HB5527ham001 96TH GENERAL ASSEMBLY

Rep. Angelo Saviano

Filed: 3/11/2010

09600HB5527ham001 LRB096 20211 RPM 37218 a

AMENDMENT TO HOUSE BILL 5527

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

"Section 5. The Uniform Prescription Drug Information Card Act is amended by changing Section 15 as follows:

(215 ILCS 138/15)

Sec. 15. Uniform prescription drug information cards required.

(a) A health benefit plan that issues a card or other technology and provides coverage for prescription drugs or devices and an administrator of such a plan including, but not limited to, third-party administrators for self-insured plans and state-administered plans shall issue to its insureds a card or other technology containing uniform prescription drug information. The uniform prescription drug information card or other technology shall specifically identify and display the following mandatory data elements on the front of the card:

(1) BIN number;

(2) Processor control number if required for claims adjudication;

(3) Group number;

(4) Card issuer identifier;

(5) Cardholder ID number; and

(6) Cardholder name.

The uniform prescription drug information card or other technology shall specifically identify and display the following mandatory data elements on the back of the card:

(1) Claims submission names and addresses; and

(2) Help desk telephone numbers and names.

(b) A new uniform prescription drug information card or other technology shall be issued by a health benefit plan upon enrollment and reissued upon any change in the insured's coverage that affects mandatory data elements contained on the card.

(c) Notwithstanding subsections (a) and (b) of this Section, a discounted health care services plan providing discounts on prescription drugs or devices shall issue to its beneficiaries a card containing the following mandatory data elements:

(1) an Internet website for beneficiaries to access up-to-date lists of preferred providers;

(2) a toll-free number for beneficiaries to access up-to-date lists of preferred providers and additional information about the discounted health care services plan;

(3) the names or logos of all available provider networks;

(4) a BIN number;

(5) a processor control number if required for claims adjudication;

(6) a group number; and

(7) a cardholder ID number.

(d) As used in this Section, "discounted health care services plan" means a preferred provider program whereby beneficiaries, in exchange for fees, dues, charges, or other consideration, are provided an incentive, in the form of discounted health care services, to use the services of the provider.

(Source: P.A. 91-777, eff. 1-1-01.)

Section 10. The Uniform Health Care Service Benefits Information Card Act is amended by changing Section 15 as follows:

(215 ILCS 139/15)

Sec. 15. Uniform health care benefit information cards required.

(a) A health benefit plan that issues a card or other technology and provides coverage for health care services including prescription drugs or devices also referred to as health care benefits and an administrator of such a plan including, but not limited to, third-party administrators for self-insured plans and state-administered plans shall issue to its insureds a card or other technology containing uniform health care benefit information. The health care benefit information card or other technology shall specifically identify and display the following mandatory data elements on the card:

(1) processor control number, if required for claims adjudication;

(2) group number;

(3) card issuer identifier;

(4) cardholder ID number; and

(5) cardholder name.

(b) The uniform health care benefit information card or other technology shall specifically identify and display the following mandatory data elements on the back of the card:

(1) claims submission names and addresses; and

(2) help desk telephone numbers and names.

(c) A new uniform health care benefit information card or other technology shall be issued by a health benefit plan upon enrollment and reissued upon any change in the insured's coverage that affects mandatory data elements contained on the card.

(d) Notwithstanding subsections (a), (b), and (c) of this Section, a discounted health care services plan shall issue to its beneficiaries a card containing the following mandatory data elements:

(1) an Internet website for beneficiaries to access up-to-date lists of preferred providers;

(2) a toll-free number for beneficiaries to access up-to-date lists of preferred providers and additional information about the discounted health care services plan;

(3) the names or logos of all available provider networks; and

(4) a cardholder ID number.

(e) As used in this Section, "discounted health care services plan" means a preferred provider program whereby beneficiaries, in exchange for fees, dues, charges, or other consideration, are provided an incentive, in the form of discounted health care services, to use the services of the provider.

(Source: P.A. 92-106, eff. 1-1-02.)".