PHARMACY-REFUSAL TO DISPENSE

Illinois General Assembly - Full Text of HB4655

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB4655

Introduced 2/3/2026, by Rep. William E Hauter

SYNOPSIS AS INTRODUCED:

225 ILCS 85/4

from Ch. 111, par. 4124
225 ILCS 85/30

from Ch. 111, par. 4150

Amends the Pharmacy Practice Act. In provisions exempting the
practice of specified professionals and their prescribing of such drugs,
medicines, or poisons as may seem appropriate to the professionals,
provides that this exemption is without regard to whether such drugs,
medicines, or poisons are not typically prescribed by such licensed
individuals or by licensed individuals in a same or similar specialty or
are self-prescribed, with the exception of controlled substances. Provides
that a licensee does not act in good faith when the licensee refuses to
compound, fill, or dispense prescriptions of physicians licensed to
practice medicine in all its branches solely because the prescriptions are
not typically issued by that physician or by physicians in the same or
similar specialty or are self-prescribed, with the exception of controlled
substances. Provides that it is a violation of specified provisions for
any prescriber or dispenser to adopt a contrary policy. Effective
immediately.
LRB104 19521 BAB 32969 b

A BILL FOR

HB4655
LRB104 19521 BAB 32969 b
1

AN ACT concerning regulation.

2

Be it enacted by the People of the State of Illinois,
3
represented in the General Assembly:

4

Section 5.
The Pharmacy Practice Act is amended by
5
changing Sections 4 and 30 as follows:

6

(225 ILCS 85/4)

(from Ch. 111, par. 4124)
7

(Section scheduled to be repealed on January 1, 2028)
8

Sec. 4.
Exemptions.
Nothing contained in any Section of
9
this Act shall apply to, or in any manner interfere with:
10

(a) the lawful practice of any physician licensed to
11

practice medicine in all of its branches, dentist,
12

podiatric physician, veterinarian, or therapeutically or
13

diagnostically certified optometrist within the limits of
14

his or her license, or prevent him or her from supplying to
15

his or her bona fide patients such drugs, medicines, or
16

poisons as may seem to him appropriate
, regardless of
17

whether such drugs, medicines, or poisons are not
18

typically prescribed by such licensed individuals or by
19

licensed individuals in a same or similar specialty or are
20

self-prescribed, with the exception of controlled
21

substances
;
22

(b) the sale of compressed gases;
23

(c) the sale of patent or proprietary medicines and

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LRB104 19521 BAB 32969 b
1

household remedies when sold in original and unbroken
2

packages only, if such patent or proprietary medicines and
3

household remedies be properly and adequately labeled as
4

to content and usage and generally considered and accepted
5

as harmless and nonpoisonous when used according to the
6

directions on the label, and also do not contain opium or
7

coca leaves, or any compound, salt or derivative thereof,
8

or any drug which, according to the latest editions of the
9

following authoritative pharmaceutical treatises and
10

standards, namely, The United States
11

Pharmacopoeia/National Formulary (USP/NF), the United
12

States Dispensatory, and the Accepted Dental Remedies of
13

the Council of Dental Therapeutics of the American Dental
14

Association or any or either of them, in use on the
15

effective date of this Act, or according to the existing
16

provisions of the Federal Food, Drug, and Cosmetic Act and
17

Regulations of the Department of Health and Human
18

Services, Food and Drug Administration, promulgated
19

thereunder now in effect, is designated, described or
20

considered as a narcotic, hypnotic, habit forming,
21

dangerous, or poisonous drug;
22

(d) the sale of poultry and livestock remedies in
23

original and unbroken packages only, labeled for poultry
24

and livestock medication;
25

(e) the sale of poisonous substances or mixture of
26

poisonous substances, in unbroken packages, for

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LRB104 19521 BAB 32969 b
1

nonmedicinal use in the arts or industries or for
2

insecticide purposes; provided, they are properly and
3

adequately labeled as to content and such nonmedicinal
4

usage, in conformity with the provisions of all applicable
5

federal, state and local laws and regulations promulgated
6

thereunder now in effect relating thereto and governing
7

the same, and those which are required under such
8

applicable laws and regulations to be labeled with the
9

word "Poison", are also labeled with the word "Poison"
10

printed thereon in prominent type and the name of a
11

readily obtainable antidote with directions for its
12

administration;
13

(f) the delegation of limited prescriptive authority
14

by a physician licensed to practice medicine in all its
15

branches to a physician assistant under Section 7.5 of the
16

Physician Assistant Practice Act of 1987. This delegated
17

authority under Section 7.5 of the Physician Assistant
18

Practice Act of 1987 may, but is not required to, include
19

prescription of controlled substances, as defined in
20

Article II of the Illinois Controlled Substances Act, in
21

accordance with a written supervision agreement;
22

(g) the delegation of prescriptive authority by a
23

physician licensed to practice medicine in all its
24

branches or a licensed podiatric physician to an advanced
25

practice registered nurse in accordance with a written
26

collaborative agreement under Sections 65-35 and 65-40 of

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LRB104 19521 BAB 32969 b
1

the Nurse Practice Act;
2

(g-5) the donation or acceptance, or the packaging,
3

repackaging, or labeling, of drugs to the extent permitted
4

under the Illinois Drug Reuse Opportunity Program Act; and
5

(h) the sale or distribution of dialysate or devices
6

necessary to perform home peritoneal renal dialysis for
7

patients with end-stage renal disease, provided that all
8

of the following conditions are met:
9

(1) the dialysate, comprised of dextrose or
10

icodextrin, or devices are approved or cleared by the
11

federal Food and Drug Administration, as required by
12

federal law;
13

(2) the dialysate or devices are lawfully held by
14

a manufacturer or the manufacturer's agent, which is
15

properly registered with the Board as a manufacturer,
16

third-party logistics provider, or wholesaler;
17

(3) the dialysate or devices are held and
18

delivered to the manufacturer or the manufacturer's
19

agent in the original, sealed packaging from the
20

manufacturing facility;
21

(4) the dialysate or devices are delivered only
22

upon receipt of a physician's prescription by a
23

licensed pharmacy in which the prescription is
24

processed in accordance with provisions set forth in
25

this Act, and the transmittal of an order from the
26

licensed pharmacy to the manufacturer or the

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LRB104 19521 BAB 32969 b
1

manufacturer's agent; and
2

(5) the manufacturer or the manufacturer's agent
3

delivers the dialysate or devices directly to: (i) a
4

patient with end-stage renal disease, or his or her
5

designee, for the patient's self-administration of the
6

dialysis therapy or (ii) a health care provider or
7

institution for administration or delivery of the
8

dialysis therapy to a patient with end-stage renal
9

disease.
10

This paragraph (h) does not include any other drugs
11

for peritoneal dialysis, except dialysate, as described in
12

item (1) of this paragraph (h). All records of sales and
13

distribution of dialysate to patients made pursuant to
14

this paragraph (h) must be retained in accordance with
15

Section 18 of this Act. A student pharmacist or licensed
16

pharmacy technician engaged in remote prescription
17

processing under Section 25.10 of this Act at a licensed
18

pharmacy described in item (4) of this paragraph (h) shall
19

be permitted to access an employer pharmacy's database
20

from his or her home or other remote location while under
21

the supervision of a pharmacist for the purpose of
22

performing certain prescription processing functions,
23

provided that the pharmacy establishes controls to protect
24

the privacy and security of confidential records.
25
(Source: P.A. 101-420, eff. 8-16-19; 102-84, eff. 7-9-21;
26
102-389, eff. 1-1-22; 102-813, eff. 5-13-22.)

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LRB104 19521 BAB 32969 b
1

(225 ILCS 85/30)

(from Ch. 111, par. 4150)
2

(Section scheduled to be repealed on January 1, 2028)
3

Sec. 30.
Refusal, revocation, suspension, or other
4
discipline.
5

(a) The Department may refuse to issue or renew, or may
6
revoke a license, or may suspend, place on probation, fine, or
7
take any disciplinary or non-disciplinary action as the
8
Department may deem proper, including fines not to exceed
9
$10,000 for each violation, with regard to any licensee for
10
any one or combination of the following causes:
11

1. Material misstatement in furnishing information to
12

the Department.
13

2. Violations of this Act, or the rules promulgated
14

hereunder.
15

3. Making any misrepresentation for the purpose of
16

obtaining licenses.
17

4. A pattern of conduct which demonstrates
18

incompetence or unfitness to practice.
19

5. Aiding or assisting another person in violating any
20

provision of this Act or rules.
21

6. Failing, within 60 days, to respond to a written
22

request made by the Department for information.
23

7. Engaging in unprofessional, dishonorable, or
24

unethical conduct of a character likely to deceive,
25

defraud, or harm the public as defined by rule.

HB4655
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LRB104 19521 BAB 32969 b
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8. Adverse action taken by another state or
2

jurisdiction against a license or other authorization to
3

practice as a pharmacy, pharmacist, registered certified
4

pharmacy technician, or registered pharmacy technician
5

that is the same or substantially equivalent to those set
6

forth in this Section, a certified copy of the record of
7

the action taken by the other state or jurisdiction being
8

prima facie evidence thereof.
9

9. Directly or indirectly giving to or receiving from
10

any person, firm, corporation, partnership, or association
11

any fee, commission, rebate, or other form of compensation
12

for any professional services not actually or personally
13

rendered. Nothing in this item 9 affects any bona fide
14

independent contractor or employment arrangements among
15

health care professionals, health facilities, health care
16

providers, or other entities, except as otherwise
17

prohibited by law. Any employment arrangements may include
18

provisions for compensation, health insurance, pension, or
19

other employment benefits for the provision of services
20

within the scope of the licensee's practice under this
21

Act. Nothing in this item 9 shall be construed to require
22

an employment arrangement to receive professional fees for
23

services rendered.
24

10. A finding by the Department that the licensee,
25

after having his license placed on probationary status,
26

has violated the terms of probation.

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LRB104 19521 BAB 32969 b
1

11. Selling or engaging in the sale of drug samples
2

provided at no cost by drug manufacturers.
3

12. Physical illness, including, but not limited to,
4

deterioration through the aging process, or loss of motor
5

skill which results in the inability to practice the
6

profession with reasonable judgment, skill or safety.
7

13. A finding that licensure or registration has been
8

applied for or obtained by fraudulent means.
9

14. Conviction by plea of guilty or nolo contendere,
10

finding of guilt, jury verdict, or entry of judgment or
11

sentencing, including, but not limited to, convictions,
12

preceding sentences of supervision, conditional discharge,
13

or first offender probation, under the laws of any
14

jurisdiction of the United States that is (i) a felony or
15

(ii) a misdemeanor, an essential element of which is
16

dishonesty, or that is directly related to the practice of
17

pharmacy or involves controlled substances.
18

15. Habitual or excessive use or addiction to alcohol,
19

narcotics, stimulants, or any other chemical agent or drug
20

which results in the inability to practice with reasonable
21

judgment, skill, or safety.
22

16. Willfully making or filing false records or
23

reports in the practice of pharmacy, including, but not
24

limited to, false records to support claims against the
25

medical assistance program of the Department of Healthcare
26

and Family Services (formerly Department of Public Aid)

HB4655
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LRB104 19521 BAB 32969 b
1

under the Public Aid Code.
2

17. Gross and willful overcharging for professional
3

services including filing false statements for collection
4

of fees for which services are not rendered, including,
5

but not limited to, filing false statements for collection
6

of monies for services not rendered from the medical
7

assistance program of the Department of Healthcare and
8

Family Services (formerly Department of Public Aid) under
9

the Public Aid Code.
10

18. Dispensing prescription drugs without receiving a
11

written or oral prescription in violation of law.
12

19. Upon a finding of a substantial discrepancy in a
13

Department audit of a prescription drug, including
14

controlled substances, as that term is defined in this Act
15

or in the Illinois Controlled Substances Act.
16

20. Physical or mental illness or any other impairment
17

or disability, including, without limitation: (A)
18

deterioration through the aging process or loss of motor
19

skills that results in the inability to practice with
20

reasonable judgment, skill, or safety; or (B) mental
21

incompetence, as declared by a court of competent
22

jurisdiction.
23

21. Violation of the Health Care Worker Self-Referral
24

Act.
25

22. Failing to sell or dispense any drug, medicine, or
26

poison in good faith. "Good faith", for the purposes of

HB4655
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LRB104 19521 BAB 32969 b
1

this Section, has the meaning ascribed to it in subsection
2

(u) of Section 102 of the Illinois Controlled Substances
3

Act. "Good faith", as used in this item (22), shall not be
4

limited to the sale or dispensing of controlled
5

substances, but shall apply to all prescription drugs.
A
6

licensee does not act in good faith when the licensee
7

refuses to compound, fill, or dispense prescriptions of
8

physicians licensed to practice medicine in all its
9

branches solely because the prescriptions are not
10

typically issued by that physician or by a physician in
11

the same or similar specialty or are self-prescribed, with
12

the exception of controlled substances. It shall be a
13

violation of this Section for any prescriber or dispenser
14

to adopt a policy contrary to this Section.

15

23. Interfering with the professional judgment of a
16

pharmacist by any licensee under this Act, or the
17

licensee's agents or employees.
18

24. Failing to report within 60 days to the Department
19

any adverse final action taken against a pharmacy,
20

pharmacist, registered pharmacy technician, or registered
21

certified pharmacy technician by another licensing
22

jurisdiction in any other state or any territory of the
23

United States or any foreign jurisdiction, any
24

governmental agency, any law enforcement agency, or any
25

court for acts or conduct similar to acts or conduct that
26

would constitute grounds for discipline as defined in this

HB4655
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LRB104 19521 BAB 32969 b
1

Section.
2

25. Failing to comply with a subpoena issued in
3

accordance with Section 35.5 of this Act.
4

26. Disclosing protected health information in
5

violation of any State or federal law.
6

27. Willfully failing to report an instance of
7

suspected abuse, neglect, financial exploitation, or
8

self-neglect of an eligible adult as defined in and
9

required by the Adult Protective Services Act.
10

28. Being named as an abuser in a verified report by
11

the Department on Aging under the Adult Protective
12

Services Act, and upon proof by clear and convincing
13

evidence that the licensee abused, neglected, or
14

financially exploited an eligible adult as defined in the
15

Adult Protective Services Act.
16

29. Using advertisements or making solicitations that
17

may jeopardize the health, safety, or welfare of patients,
18

including, but not limited to, the use of advertisements
19

or solicitations that:
20

(A) are false, fraudulent, deceptive, or
21

misleading; or
22

(B) include any claim regarding a professional
23

service or product or the cost or price thereof that
24

cannot be substantiated by the licensee.
25

30. Requiring a pharmacist to participate in the use
26

or distribution of advertisements or in making

HB4655
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LRB104 19521 BAB 32969 b
1

solicitations that may jeopardize the health, safety, or
2

welfare of patients.
3

31. Failing to provide a working environment for all
4

pharmacy personnel that protects the health, safety, and
5

welfare of a patient, which includes, but is not limited
6

to, failing to:
7

(A) employ sufficient personnel to prevent
8

fatigue, distraction, or other conditions that
9

interfere with a pharmacist's ability to practice with
10

competency and safety or creates an environment that
11

jeopardizes patient care;
12

(B) provide appropriate opportunities for
13

uninterrupted rest periods and meal breaks;
14

(C) provide adequate time for a pharmacist to
15

complete professional duties and responsibilities,
16

including, but not limited to:
17

(i) drug utilization review;
18

(ii) immunization;
19

(iii) counseling;
20

(iv) verification of the accuracy of a
21

prescription; and
22

(v) all other duties and responsibilities of a
23

pharmacist as listed in the rules of the
24

Department.
25

32. Introducing or enforcing external factors, such as
26

productivity or production quotas or other programs

HB4655
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LRB104 19521 BAB 32969 b
1

against pharmacists, student pharmacists or pharmacy
2

technicians, to the extent that they interfere with the
3

ability of those individuals to provide appropriate
4

professional services to the public.
5

33. Providing an incentive for or inducing the
6

transfer of a prescription for a patient absent a
7

professional rationale.
8

(b) The Department may refuse to issue or may suspend the
9
license of any person who fails to file a return, or to pay the
10
tax, penalty, or interest shown in a filed return, or to pay
11
any final assessment of tax, penalty, or interest, as required
12
by any tax Act administered by the Illinois Department of
13
Revenue, until such time as the requirements of any such tax
14
Act are satisfied.
15

(c) The Department shall revoke any license issued under
16
the provisions of this Act or any prior Act of this State of
17
any person who has been convicted a second time of committing
18
any felony under the Illinois Controlled Substances Act, or
19
who has been convicted a second time of committing a Class 1
20
felony under Sections 8A-3 and 8A-6 of the Illinois Public Aid
21
Code. A person whose license issued under the provisions of
22
this Act or any prior Act of this State is revoked under this
23
subsection (c) shall be prohibited from engaging in the
24
practice of pharmacy in this State.
25

(c-5) The Department shall not revoke, suspend, summarily
26
suspend, place on prohibition, reprimand, refuse to issue or

HB4655
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LRB104 19521 BAB 32969 b
1
renew, or take any other disciplinary or non-disciplinary
2
action against a person's authorization to practice under this
3
Act based solely upon the person providing, authorizing,
4
recommending, aiding, assisting, referring for, or otherwise
5
participating in any health care service, so long as the care
6
was not unlawful under the laws of this State, regardless of
7
whether the patient was a resident of this State or another
8
state.
9

(c-10) The Department shall not revoke, suspend, summarily
10
suspend, place on prohibition, reprimand, refuse to issue or
11
renew, or take any other disciplinary or non-disciplinary
12
action against a person's authorization to practice under this
13
Act based upon the person's license, registration, or permit
14
being revoked or suspended, or the person being otherwise
15
disciplined, by any other state if that revocation,
16
suspension, or other form of discipline was based solely on
17
the person violating another state's laws prohibiting the
18
provision of, authorization of, recommendation of, aiding or
19
assisting in, referring for, or participation in any health
20
care service if that health care service as provided would not
21
have been unlawful under the laws of this State and is
22
consistent with the applicable standard of conduct for a
23
person practicing in Illinois under this Act.
24

(c-15) The conduct specified in subsections (c-5) and
25
(c-10) shall not constitute grounds for suspension under
26
Section 35.16.

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LRB104 19521 BAB 32969 b
1

(c-20) An applicant seeking licensure, certification, or
2
authorization pursuant to this Act who has been subject to
3
disciplinary action by a duly authorized professional
4
disciplinary agency of another jurisdiction solely on the
5
basis of having provided, authorized, recommended, aided,
6
assisted, referred for, or otherwise participated in health
7
care shall not be denied such licensure, certification, or
8
authorization, unless the Department determines that such
9
action would have constituted professional misconduct in this
10
State; however, nothing in this Section shall be construed as
11
prohibiting the Department from evaluating the conduct of such
12
applicant and making a determination regarding the licensure,
13
certification, or authorization to practice a profession under
14
this Act.
15

(d) Fines may be imposed in conjunction with other forms
16
of disciplinary action, but shall not be the exclusive
17
disposition of any disciplinary action arising out of conduct
18
resulting in death or injury to a patient. Fines shall be paid
19
within 60 days or as otherwise agreed to by the Department. Any
20
funds collected from such fines shall be deposited in the
21
Illinois State Pharmacy Disciplinary Fund.
22

(e) The entry of an order or judgment by any circuit court
23
establishing that any person holding a license or certificate
24
under this Act is a person in need of mental treatment operates
25
as a suspension of that license. A licensee may resume his or
26
her practice only upon the entry of an order of the Department

HB4655
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LRB104 19521 BAB 32969 b
1
based upon a finding by the Board that he or she has been
2
determined to be recovered from mental illness by the court
3
and upon the Board's recommendation that the licensee be
4
permitted to resume his or her practice.
5

(f) The Department shall issue quarterly to the Board a
6
status of all complaints related to the profession received by
7
the Department.
8

(g) In enforcing this Section, the Board or the
9
Department, upon a showing of a possible violation, may compel
10
any licensee or applicant for licensure under this Act to
11
submit to a mental or physical examination or both, as
12
required by and at the expense of the Department. The
13
examining physician, or multidisciplinary team involved in
14
providing physical and mental examinations led by a physician
15
consisting of one or a combination of licensed physicians,
16
licensed clinical psychologists, licensed clinical social
17
workers, licensed clinical professional counselors, and other
18
professional and administrative staff, shall be those
19
specifically designated by the Department. The Board or the
20
Department may order the examining physician or any member of
21
the multidisciplinary team to present testimony concerning
22
this mental or physical examination of the licensee or
23
applicant. No information, report, or other documents in any
24
way related to the examination shall be excluded by reason of
25
any common law or statutory privilege relating to
26
communication between the licensee or applicant and the

HB4655
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LRB104 19521 BAB 32969 b
1
examining physician or any member of the multidisciplinary
2
team. The individual to be examined may have, at his or her own
3
expense, another physician of his or her choice present during
4
all aspects of the examination. Failure of any individual to
5
submit to a mental or physical examination when directed shall
6
result in the automatic suspension of his or her license until
7
such time as the individual submits to the examination. If the
8
Board or Department finds a pharmacist, registered certified
9
pharmacy technician, or registered pharmacy technician unable
10
to practice because of the reasons set forth in this Section,
11
the Board or Department shall require such pharmacist,
12
registered certified pharmacy technician, or registered
13
pharmacy technician to submit to care, counseling, or
14
treatment by physicians or other appropriate health care
15
providers approved or designated by the Department as a
16
condition for continued, restored, or renewed licensure to
17
practice. Any pharmacist, registered certified pharmacy
18
technician, or registered pharmacy technician whose license
19
was granted, continued, restored, renewed, disciplined, or
20
supervised, subject to such terms, conditions, or
21
restrictions, and who fails to comply with such terms,
22
conditions, or restrictions or to complete a required program
23
of care, counseling, or treatment, as determined by the chief
24
pharmacy coordinator, shall be referred to the Secretary for a
25
determination as to whether the licensee shall have his or her
26
license suspended immediately, pending a hearing by the Board.

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In instances in which the Secretary immediately suspends a
2
license under this subsection (g), a hearing upon such
3
person's license must be convened by the Board within 15 days
4
after such suspension and completed without appreciable delay.
5
The Department and Board shall have the authority to review
6
the subject pharmacist's, registered certified pharmacy
7
technician's, or registered pharmacy technician's record of
8
treatment and counseling regarding the impairment.
9

(h) An individual or organization acting in good faith,
10
and not in a willful and wanton manner, in complying with this
11
Section by providing a report or other information to the
12
Board, by assisting in the investigation or preparation of a
13
report or information, by participating in proceedings of the
14
Board, or by serving as a member of the Board shall not, as a
15
result of such actions, be subject to criminal prosecution or
16
civil damages. Any person who reports a violation of this
17
Section to the Department is protected under subsection (b) of
18
Section 15 of the Whistleblower Act.
19

(i) Members of the Board shall have no liability in any
20
action based upon any disciplinary proceedings or other
21
activity performed in good faith as a member of the Board. The
22
Attorney General shall defend all such actions unless he or
23
she determines either that there would be a conflict of
24
interest in such representation or that the actions complained
25
of were not in good faith or were willful and wanton.
26

If the Attorney General declines representation, the

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1
member shall have the right to employ counsel of his or her
2
choice, whose fees shall be provided by the State, after
3
approval by the Attorney General, unless there is a
4
determination by a court that the member's actions were not in
5
good faith or were willful and wanton.
6

The member must notify the Attorney General within 7 days
7
of receipt of notice of the initiation of any action involving
8
services of the Board. Failure to so notify the Attorney
9
General shall constitute an absolute waiver of the right to a
10
defense and indemnification.
11

The Attorney General shall determine, within 7 days after
12
receiving such notice, whether he or she will undertake to
13
represent the member.
14

(j) The Department may adopt rules to implement,
15
administer, and enforce this Section.
16
(Source: P.A. 104-432, eff. 1-1-26
.)

17

Section 99.
Effective date.
This Act takes effect upon
18
becoming law.

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