HB4796 (104th General Assembly) is a proposed amendment affecting 720 ILCS 570/201 that would require the Illinois Department of Human Services to reschedule a substance within 30 days after publication of a Federal Register final order if the DEA reschedules a Schedule I substance for mental health treatment purposes. If enacted, this could accelerate state controlled-substance scheduling alignment in Illinois following federal rescheduling actions, with downstream impacts for healthcare providers, dispensing controls, and compliance policies around newly rescheduled therapies.
Illinois HB5046 (104th General Assembly) was introduced on 2026-02-10 and proposes amendments impacting 720 ILCS 570/311.6 (electronic prescribing for Schedule II–V controlled substances). As described in the bill text, it would (1) require a dispenser/pharmacy that cannot fill an initial electronically received prescription due to out-of-stock conditions to immediately contact the patient and ask whether the prescription should be electronically transferred to a pharmacy of the patient’s choosing (consistent with 21 CFR 1306), and (2) expand/clarify exceptions to mandatory electronic prescribing where drugs may need to be filled outside typical retail hours or are difficult to obtain due to drug shortages/inventory limitations. The bill also contains conforming changes to the Pharmacy Practice Act (225 ILCS 85/19). Compliance teams at pharmacies, health systems, and prescriber organizations should monitor this bill because it would change operational workflows for patient communication and prescription transfer, and would adjust when non-electronic prescribing is permitted for controlled substances.
SB3521 (104th General Assembly) was introduced on 2026-02-05 and proposes amendments to 720 ILCS 570/318 (Confidentiality of information) relating to the prescriber and dispenser inquiry system (PMP). The proposal would clarify that a “one-to-one secure link” includes communications exchange platforms aligned with widely adopted standards (including PMIX) to facilitate secure (including cross-state) PMP data transfer. The introduced text also includes provisions to automatically create a log-in to the inquiry system when a prescriber/dispenser obtains or renews a controlled substance license, and to require IDFPR to provide the PMP with electronic access to license information to facilitate profile creation. If enacted, it would affect prescriber/dispenser PMP access workflows, identity provisioning, and technical interoperability planning for organizations operating in Illinois.
SB3221 (104th General Assembly) proposes adding xylazine as a Class III (Schedule III) controlled substance under the Illinois Controlled Substances Act while providing that xylazine is not considered a controlled substance in specified circumstances (exemptions for certain legitimate uses). The bill PDF text indicates an effective date of 2027-01-01. Organizations that handle xylazine (including veterinary and related regulated activities) should monitor because scheduling would impose controlled-substance controls unless an exemption applies.
SB3191 (104th General Assembly) was introduced on 2026-02-02 and proposes amendments to the Illinois Controlled Substances Act (including 720 ILCS 570/401 and 720 ILCS 570/401.1) to increase/modify fentanyl-related criminal penalties. As summarized in the introduced bill text, it would make unlawfully selling or dispensing any scheduled drug containing a detectable amount of fentanyl a Class X felony with specified sentencing/fine provisions, and would add a felony provision for knowingly using an electronic communication device in furtherance of controlled substance trafficking involving any amount of fentanyl (in addition to other penalties). Compliance and risk teams in healthcare/pharmacy and regulated distribution should monitor because changes could affect enforcement risk, diversion prevention programs, and reporting/escalation practices around suspected fentanyl diversion or illicit distribution.
The Illinois Compiled Statutes text for 720 ILCS 570/302(c)(3) reflects an update (source note: Public Act 104-336) to explicitly include authorized employees of organizations providing hospice services or home health services among persons who may lawfully possess a controlled substance prescribed for the ultimate user. The ILCS source note indicates an effective date of 2026-01-01. This change affects compliance policies for hospice and home health providers regarding possession, custody, and handling of patient-prescribed controlled substances and may require updates to internal authorization/training documentation and controlled substance handling procedures.
In its Fall 2025 Compliance Capsule newsletter, IDFPR highlights 720 ILCS 570/311.6(e), emphasizing that a pharmacist may not refuse to fill a valid controlled-substance prescription solely because it is not prescribed electronically, and that pharmacists are not responsible for enforcing prescriber compliance with electronic prescribing of controlled substances (EPCS) requirements. This guidance is operationally relevant for pharmacies’ dispensing policies, staff training, and refusal-to-fill procedures, especially where workflows have been configured to reject non-electronic controlled-substance prescriptions.
HB0077 (104th General Assembly) proposes amending the Illinois Controlled Substances Act to schedule xylazine as a Schedule III controlled substance and to establish explicit exemptions for defined lawful activities (e.g., use by licensed veterinarians in professional practice; certain euthanasia technicians; wildlife biologists under veterinary supervision; other specified lawful uses). The bill status page shows last action on 2025-03-21 (re-referred to Rules Committee). If enacted, regulated entities (veterinary practices, suppliers, facilities handling xylazine) would need to implement controlled-substance handling controls unless covered by an exemption.
HB2804 (104th General Assembly) proposes amendments to the Illinois Controlled Substances Act (including Sections 401 and 401.1 per the bill materials) to create/expand fentanyl-specific criminal provisions. The introduced bill materials describe Class X felony treatment for knowingly/unlawfully selling or dispensing any scheduled drug containing a detectable amount of fentanyl, an additional felony for using an electronic communication device in furtherance of trafficking involving fentanyl, and additional sentencing provisions for specified fentanyl/carfentanil amounts and presentations. The ILGA status page shows last action 2025-02-06 (referred to House Rules Committee).
SB1773 (104th General Assembly) proposes amendments to the Illinois Controlled Substances Act to schedule xylazine as a Class III controlled substance; the bill PDF synopsis states an effective date of 2026-01-01. An amendment document was also identified that adds xylazine exemption language (e.g., circumstances where xylazine would not be considered a controlled substance). Stakeholders should monitor because scheduling would create new controlled-substance compliance obligations for entities handling xylazine unless exempted.
SB1553 (104th General Assembly) proposes amending the Illinois Controlled Substances Act to add xylazine to the Schedule III controlled substances list and to establish additional provisions addressing xylazine (including a veterinarian-related provision described in the introduced bill text, and penalty-related amendments tied to manufacture/delivery/possession-with-intent). If enacted, it would extend controlled-substance compliance obligations to xylazine in Illinois, affecting veterinary supply chains and any entities handling xylazine outside the scope of professional-practice exceptions.
An ILPMP newsletter (Feb 2025) reports that Public Act 103-1064 (effective 2025-02-07) was incorporated into the Illinois Controlled Substances Act and imposes stricter prerequisites for law-enforcement/authorized requestors seeking confidential ILPMP data. The newsletter describes requirements including a reason-to-believe standard, that the request be reasonably related to an investigation, and that a valid court order or subpoena be provided (with limitations described for administrative subpoenas). It also notes the prior online law-enforcement request portal is no longer available. This is compliance-relevant for agencies and entities requesting ILPMP data and for program administrators handling disclosures, as request intake, documentation review, and disclosure procedures must align with the updated statutory requirements.
HB1038 (104th General Assembly) proposes amendments to 720 ILCS 570/401 and 720 ILCS 570/401.1 to increase fentanyl-related penalties (including reclassification and sentencing changes for certain fentanyl quantities and enhancements when fentanyl is present). The ILGA bill status page shows the most recent action as 2025-01-09 (referred to the House Rules Committee). While not enacted per the provided sources, it remains a relevant proposed change for stakeholders monitoring potential future fentanyl penalty increases under the Illinois Controlled Substances Act.