99TH GENERAL ASSEMBLY
State of Illinois
2015 and 2016
SB3152

 

Introduced 2/19/2016, by Sen. Wm. Sam McCann

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 138/15

    Amends the Uniform Prescription Drug Information Card Act. Provides that the uniform prescription drug information card or other technology shall specifically identify and display an Internet website with information on frequently asked questions and contact information.


LRB099 19952 EGJ 44351 b

 

 

A BILL FOR

 

SB3152LRB099 19952 EGJ 44351 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Uniform Prescription Drug Information Card
5Act is amended by changing Section 15 as follows:
 
6    (215 ILCS 138/15)
7    Sec. 15. Uniform prescription drug information cards
8required.
9    (a) A health benefit plan that issues a card or other
10technology and provides coverage for prescription drugs or
11devices and an administrator of such a plan including, but not
12limited to, third-party administrators for self-insured plans
13and state-administered plans shall issue to its insureds a card
14or other technology containing uniform prescription drug
15information. The uniform prescription drug information card or
16other technology shall specifically identify and display the
17following mandatory data elements on the front of the card:
18        (1) BIN number;
19        (2) Processor control number if required for claims
20    adjudication;
21        (3) Group number;
22        (4) Card issuer identifier;
23        (5) Cardholder ID number; and

 

 

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1        (6) Cardholder name.
2    The uniform prescription drug information card or other
3technology shall specifically identify and display the
4following mandatory data elements on the back of the card:
5        (1) Claims submission names and addresses; and
6        (2) Help desk telephone numbers and names; and .
7        (3) An Internet website with information on frequently
8    asked questions and contact information.
9    (b) A new uniform prescription drug information card or
10other technology shall be issued by a health benefit plan upon
11enrollment and reissued upon any change in the insured's
12coverage that affects mandatory data elements contained on the
13card.
14    (c) Notwithstanding subsections (a) and (b) of this
15Section, a discounted health care services plan administrator
16providing discounts on prescription drugs or devices shall
17issue to its beneficiaries a card containing the following
18mandatory data elements:
19        (1) an Internet website for beneficiaries to access
20    up-to-date lists of preferred providers;
21        (2) a toll-free help desk number for beneficiaries and
22    providers to access up-to-date lists of preferred
23    providers and additional information about the discounted
24    health care services plan;
25        (3) the name or logo of the provider network;
26        (4) a group number;

 

 

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1        (5) a cardholder ID number;
2        (6) the cardholder's name or a space to permit the
3    cardholder to print his or her name, if the cardholder pays
4    a periodic charge for use of the card;
5        (7) a processor control number, if required for claims
6    adjudication; and
7        (8) a statement that the plan is not insurance.
8    (d) As used in this Section, "discounted health care
9services plan administrator" means any person, partnership, or
10corporation, other than an insurer, health service
11corporation, limited health service organization holding a
12certificate of authority under the Limited Health Service
13Organization Act, or health maintenance organization holding a
14certificate of authority under the Health Maintenance
15Organization Act that arranges, contracts with, or administers
16contracts with a provider whereby insureds or beneficiaries are
17provided an incentive to use health care services provided by
18health care services providers under a discounted health care
19services plan in which there are no other incentives, such as
20copayment, coinsurance, or any other reimbursement
21differential, for beneficiaries to utilize the provider.
22"Discounted health care services plan administrator" also
23includes any person, partnership, or corporation, other than an
24insurer, health service corporation, limited health service
25organization holding a certificate of authority under the
26Limited Health Service Organization Act, or health maintenance

 

 

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1organization holding a certificate of authority under the
2Health Maintenance Organization Act that enters into a contract
3with another administrator to enroll beneficiaries or insureds
4in a preferred provider program marketed as an independently
5identifiable program based on marketing materials or member
6benefit identification cards.
7(Source: P.A. 96-1326, eff. 1-1-11.)