Rep. Angelo Saviano
Filed: 3/11/2010
 
 

 




 

 		












09600HB5527ham001

LRB096 20211 RPM 37218 a






1

AMENDMENT TO HOUSE BILL 5527 




2
    AMENDMENT NO. ______. Amend House Bill 5527 by replacing 
3
everything after the enacting clause with the following:

 
4
    "Section 5. The Uniform Prescription Drug Information Card 
5
Act is amended  by changing Section 15 as follows:
 
6
    (215 ILCS 138/15)
7
    Sec. 15. Uniform prescription drug information cards 
8
required. 
9
    (a) A health benefit plan that issues a card or other 
10
technology and
provides coverage for prescription drugs or

11
devices
and an administrator of such a plan including, but not 
12
limited to, third-party
administrators for self-insured plans 
13
and state-administered plans shall issue
to its
insureds a card 
14
or other technology containing uniform prescription drug

15
information.  The uniform prescription drug information card or 
16
other
technology shall
specifically identify and display the 
 


 






09600HB5527ham001
- 2 -
LRB096 20211 RPM 37218 a




1
following
mandatory data elements on the front of the card:
2
        (1) BIN number;
3
        (2) Processor control number if required for claims 
4
    adjudication;
5
        (3) Group number;
6
        (4) Card issuer identifier;
7
        (5) Cardholder ID number; and
8
        (6) Cardholder name.
9
    The uniform prescription drug information card or other 
10
technology shall
specifically identify and display the 
11
following mandatory data elements on the
back of the card:
12
        (1) Claims submission names and addresses; and
13
        (2) Help desk telephone numbers and names.
14
    (b) A new uniform prescription drug information card or 
15
other technology
shall be
issued by a health benefit plan upon 
16
enrollment and reissued upon any change in
the insured's 
17
coverage that affects mandatory data elements contained on the

18
card.
19
    (c) Notwithstanding subsections (a) and (b) of this 
20
Section, a discounted health care services plan providing 
21
discounts on prescription drugs or devices shall issue to its 
22
beneficiaries a card containing the following mandatory data 
23
elements:
24
        (1) an Internet website for beneficiaries to access 
25
    up-to-date lists of preferred providers;
26
        (2) a toll-free number for beneficiaries to access 
 


 






09600HB5527ham001
- 3 -
LRB096 20211 RPM 37218 a




1
    up-to-date lists of preferred providers and additional 
2
    information about the discounted health care services 
3
    plan;
4
        (3) the names or logos of all available provider 
5
    networks;
6
        (4) a BIN number;
7
        (5) a processor control number if required for claims 
8
    adjudication;
9
        (6) a group number; and
10
        (7) a cardholder ID number.
11
    (d) As used in this Section, "discounted health care 
12
services plan" means a preferred provider program whereby 
13
beneficiaries, in exchange for fees, dues, charges, or other 
14
consideration, are provided an incentive, in the form of 
15
discounted health care services, to use the services of the 
16
provider. 
17
(Source: P.A. 91-777, eff. 1-1-01.)
 
18
    Section 10. The Uniform Health Care Service Benefits 
19
Information Card Act is amended  by changing Section 15 as 
20
follows:
 
21
    (215 ILCS 139/15)
22
    Sec. 15. Uniform health care benefit information cards 
23
required. 
24
    (a) A health benefit plan that issues a card or other 
 


 






09600HB5527ham001
- 4 -
LRB096 20211 RPM 37218 a




1
technology and
provides coverage for health care services 
2
including prescription drugs or
devices also referred to as 
3
health care benefits and an administrator of such a
plan 
4
including, but not limited to, third-party administrators for 
5
self-insured
plans and state-administered plans shall issue to 
6
its insureds a card or other
technology containing uniform 
7
health care benefit information.  The health care
benefit 
8
information card or other technology shall specifically 
9
identify and
display the following mandatory data elements on 
10
the card:
11
        (1) processor control number, if required for claims 
12
    adjudication;
13
        (2) group number;
14
        (3) card issuer identifier;
15
        (4) cardholder ID number; and
16
        (5) cardholder name.
17
    (b) The uniform health care benefit information card or 
18
other technology
shall specifically identify and display the 
19
following mandatory data elements
on the back of the card:
20
        (1) claims submission names and addresses; and
21
        (2) help desk telephone numbers and names.
22
    (c) A new uniform health care benefit information card or 
23
other technology
shall be issued by a health benefit plan upon 
24
enrollment and reissued upon any
change in the insured's 
25
coverage that affects mandatory data elements contained
on the 
26
card.
 


 






09600HB5527ham001
- 5 -
LRB096 20211 RPM 37218 a




1
    (d) Notwithstanding subsections (a), (b), and (c) of this 
2
Section, a discounted health care services plan shall issue to 
3
its beneficiaries a card containing the following mandatory 
4
data elements:
5
        (1) an Internet website for beneficiaries to access 
6
    up-to-date lists of preferred providers;
7
        (2) a toll-free number for beneficiaries to access 
8
    up-to-date lists of preferred providers and additional 
9
    information about the discounted health care services 
10
    plan;
11
        (3) the names or logos of all available provider 
12
    networks; and
13
        (4) a cardholder ID number.
14
    (e) As used in this Section, "discounted health care 
15
services plan" means a preferred provider program whereby 
16
beneficiaries, in exchange for fees, dues, charges, or other 
17
consideration, are provided an incentive, in the form of 
18
discounted health care services, to use the services of the 
19
provider. 
20
(Source: P.A. 92-106, eff. 1-1-02.)".