Full Text of HB5527 96th General Assembly
HB5527ham001 96TH GENERAL ASSEMBLY
|
Rep. Angelo Saviano
Filed: 3/11/2010
|
|
09600HB5527ham001 |
|
LRB096 20211 RPM 37218 a |
|
| 1 |
| AMENDMENT TO HOUSE BILL 5527
| 2 |
| AMENDMENT NO. ______. Amend House Bill 5527 by replacing | 3 |
| everything after the enacting clause with the following:
| 4 |
| "Section 5. The Uniform Prescription Drug Information Card | 5 |
| Act is amended by changing Section 15 as follows: | 6 |
| (215 ILCS 138/15) | 7 |
| Sec. 15. Uniform prescription drug information cards | 8 |
| required. | 9 |
| (a) A health benefit plan that issues a card or other | 10 |
| technology and
provides coverage for prescription drugs or
| 11 |
| devices
and an administrator of such a plan including, but not | 12 |
| limited to, third-party
administrators for self-insured plans | 13 |
| and state-administered plans shall issue
to its
insureds a card | 14 |
| or other technology containing uniform prescription drug
| 15 |
| information. The uniform prescription drug information card or | 16 |
| other
technology shall
specifically identify and display the |
|
|
|
09600HB5527ham001 |
- 2 - |
LRB096 20211 RPM 37218 a |
|
| 1 |
| following
mandatory data elements on the front of the card: | 2 |
| (1) BIN number; | 3 |
| (2) Processor control number if required for claims | 4 |
| adjudication; | 5 |
| (3) Group number; | 6 |
| (4) Card issuer identifier; | 7 |
| (5) Cardholder ID number; and | 8 |
| (6) Cardholder name. | 9 |
| The uniform prescription drug information card or other | 10 |
| technology shall
specifically identify and display the | 11 |
| following mandatory data elements on the
back of the card: | 12 |
| (1) Claims submission names and addresses; and | 13 |
| (2) Help desk telephone numbers and names. | 14 |
| (b) A new uniform prescription drug information card or | 15 |
| other technology
shall be
issued by a health benefit plan upon | 16 |
| enrollment and reissued upon any change in
the insured's | 17 |
| coverage that affects mandatory data elements contained on the
| 18 |
| card. | 19 |
| (c) Notwithstanding subsections (a) and (b) of this | 20 |
| Section, a discounted health care services plan providing | 21 |
| discounts on prescription drugs or devices shall issue to its | 22 |
| beneficiaries a card containing the following mandatory data | 23 |
| elements: | 24 |
| (1) an Internet website for beneficiaries to access | 25 |
| up-to-date lists of preferred providers; | 26 |
| (2) a toll-free number for beneficiaries to access |
|
|
|
09600HB5527ham001 |
- 3 - |
LRB096 20211 RPM 37218 a |
|
| 1 |
| up-to-date lists of preferred providers and additional | 2 |
| information about the discounted health care services | 3 |
| plan; | 4 |
| (3) the names or logos of all available provider | 5 |
| networks; | 6 |
| (4) a BIN number; | 7 |
| (5) a processor control number if required for claims | 8 |
| adjudication; | 9 |
| (6) a group number; and | 10 |
| (7) a cardholder ID number. | 11 |
| (d) As used in this Section, "discounted health care | 12 |
| services plan" means a preferred provider program whereby | 13 |
| beneficiaries, in exchange for fees, dues, charges, or other | 14 |
| consideration, are provided an incentive, in the form of | 15 |
| discounted health care services, to use the services of the | 16 |
| provider. | 17 |
| (Source: P.A. 91-777, eff. 1-1-01.) | 18 |
| Section 10. The Uniform Health Care Service Benefits | 19 |
| Information Card Act is amended by changing Section 15 as | 20 |
| follows: | 21 |
| (215 ILCS 139/15) | 22 |
| Sec. 15. Uniform health care benefit information cards | 23 |
| required. | 24 |
| (a) A health benefit plan that issues a card or other |
|
|
|
09600HB5527ham001 |
- 4 - |
LRB096 20211 RPM 37218 a |
|
| 1 |
| technology and
provides coverage for health care services | 2 |
| including prescription drugs or
devices also referred to as | 3 |
| health care benefits and an administrator of such a
plan | 4 |
| including, but not limited to, third-party administrators for | 5 |
| self-insured
plans and state-administered plans shall issue to | 6 |
| its insureds a card or other
technology containing uniform | 7 |
| health care benefit information. The health care
benefit | 8 |
| information card or other technology shall specifically | 9 |
| identify and
display the following mandatory data elements on | 10 |
| the card: | 11 |
| (1) processor control number, if required for claims | 12 |
| adjudication; | 13 |
| (2) group number; | 14 |
| (3) card issuer identifier; | 15 |
| (4) cardholder ID number; and | 16 |
| (5) cardholder name. | 17 |
| (b) The uniform health care benefit information card or | 18 |
| other technology
shall specifically identify and display the | 19 |
| following mandatory data elements
on the back of the card: | 20 |
| (1) claims submission names and addresses; and | 21 |
| (2) help desk telephone numbers and names. | 22 |
| (c) A new uniform health care benefit information card or | 23 |
| other technology
shall be issued by a health benefit plan upon | 24 |
| enrollment and reissued upon any
change in the insured's | 25 |
| coverage that affects mandatory data elements contained
on the | 26 |
| card. |
|
|
|
09600HB5527ham001 |
- 5 - |
LRB096 20211 RPM 37218 a |
|
| 1 |
| (d) Notwithstanding subsections (a), (b), and (c) of this | 2 |
| Section, a discounted health care services plan shall issue to | 3 |
| its beneficiaries a card containing the following mandatory | 4 |
| data elements: | 5 |
| (1) an Internet website for beneficiaries to access | 6 |
| up-to-date lists of preferred providers; | 7 |
| (2) a toll-free number for beneficiaries to access | 8 |
| up-to-date lists of preferred providers and additional | 9 |
| information about the discounted health care services | 10 |
| plan; | 11 |
| (3) the names or logos of all available provider | 12 |
| networks; and | 13 |
| (4) a cardholder ID number. | 14 |
| (e) As used in this Section, "discounted health care | 15 |
| services plan" means a preferred provider program whereby | 16 |
| beneficiaries, in exchange for fees, dues, charges, or other | 17 |
| consideration, are provided an incentive, in the form of | 18 |
| discounted health care services, to use the services of the | 19 |
| provider. | 20 |
| (Source: P.A. 92-106, eff. 1-1-02.)".
|
|