(215 ILCS 5/356K) (from Ch. 73, par. 968K)
Sec. 356K.
Coverage for Organ Transplantation Procedures.
No accident
and health insurer providing coverage under this Act for hospital or
medical expenses shall deny reimbursement for an otherwise covered expense
incurred for any organ transplantation procedure solely on the basis that
such procedure is deemed experimental or investigational unless supported
by the determination of the Office of Health Care Technology Assessment
within the Agency for Health Care Policy and Research within the federal
Department of Health and Human Services that such procedure is either
experimental or investigational or that there is insufficient data or
experience to determine whether an organ transplantation procedure is
clinically acceptable. If an accident and health insurer has made written
request, or had one made on its behalf by a national organization, for
determination by the Office of Health Care Technology Assessment within the
Agency for Health Care Policy and Research within the federal Department of
Health and Human Services as to whether a specific organ transplantation
procedure is clinically acceptable and said organization fails to respond
to such a request within a period of 90 days, the failure to act may be
deemed a determination that the procedure is deemed to be experimental or
investigational.
(Source: P.A. 87-218.)
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