ELECTRONIC PRESCRIPTIONS

Illinois General Assembly - Full Text of HB5046

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB5046

Introduced 2/10/2026, by Rep. Kelly M. Cassidy

SYNOPSIS AS INTRODUCED:

225 ILCS 85/19

from Ch. 111, par. 4139
720 ILCS 570/311.6

Amends the Illinois Controlled Substances Act. Provides that, if a
pharmacy is unable to fill an initial prescription received electronically
because the prescribed drug is not in stock, the dispenser must
immediately contact the patient to notify the patient of the situation and
ask if the patient would like the prescription transferred electronically
to a pharmacy of the patient's choosing, consistent with federal
regulations concerning the prescribing of controlled substances. Provides
that the prescriber shall not be required to issue prescriptions
electronically if the prescriptions need to be filled outside of typical
retail pharmacy operating hours or may be difficult to obtain because of
drug shortages or pharmacy inventory limitations. Amends the Pharmacy
Practice Act to make conforming changes. Effective immediately.
LRB104 17659 RLC 31090 b

A BILL FOR

HB5046
LRB104 17659 RLC 31090 b
1

AN ACT concerning electronic prescriptions.

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 Section 19 as follows:

6

(225 ILCS 85/19)

(from Ch. 111, par. 4139)
7

(Section scheduled to be repealed on January 1, 2028)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

Sec. 19.
Nothing contained in this Act shall be construed
9
to prohibit a pharmacist licensed in this State from filling
10
or refilling a valid prescription for prescription drugs which
11
is on file in a pharmacy licensed in any state and has been
12
transferred from one pharmacy to another by any means,
13
including by way of electronic data processing equipment upon
14
the following conditions and exceptions:
15

(1) Prior to dispensing pursuant to any such
16

prescription, the dispensing pharmacist shall:
17

(a) Advise the patient that the prescription on
18

file at such other pharmacy must be canceled before he
19

or she will be able to fill or refill it.
20

(b) Determine that the prescription is valid and
21

on file at such other pharmacy and that such
22

prescription may be filled or refilled, as requested,
23

in accordance with the prescriber's intent expressed

HB5046
- 2 -
LRB104 17659 RLC 31090 b
1

on such prescription.
2

(c) Notify the pharmacy where the prescription is
3

on file that the prescription must be canceled.
4

(d) Record in writing or electronically the
5

prescription order, the name of the pharmacy at which
6

the prescription was on file, the prescription number,
7

the name of the drug and the original amount
8

dispensed, the date of original dispensing, and the
9

number of remaining authorized refills.
10

(e) Obtain the consent of the prescriber to the
11

refilling of the prescription when the prescription,
12

in the professional judgment of the dispensing
13

pharmacist, so requires.
14

(2) Upon receipt of a request for prescription
15

information set forth in subparagraph (d) of paragraph (1)
16

of this Section, if the requested pharmacist is satisfied
17

in his professional judgment that such request is valid
18

and legal, the requested pharmacist shall:
19

(a) Provide such information accurately and
20

completely.
21

(b) Record electronically or, if in writing, on
22

the face of the prescription, the name of the
23

requesting pharmacy and pharmacist and the date of
24

request.
25

(c) Cancel the prescription on file by writing the
26

word "void" on its face or the electronic equivalent,

HB5046
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LRB104 17659 RLC 31090 b
1

if not in written format. No further prescription
2

information shall be given or medication dispensed
3

pursuant to such original prescription.
4

(3) In the event that, after the information set forth
5

in subparagraph (d) of paragraph (1) of this Section has
6

been provided, a prescription is not dispensed by the
7

requesting pharmacist, then such pharmacist shall provide
8

notice of this fact to the pharmacy from which such
9

information was obtained; such notice shall then cancel
10

the prescription in the same manner as set forth in
11

subparagraph (c) of paragraph (2) of this Section.
12

(4) When filling or refilling a valid prescription on
13

file in another state, the dispensing pharmacist shall be
14

required to follow all the requirements of Illinois law
15

which apply to the dispensing of prescription drugs. If
16

anything in Illinois law prevents the filling or refilling
17

of the original prescription it shall be unlawful to
18

dispense pursuant to this Section.
19

(5) Prescriptions for drugs in Schedules
II,
III, IV,
20

and V of the Illinois Controlled Substances Act may be
21

transferred only once and may not be further transferred
,
22

consistent with 21 CFR 1306
. However, pharmacies
23

electronically sharing a real-time, online database may
24

transfer up to the maximum refills permitted by the law
25

and the prescriber's authorization.
26
(Source: P.A. 100-497, eff. 9-8-17
.)

HB5046
- 4 -
LRB104 17659 RLC 31090 b
1

Section 10.
The Illinois Controlled Substances Act is
2
amended by changing Section 311.6 as follows:

3

(720 ILCS 570/311.6)
4

Sec. 311.6.
Prescriptions for substance classified in
5
Schedule II, III, IV, or V sent electronically; exceptions.
6

(a) Notwithstanding any other provision of law, a
7
prescription for a substance classified in Schedule II, III,
8
IV, or V must be sent electronically, in accordance with
9
Section 316. Prescriptions sent in accordance with this
10
subsection (a) must be accepted by the dispenser in electronic
11
format.
12

(a-5) If a pharmacy is unable to fill an initial
13
prescription received electronically because the prescribed
14
drug is not in stock, the dispenser must immediately contact
15
the patient to notify the patient of the situation and ask if
16
the patient would like the prescription transferred
17
electronically to a pharmacy of the patient's choosing,
18
consistent with 21 CFR 1306.

19

(b) Beginning on January 1, 2024 (the effective date of
20
Public Act 103-425) until December 31, 2028, notwithstanding
21
any other provision of this Section or any other provision of
22
law, a prescriber shall not be required to issue prescriptions
23
electronically if he or she certifies to the Department of
24
Financial and Professional Regulation that he or she will not

HB5046
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LRB104 17659 RLC 31090 b
1
issue more than 150 prescriptions during a 12-month period.
2
Prescriptions in both oral and written form for controlled
3
substances shall be included in determining whether the
4
prescriber will reach the limit of 150 prescriptions.
5
Beginning January 1, 2029, notwithstanding any other provision
6
of this Section or any other provision of law, a prescriber
7
shall not be required to issue prescriptions electronically if
8
he or she certifies to the Department of Financial and
9
Professional Regulation that he or she will not issue more
10
than 50 prescriptions during a 12-month period. Prescriptions
11
in both oral and written form for controlled substances shall
12
be included in determining whether the prescriber will reach
13
the limit of 50 prescriptions.
14

(b-5) Notwithstanding any other provision of this Section
15
or any other provision of law, a prescriber shall not be
16
required to issue prescriptions electronically under the
17
following circumstances:
18

(1) prior to January 1, 2026, the prescriber
19

demonstrates financial difficulties in buying or managing
20

an electronic prescription option, whether it is an
21

electronic health record or some other electronic
22

prescribing product;
23

(2) on and after January 1, 2026, the prescriber
24

provides proof of a waiver from the Centers for Medicare
25

and Medicaid Services for the Electronic Prescribing for
26

Controlled Substances Program due to demonstrated economic

HB5046
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LRB104 17659 RLC 31090 b
1

hardship for the previous compliance year;
2

(3) there is a temporary technological or electrical
3

failure that prevents an electronic prescription from
4

being issued;
5

(4) the prescription is for a drug that the
6

practitioner reasonably determines would be impractical
7

for the patient to obtain in a timely manner if prescribed
8

by an electronic data transmission prescription and the
9

delay would adversely impact the patient's medical
10

condition
. This includes prescriptions that may need to be
11

filled outside of typical retail pharmacy operating hours
12

or that may be difficult to obtain because of drug
13

shortages or pharmacy inventory limitations
;
14

(5) the prescription is for an individual who:
15

(A) resides in a nursing or assisted living
16

facility;
17

(B) is receiving hospice or palliative care;
18

(C) is receiving care at an outpatient renal
19

dialysis facility and the prescription is related to
20

the care provided;
21

(D) is receiving care through the United States
22

Department of Veterans Affairs; or
23

(E) is incarcerated in a state, detained, or
24

confined in a correctional facility;
25

(6) the prescription prescribes a drug under a
26

research protocol;

HB5046
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LRB104 17659 RLC 31090 b
1

(7) the prescription is a non-patient specific
2

prescription dispensed under a standing order, approved
3

protocol for drug therapy, collaborative drug management,
4

or comprehensive medication management, or in response to
5

a public health emergency or other circumstance in which
6

the practitioner may issue a non-patient specific
7

prescription;
8

(8) the prescription is issued when the prescriber and
9

dispenser are the same entity;
10

(9) the prescription is issued for a compound
11

prescription containing 2 or more compounds; or
12

(10) the prescription is issued by a licensed
13

veterinarian within 7 years after November 17, 2023 (the
14

effective date of Public Act 103-563).
15

(c) The Department of Financial and Professional
16
Regulation may adopt rules for the administration of this
17
Section to the requirements under this Section that the
18
Department of Financial and Professional Regulation may deem
19
appropriate.
20

(d) Any prescriber who makes a good faith effort to
21
prescribe electronically, but for reasons not within the
22
prescriber's control is unable to prescribe electronically,
23
may be exempt from any disciplinary action.
24

(e) Any pharmacist who dispenses in good faith based upon
25
a valid prescription that is not prescribed electronically may
26
be exempt from any disciplinary action. A pharmacist is not

HB5046
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LRB104 17659 RLC 31090 b
1
required to ensure or responsible for ensuring the
2
prescriber's compliance under subsection (b), nor may any
3
other entity or organization require a pharmacist to ensure
4
the prescriber's compliance with that subsection. A pharmacist
5
may not refuse to fill a valid prescription solely because it
6
is not prescribed electronically.
7

(f) It shall be a violation of this Section for any
8
prescriber or dispenser to adopt a policy contrary to this
9
Section.
10

(g) A compliance action with respect to this Section
11
initiated by the Department of Financial and Professional
12
Regulation prior to December 31, 2030 is limited to a
13
non-disciplinary warning letter or citation, unless the
14
prescriber or dispenser fails to abide by the initial
15
non-disciplinary warning letter or citation, has acted in bad
16
faith, or a pattern of practice in violation of this Section
17
occurs.
18
(Source: P.A. 103-425, eff. 1-1-24; 103-563, eff. 11-17-23;
19
103-732, eff. 8-2-24; 104-424, eff. 8-15-25.)

20

Section 99.
Effective date.
This Act takes effect upon
21
becoming law.

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