Rep. Mary E. Flowers
Filed: 3/26/2009
 
 

 




 

 		












09600HB0528ham004

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AMENDMENT TO HOUSE BILL 528




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    AMENDMENT NO. ______. Amend House Bill 528, AS AMENDED, by 
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replacing everything after the enacting clause with the 
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following:

 
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    "Section 5. The State Employees Group Insurance Act of 1971 
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is amended  by changing Section 6.11 as follows:
 


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    (5 ILCS 375/6.11)

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    (Text of Section before amendment by P.A. 95-958)
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    Sec. 6.11. Required health benefits; Illinois Insurance 
10
Code
requirements.  The program of health
benefits shall provide 
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the post-mastectomy care benefits required to be covered
by a 
12
policy of accident and health insurance under Section 356t of 
13
the Illinois
Insurance Code.  The program of health benefits 
14
shall provide the coverage
required under Sections 356g.5,

15
356u, 356w, 356x, 356z.2, 356z.4, 356z.6, 356z.9, 356z.10, 
16
356z.13
356z.11, and 356z.14, and 356z.15
of the
Illinois 
 


 






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Insurance Code.
The program of health benefits must comply with 
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Section 155.37 of the
Illinois Insurance Code.

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(Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; 
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95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-978, eff. 
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1-1-09; 95-1005, eff. 12-12-08; revised 12-15-08.)

 
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    (Text of Section after amendment by P.A. 95-958)

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    Sec. 6.11. Required health benefits; Illinois Insurance 
8
Code
requirements.  The program of health
benefits shall provide 
9
the post-mastectomy care benefits required to be covered
by a 
10
policy of accident and health insurance under Section 356t of 
11
the Illinois
Insurance Code.  The program of health benefits 
12
shall provide the coverage
required under Sections 356g.5,

13
356u, 356w, 356x, 356z.2, 356z.4, 356z.6, 356z.9, 356z.10, 
14
356z.11, and 356z.12, 356z.13
356z.11, and 356z.14, and 356z.15 
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of the
Illinois Insurance Code.
The program of health benefits 
16
must comply with Section 155.37 of the
Illinois Insurance Code.

17
(Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; 
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95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-958, eff. 
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6-1-09; 95-978, eff. 1-1-09; 95-1005, eff. 12-12-08; revised 
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12-15-08.)
 
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    Section 10. The Counties Code is amended  by changing 
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Section 5-1069.3 as follows:
 
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    (55 ILCS 5/5-1069.3)

 


 






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    (Text of Section before amendment by P.A. 95-958)

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    Sec. 5-1069.3. Required health benefits.   If a county, 
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including a home
rule
county, is a self-insurer for purposes of 
4
providing health insurance coverage
for its employees, the 
5
coverage shall include coverage for the post-mastectomy
care 
6
benefits required to be covered by a policy of accident and 
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health
insurance under Section 356t and the coverage required 
8
under Sections 356g.5, 356u,
356w, 356x, 356z.6, 356z.9, 
9
356z.10, 356z.13
356z.11, and 356z.14, and 356z.15 of
the 
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Illinois Insurance Code.  The requirement that health benefits 
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be covered
as provided in this Section is an
exclusive power 
12
and function of the State and is a denial and limitation under

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Article VII, Section 6, subsection (h) of the Illinois 
14
Constitution.  A home
rule county to which this Section applies 
15
must comply with every provision of
this Section.


16
(Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; 
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95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-978, eff. 
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1-1-09; 95-1005, eff. 12-12-08; revised 12-15-08.)

 
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    (Text of Section after amendment by P.A. 95-958)
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    Sec. 5-1069.3. Required health benefits.   If a county, 
21
including a home
rule
county, is a self-insurer for purposes of 
22
providing health insurance coverage
for its employees, the 
23
coverage shall include coverage for the post-mastectomy
care 
24
benefits required to be covered by a policy of accident and 
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health
insurance under Section 356t and the coverage required 
 


 






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under Sections 356g.5, 356u,
356w, 356x, 356z.6, 356z.9, 
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356z.10, 356z.11, and 356z.12, 356z.13
356z.11, and 356z.14, 
3
and 356z.15 of
the Illinois Insurance Code.  The requirement 
4
that health benefits be covered
as provided in this Section is 
5
an
exclusive power and function of the State and is a denial 
6
and limitation under
Article VII, Section 6, subsection (h) of 
7
the Illinois Constitution.  A home
rule county to which this 
8
Section applies must comply with every provision of
this 
9
Section.


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(Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; 
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95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-958, eff. 
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6-1-09; 95-978, eff. 1-1-09; 95-1005, eff. 12-12-08; revised 
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12-15-08.)
 
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    Section 15. The Illinois Municipal Code is amended  by 
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changing Section 10-4-2.3 as follows:
 
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    (65 ILCS 5/10-4-2.3)

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    (Text of Section before amendment by P.A. 95-958)

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    Sec. 10-4-2.3. Required health benefits.   If a 
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municipality, including a
home rule municipality, is a 
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self-insurer for purposes of providing health
insurance 
21
coverage for its employees, the coverage shall include coverage 
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for
the post-mastectomy care benefits required to be covered by 
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a policy of
accident and health insurance under Section 356t 
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and the coverage required
under Sections 356g.5, 356u, 356w, 
 


 






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356x, 356z.6, 356z.9, 356z.10, 356z.13
356z.11, and 356z.14, 
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and 356z.15 of the Illinois
Insurance
Code.  The requirement 
3
that health
benefits be covered as provided in this is an 
4
exclusive power and function of
the State and is a denial and 
5
limitation under Article VII, Section 6,
subsection (h) of the 
6
Illinois Constitution.  A home rule municipality to which
this 
7
Section applies must comply with every provision of this 
8
Section.


9
(Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; 
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95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-978, eff. 
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1-1-09; 95-1005, eff. 12-12-08; revised 12-15-08.)

 
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    (Text of Section after amendment by P.A. 95-958)
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    Sec. 10-4-2.3. Required health benefits.   If a 
14
municipality, including a
home rule municipality, is a 
15
self-insurer for purposes of providing health
insurance 
16
coverage for its employees, the coverage shall include coverage 
17
for
the post-mastectomy care benefits required to be covered by 
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a policy of
accident and health insurance under Section 356t 
19
and the coverage required
under Sections 356g.5, 356u, 356w, 
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356x, 356z.6, 356z.9, 356z.10, 356z.11, and 356z.12, 356z.13

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356z.11, and 356z.14, and 356z.15 of the Illinois
Insurance

22
Code.  The requirement that health
benefits be covered as 
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provided in this is an exclusive power and function of
the 
24
State and is a denial and limitation under Article VII, Section 
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6,
subsection (h) of the Illinois Constitution.  A home rule 
 


 






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municipality to which
this Section applies must comply with 
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every provision of this Section.


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(Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; 
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95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-958, eff. 
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6-1-09; 95-978, eff. 1-1-09; 95-1005, eff. 12-12-08; revised 
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12-15-08.)
 
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    Section 20. The Illinois Insurance Code is amended  by 
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adding Section 356z.15 as follows:
 
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    (215 ILCS 5/356z.15  new)
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    Sec. 356z.15. Hospital patient assessments. A group or 
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individual policy of accident and health insurance or managed 
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care plan amended, delivered, issued, or renewed after the 
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effective date of this amendatory Act of the 96th General 
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Assembly that provides coverage for hospital care shall include 
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in that coverage all services ordered by a physician and 
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provided in the hospital that are considered medically 
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necessary for the evaluation, assessment, and diagnosis of the 
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illness or condition that resulted in the hospital stay of the  
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enrollee or recipient. Such services are subject to reasonable 
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review and utilization standards required by the policy or plan 
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for all hospital services, as defined by the Division of 
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Insurance of the Illinois Department of Financial and 
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Professional Regulation, or its successor agency.
 
 


 






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    Section 25. The Illinois Public Aid Code is amended  by 
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changing Section 5-16.8 as follows:
 



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    (305 ILCS 5/5-16.8)


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

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under Sections 356g.5, 356u, 356w, 356x, and 356z.6, and 
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356z.15 of the Illinois
Insurance Code and (ii) be subject to 
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the provisions of Section 364.01 of the Illinois
Insurance 
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Code.

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(Source: P.A. 95-189, eff. 8-16-07; 95-331, eff. 8-21-07.)

 
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    Section 30. The Medical Patient Rights Act is amended  by 
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changing Sections 2.04 and 5  and adding Sections 5.1 and 5.2 as 
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follows:

 



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    (410 ILCS 50/2.04)  (from Ch. 111 1/2, par. 5402.04)



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    Sec. 2.04. 
"Insurance company" means (1) an insurance 
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company, fraternal
benefit society, and any other insurer 
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subject to regulation under the
Illinois Insurance Code; or (2) 
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a health maintenance organization, a limited health service 
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organization under the Limited Health Service Organization 
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Act, or a voluntary health services plan under the Voluntary 
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Health Services Plans Act.

 


 






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(Source: P.A. 85-677; 85-679.)

 



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    (410 ILCS 50/5)


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    Sec. 5. Statement of hospital patient's rights. 


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    (a) Each patient admitted to a hospital, and the guardian 
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or authorized
representative or parent of a minor patient, 
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shall be given a written
statement of all the rights enumerated 
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in this Act, or a similar statement of
patients' rights 
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required of the hospital by the Joint Commission on

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Accreditation of Healthcare Organizations or a similar 
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accrediting
organization.  The statement shall be given at the 
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time of admission or as soon
thereafter as the condition of the 
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patient permits.

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    (b) If a patient is unable to read the written statement, a 
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hospital
shall make a reasonable effort to provide it to the 
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guardian or authorized
representative of the patient.

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    (c) The statement shall also include the right not to be 
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discriminated against by the hospital due to the patient's 
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race, color, or national origin where such characteristics are 
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not relevant to the patient's medical diagnosis and treatment.  
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The statement shall further provide each admitted patient or 
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the patient's representative or guardian with notice of how to 
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initiate a grievance regarding improper discrimination with 
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the hospital and how the patient may lodge a grievance with the 
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Illinois Department of Public Health regardless of whether the 
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patient has first used the hospital's grievance process. 
 


 






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(Source: P.A. 88-56; 88-670, eff. 12-2-94.)


 
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    (410 ILCS 50/5.1 new)

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    Sec. 5.1. Discrimination grievance procedures. Upon 
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receipt of a grievance alleging unlawful discrimination on the 
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basis of race, color, or national origin, the hospital must 
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investigate the claim and work with the patient to address 
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valid or proven concerns in accordance with the hospital's 
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grievance process. At the conclusion of the hospital's 
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grievance process, the hospital shall inform the patient that 
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such grievances may be reported to the Illinois Department of 
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Public Health if not resolved to the patient's satisfaction at 
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the hospital level.
 
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    (410 ILCS 50/5.2 new)

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    Sec. 5.2. Emergency room anti-discrimination notice. Every 
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hospital shall post a sign next to or in close proximity of its 
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sign required by Section 489.20 (q)(1) of Title 42 of the  Code 
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of Federal Regulations stating the following:
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    "You have the right not to be discriminated against by the 
19
hospital due to your race, color, or national origin if these 
20
characteristics are unrelated to your diagnosis or treatment.  
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If you believe this right has been violated, please call 
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(insert number for hospital grievance officer)." 

 
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    Section 95. No acceleration or delay. Where this Act makes 
 


 






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changes in a statute that is represented in this Act by text 
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that is not yet or no longer in effect (for example, a Section 
3
represented by multiple versions), the use of that text does 
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not accelerate or delay the taking effect of (i) the changes 
5
made by this Act or (ii) provisions derived from any other 
6
Public Act.
 
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    Section 99. Effective date. This Act takes effect upon 
8
becoming law.".