:
(b) Upon finding a violation of Section 15 of this Act, a court may order:
(1) temporary, preliminary, or permanent injunctive relief for any act, policy, or practice that violates this Act;
10400HB4327ham001 -13- LRB104 17027 BAB 38183 a (1) temporary, preliminary, or permanent injunctive relief for any act, policy, or practice that violates this Act;
10400HB2371sam002.) (10400HB2371sam002, Sec.
99) Sec.
99.
Effective date.
This Act takes effect upon becoming law or on the effective date of House Bill 4327 of the 104th General Assembly, whichever is later;
however, this Act does not take effect at all unless House Bill 4327 of the 104th General Assembly becomes law.
(Source:
HB4327 Enrolled - 15 - LRB104 17027 BAB 30442 b (30 ILCS 105/5.1038 new) Sec.
(30 ILCS 105/5.1038 new) Sec.
This Act takes effect upon becoming law or on the effective date of House Bill 2371 of the 104th General Assembly, as amended by Senate Amendment No.
This Act takes effect upon becoming law, but this Act does not take effect at all unless House Bill 2371 of the 104th General Assembly, as amended by Senate Amendment No.
2, whichever is later;
2, becomes law.".
however, this Act does not take effect at all unless House Bill 2371 of the 104th General Assembly, as amended by Senate Amendment No.
2, becomes law.