Sen. Rachelle Crowe

Filed: 4/24/2019

 

 


 

 


 
10100HB3509sam001LRB101 09808 AMC 59222 a

1
AMENDMENT TO HOUSE BILL 3509

2    AMENDMENT NO. ______. Amend House Bill 3509 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The State Employees Group Insurance Act of 1971
5is amended by adding Section 6.16 as follows:
 
6    (5 ILCS 375/6.16 new)
7    Sec. 6.16. Human breast milk coverage. Notwithstanding any
8other provision of this Act, pasteurized donated human breast
9milk, which may include human milk fortifiers if indicated by a
10prescribing licensed medical practitioner, shall be covered
11under a health plan for persons who are otherwise eligible for
12coverage under this Act, if the covered person is an infant
13under the age of 6 months, a physician prescribes the milk for
14the covered person, and all of the following conditions are
15met:
16        (1) the milk is obtained from a human milk bank that is

 

 

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1    licensed by the Department of Public Health;
2        (2) the infant is critically ill and the infant's
3    mother is medically or physically unable to produce
4    maternal breast milk or produce maternal breast milk in
5    sufficient quantities to meet the infant's needs or the
6    maternal breast milk is contraindicated;
7        (3) the milk has been determined to be medically
8    necessary for the infant; and
9        (4) one or more of the following applies:
10            (A) the infant's birth weight is below 1,500 grams;
11            (B) the infant has a congenital or acquired
12        condition that places the infant at a high risk for
13        development of necrotizing enterocolitis;
14            (C) the infant has infant hypoglycemia;
15            (D) the infant has congenital heart disease;
16            (E) the infant has had or will have an organ
17        transplant;
18            (F) the infant has sepsis; or
19            (G) the infant has any other serious congenital or
20        acquired condition for which the use of donated human
21        breast milk is medically necessary and supports the
22        treatment and recovery of the infant.
 
23    Section 10. The Illinois Insurance Code is amended by
24adding Section 356z.33 as follows:
 

 

 

10100HB3509sam001- 3 -LRB101 09808 AMC 59222 a

1    (215 ILCS 5/356z.33 new)
2    Sec. 356z.33. Human breast milk coverage. Notwithstanding
3any other provision of this Act, pasteurized donated human
4breast milk, which may include human milk fortifiers if
5indicated by a prescribing licensed medical practitioner,
6shall be covered under an individual or group health insurance
7for persons who are otherwise eligible for coverage under this
8Act, if the covered person is an infant under the age of 6
9months, a physician prescribes the milk for the covered person,
10and all of the following conditions are met:
11        (1) the milk is obtained from a human milk bank that is
12    licensed by the Department of Public Health;
13        (2) the infant is critically ill and the infant's
14    mother is medically or physically unable to produce
15    maternal breast milk or produce maternal breast milk in
16    sufficient quantities to meet the infant's needs or the
17    maternal breast milk is contraindicated;
18        (3) the milk has been determined to be medically
19    necessary for the infant; and
20        (4) one or more of the following applies:
21            (A) the infant's birth weight is below 1,500 grams;
22            (B) the infant has a congenital or acquired
23        condition that places the infant at a high risk for
24        development of necrotizing enterocolitis;
25            (C) the infant has infant hypoglycemia;
26            (D) the infant has congenital heart disease;

 

 

10100HB3509sam001- 4 -LRB101 09808 AMC 59222 a

1            (E) the infant has had or will have an organ
2        transplant;
3            (F) the infant has sepsis; or
4            (G) the infant has any other serious congenital or
5        acquired condition for which the use of donated human
6        breast milk is medically necessary and supports the
7        treatment and recovery of the infant.
 
8    Section 15. The Illinois Public Aid Code is amended by
9adding Section 5-40 as follows:
 
10    (305 ILCS 5/5-40 new)
11    Sec. 5-40. Human breast milk coverage. Notwithstanding any
12other provision of this Act, pasteurized donated human breast
13milk, which may include human milk fortifiers if indicated by a
14prescribing licensed medical practitioner, shall be covered
15under a health plan for persons who are otherwise eligible for
16coverage under this Act, if the covered person is an infant
17under the age of 6 months, a physician prescribes the milk for
18the covered person, and all of the following conditions are
19met:
20        (1) the milk is obtained from a human milk bank that is
21    licensed by the Department of Public Health;
22        (2) the infant is critically ill and the infant's
23    mother is medically or physically unable to produce
24    maternal breast milk or produce maternal breast milk in

 

 

10100HB3509sam001- 5 -LRB101 09808 AMC 59222 a

1    sufficient quantities to meet the infant's needs or the
2    maternal breast milk is contraindicated;
3        (3) the milk has been determined to be medically
4    necessary for the infant; and
5        (4) one or more of the following applies:
6            (A) the infant's birth weight is below 1,500 grams;
7            (B) the infant has a congenital or acquired
8        condition that places the infant at a high risk for
9        development of necrotizing enterocolitis;
10            (C) the infant has infant hypoglycemia;
11            (D) the infant has congenital heart disease;
12            (E) the infant has had or will have an organ
13        transplant;
14            (F) the infant has sepsis; or
15            (G) the infant has any other serious congenital or
16        acquired condition for which the use of donated human
17        breast milk is medically necessary and supports the
18        treatment and recovery of the infant.
 
19    Section 99. Effective date. This Act takes effect January
201, 2020.".