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1 | AN ACT concerning regulation.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
| ||||||
4 | Section 5. The State Employees Group Insurance Act of 1971 | ||||||
5 | is amended by changing Section 6.11 as follows:
| ||||||
6 | (5 ILCS 375/6.11)
| ||||||
7 | (Text of Section before amendment by P.A. 100-1170 ) | ||||||
8 | Sec. 6.11. Required health benefits; Illinois Insurance | ||||||
9 | Code
requirements. The program of health
benefits shall provide | ||||||
10 | the post-mastectomy care benefits required to be covered
by a | ||||||
11 | policy of accident and health insurance under Section 356t of | ||||||
12 | the Illinois
Insurance Code. The program of health benefits | ||||||
13 | shall provide the coverage
required under Sections 356g, | ||||||
14 | 356g.5, 356g.5-1, 356m,
356u, 356w, 356x, 356z.2, 356z.4, | ||||||
15 | 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, | ||||||
16 | 356z.14, 356z.15, 356z.17, 356z.22, 356z.25, and 356z.26, and | ||||||
17 | 356z.29 , 356z.32, and 356z.33 of the
Illinois Insurance Code.
| ||||||
18 | The program of health benefits must comply with Sections | ||||||
19 | 155.22a, 155.37, 355b, 356z.19, 370c, and 370c.1 of the
| ||||||
20 | Illinois Insurance Code. The Department of Insurance shall | ||||||
21 | enforce the requirements of this Section.
| ||||||
22 | Rulemaking authority to implement Public Act 95-1045, if | ||||||
23 | any, is conditioned on the rules being adopted in accordance |
| |||||||
| |||||||
1 | with all provisions of the Illinois Administrative Procedure | ||||||
2 | Act and all rules and procedures of the Joint Committee on | ||||||
3 | Administrative Rules; any purported rule not so adopted, for | ||||||
4 | whatever reason, is unauthorized. | ||||||
5 | (Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17; | ||||||
6 | 100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1024, eff. | ||||||
7 | 1-1-19; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; revised | ||||||
8 | 1-8-19.) | ||||||
9 | (Text of Section after amendment by P.A. 100-1170 ) | ||||||
10 | Sec. 6.11. Required health benefits; Illinois Insurance | ||||||
11 | Code
requirements. The program of health
benefits shall provide | ||||||
12 | the post-mastectomy care benefits required to be covered
by a | ||||||
13 | policy of accident and health insurance under Section 356t of | ||||||
14 | the Illinois
Insurance Code. The program of health benefits | ||||||
15 | shall provide the coverage
required under Sections 356g, | ||||||
16 | 356g.5, 356g.5-1, 356m,
356u, 356w, 356x, 356z.2, 356z.4, | ||||||
17 | 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, | ||||||
18 | 356z.14, 356z.15, 356z.17, 356z.22, 356z.25, 356z.26, 356z.29, | ||||||
19 | and 356z.32 , and 356z.33 of the
Illinois Insurance Code.
The | ||||||
20 | program of health benefits must comply with Sections 155.22a, | ||||||
21 | 155.37, 355b, 356z.19, 370c, and 370c.1 of the
Illinois | ||||||
22 | Insurance Code. The Department of Insurance shall enforce the | ||||||
23 | requirements of this Section with respect to Sections 370c and | ||||||
24 | 370c.1 of the Illinois Insurance Code; all other requirements | ||||||
25 | of this Section shall be enforced by the Department of Central |
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| |||||||
1 | Management Services.
| ||||||
2 | Rulemaking authority to implement Public Act 95-1045, if | ||||||
3 | any, is conditioned on the rules being adopted in accordance | ||||||
4 | with all provisions of the Illinois Administrative Procedure | ||||||
5 | Act and all rules and procedures of the Joint Committee on | ||||||
6 | Administrative Rules; any purported rule not so adopted, for | ||||||
7 | whatever reason, is unauthorized. | ||||||
8 | (Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17; | ||||||
9 | 100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1024, eff. | ||||||
10 | 1-1-19; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; | ||||||
11 | 100-1170, eff. 6-1-19.) | ||||||
12 | Section 10. The Counties Code is amended by changing | ||||||
13 | Section 5-1069.3 as follows: | ||||||
14 | (55 ILCS 5/5-1069.3)
| ||||||
15 | Sec. 5-1069.3. Required health benefits. If a county, | ||||||
16 | including a home
rule
county, is a self-insurer for purposes of | ||||||
17 | providing health insurance coverage
for its employees, the | ||||||
18 | coverage shall include coverage for the post-mastectomy
care | ||||||
19 | benefits required to be covered by a policy of accident and | ||||||
20 | health
insurance under Section 356t and the coverage required | ||||||
21 | under Sections 356g, 356g.5, 356g.5-1, 356u,
356w, 356x, | ||||||
22 | 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, | ||||||
23 | 356z.14, 356z.15, 356z.22, 356z.25, and 356z.26, and 356z.29 , | ||||||
24 | 356z.32, and 356z.33 of
the Illinois Insurance Code. The |
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| |||||||
1 | coverage shall comply with Sections 155.22a, 355b, 356z.19, and | ||||||
2 | 370c of
the Illinois Insurance Code. The Department of | ||||||
3 | Insurance shall enforce the requirements of this Section. The | ||||||
4 | requirement that health benefits be covered
as provided in this | ||||||
5 | Section is an
exclusive power and function of the State and is | ||||||
6 | a denial and limitation under
Article VII, Section 6, | ||||||
7 | subsection (h) of the Illinois Constitution. A home
rule county | ||||||
8 | to which this Section applies must comply with every provision | ||||||
9 | of
this Section.
| ||||||
10 | Rulemaking authority to implement Public Act 95-1045, if | ||||||
11 | any, is conditioned on the rules being adopted in accordance | ||||||
12 | with all provisions of the Illinois Administrative Procedure | ||||||
13 | Act and all rules and procedures of the Joint Committee on | ||||||
14 | Administrative Rules; any purported rule not so adopted, for | ||||||
15 | whatever reason, is unauthorized. | ||||||
16 | (Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17; | ||||||
17 | 100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1024, eff. | ||||||
18 | 1-1-19; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; revised | ||||||
19 | 10-3-18.) | ||||||
20 | Section 15. The Illinois Municipal Code is amended by | ||||||
21 | changing Section 10-4-2.3 as follows: | ||||||
22 | (65 ILCS 5/10-4-2.3)
| ||||||
23 | Sec. 10-4-2.3. Required health benefits. If a | ||||||
24 | municipality, including a
home rule municipality, is a |
| |||||||
| |||||||
1 | self-insurer for purposes of providing health
insurance | ||||||
2 | coverage for its employees, the coverage shall include coverage | ||||||
3 | for
the post-mastectomy care benefits required to be covered by | ||||||
4 | a policy of
accident and health insurance under Section 356t | ||||||
5 | and the coverage required
under Sections 356g, 356g.5, | ||||||
6 | 356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.10, | ||||||
7 | 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, | ||||||
8 | and 356z.26, and 356z.29 , 356z.32, and 356z.33 of the Illinois
| ||||||
9 | Insurance
Code. The coverage shall comply with Sections | ||||||
10 | 155.22a, 355b, 356z.19, and 370c of
the Illinois Insurance | ||||||
11 | Code. The Department of Insurance shall enforce the | ||||||
12 | requirements of this Section. The requirement that health
| ||||||
13 | benefits be covered as provided in this is an exclusive power | ||||||
14 | and function of
the State and is a denial and limitation under | ||||||
15 | Article VII, Section 6,
subsection (h) of the Illinois | ||||||
16 | Constitution. A home rule municipality to which
this Section | ||||||
17 | applies must comply with every provision of this Section.
| ||||||
18 | Rulemaking authority to implement Public Act 95-1045, if | ||||||
19 | any, is conditioned on the rules being adopted in accordance | ||||||
20 | with all provisions of the Illinois Administrative Procedure | ||||||
21 | Act and all rules and procedures of the Joint Committee on | ||||||
22 | Administrative Rules; any purported rule not so adopted, for | ||||||
23 | whatever reason, is unauthorized. | ||||||
24 | (Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17; | ||||||
25 | 100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1024, eff. | ||||||
26 | 1-1-19; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; revised |
| |||||||
| |||||||
1 | 10-4-18.) | ||||||
2 | Section 20. The School Code is amended by changing Section | ||||||
3 | 10-22.3f as follows: | ||||||
4 | (105 ILCS 5/10-22.3f)
| ||||||
5 | Sec. 10-22.3f. Required health benefits. Insurance | ||||||
6 | protection and
benefits
for employees shall provide the | ||||||
7 | post-mastectomy care benefits required to be
covered by a | ||||||
8 | policy of accident and health insurance under Section 356t and | ||||||
9 | the
coverage required under Sections 356g, 356g.5, 356g.5-1, | ||||||
10 | 356u, 356w, 356x,
356z.6, 356z.8, 356z.9, 356z.11, 356z.12, | ||||||
11 | 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, and 356z.26, and | ||||||
12 | 356z.29 , 356z.32, and 356z.33 of
the
Illinois Insurance Code.
| ||||||
13 | Insurance policies shall comply with Section 356z.19 of the | ||||||
14 | Illinois Insurance Code. The coverage shall comply with | ||||||
15 | Sections 155.22a, 355b, and 370c of
the Illinois Insurance | ||||||
16 | Code. The Department of Insurance shall enforce the | ||||||
17 | requirements of this Section.
| ||||||
18 | Rulemaking authority to implement Public Act 95-1045, if | ||||||
19 | any, is conditioned on the rules being adopted in accordance | ||||||
20 | with all provisions of the Illinois Administrative Procedure | ||||||
21 | Act and all rules and procedures of the Joint Committee on | ||||||
22 | Administrative Rules; any purported rule not so adopted, for | ||||||
23 | whatever reason, is unauthorized. | ||||||
24 | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; |
| |||||||
| |||||||
1 | 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. | ||||||
2 | 1-1-19; 100-1102, eff. 1-1-19; revised 10-4-18.) | ||||||
3 | Section 25. The Illinois Insurance Code is amended by | ||||||
4 | adding Section 356z.33 as follows: | ||||||
5 | (215 ILCS 5/356z.33 new) | ||||||
6 | Sec. 356z.33. Coverage for epinephrine and insulin | ||||||
7 | auto-injectors. A policy of accident and health insurance | ||||||
8 | amended, delivered, issued, or renewed on or after the | ||||||
9 | effective date of this amendatory Act of the 101st General | ||||||
10 | Assembly that provides prescription drug benefits shall offer | ||||||
11 | generic alternatives to brand name epinephrine and insulin | ||||||
12 | auto-injectors, where available. | ||||||
13 | Section 30. The Health Maintenance Organization Act is | ||||||
14 | amended by changing Section 5-3 as follows:
| ||||||
15 | (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
| ||||||
16 | Sec. 5-3. Insurance Code provisions.
| ||||||
17 | (a) Health Maintenance Organizations
shall be subject to | ||||||
18 | the provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
| ||||||
19 | 141.2, 141.3, 143, 143c, 147, 148, 149, 151,
152, 153, 154, | ||||||
20 | 154.5, 154.6,
154.7, 154.8, 155.04, 155.22a, 355.2, 355.3, | ||||||
21 | 355b, 356g.5-1, 356m, 356v, 356w, 356x, 356y,
356z.2, 356z.4, | ||||||
22 | 356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, |
| |||||||
| |||||||
1 | 356z.13, 356z.14, 356z.15, 356z.17, 356z.18, 356z.19, 356z.21, | ||||||
2 | 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 356z.33, | ||||||
3 | 364, 364.01, 367.2, 367.2-5, 367i, 368a, 368b, 368c, 368d, | ||||||
4 | 368e, 370c,
370c.1, 401, 401.1, 402, 403, 403A,
408, 408.2, | ||||||
5 | 409, 412, 444,
and
444.1,
paragraph (c) of subsection (2) of | ||||||
6 | Section 367, and Articles IIA, VIII 1/2,
XII,
XII 1/2, XIII, | ||||||
7 | XIII 1/2, XXV, and XXVI of the Illinois Insurance Code.
| ||||||
8 | (b) For purposes of the Illinois Insurance Code, except for | ||||||
9 | Sections 444
and 444.1 and Articles XIII and XIII 1/2, Health | ||||||
10 | Maintenance Organizations in
the following categories are | ||||||
11 | deemed to be "domestic companies":
| ||||||
12 | (1) a corporation authorized under the
Dental Service | ||||||
13 | Plan Act or the Voluntary Health Services Plans Act;
| ||||||
14 | (2) a corporation organized under the laws of this | ||||||
15 | State; or
| ||||||
16 | (3) a corporation organized under the laws of another | ||||||
17 | state, 30% or more
of the enrollees of which are residents | ||||||
18 | of this State, except a
corporation subject to | ||||||
19 | substantially the same requirements in its state of
| ||||||
20 | organization as is a "domestic company" under Article VIII | ||||||
21 | 1/2 of the
Illinois Insurance Code.
| ||||||
22 | (c) In considering the merger, consolidation, or other | ||||||
23 | acquisition of
control of a Health Maintenance Organization | ||||||
24 | pursuant to Article VIII 1/2
of the Illinois Insurance Code,
| ||||||
25 | (1) the Director shall give primary consideration to | ||||||
26 | the continuation of
benefits to enrollees and the financial |
| |||||||
| |||||||
1 | conditions of the acquired Health
Maintenance Organization | ||||||
2 | after the merger, consolidation, or other
acquisition of | ||||||
3 | control takes effect;
| ||||||
4 | (2)(i) the criteria specified in subsection (1)(b) of | ||||||
5 | Section 131.8 of
the Illinois Insurance Code shall not | ||||||
6 | apply and (ii) the Director, in making
his determination | ||||||
7 | with respect to the merger, consolidation, or other
| ||||||
8 | acquisition of control, need not take into account the | ||||||
9 | effect on
competition of the merger, consolidation, or | ||||||
10 | other acquisition of control;
| ||||||
11 | (3) the Director shall have the power to require the | ||||||
12 | following
information:
| ||||||
13 | (A) certification by an independent actuary of the | ||||||
14 | adequacy
of the reserves of the Health Maintenance | ||||||
15 | Organization sought to be acquired;
| ||||||
16 | (B) pro forma financial statements reflecting the | ||||||
17 | combined balance
sheets of the acquiring company and | ||||||
18 | the Health Maintenance Organization sought
to be | ||||||
19 | acquired as of the end of the preceding year and as of | ||||||
20 | a date 90 days
prior to the acquisition, as well as pro | ||||||
21 | forma financial statements
reflecting projected | ||||||
22 | combined operation for a period of 2 years;
| ||||||
23 | (C) a pro forma business plan detailing an | ||||||
24 | acquiring party's plans with
respect to the operation | ||||||
25 | of the Health Maintenance Organization sought to
be | ||||||
26 | acquired for a period of not less than 3 years; and
|
| |||||||
| |||||||
1 | (D) such other information as the Director shall | ||||||
2 | require.
| ||||||
3 | (d) The provisions of Article VIII 1/2 of the Illinois | ||||||
4 | Insurance Code
and this Section 5-3 shall apply to the sale by | ||||||
5 | any health maintenance
organization of greater than 10% of its
| ||||||
6 | enrollee population (including without limitation the health | ||||||
7 | maintenance
organization's right, title, and interest in and to | ||||||
8 | its health care
certificates).
| ||||||
9 | (e) In considering any management contract or service | ||||||
10 | agreement subject
to Section 141.1 of the Illinois Insurance | ||||||
11 | Code, the Director (i) shall, in
addition to the criteria | ||||||
12 | specified in Section 141.2 of the Illinois
Insurance Code, take | ||||||
13 | into account the effect of the management contract or
service | ||||||
14 | agreement on the continuation of benefits to enrollees and the
| ||||||
15 | financial condition of the health maintenance organization to | ||||||
16 | be managed or
serviced, and (ii) need not take into account the | ||||||
17 | effect of the management
contract or service agreement on | ||||||
18 | competition.
| ||||||
19 | (f) Except for small employer groups as defined in the | ||||||
20 | Small Employer
Rating, Renewability and Portability Health | ||||||
21 | Insurance Act and except for
medicare supplement policies as | ||||||
22 | defined in Section 363 of the Illinois
Insurance Code, a Health | ||||||
23 | Maintenance Organization may by contract agree with a
group or | ||||||
24 | other enrollment unit to effect refunds or charge additional | ||||||
25 | premiums
under the following terms and conditions:
| ||||||
26 | (i) the amount of, and other terms and conditions with |
| |||||||
| |||||||
1 | respect to, the
refund or additional premium are set forth | ||||||
2 | in the group or enrollment unit
contract agreed in advance | ||||||
3 | of the period for which a refund is to be paid or
| ||||||
4 | additional premium is to be charged (which period shall not | ||||||
5 | be less than one
year); and
| ||||||
6 | (ii) the amount of the refund or additional premium | ||||||
7 | shall not exceed 20%
of the Health Maintenance | ||||||
8 | Organization's profitable or unprofitable experience
with | ||||||
9 | respect to the group or other enrollment unit for the | ||||||
10 | period (and, for
purposes of a refund or additional | ||||||
11 | premium, the profitable or unprofitable
experience shall | ||||||
12 | be calculated taking into account a pro rata share of the
| ||||||
13 | Health Maintenance Organization's administrative and | ||||||
14 | marketing expenses, but
shall not include any refund to be | ||||||
15 | made or additional premium to be paid
pursuant to this | ||||||
16 | subsection (f)). The Health Maintenance Organization and | ||||||
17 | the
group or enrollment unit may agree that the profitable | ||||||
18 | or unprofitable
experience may be calculated taking into | ||||||
19 | account the refund period and the
immediately preceding 2 | ||||||
20 | plan years.
| ||||||
21 | The Health Maintenance Organization shall include a | ||||||
22 | statement in the
evidence of coverage issued to each enrollee | ||||||
23 | describing the possibility of a
refund or additional premium, | ||||||
24 | and upon request of any group or enrollment unit,
provide to | ||||||
25 | the group or enrollment unit a description of the method used | ||||||
26 | to
calculate (1) the Health Maintenance Organization's |
| |||||||
| |||||||
1 | profitable experience with
respect to the group or enrollment | ||||||
2 | unit and the resulting refund to the group
or enrollment unit | ||||||
3 | or (2) the Health Maintenance Organization's unprofitable
| ||||||
4 | experience with respect to the group or enrollment unit and the | ||||||
5 | resulting
additional premium to be paid by the group or | ||||||
6 | enrollment unit.
| ||||||
7 | In no event shall the Illinois Health Maintenance | ||||||
8 | Organization
Guaranty Association be liable to pay any | ||||||
9 | contractual obligation of an
insolvent organization to pay any | ||||||
10 | refund authorized under this Section.
| ||||||
11 | (g) Rulemaking authority to implement Public Act 95-1045, | ||||||
12 | if any, is conditioned on the rules being adopted in accordance | ||||||
13 | with all provisions of the Illinois Administrative Procedure | ||||||
14 | Act and all rules and procedures of the Joint Committee on | ||||||
15 | Administrative Rules; any purported rule not so adopted, for | ||||||
16 | whatever reason, is unauthorized. | ||||||
17 | (Source: P.A. 99-761, eff. 1-1-18; 100-24, eff. 7-18-17; | ||||||
18 | 100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1026, eff. | ||||||
19 | 8-22-18; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; revised | ||||||
20 | 10-4-18.) | ||||||
21 | Section 35. The Limited Health Service Organization Act is | ||||||
22 | amended by changing Section 4003 as follows:
| ||||||
23 | (215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
| ||||||
24 | Sec. 4003. Illinois Insurance Code provisions. Limited |
| |||||||
| |||||||
1 | health service
organizations shall be subject to the provisions | ||||||
2 | of Sections 133, 134, 136, 137, 139,
140, 141.1, 141.2, 141.3, | ||||||
3 | 143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5,
154.6, | ||||||
4 | 154.7, 154.8, 155.04, 155.37, 355.2, 355.3, 355b, 356v, | ||||||
5 | 356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.32, | ||||||
6 | 356z.33, 368a, 401, 401.1,
402,
403, 403A, 408,
408.2, 409, | ||||||
7 | 412, 444, and 444.1 and Articles IIA, VIII 1/2, XII, XII 1/2,
| ||||||
8 | XIII,
XIII 1/2, XXV, and XXVI of the Illinois Insurance Code. | ||||||
9 | For purposes of the
Illinois Insurance Code, except for | ||||||
10 | Sections 444 and 444.1 and Articles XIII
and XIII 1/2, limited | ||||||
11 | health service organizations in the following categories
are | ||||||
12 | deemed to be domestic companies:
| ||||||
13 | (1) a corporation under the laws of this State; or
| ||||||
14 | (2) a corporation organized under the laws of another | ||||||
15 | state, 30% or more
of the enrollees of which are residents | ||||||
16 | of this State, except a corporation
subject to | ||||||
17 | substantially the same requirements in its state of | ||||||
18 | organization as
is a domestic company under Article VIII | ||||||
19 | 1/2 of the Illinois Insurance Code.
| ||||||
20 | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; | ||||||
21 | 100-201, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1057, eff. | ||||||
22 | 1-1-19; 100-1102, eff. 1-1-19; revised 10-4-18.)
| ||||||
23 | Section 40. The Voluntary Health Services Plans Act is | ||||||
24 | amended by changing Section 10 as follows:
|
| |||||||
| |||||||
1 | (215 ILCS 165/10) (from Ch. 32, par. 604)
| ||||||
2 | Sec. 10. Application of Insurance Code provisions. Health | ||||||
3 | services
plan corporations and all persons interested therein | ||||||
4 | or dealing therewith
shall be subject to the provisions of | ||||||
5 | Articles IIA and XII 1/2 and Sections
3.1, 133, 136, 139, 140, | ||||||
6 | 143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b, 356g, | ||||||
7 | 356g.5, 356g.5-1, 356r, 356t, 356u, 356v,
356w, 356x, 356y, | ||||||
8 | 356z.1, 356z.2, 356z.4, 356z.5, 356z.6, 356z.8, 356z.9,
| ||||||
9 | 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.18, | ||||||
10 | 356z.19, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, | ||||||
11 | 356z.32, 356z.33, 364.01, 367.2, 368a, 401, 401.1,
402,
403, | ||||||
12 | 403A, 408,
408.2, and 412, and paragraphs (7) and (15) of | ||||||
13 | Section 367 of the Illinois
Insurance Code.
| ||||||
14 | Rulemaking authority to implement Public Act 95-1045, if | ||||||
15 | any, is conditioned on the rules being adopted in accordance | ||||||
16 | with all provisions of the Illinois Administrative Procedure | ||||||
17 | Act and all rules and procedures of the Joint Committee on | ||||||
18 | Administrative Rules; any purported rule not so adopted, for | ||||||
19 | whatever reason, is unauthorized. | ||||||
20 | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; | ||||||
21 | 100-863, eff. 8-14-18; 100-1026, eff. 8-22-18; 100-1057, eff. | ||||||
22 | 1-1-19; 100-1102, eff. 1-1-19; revised 10-4-18.) | ||||||
23 | Section 45. The Illinois Public Aid Code is amended by | ||||||
24 | changing Section 5-16.8 as follows:
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1 | (305 ILCS 5/5-16.8)
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2 | Sec. 5-16.8. Required health benefits. The medical | ||||||
3 | assistance program
shall
(i) provide the post-mastectomy care | ||||||
4 | benefits required to be covered by a policy of
accident and | ||||||
5 | health insurance under Section 356t and the coverage required
| ||||||
6 | under Sections 356g.5, 356u, 356w, 356x, 356z.6, 356z.26, and | ||||||
7 | 356z.29 , 356z.32, and 356z.33 of the Illinois
Insurance Code | ||||||
8 | and (ii) be subject to the provisions of Sections 356z.19, | ||||||
9 | 364.01, 370c, and 370c.1 of the Illinois
Insurance Code.
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10 | On and after July 1, 2012, the Department shall reduce any | ||||||
11 | rate of reimbursement for services or other payments or alter | ||||||
12 | any methodologies authorized by this Code to reduce any rate of | ||||||
13 | reimbursement for services or other payments in accordance with | ||||||
14 | Section 5-5e. | ||||||
15 | To ensure full access to the benefits set forth in this | ||||||
16 | Section, on and after January 1, 2016, the Department shall | ||||||
17 | ensure that provider and hospital reimbursement for | ||||||
18 | post-mastectomy care benefits required under this Section are | ||||||
19 | no lower than the Medicare reimbursement rate. | ||||||
20 | (Source: P.A. 99-433, eff. 8-21-15; 99-480, eff. 9-9-15; | ||||||
21 | 99-642, eff. 7-28-16; 100-138, eff. 8-18-17; 100-863, eff. | ||||||
22 | 8-14-18; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; revised | ||||||
23 | 10-4-18.)
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24 | Section 95. No acceleration or delay. Where this Act makes | ||||||
25 | changes in a statute that is represented in this Act by text |
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1 | that is not yet or no longer in effect (for example, a Section | ||||||
2 | represented by multiple versions), the use of that text does | ||||||
3 | not accelerate or delay the taking effect of (i) the changes | ||||||
4 | made by this Act or (ii) provisions derived from any other | ||||||
5 | Public Act. | ||||||
6 | Section 999. Effective date. This Act takes effect upon | ||||||
7 | becoming law.
|