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91_HB4176enr
HB4176 Enrolled LRB9109951JSpc
1 AN ACT concerning prescription drug information cards.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 1. Short title. This Act may be cited as the
5 Uniform Prescription Drug Information Card Act.
6 Section 5. Legislative intent. It is the intent of the
7 legislature to lessen patients' waiting times, decrease
8 administrative burdens for pharmacies, and improve care to
9 patients by minimizing confusion, eliminating unnecessary
10 paperwork, and streamlining the dispensing of prescription
11 products paid for by third-party payors. This Act shall be
12 broadly applied and interpreted to effectuate this purpose.
13 Section 10. Definitions. As used in this Act, the
14 following terms have the meanings given in this Section.
15 "Department" means the Department of Insurance.
16 "Director" means the Director of Insurance.
17 "Health benefit plan" means an accident and health
18 insurance policy or certificate subject to the Illinois
19 Insurance Code, a voluntary health services plan subject to
20 the Voluntary Health Services Plans Act, a health maintenance
21 organization subscriber contract subject to the Health
22 Maintenance Organization Act, a plan provided by a multiple
23 employer welfare arrangement, or a plan provided by another
24 benefit arrangement. Without limitation, "health benefit
25 plan" does not mean any of the following types of insurance:
26 (1) accident;
27 (2) credit;
28 (3) disability income;
29 (4) long-term or nursing home care;
30 (5) specified disease;
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1 (6) dental or vision;
2 (7) coverage issued as a supplement to liability
3 insurance;
4 (8) medical payments under automobile or
5 homeowners;
6 (9) insurance under which benefits are payable with
7 or without regard to fault as statutorily required to be
8 contained in any liability policy or equivalent
9 self-insurance;
10 (10) hospital income or indemnity;
11 (11) self-insured health benefit plans under the
12 federal Employee Retirement Income Security Act of 1974.
13 Section 15. Uniform prescription drug information cards
14 required.
15 (a) A health benefit plan that issues a card or other
16 technology and provides coverage for prescription drugs or
17 devices and an administrator of such a plan including, but
18 not limited to, third-party administrators for self-insured
19 plans and state-administered plans shall issue to its
20 insureds a card or other technology containing uniform
21 prescription drug information. The uniform prescription drug
22 information card or other technology shall specifically
23 identify and display the following mandatory data elements on
24 the front of the card:
25 (1) BIN number;
26 (2) Processor control number if required for claims
27 adjudication;
28 (3) Group number;
29 (4) Card issuer identifier;
30 (5) Cardholder ID number; and
31 (6) Cardholder name.
32 The uniform prescription drug information card or other
33 technology shall specifically identify and display the
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1 following mandatory data elements on the back of the card:
2 (1) Claims submission names and addresses; and
3 (2) Help desk telephone numbers and names.
4 (b) A new uniform prescription drug information card or
5 other technology shall be issued by a health benefit plan
6 upon enrollment and reissued upon any change in the insured's
7 coverage that affects mandatory data elements contained on
8 the card.
9 Section 20. Applicability and enforcement.
10 (a) This Act applies to health benefit plans that are
11 amended, delivered, issued, or renewed on and after the
12 effective date of this amendatory Act of the 91st General
13 Assembly.
14 (b) The Director may adopt rules necessary to implement
15 the Department's responsibilities under this Act. To enforce
16 the provisions of this Act, the Director may issue a cease
17 and desist order or require a health benefit plan to submit a
18 plan of correction for violations of this Act, or both.
19 Subject to the provisions of the Illinois Administrative
20 Procedure Act, the Director may, pursuant to Section 403A of
21 the Illinois Insurance Code, impose upon a health benefit
22 plan an administrative fine not to exceed $250,000 for
23 failure to submit a requested plan of correction, failure to
24 comply with its plan or correction, or repeated violations of
25 this Act.
26 Section 99. Effective date. This Act takes effect on
27 January 1, 2001.
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