Rep. Terra Costa Howard

Filed: 3/4/2020

 

 


 

 


 
10100HB3700ham002LRB101 05169 BMS 70274 a

1
AMENDMENT TO HOUSE BILL 3700

2    AMENDMENT NO. ______. Amend House Bill 3700 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The State Employees Group Insurance Act of 1971
5is amended by changing Section 6.11 as follows:
 
6    (5 ILCS 375/6.11)
7    (Text of Section before amendment by P.A. 101-625)
8    Sec. 6.11. Required health benefits; Illinois Insurance
9Code requirements. The program of health benefits shall provide
10the post-mastectomy care benefits required to be covered by a
11policy of accident and health insurance under Section 356t of
12the Illinois Insurance Code. The program of health benefits
13shall provide the coverage required under Sections 356g,
14356g.5, 356g.5-1, 356m, 356u, 356w, 356x, 356z.2, 356z.4,
15356z.4a, 356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
16356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22, 356z.25,

 

 

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1356z.26, 356z.29, 356z.30a, 356z.32, and 356z.33, and 356z.36
2of the Illinois Insurance Code. The program of health benefits
3must comply with Sections 155.22a, 155.37, 355b, 356z.19, 370c,
4and 370c.1, and Article XXXIIB of the Illinois Insurance Code.
5The Department of Insurance shall enforce the requirements of
6this Section with respect to Sections 370c and 370c.1 of the
7Illinois Insurance Code; all other requirements of this Section
8shall be enforced by the Department of Central Management
9Services.
10    Rulemaking authority to implement Public Act 95-1045, if
11any, is conditioned on the rules being adopted in accordance
12with all provisions of the Illinois Administrative Procedure
13Act and all rules and procedures of the Joint Committee on
14Administrative Rules; any purported rule not so adopted, for
15whatever reason, is unauthorized.
16(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
17100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
181-1-19; 100-1102, eff. 1-1-19; 100-1170, eff. 6-1-19; 101-13,
19eff. 6-12-19; 101-281, eff. 1-1-20; 101-393, eff. 1-1-20;
20101-452, eff. 1-1-20; 101-461, eff. 1-1-20; revised 10-16-19.)
 
21    (Text of Section after amendment by P.A. 101-625)
22    Sec. 6.11. Required health benefits; Illinois Insurance
23Code requirements. The program of health benefits shall provide
24the post-mastectomy care benefits required to be covered by a
25policy of accident and health insurance under Section 356t of

 

 

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1the Illinois Insurance Code. The program of health benefits
2shall provide the coverage required under Sections 356g,
3356g.5, 356g.5-1, 356m, 356u, 356w, 356x, 356z.2, 356z.4,
4356z.4a, 356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
5356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22, 356z.25,
6356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, and
7356z.41 of the Illinois Insurance Code. The program of health
8benefits must comply with Sections 155.22a, 155.37, 355b,
9356z.19, 370c, and 370c.1 and Article XXXIIB of the Illinois
10Insurance Code. The Department of Insurance shall enforce the
11requirements of this Section with respect to Sections 370c and
12370c.1 of the Illinois Insurance Code; all other requirements
13of this Section shall be enforced by the Department of Central
14Management Services.
15    Rulemaking authority to implement Public Act 95-1045, if
16any, is conditioned on the rules being adopted in accordance
17with all provisions of the Illinois Administrative Procedure
18Act and all rules and procedures of the Joint Committee on
19Administrative Rules; any purported rule not so adopted, for
20whatever reason, is unauthorized.
21(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
22100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
231-1-19; 100-1102, eff. 1-1-19; 100-1170, eff. 6-1-19; 101-13,
24eff. 6-12-19; 101-281, eff. 1-1-20; 101-393, eff. 1-1-20;
25101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
261-1-21.)
 

 

 

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1    Section 10. The Counties Code is amended by changing
2Section 5-1069.3 as follows:
 
3    (55 ILCS 5/5-1069.3)
4    (Text of Section before amendment by P.A. 101-625)
5    Sec. 5-1069.3. Required health benefits. If a county,
6including a home rule county, is a self-insurer for purposes of
7providing health insurance coverage for its employees, the
8coverage shall include coverage for the post-mastectomy care
9benefits required to be covered by a policy of accident and
10health insurance under Section 356t and the coverage required
11under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x,
12356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12,
13356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
14356z.30a, and 356z.32, and 356z.33, and 356z.36 of the Illinois
15Insurance Code. The coverage shall comply with Sections
16155.22a, 355b, 356z.19, and 370c of the Illinois Insurance
17Code. The Department of Insurance shall enforce the
18requirements of this Section. The requirement that health
19benefits be covered as provided in this Section is an exclusive
20power and function of the State and is a denial and limitation
21under Article VII, Section 6, subsection (h) of the Illinois
22Constitution. A home rule county to which this Section applies
23must comply with every provision of this Section.
24    Rulemaking authority to implement Public Act 95-1045, if

 

 

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1any, is conditioned on the rules being adopted in accordance
2with all provisions of the Illinois Administrative Procedure
3Act and all rules and procedures of the Joint Committee on
4Administrative Rules; any purported rule not so adopted, for
5whatever reason, is unauthorized.
6(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
7100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
81-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
9eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
10revised 10-16-19.)
 
11    (Text of Section after amendment by P.A. 101-625)
12    Sec. 5-1069.3. Required health benefits. If a county,
13including a home rule county, is a self-insurer for purposes of
14providing health insurance coverage for its employees, the
15coverage shall include coverage for the post-mastectomy care
16benefits required to be covered by a policy of accident and
17health insurance under Section 356t and the coverage required
18under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x,
19356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12,
20356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
21356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41 of the
22Illinois Insurance Code. The coverage shall comply with
23Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
24Insurance Code. The Department of Insurance shall enforce the
25requirements of this Section. The requirement that health

 

 

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1benefits be covered as provided in this Section is an exclusive
2power and function of the State and is a denial and limitation
3under Article VII, Section 6, subsection (h) of the Illinois
4Constitution. A home rule county to which this Section applies
5must comply with every provision of this Section.
6    Rulemaking authority to implement Public Act 95-1045, if
7any, is conditioned on the rules being adopted in accordance
8with all provisions of the Illinois Administrative Procedure
9Act and all rules and procedures of the Joint Committee on
10Administrative Rules; any purported rule not so adopted, for
11whatever reason, is unauthorized.
12(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
13100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
141-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
15eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
16101-625, eff. 1-1-21.)
 
17    Section 15. The Illinois Municipal Code is amended by
18changing Section 10-4-2.3 as follows:
 
19    (65 ILCS 5/10-4-2.3)
20    (Text of Section before amendment by P.A. 101-625)
21    Sec. 10-4-2.3. Required health benefits. If a
22municipality, including a home rule municipality, is a
23self-insurer for purposes of providing health insurance
24coverage for its employees, the coverage shall include coverage

 

 

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1for the post-mastectomy care benefits required to be covered by
2a policy of accident and health insurance under Section 356t
3and the coverage required under Sections 356g, 356g.5,
4356g.5-1, 356u, 356w, 356x, 356z.5, 356z.6, 356z.8, 356z.9,
5356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
6356z.25, 356z.26, 356z.29, 356z.30a, and 356z.32, and 356z.33,
7and 356z.36 of the Illinois Insurance Code. The coverage shall
8comply with Sections 155.22a, 355b, 356z.19, and 370c of the
9Illinois Insurance Code. The Department of Insurance shall
10enforce the requirements of this Section. The requirement that
11health benefits be covered as provided in this is an exclusive
12power and function of the State and is a denial and limitation
13under Article VII, Section 6, subsection (h) of the Illinois
14Constitution. A home rule municipality to which this Section
15applies must comply with every provision of this Section.
16    Rulemaking authority to implement Public Act 95-1045, if
17any, is conditioned on the rules being adopted in accordance
18with all provisions of the Illinois Administrative Procedure
19Act and all rules and procedures of the Joint Committee on
20Administrative Rules; any purported rule not so adopted, for
21whatever reason, is unauthorized.
22(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
23100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
241-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
25eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
26revised 10-16-19.)
 

 

 

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1    (Text of Section after amendment by P.A. 101-625)
2    Sec. 10-4-2.3. Required health benefits. If a
3municipality, including a home rule municipality, is a
4self-insurer for purposes of providing health insurance
5coverage for its employees, the coverage shall include coverage
6for the post-mastectomy care benefits required to be covered by
7a policy of accident and health insurance under Section 356t
8and the coverage required under Sections 356g, 356g.5,
9356g.5-1, 356u, 356w, 356x, 356z.5, 356z.6, 356z.8, 356z.9,
10356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
11356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
12356z.36, and 356z.41 of the Illinois Insurance Code. The
13coverage shall comply with Sections 155.22a, 355b, 356z.19, and
14370c of the Illinois Insurance Code. The Department of
15Insurance shall enforce the requirements of this Section. The
16requirement that health benefits be covered as provided in this
17is an exclusive power and function of the State and is a denial
18and limitation under Article VII, Section 6, subsection (h) of
19the Illinois Constitution. A home rule municipality to which
20this Section applies must comply with every provision of this
21Section.
22    Rulemaking authority to implement Public Act 95-1045, if
23any, is conditioned on the rules being adopted in accordance
24with all provisions of the Illinois Administrative Procedure
25Act and all rules and procedures of the Joint Committee on

 

 

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1Administrative Rules; any purported rule not so adopted, for
2whatever reason, is unauthorized.
3(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
4100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
51-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
6eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
7101-625, eff. 1-1-21.)
 
8    Section 20. The School Code is amended by changing Section
910-22.3f as follows:
 
10    (105 ILCS 5/10-22.3f)
11    (Text of Section before amendment by P.A. 101-625)
12    Sec. 10-22.3f. Required health benefits. Insurance
13protection and benefits for employees shall provide the
14post-mastectomy care benefits required to be covered by a
15policy of accident and health insurance under Section 356t and
16the coverage required under Sections 356g, 356g.5, 356g.5-1,
17356u, 356w, 356x, 356z.5, 356z.6, 356z.8, 356z.9, 356z.11,
18356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
19356z.29, 356z.30a, and 356z.32, and 356z.33, and 356z.36 of the
20Illinois Insurance Code. Insurance policies shall comply with
21Section 356z.19 of the Illinois Insurance Code. The coverage
22shall comply with Sections 155.22a, 355b, and 370c of the
23Illinois Insurance Code. The Department of Insurance shall
24enforce the requirements of this Section.

 

 

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1    Rulemaking authority to implement Public Act 95-1045, if
2any, is conditioned on the rules being adopted in accordance
3with all provisions of the Illinois Administrative Procedure
4Act and all rules and procedures of the Joint Committee on
5Administrative Rules; any purported rule not so adopted, for
6whatever reason, is unauthorized.
7(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
8100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
91-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
10eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
11revised 10-16-19.)
 
12    (Text of Section after amendment by P.A. 101-625)
13    Sec. 10-22.3f. Required health benefits. Insurance
14protection and benefits for employees shall provide the
15post-mastectomy care benefits required to be covered by a
16policy of accident and health insurance under Section 356t and
17the coverage required under Sections 356g, 356g.5, 356g.5-1,
18356u, 356w, 356x, 356z.5, 356z.6, 356z.8, 356z.9, 356z.11,
19356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
20356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41 of
21the Illinois Insurance Code. Insurance policies shall comply
22with Section 356z.19 of the Illinois Insurance Code. The
23coverage shall comply with Sections 155.22a, 355b, and 370c of
24the Illinois Insurance Code. The Department of Insurance shall
25enforce the requirements of this Section.

 

 

10100HB3700ham002- 11 -LRB101 05169 BMS 70274 a

1    Rulemaking authority to implement Public Act 95-1045, if
2any, is conditioned on the rules being adopted in accordance
3with all provisions of the Illinois Administrative Procedure
4Act and all rules and procedures of the Joint Committee on
5Administrative Rules; any purported rule not so adopted, for
6whatever reason, is unauthorized.
7(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
8100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
91-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
10eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
11101-625, eff. 1-1-21.)
 
12    Section 25. The Illinois Insurance Code is amended by
13changing Section 356z.5 as follows:
 
14    (215 ILCS 5/356z.5)
15    Sec. 356z.5. Prescription inhalants. A group or individual
16policy of accident and health insurance or managed care plan
17amended, delivered, issued, or renewed on or after the
18effective date of this amendatory Act of the 101st General
19Assembly this amendatory Act of the 93rd General Assembly that
20provides coverage for prescription drugs must provide coverage
21for prescription inhalants and shall may not deny or limit
22coverage for prescription inhalants to enable persons to
23breathe when suffering from asthma or other life-threatening
24bronchial ailments based upon any restriction on the number of

 

 

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1days before an inhaler refill may be obtained if, contrary to
2those restrictions, the inhalants have been ordered or
3prescribed by the treating physician and are medically
4appropriate.
5(Source: P.A. 95-331, eff. 8-21-07.)
 
6    Section 30. The Limited Health Service Organization Act is
7amended by changing Section 4003 as follows:
 
8    (215 ILCS 130/4003)  (from Ch. 73, par. 1504-3)
9    (Text of Section before amendment by P.A. 101-625)
10    Sec. 4003. Illinois Insurance Code provisions. Limited
11health service organizations shall be subject to the provisions
12of Sections 133, 134, 136, 137, 139, 140, 141.1, 141.2, 141.3,
13143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5, 154.6,
14154.7, 154.8, 155.04, 155.37, 355.2, 355.3, 355b, 356v, 356z.5,
15356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29,
16356z.30a, 356z.32, 356z.33, 368a, 401, 401.1, 402, 403, 403A,
17408, 408.2, 409, 412, 444, and 444.1 and Articles IIA, VIII
181/2, XII, XII 1/2, XIII, XIII 1/2, XXV, and XXVI of the
19Illinois Insurance Code. For purposes of the Illinois Insurance
20Code, except for Sections 444 and 444.1 and Articles XIII and
21XIII 1/2, limited health service organizations in the following
22categories are deemed to be domestic companies:
23        (1) a corporation under the laws of this State; or
24        (2) a corporation organized under the laws of another

 

 

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1    state, 30% or more of the enrollees of which are residents
2    of this State, except a corporation subject to
3    substantially the same requirements in its state of
4    organization as is a domestic company under Article VIII
5    1/2 of the Illinois Insurance Code.
6(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
7100-201, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1057, eff.
81-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
9eff. 1-1-20; 101-393, eff. 1-1-20; revised 10-16-19.)
 
10    (Text of Section after amendment by P.A. 101-625)
11    Sec. 4003. Illinois Insurance Code provisions. Limited
12health service organizations shall be subject to the provisions
13of Sections 133, 134, 136, 137, 139, 140, 141.1, 141.2, 141.3,
14143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5, 154.6,
15154.7, 154.8, 155.04, 155.37, 355.2, 355.3, 355b, 356v, 356z.5,
16356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29,
17356z.30a, 356z.32, 356z.33, 356z.41, 368a, 401, 401.1, 402,
18403, 403A, 408, 408.2, 409, 412, 444, and 444.1 and Articles
19IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, and XXVI of
20the Illinois Insurance Code. For purposes of the Illinois
21Insurance Code, except for Sections 444 and 444.1 and Articles
22XIII and XIII 1/2, limited health service organizations in the
23following categories are deemed to be domestic companies:
24        (1) a corporation under the laws of this State; or
25        (2) a corporation organized under the laws of another

 

 

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1    state, 30% or more of the enrollees of which are residents
2    of this State, except a corporation subject to
3    substantially the same requirements in its state of
4    organization as is a domestic company under Article VIII
5    1/2 of the Illinois Insurance Code.
6(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
7100-201, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1057, eff.
81-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
9eff. 1-1-20; 101-393, eff. 1-1-20; 101-625, eff. 1-1-21.)
 
10    Section 35. The Illinois Public Aid Code is amended by
11changing Section 5-16.8 as follows:
 
12    (305 ILCS 5/5-16.8)
13    Sec. 5-16.8. Required health benefits. The medical
14assistance program shall (i) provide the post-mastectomy care
15benefits required to be covered by a policy of accident and
16health insurance under Section 356t and the coverage required
17under Sections 356g.5, 356u, 356w, 356x, 356z.5, 356z.6,
18356z.26, 356z.29, and 356z.32, and 356z.33, 356z.34, 356z.35,
19and 356z.39 of the Illinois Insurance Code and (ii) be subject
20to the provisions of Sections 356z.19, 364.01, 370c, and 370c.1
21of the Illinois Insurance Code.
22    On and after July 1, 2012, the Department shall reduce any
23rate of reimbursement for services or other payments or alter
24any methodologies authorized by this Code to reduce any rate of

 

 

10100HB3700ham002- 15 -LRB101 05169 BMS 70274 a

1reimbursement for services or other payments in accordance with
2Section 5-5e.
3    To ensure full access to the benefits set forth in this
4Section, on and after January 1, 2016, the Department shall
5ensure that provider and hospital reimbursement for
6post-mastectomy care benefits required under this Section are
7no lower than the Medicare reimbursement rate.
8(Source: P.A. 100-138, eff. 8-18-17; 100-863, eff. 8-14-18;
9100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff.
107-12-19; 101-218, eff. 1-1-20; 101-281, eff. 1-1-20; 101-371,
11eff. 1-1-20; 101-574, eff. 1-1-20; revised 10-16-19.)
 
12    Section 95. No acceleration or delay. Where this Act makes
13changes in a statute that is represented in this Act by text
14that is not yet or no longer in effect (for example, a Section
15represented by multiple versions), the use of that text does
16not accelerate or delay the taking effect of (i) the changes
17made by this Act or (ii) provisions derived from any other
18Public Act.
 
19    Section 99. Effective date. This Act takes effect January
201, 2021.".