Sen. Rachelle Crowe

Filed: 5/17/2019

 

 


 

 


 
10100HB3509sam003LRB101 09808 RPS 60517 a

1
AMENDMENT TO HOUSE BILL 3509

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

 

 

10100HB3509sam003- 2 -LRB101 09808 RPS 60517 a

1        (1) the milk is obtained from a human milk bank that
2    meets quality guidelines established by the Human Milk
3    Banking Association of North America or is licensed by the
4    Department of Public Health;
5        (2) the infant's mother is medically or physically
6    unable to produce maternal breast milk or produce maternal
7    breast milk in sufficient quantities to meet the infant's
8    needs or the maternal breast milk is contraindicated;
9        (3) the milk has been determined to be medically
10    necessary for the infant; and
11        (4) one or more of the following applies:
12            (A) the infant's birth weight is below 1,500 grams;
13            (B) the infant has a congenital or acquired
14        condition that places the infant at a high risk for
15        development of necrotizing enterocolitis;
16            (C) the infant has infant hypoglycemia;
17            (D) the infant has congenital heart disease;
18            (E) the infant has had or will have an organ
19        transplant;
20            (F) the infant has sepsis; or
21            (G) the infant has any other serious congenital or
22        acquired condition for which the use of donated human
23        breast milk is medically necessary and supports the
24        treatment and recovery of the infant.
25    (b) Notwithstanding any other provision of this Act,
26pasteurized donated human breast milk, which may include human

 

 

10100HB3509sam003- 3 -LRB101 09808 RPS 60517 a

1milk fortifiers if indicated by a prescribing licensed medical
2practitioner, shall be covered under a health plan for persons
3who are otherwise eligible for coverage under this Act if the
4covered person is a child 6 months through 12 months of age, a
5licensed medical practitioner prescribes the milk for the
6covered person, and all of the following conditions are met:
7        (1) the milk is obtained from a human milk bank that
8    meets quality guidelines established by the Human Milk
9    Banking Association of North America or is licensed by the
10    Department of Public Health;
11        (2) the child's mother is medically or physically
12    unable to produce maternal breast milk or produce maternal
13    breast milk in sufficient quantities to meet the child's
14    needs or the maternal breast milk is contraindicated;
15        (3) the milk has been determined to be medically
16    necessary for the child; and
17        (4) one or more of the following applies:
18            (A) the child has spinal muscular atrophy;
19            (B) the child's birth weight was below 1,500 grams
20        and he or she has long-term feeding or gastrointestinal
21        complications related to prematurity;
22            (C) the child has had or will have an organ
23        transplant; or
24            (D) the child has a congenital or acquired
25        condition for which the use of donated human breast
26        milk is medically necessary and supports the treatment

 

 

10100HB3509sam003- 4 -LRB101 09808 RPS 60517 a

1        and recovery of the child.
 
2    Section 10. The Illinois Insurance Code is amended by
3adding Section 356z.33 as follows:
 
4    (215 ILCS 5/356z.33 new)
5    Sec. 356z.33. Human breast milk coverage.
6    (a) Notwithstanding any other provision of this Act,
7pasteurized donated human breast milk, which may include human
8milk fortifiers if indicated by a prescribing licensed medical
9practitioner, shall be covered under an individual or group
10health insurance for persons who are otherwise eligible for
11coverage under this Act if the covered person is an infant
12under the age of 6 months, a licensed medical practitioner
13prescribes the milk for the covered person, and all of the
14following conditions are met:
15        (1) the milk is obtained from a human milk bank that
16    meets quality guidelines established by the Human Milk
17    Banking Association of North America or is licensed by the
18    Department of Public Health;
19        (2) the infant's mother is medically or physically
20    unable to produce maternal breast milk or produce maternal
21    breast milk in sufficient quantities to meet the infant's
22    needs or the maternal breast milk is contraindicated;
23        (3) the milk has been determined to be medically
24    necessary for the infant; and

 

 

10100HB3509sam003- 5 -LRB101 09808 RPS 60517 a

1        (4) one or more of the following applies:
2            (A) the infant's birth weight is below 1,500 grams;
3            (B) the infant has a congenital or acquired
4        condition that places the infant at a high risk for
5        development of necrotizing enterocolitis;
6            (C) the infant has infant hypoglycemia;
7            (D) the infant has congenital heart disease;
8            (E) the infant has had or will have an organ
9        transplant;
10            (F) the infant has sepsis; or
11            (G) the infant has any other serious congenital or
12        acquired condition for which the use of donated human
13        breast milk is medically necessary and supports the
14        treatment and recovery of the infant.
15    (b) Notwithstanding any other provision of this Act,
16pasteurized donated human breast milk, which may include human
17milk fortifiers if indicated by a prescribing licensed medical
18practitioner, shall be covered under an individual or group
19health insurance for persons who are otherwise eligible for
20coverage under this Act if the covered person is a child 6
21months through 12 months of age, a licensed medical
22practitioner prescribes the milk for the covered person, and
23all of the following conditions are met:
24        (1) the milk is obtained from a human milk bank that
25    meets quality guidelines established by the Human Milk
26    Banking Association of North America or is licensed by the

 

 

10100HB3509sam003- 6 -LRB101 09808 RPS 60517 a

1    Department of Public Health;
2        (2) the child's mother is medically or physically
3    unable to produce maternal breast milk or produce maternal
4    breast milk in sufficient quantities to meet the child's
5    needs or the maternal breast milk is contraindicated;
6        (3) the milk has been determined to be medically
7    necessary for the child; and
8        (4) one or more of the following applies:
9            (A) the child has spinal muscular atrophy;
10            (B) the child's birth weight was below 1,500 grams
11        and he or she has long-term feeding or gastrointestinal
12        complications related to prematurity;
13            (C) the child has had or will have an organ
14        transplant; or
15            (D) the child has a congenital or acquired
16        condition for which the use of donated human breast
17        milk is medically necessary and supports the treatment
18        and recovery of the child.
 
19    Section 15. The Illinois Public Aid Code is amended by
20adding Section 5-40 as follows:
 
21    (305 ILCS 5/5-40 new)
22    Sec. 5-40. Human breast milk coverage.
23    (a) Notwithstanding any other provision of this Act,
24pasteurized donated human breast milk, which may include human

 

 

10100HB3509sam003- 7 -LRB101 09808 RPS 60517 a

1milk fortifiers if indicated by a prescribing licensed medical
2practitioner, shall be covered under a health plan for persons
3who are otherwise eligible for coverage under this Act if the
4covered person is an infant under the age of 6 months, a
5licensed medical practitioner prescribes the milk for the
6covered person, and all of the following conditions are met:
7        (1) the milk is obtained from a human milk bank that
8    meets quality guidelines established by the Human Milk
9    Banking Association of North America or is licensed by the
10    Department of Public Health;
11        (2) the infant's mother is medically or physically
12    unable to produce maternal breast milk or produce maternal
13    breast milk in sufficient quantities to meet the infant's
14    needs or the maternal breast milk is contraindicated;
15        (3) the milk has been determined to be medically
16    necessary for the infant; and
17        (4) one or more of the following applies:
18            (A) the infant's birth weight is below 1,500 grams;
19            (B) the infant has a congenital or acquired
20        condition that places the infant at a high risk for
21        development of necrotizing enterocolitis;
22            (C) the infant has infant hypoglycemia;
23            (D) the infant has congenital heart disease;
24            (E) the infant has had or will have an organ
25        transplant;
26            (F) the infant has sepsis; or

 

 

10100HB3509sam003- 8 -LRB101 09808 RPS 60517 a

1            (G) the infant has any other serious congenital or
2        acquired condition for which the use of donated human
3        breast milk is medically necessary and supports the
4        treatment and recovery of the infant.
5    (b) Notwithstanding any other provision of this Act,
6pasteurized donated human breast milk, which may include human
7milk fortifiers if indicated by a prescribing licensed medical
8practitioner, shall be covered under a health plan for persons
9who are otherwise eligible for coverage under this Act if the
10covered person is a child 6 months through 12 months of age, a
11licensed medical practitioner prescribes the milk for the
12covered person, and all of the following conditions are met:
13        (1) the milk is obtained from a human milk bank that
14    meets quality guidelines established by the Human Milk
15    Banking Association of North America or is licensed by the
16    Department of Public Health;
17        (2) the child's mother is medically or physically
18    unable to produce maternal breast milk or produce maternal
19    breast milk in sufficient quantities to meet the child's
20    needs or the maternal breast milk is contraindicated;
21        (3) the milk has been determined to be medically
22    necessary for the child; and
23        (4) one or more of the following applies:
24            (A) the child has spinal muscular atrophy;
25            (B) the child's birth weight was below 1,500 grams
26        and he or she has long-term feeding or gastrointestinal

 

 

10100HB3509sam003- 9 -LRB101 09808 RPS 60517 a

1        complications related to prematurity;
2            (C) the child has had or will have an organ
3        transplant; or
4            (D) the child has a congenital or acquired
5        condition for which the use of donated human breast
6        milk is medically necessary and supports the treatment
7        and recovery of the child.
8    (c) Notwithstanding any other provision of this Act,
9pasteurized donated human breast milk, which may include human
10milk fortifiers if indicated by a prescribing licensed medical
11practitioner, shall be covered under a health plan for persons
12who are otherwise eligible for coverage under this Act if the
13covered person is a child 12 months of age or older, a licensed
14medical practitioner prescribes the milk for the covered
15person, and all of the following conditions are met:
16        (1) the milk is obtained from a human milk bank that
17    meets quality guidelines established by the Human Milk
18    Banking Association of North America or is licensed by the
19    Department of Public Health;
20        (2) the child's mother is medically or physically
21    unable to produce maternal breast milk or produce maternal
22    breast milk in sufficient quantities to meet the child's
23    needs or the maternal breast milk is contraindicated;
24        (3) the milk has been determined to be medically
25    necessary for the child; and
26        (4) the child has spinal muscular atrophy.
 

 

 

10100HB3509sam003- 10 -LRB101 09808 RPS 60517 a

1    Section 99. Effective date. This Act takes effect January
21, 2020.".