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| 1 | AN ACT concerning regulation.
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| 2 | Be it enacted by the People of the State of Illinois,
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| 3 | represented in the General Assembly:
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| 4 | Section 5. The Illinois Insurance Code is amended by | ||||||
| 5 | adding Sections 356z.43 and 356z.44 as follows: | ||||||
| 6 | (215 ILCS 5/356z.43 new) | ||||||
| 7 | Sec. 356z.43. A1C testing. | ||||||
| 8 | (a) As used in this Section, "A1C testing" means blood | ||||||
| 9 | sugar level testing used to diagnose prediabetes, type 1 | ||||||
| 10 | diabetes, and type 2 diabetes and to monitor management of | ||||||
| 11 | blood sugar levels. | ||||||
| 12 | (b) A group or individual policy of accident and health | ||||||
| 13 | insurance or managed care plan amended, delivered, issued, or | ||||||
| 14 | renewed on or after the effective date of this amendatory Act | ||||||
| 15 | of the 102nd General Assembly shall provide coverage for A1C | ||||||
| 16 | testing recommended by a health care provider for prediabetes, | ||||||
| 17 | type 1 diabetes, and type 2 diabetes in accordance with | ||||||
| 18 | prediabetes and diabetes risk factors identified by the United | ||||||
| 19 | States Centers for Disease Control and Prevention. | ||||||
| 20 | (1) Risk factors for prediabetes may include, but are | ||||||
| 21 | not limited to, being overweight or obese, being aged 35 | ||||||
| 22 | or older, having an immediate family member with type 2 | ||||||
| 23 | diabetes, previous diagnosis of gestational diabetes and | ||||||
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| 1 | being African American, Hispanic or Latino American, | ||||||
| 2 | American Indian, or Alaska Native. | ||||||
| 3 | (2) Risk factors for type 1 diabetes may include, but | ||||||
| 4 | are not limited to, family history of diabetes. | ||||||
| 5 | (3) Risk factors for type 2 diabetes may include, but | ||||||
| 6 | are not limited to, having prediabetes, being overweight | ||||||
| 7 | or obese, being aged 35 or older, having an immediate | ||||||
| 8 | family member with type 1 or type 2 diabetes, previous | ||||||
| 9 | diagnosis of gestational diabetes and being African | ||||||
| 10 | American, Hispanic or Latino American, American Indian, or | ||||||
| 11 | Alaska Native. | ||||||
| 12 | (215 ILCS 5/356z.44 new) | ||||||
| 13 | Sec. 356z.44. Vitamin D testing. | ||||||
| 14 | (a) As used in this Section, "vitamin D testing" means | ||||||
| 15 | vitamin D blood testing that measures the level of vitamin D in | ||||||
| 16 | an individual's blood. | ||||||
| 17 | (b) A group or individual policy of accident and health | ||||||
| 18 | insurance or managed care plan amended, delivered, issued, or | ||||||
| 19 | renewed on or after the effective date of this amendatory Act | ||||||
| 20 | of the 102nd General Assembly shall provide coverage for | ||||||
| 21 | vitamin D testing recommended by a health care provider in | ||||||
| 22 | accordance with vitamin D deficiency risk factors identified | ||||||
| 23 | by the United States Centers for Disease Control and | ||||||
| 24 | Prevention. Risk factors for vitamin D deficiency include, but | ||||||
| 25 | are not limited to: | ||||||
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| 1 | (1) having osteoporosis or other bone-health problems; | ||||||
| 2 | (2) having conditions that affect fat absorption, | ||||||
| 3 | including celiac disease or weight loss surgery; | ||||||
| 4 | (3) routinely taking medications that interfere with | ||||||
| 5 | vitamin D activity, including anticonvulsants and | ||||||
| 6 | glucocorticoids; | ||||||
| 7 | (4) beneficiaries aged 55 and older; | ||||||
| 8 | (5) having a darker skin color; | ||||||
| 9 | (6) inadequate sunlight exposure; | ||||||
| 10 | (7) being obese; | ||||||
| 11 | (8) previous diagnosis of diabetes or kidney disease; | ||||||
| 12 | and | ||||||
| 13 | (9) exhibiting poor muscle strength or constant | ||||||
| 14 | tiredness. | ||||||
| 15 | Section 10. The Illinois Public Aid Code is amended by | ||||||
| 16 | changing Section 5-16.8 as follows:
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| 17 | (305 ILCS 5/5-16.8)
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| 18 | Sec. 5-16.8. Required health benefits. The medical | ||||||
| 19 | assistance program
shall
(i) provide the post-mastectomy care | ||||||
| 20 | benefits required to be covered by a policy of
accident and | ||||||
| 21 | health insurance under Section 356t and the coverage required
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| 22 | under Sections 356g.5, 356u, 356w, 356x, 356z.6, 356z.26, | ||||||
| 23 | 356z.29, 356z.32, 356z.33, 356z.34, and 356z.35 of the | ||||||
| 24 | Illinois
Insurance Code and (ii) be subject to the provisions | ||||||
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| 1 | of Sections 356z.19, 356z.43, 356z.44, 364.01, 370c, and | ||||||
| 2 | 370c.1 of the Illinois
Insurance Code.
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| 3 | The Department, by rule, shall adopt a model similar to | ||||||
| 4 | the requirements of Section 356z.39 of the Illinois Insurance | ||||||
| 5 | Code. | ||||||
| 6 | On and after July 1, 2012, the Department shall reduce any | ||||||
| 7 | rate of reimbursement for services or other payments or alter | ||||||
| 8 | any methodologies authorized by this Code to reduce any rate | ||||||
| 9 | of reimbursement for services or other payments in accordance | ||||||
| 10 | with Section 5-5e. | ||||||
| 11 | To ensure full access to the benefits set forth in this | ||||||
| 12 | Section, on and after January 1, 2016, the Department shall | ||||||
| 13 | ensure that provider and hospital reimbursement for | ||||||
| 14 | post-mastectomy care benefits required under this Section are | ||||||
| 15 | no lower than the Medicare reimbursement rate. | ||||||
| 16 | (Source: P.A. 100-138, eff. 8-18-17; 100-863, eff. 8-14-18; | ||||||
| 17 | 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. | ||||||
| 18 | 7-12-19; 101-218, eff. 1-1-20; 101-281, eff. 1-1-20; 101-371, | ||||||
| 19 | eff. 1-1-20; 101-574, eff. 1-1-20; 101-649, eff. 7-7-20.)
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