Public Act 102-0530
 
SB1854 EnrolledLRB102 16436 BMS 21828 b


  
    AN ACT concerning regulation.
  
 
    Be it enacted by the People of the State of Illinois,
 
represented in the General Assembly:
  
 
 
    Section 5. The Illinois Insurance Code is amended  by 
adding Sections 356z.43 and 356z.44 as follows:
 
    (215 ILCS 5/356z.43 new)
    Sec. 356z.43. A1C testing.
    (a)   As used in this Section, "A1C testing" means blood 
sugar level testing used to diagnose prediabetes, type 1 
diabetes, and type 2 diabetes and to monitor management of 
blood sugar levels.
    (b)   A   group or individual policy of accident and health 
insurance or managed care plan amended, delivered, issued, or 
renewed on or after the effective date of this amendatory Act 
of the 102nd General Assembly shall  provide coverage for A1C 
testing recommended by a health care provider for prediabetes, 
type 1 diabetes, and type 2 diabetes in accordance with 
prediabetes and diabetes risk factors identified by the United 
States Centers for Disease Control and Prevention.
        (1)   Risk factors for prediabetes may include, but are 
    not limited to, being overweight or obese, being aged 35 
    or older, having an immediate family member with type 2 
    diabetes, previous diagnosis of gestational diabetes and 
    being African American, Hispanic or Latino American, 
    American Indian, or Alaska Native.
        (2)   Risk factors for type 1 diabetes may include, but 
    are not limited to, family history of diabetes.
        (3)   Risk factors for type 2 diabetes may include, but 
    are not limited to, having prediabetes, being overweight 
    or obese, being aged 35 or older, having an immediate 
    family member with type 1 or type 2 diabetes, previous 
    diagnosis of gestational diabetes and being African 
    American, Hispanic or Latino American, American Indian, or 
    Alaska Native.
 
    (215 ILCS 5/356z.44 new)
    Sec. 356z.44. Vitamin D testing.
    (a)   As used in this Section, "vitamin D testing" means 
vitamin D blood testing that measures the level of vitamin D in 
an individual's blood.
    (b)   A   group or individual policy of accident and health 
insurance or managed care plan amended, delivered, issued, or 
renewed on or after the effective date of this amendatory Act 
of the 102nd General Assembly shall  provide coverage for 
vitamin D testing recommended by a health care provider in 
accordance with vitamin D deficiency risk factors identified 
by the United States Centers for Disease Control and 
Prevention. Risk factors for vitamin D deficiency include, but 
are not limited to:
        (1)   having osteoporosis or other bone-health problems;
        (2)   having conditions that affect fat absorption, 
    including celiac disease or weight loss surgery;
        (3)   routinely taking medications that interfere with 
    vitamin D activity, including anticonvulsants and 
    glucocorticoids;
        (4)   beneficiaries aged 55 and older;
        (5)   having a darker skin color;
        (6)   inadequate sunlight exposure;
        (7)   being obese;
        (8)   previous diagnosis of diabetes or kidney disease; 
    and
        (9)   exhibiting poor muscle strength or constant 
    tiredness.
 
    Section 10. The Illinois Public Aid Code is amended  by 
changing Section 5-16.8 as follows:
 


    (305 ILCS 5/5-16.8)



    Sec. 5-16.8. Required health benefits. The medical 
assistance program
shall
(i) provide the post-mastectomy care 
benefits required to be covered by a policy of
accident and 
health insurance under Section 356t and the coverage required

under Sections 356g.5, 356u, 356w, 356x, 356z.6, 356z.26, 
356z.29, 356z.32, 356z.33, 356z.34, and 356z.35 of the 
Illinois
Insurance Code and (ii) be subject to the provisions 
of Sections 356z.19, 356z.43, 356z.44, 364.01, 370c, and 
370c.1 of the Illinois
Insurance Code.

    The Department, by rule, shall adopt a model similar to 
the requirements of Section 356z.39 of the Illinois Insurance 
Code. 
    On and after July 1, 2012, the Department shall reduce any 
rate of reimbursement for services or other payments or alter 
any methodologies authorized by this Code to reduce any rate 
of reimbursement for services or other payments in accordance 
with Section 5-5e. 
    To ensure full access to the benefits set forth in this 
Section, on and after January 1, 2016, the Department shall 
ensure that provider and hospital reimbursement  for 
post-mastectomy care benefits required under this Section are 
no lower than the Medicare reimbursement rate. 
(Source: P.A. 100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 
100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 
7-12-19; 101-218, eff. 1-1-20; 101-281, eff. 1-1-20; 101-371, 
eff. 1-1-20; 101-574, eff. 1-1-20; 101-649, eff. 7-7-20.)