Rep. Kelly M. Cassidy

Filed: 5/19/2023

 

 


 

 


 
10300SB1561ham001LRB103 27713 BMS 62257 a

1
AMENDMENT TO SENATE BILL 1561

2    AMENDMENT NO. ______. Amend Senate Bill 1561 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. "An Act concerning regulation", approved
5January 13, 2023, Public Act 102-1117, is amended by changing
6Section 99-99 as follows:
 
7    (P.A. 102-1117, Sec. 99-99)
8    Sec. 99-99. Effective date. This Act takes effect upon
9becoming law, except that Article 16 takes effect on January
101, 2025.
11(Source: P.A. 102-1117, eff. 1-13-23.)
 
12    Section 10. The State Employees Group Insurance Act of
131971 is amended by changing Section 6.11 as follows:
 
14    (5 ILCS 375/6.11)

 

 

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1    (Text of Section before amendment by P.A. 102-768)
2    Sec. 6.11. Required health benefits; Illinois Insurance
3Code requirements. The program of health benefits shall
4provide the post-mastectomy care benefits required to be
5covered by a policy of accident and health insurance under
6Section 356t of the Illinois Insurance Code. The program of
7health benefits shall provide the coverage required under
8Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
9356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
10356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
11356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
12356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
13356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and
14356z.62 of the Illinois Insurance Code. The program of health
15benefits must comply with Sections 155.22a, 155.37, 355b,
16356z.19, 370c, and 370c.1 and Article XXXIIB of the Illinois
17Insurance Code. The Department of Insurance shall enforce the
18requirements of this Section with respect to Sections 370c and
19370c.1 of the Illinois Insurance Code; all other requirements
20of this Section shall be enforced by the Department of Central
21Management Services.
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
26Administrative Rules; any purported rule not so adopted, for

 

 

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1whatever reason, is unauthorized.
2(Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
3101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
41-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
5eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
6102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
71-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
8eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
9revised 12-13-22.)
 
10    (Text of Section after amendment by P.A. 102-768)
11    Sec. 6.11. Required health benefits; Illinois Insurance
12Code requirements. The program of health benefits shall
13provide the post-mastectomy care benefits required to be
14covered by a policy of accident and health insurance under
15Section 356t of the Illinois Insurance Code. The program of
16health benefits shall provide the coverage required under
17Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
18356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
19356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
20356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
21356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
22356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59, and
23356z.60, and 356z.62 of the Illinois Insurance Code. The
24program of health benefits must comply with Sections 155.22a,
25155.37, 355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of

 

 

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1the Illinois Insurance Code. The Department of Insurance shall
2enforce the requirements of this Section with respect to
3Sections 370c and 370c.1 of the Illinois Insurance Code; all
4other requirements of this Section shall be enforced by the
5Department of Central Management Services.
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. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
13101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
141-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
15eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
16102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
171-1-23; 102-768, eff. 1-1-24; 102-804, eff. 1-1-23; 102-813,
18eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff. 1-1-23;
19102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
 
20    Section 15. The Criminal Identification Act is amended by
21changing Section 3.2 as follows:
 
22    (20 ILCS 2630/3.2)  (from Ch. 38, par. 206-3.2)
23    Sec. 3.2. (a) It is the duty of any person conducting or
24operating a medical facility, or any physician or nurse as

 

 

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1soon as treatment permits to notify the local law enforcement
2agency of that jurisdiction upon the application for treatment
3of a person who is not accompanied by a law enforcement
4officer, when it reasonably appears that the person requesting
5treatment has received:
6        (1) any injury resulting from the discharge of a
7    firearm; or
8        (2) any injury sustained in the commission of or as a
9    victim of a criminal offense.
10    Any hospital, physician or nurse shall be forever held
11harmless from any civil liability for their reasonable
12compliance with the provisions of this Section.
13    (b) Notwithstanding subsection (a), nothing in this
14Section shall be construed to require the reporting of lawful
15health care activity, whether such activity may constitute a
16violation of another state's law.
17    (c) As used in this Section:
18    "Lawful health care" means:
19        (1) reproductive health care that is not unlawful
20    under the laws of this State or was not unlawful under the
21    laws of this State as of January 13, 2023 (the effective
22    date of Public Act 102-1117), including on any theory of
23    vicarious, joint, several, or conspiracy liability; or
24        (2) the treatment of gender dysphoria or the
25    affirmation of an individual's gender identity or gender
26    expression, including but not limited to, all supplies,

 

 

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1    care, and services of a medical, behavioral health, mental
2    health, surgical, psychiatric, therapeutic, diagnostic,
3    preventative, rehabilitative, or supportive nature that is
4    not unlawful under the laws of this State or was not
5    unlawful under the laws of this State as of January 13,
6    2023 (the effective date of Public Act 102-1117),
7    including on any theory of vicarious, joint, several, or
8    conspiracy liability.
9    "Lawful health care activity" means seeking, providing,
10receiving, assisting in seeking, providing, or receiving,
11providing material support for, or traveling to obtain lawful
12health care.
13(Source: P.A. 102-1117, eff. 1-13-23.)
 
14    Section 20. The Counties Code is amended by changing
15Section 5-1069.3 as follows:
 
16    (55 ILCS 5/5-1069.3)
17    Sec. 5-1069.3. Required health benefits. If a county,
18including a home rule county, is a self-insurer for purposes
19of providing health insurance coverage for its employees, the
20coverage shall include coverage for the post-mastectomy care
21benefits required to be covered by a policy of accident and
22health insurance under Section 356t and the coverage required
23under Sections 356g, 356g.5, 356g.5-1, 356q, 356u, 356w, 356x,
24356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,

 

 

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1356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
2356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, 356z.40,
3356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53,
4356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and 356z.62
5of the Illinois Insurance Code. The coverage shall comply with
6Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
7Insurance Code. The Department of Insurance shall enforce the
8requirements of this Section. The requirement that health
9benefits be covered as provided in this Section is an
10exclusive power and function of the State and is a denial and
11limitation under Article VII, Section 6, subsection (h) of the
12Illinois Constitution. A home rule county to which this
13Section applies must comply with every provision of this
14Section.
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. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
22101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
231-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
24eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
25102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
261-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,

 

 

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1eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
2102-1117, eff. 1-13-23.)
 
3    Section 25. The Illinois Municipal Code is amended by
4changing Section 10-4-2.3 as follows:
 
5    (65 ILCS 5/10-4-2.3)
6    Sec. 10-4-2.3. Required health benefits. If a
7municipality, including a home rule municipality, is a
8self-insurer for purposes of providing health insurance
9coverage for its employees, the coverage shall include
10coverage for the post-mastectomy care benefits required to be
11covered by a policy of accident and health insurance under
12Section 356t and the coverage required under Sections 356g,
13356g.5, 356g.5-1, 356q, 356u, 356w, 356x, 356z.4, 356z.4a,
14356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
15356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
16356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41,
17356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54,
18356z.56, 356z.57, 356z.59, and 356z.60, and 356z.62 of the
19Illinois Insurance Code. The coverage shall comply with
20Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
21Insurance Code. The Department of Insurance shall enforce the
22requirements of this Section. The requirement that health
23benefits be covered as provided in this is an exclusive power
24and function of the State and is a denial and limitation under

 

 

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1Article VII, Section 6, subsection (h) of the Illinois
2Constitution. A home rule municipality to which this Section
3applies must comply with every provision of this Section.
4    Rulemaking authority to implement Public Act 95-1045, if
5any, is conditioned on the rules being adopted in accordance
6with all provisions of the Illinois Administrative Procedure
7Act and all rules and procedures of the Joint Committee on
8Administrative Rules; any purported rule not so adopted, for
9whatever reason, is unauthorized.
10(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
11101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
121-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
13eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
14102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
151-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
16eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
17102-1117, eff. 1-13-23.)
 
18    Section 30. The School Code is amended by changing Section
1910-22.3f as follows:
 
20    (105 ILCS 5/10-22.3f)
21    Sec. 10-22.3f. Required health benefits. Insurance
22protection and benefits for employees shall provide the
23post-mastectomy care benefits required to be covered by a
24policy of accident and health insurance under Section 356t and

 

 

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1the coverage required under Sections 356g, 356g.5, 356g.5-1,
2356q, 356u, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8,
3356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
4356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
5356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
6356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and
7356z.62 of the Illinois Insurance Code. Insurance policies
8shall comply with Section 356z.19 of the Illinois Insurance
9Code. The coverage shall comply with Sections 155.22a, 355b,
10and 370c of the Illinois Insurance Code. The Department of
11Insurance shall enforce the requirements of this Section.
12    Rulemaking authority to implement Public Act 95-1045, if
13any, is conditioned on the rules being adopted in accordance
14with all provisions of the Illinois Administrative Procedure
15Act and all rules and procedures of the Joint Committee on
16Administrative Rules; any purported rule not so adopted, for
17whatever reason, is unauthorized.
18(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
19101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
201-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
21eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff. 1-1-22;
22102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804, eff.
231-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
24eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
 
25    Section 35. The Illinois Insurance Code is amended by

 

 

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1changing Section 356z.4 and by adding Section 356z.62 as
2follows:
 
3    (215 ILCS 5/356z.4)
4    Sec. 356z.4. Coverage for contraceptives.
5    (a)(1) The General Assembly hereby finds and declares all
6of the following:
7        (A) Illinois has a long history of expanding timely
8    access to birth control to prevent unintended pregnancy.
9        (B) The federal Patient Protection and Affordable Care
10    Act includes a contraceptive coverage guarantee as part of
11    a broader requirement for health insurance to cover key
12    preventive care services without out-of-pocket costs for
13    patients.
14        (C) The General Assembly intends to build on existing
15    State and federal law to promote gender equity and women's
16    health and to ensure greater contraceptive coverage equity
17    and timely access to all federal Food and Drug
18    Administration approved methods of birth control for all
19    individuals covered by an individual or group health
20    insurance policy in Illinois.
21        (D) Medical management techniques such as denials,
22    step therapy, or prior authorization in public and private
23    health care coverage can impede access to the most
24    effective contraceptive methods.
25    (2) As used in this subsection (a):

 

 

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1    "Contraceptive services" includes consultations,
2examinations, procedures, and medical services related to the
3use of contraceptive methods (including natural family
4planning) to prevent an unintended pregnancy.
5    "Medical necessity", for the purposes of this subsection
6(a), includes, but is not limited to, considerations such as
7severity of side effects, differences in permanence and
8reversibility of contraceptive, and ability to adhere to the
9appropriate use of the item or service, as determined by the
10attending provider.
11    "Therapeutic equivalent version" means drugs, devices, or
12products that can be expected to have the same clinical effect
13and safety profile when administered to patients under the
14conditions specified in the labeling and satisfy the following
15general criteria:
16        (i) they are approved as safe and effective;
17        (ii) they are pharmaceutical equivalents in that they
18    (A) contain identical amounts of the same active drug
19    ingredient in the same dosage form and route of
20    administration and (B) meet compendial or other applicable
21    standards of strength, quality, purity, and identity;
22        (iii) they are bioequivalent in that (A) they do not
23    present a known or potential bioequivalence problem and
24    they meet an acceptable in vitro standard or (B) if they do
25    present such a known or potential problem, they are shown
26    to meet an appropriate bioequivalence standard;

 

 

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1        (iv) they are adequately labeled; and
2        (v) they are manufactured in compliance with Current
3    Good Manufacturing Practice regulations.
4    (3) An individual or group policy of accident and health
5insurance amended, delivered, issued, or renewed in this State
6after the effective date of this amendatory Act of the 99th
7General Assembly shall provide coverage for all of the
8following services and contraceptive methods:
9        (A) All contraceptive drugs, devices, and other
10    products approved by the United States Food and Drug
11    Administration. This includes all over-the-counter
12    contraceptive drugs, devices, and products approved by the
13    United States Food and Drug Administration, excluding male
14    condoms, except as provided in the current comprehensive
15    guidelines supported by the Health Resources and Services
16    Administration. The following apply:
17            (i) If the United States Food and Drug
18        Administration has approved one or more therapeutic
19        equivalent versions of a contraceptive drug, device,
20        or product, a policy is not required to include all
21        such therapeutic equivalent versions in its formulary,
22        so long as at least one is included and covered without
23        cost-sharing and in accordance with this Section.
24            (ii) If an individual's attending provider
25        recommends a particular service or item approved by
26        the United States Food and Drug Administration based

 

 

10300SB1561ham001- 14 -LRB103 27713 BMS 62257 a

1        on a determination of medical necessity with respect
2        to that individual, the plan or issuer must cover that
3        service or item without cost sharing. The plan or
4        issuer must defer to the determination of the
5        attending provider.
6            (iii) If a drug, device, or product is not
7        covered, plans and issuers must have an easily
8        accessible, transparent, and sufficiently expedient
9        process that is not unduly burdensome on the
10        individual or a provider or other individual acting as
11        a patient's authorized representative to ensure
12        coverage without cost sharing.
13            (iv) This coverage must provide for the dispensing
14        of 12 months' worth of contraception at one time.
15        (B) Voluntary sterilization procedures.
16        (C) Contraceptive services, patient education, and
17    counseling on contraception.
18        (D) Follow-up services related to the drugs, devices,
19    products, and procedures covered under this Section,
20    including, but not limited to, management of side effects,
21    counseling for continued adherence, and device insertion
22    and removal.
23    (4) Except as otherwise provided in this subsection (a), a
24policy subject to this subsection (a) shall not impose a
25deductible, coinsurance, copayment, or any other cost-sharing
26requirement on the coverage provided. The provisions of this

 

 

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1paragraph do not apply to coverage of voluntary male
2sterilization procedures to the extent such coverage would
3disqualify a high-deductible health plan from eligibility for
4a health savings account pursuant to the federal Internal
5Revenue Code, 26 U.S.C. 223.
6    (5) Except as otherwise authorized under this subsection
7(a), a policy shall not impose any restrictions or delays on
8the coverage required under this subsection (a).
9    (6) If, at any time, the Secretary of the United States
10Department of Health and Human Services, or its successor
11agency, promulgates rules or regulations to be published in
12the Federal Register or publishes a comment in the Federal
13Register or issues an opinion, guidance, or other action that
14would require the State, pursuant to any provision of the
15Patient Protection and Affordable Care Act (Public Law
16111-148), including, but not limited to, 42 U.S.C.
1718031(d)(3)(B) or any successor provision, to defray the cost
18of any coverage outlined in this subsection (a), then this
19subsection (a) is inoperative with respect to all coverage
20outlined in this subsection (a) other than that authorized
21under Section 1902 of the Social Security Act, 42 U.S.C.
221396a, and the State shall not assume any obligation for the
23cost of the coverage set forth in this subsection (a).
24    (b) This subsection (b) shall become operative if and only
25if subsection (a) becomes inoperative.
26    An individual or group policy of accident and health

 

 

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1insurance amended, delivered, issued, or renewed in this State
2after the date this subsection (b) becomes operative that
3provides coverage for outpatient services and outpatient
4prescription drugs or devices must provide coverage for the
5insured and any dependent of the insured covered by the policy
6for all outpatient contraceptive services and all outpatient
7contraceptive drugs and devices approved by the Food and Drug
8Administration. Coverage required under this Section may not
9impose any deductible, coinsurance, waiting period, or other
10cost-sharing or limitation that is greater than that required
11for any outpatient service or outpatient prescription drug or
12device otherwise covered by the policy.
13    Nothing in this subsection (b) shall be construed to
14require an insurance company to cover services related to
15permanent sterilization that requires a surgical procedure.
16    As used in this subsection (b), "outpatient contraceptive
17service" means consultations, examinations, procedures, and
18medical services, provided on an outpatient basis and related
19to the use of contraceptive methods (including natural family
20planning) to prevent an unintended pregnancy.
21    (c) (Blank).
22    (d) If a plan or issuer utilizes a network of providers,
23nothing in this Section shall be construed to require coverage
24or to prohibit the plan or issuer from imposing cost-sharing
25for items or services described in this Section that are
26provided or delivered by an out-of-network provider, unless

 

 

10300SB1561ham001- 17 -LRB103 27713 BMS 62257 a

1the plan or issuer does not have in its network a provider who
2is able to or is willing to provide the applicable items or
3services.
4(Source: P.A. 100-1102, eff. 1-1-19; 101-13, eff. 6-12-19.)
 
5    (215 ILCS 5/356z.62 new)
6    Sec. 356z.62. Coverage of preventive health services.
7    (a) A policy of group health insurance coverage or
8individual health insurance coverage as defined in Section 5
9of the Illinois Health Insurance Portability and
10Accountability Act shall, at a minimum, provide coverage for
11and shall not impose any cost-sharing requirements, including
12a copayment, coinsurance, or deductible, for:
13        (1) evidence-based items or services that have in
14    effect a rating of "A" or "B" in the current
15    recommendations of the United States Preventive Services
16    Task Force;
17        (2) immunizations that have in effect a recommendation
18    from the Advisory Committee on Immunization Practices of
19    the Centers for Disease Control and Prevention with
20    respect to the individual involved;
21        (3) with respect to infants, children, and
22    adolescents, evidence-informed preventive care and
23    screenings provided for in the comprehensive guidelines
24    supported by the Health Resources and Services
25    Administration; and

 

 

10300SB1561ham001- 18 -LRB103 27713 BMS 62257 a

1        (4) with respect to women, such additional preventive
2    care and screenings not described in paragraph (1) of this
3    subsection (a) as provided for in comprehensive guidelines
4    supported by the Health Resources and Services
5    Administration for purposes of this paragraph.
6    (b) For purposes of this Section, and for purposes of any
7other provision of State law, recommendations of the United
8States Preventive Services Task Force regarding breast cancer
9screening, mammography, and prevention issued in or around
10November 2009 are not considered to be current.
11    (c) For office visits:
12        (1) if an item or service described in subsection (a)
13    is billed separately or is tracked as individual encounter
14    data separately from an office visit, then a policy may
15    impose cost-sharing requirements with respect to the
16    office visit;
17        (2) if an item or service described in subsection (a)
18    is not billed separately or is not tracked as individual
19    encounter data separately from an office visit and the
20    primary purpose of the office visit is the delivery of
21    such an item or service, then a policy may not impose
22    cost-sharing requirements with respect to the office
23    visit; and
24        (3) if an item or service described in subsection (a)
25    is not billed separately or is not tracked as individual
26    encounter data separately from an office visit and the

 

 

10300SB1561ham001- 19 -LRB103 27713 BMS 62257 a

1    primary purpose of the office visit is not the delivery of
2    such an item or service, then a policy may impose
3    cost-sharing requirements with respect to the office
4    visit.
5    (d) A policy must provide coverage pursuant to subsection
6(a) for plan or policy years that begin on or after the date
7that is one year after the date the recommendation or
8guideline is issued. If a recommendation or guideline is in
9effect on the first day of the plan or policy year, the policy
10shall cover the items and services specified in the
11recommendation or guideline through the last day of the plan
12or policy year unless either:
13        (1) a recommendation under paragraph (1) of subsection
14    (a) is downgraded to a "D" rating; or
15        (2) the item or service is subject to a safety recall
16    or is otherwise determined to pose a significant safety
17    concern by a federal agency authorized to regulate the
18    item or service during the plan or policy year.
19    (e) Network limitations.
20        (1) Subject to paragraph (3) of this subsection,
21    nothing in this Section requires coverage for items or
22    services described in subsection (a) that are delivered by
23    an out-of-network provider under a health maintenance
24    organization health care plan, other than a
25    point-of-service contract, or under a voluntary health
26    services plan that generally excludes coverage for

 

 

10300SB1561ham001- 20 -LRB103 27713 BMS 62257 a

1    out-of-network services except as otherwise required by
2    law.
3        (2) Subject to paragraph (3) of this subsection,
4    nothing in this Section precludes a policy with a
5    preferred provider program under Article XX-1/2 of this
6    Code, a health maintenance organization point-of-service
7    contract, or a similarly designed voluntary health
8    services plan from imposing cost-sharing requirements for
9    items or services described in subsection (a) that are
10    delivered by an out-of-network provider.
11        (3) If a policy does not have in its network a provider
12    who can provide an item or service described in subsection
13    (a), then the policy must cover the item or service when
14    performed by an out-of-network provider and it may not
15    impose cost-sharing with respect to the item or service.
16    (f) Nothing in this Section prevents a company from using
17reasonable medical management techniques to determine the
18frequency, method, treatment, or setting for an item or
19service described in subsection (a) to the extent not
20specified in the recommendation or guideline.
21    (g) Nothing in this Section shall be construed to prohibit
22a policy from providing coverage for items or services in
23addition to those required under subsection (a) or from
24denying coverage for items or services that are not required
25under subsection (a). Unless prohibited by other law, a policy
26may impose cost-sharing requirements for a treatment not

 

 

10300SB1561ham001- 21 -LRB103 27713 BMS 62257 a

1described in subsection (a) even if the treatment results from
2an item or service described in subsection (a). Nothing in
3this Section shall be construed to limit coverage requirements
4provided under other law.
5    (h) The Director may develop guidelines to permit a
6company to utilize value-based insurance designs. In the
7absence of guidelines developed by the Director, any such
8guidelines developed by the Secretary of the U.S. Department
9of Health and Human Services that are in force under 42 U.S.C.
10300gg-13 shall apply.
11    (i) For student health insurance coverage as defined at 45
12CFR 147.145, student administrative health fees are not
13considered cost-sharing requirements with respect to
14preventive services specified under subsection (a). As used in
15this subsection, "student administrative health fee" means a
16fee charged by an institution of higher education on a
17periodic basis to its students to offset the cost of providing
18health care through health clinics regardless of whether the
19students utilize the health clinics or enroll in student
20health insurance coverage.
21    (j) For any recommendation or guideline specifically
22referring to women or men, a company shall not deny or limit
23the coverage required or a claim made under subsection (a)
24based solely on the individual's recorded sex or actual or
25perceived gender identity, or for the reason that the
26individual is gender nonconforming, intersex, transgender, or

 

 

10300SB1561ham001- 22 -LRB103 27713 BMS 62257 a

1has undergone, or is in the process of undergoing, gender
2transition, if, notwithstanding the sex or gender assigned at
3birth, the covered individual meets the conditions for the
4recommendation or guideline at the time the item or service is
5furnished.
6    (k) This Section does not apply to grandfathered health
7plans, excepted benefits, or short-term, limited-duration
8health insurance coverage.
 
9    Section 40. The Health Maintenance Organization Act is
10amended by changing Section 5-3 as follows:
 
11    (215 ILCS 125/5-3)  (from Ch. 111 1/2, par. 1411.2)
12    Sec. 5-3. Insurance Code provisions.
13    (a) Health Maintenance Organizations shall be subject to
14the provisions of Sections 133, 134, 136, 137, 139, 140,
15141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153,
16154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 355.2,
17355.3, 355b, 355c, 356g.5-1, 356m, 356q, 356v, 356w, 356x,
18356y, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6,
19356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14,
20356z.15, 356z.17, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
21356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
22356z.35, 356z.36, 356z.40, 356z.41, 356z.46, 356z.47, 356z.48,
23356z.50, 356z.51, 356z.53 256z.53, 356z.54, 356z.56, 356z.57,
24356z.59, 356z.60, 356z.62, 364, 364.01, 364.3, 367.2, 367.2-5,

 

 

10300SB1561ham001- 23 -LRB103 27713 BMS 62257 a

1367i, 368a, 368b, 368c, 368d, 368e, 370c, 370c.1, 401, 401.1,
2402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1,
3paragraph (c) of subsection (2) of Section 367, and Articles
4IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and
5XXXIIB of the Illinois Insurance Code.
6    (b) For purposes of the Illinois Insurance Code, except
7for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
8Health Maintenance Organizations in the following categories
9are deemed to be "domestic companies":
10        (1) a corporation authorized under the Dental Service
11    Plan Act or the Voluntary Health Services Plans Act;
12        (2) a corporation organized under the laws of this
13    State; or
14        (3) 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    (c) In considering the merger, consolidation, or other
21acquisition of control of a Health Maintenance Organization
22pursuant to Article VIII 1/2 of the Illinois Insurance Code,
23        (1) the Director shall give primary consideration to
24    the continuation of benefits to enrollees and the
25    financial conditions of the acquired Health Maintenance
26    Organization after the merger, consolidation, or other

 

 

10300SB1561ham001- 24 -LRB103 27713 BMS 62257 a

1    acquisition of control takes effect;
2        (2)(i) the criteria specified in subsection (1)(b) of
3    Section 131.8 of the Illinois Insurance Code shall not
4    apply and (ii) the Director, in making his determination
5    with respect to the merger, consolidation, or other
6    acquisition of control, need not take into account the
7    effect on competition of the merger, consolidation, or
8    other acquisition of control;
9        (3) the Director shall have the power to require the
10    following information:
11            (A) certification by an independent actuary of the
12        adequacy of the reserves of the Health Maintenance
13        Organization sought to be acquired;
14            (B) pro forma financial statements reflecting the
15        combined balance sheets of the acquiring company and
16        the Health Maintenance Organization sought to be
17        acquired as of the end of the preceding year and as of
18        a date 90 days prior to the acquisition, as well as pro
19        forma financial statements reflecting projected
20        combined operation for a period of 2 years;
21            (C) a pro forma business plan detailing an
22        acquiring party's plans with respect to the operation
23        of the Health Maintenance Organization sought to be
24        acquired for a period of not less than 3 years; and
25            (D) such other information as the Director shall
26        require.

 

 

10300SB1561ham001- 25 -LRB103 27713 BMS 62257 a

1    (d) The provisions of Article VIII 1/2 of the Illinois
2Insurance Code and this Section 5-3 shall apply to the sale by
3any health maintenance organization of greater than 10% of its
4enrollee population (including without limitation the health
5maintenance organization's right, title, and interest in and
6to its health care certificates).
7    (e) In considering any management contract or service
8agreement subject to Section 141.1 of the Illinois Insurance
9Code, the Director (i) shall, in addition to the criteria
10specified in Section 141.2 of the Illinois Insurance Code,
11take into account the effect of the management contract or
12service agreement on the continuation of benefits to enrollees
13and the financial condition of the health maintenance
14organization to be managed or serviced, and (ii) need not take
15into account the effect of the management contract or service
16agreement on competition.
17    (f) Except for small employer groups as defined in the
18Small Employer Rating, Renewability and Portability Health
19Insurance Act and except for medicare supplement policies as
20defined in Section 363 of the Illinois Insurance Code, a
21Health Maintenance Organization may by contract agree with a
22group or other enrollment unit to effect refunds or charge
23additional premiums under the following terms and conditions:
24        (i) the amount of, and other terms and conditions with
25    respect to, the refund or additional premium are set forth
26    in the group or enrollment unit contract agreed in advance

 

 

10300SB1561ham001- 26 -LRB103 27713 BMS 62257 a

1    of the period for which a refund is to be paid or
2    additional premium is to be charged (which period shall
3    not be less than one year); and
4        (ii) the amount of the refund or additional premium
5    shall not exceed 20% of the Health Maintenance
6    Organization's profitable or unprofitable experience with
7    respect to the group or other enrollment unit for the
8    period (and, for purposes of a refund or additional
9    premium, the profitable or unprofitable experience shall
10    be calculated taking into account a pro rata share of the
11    Health Maintenance Organization's administrative and
12    marketing expenses, but shall not include any refund to be
13    made or additional premium to be paid pursuant to this
14    subsection (f)). The Health Maintenance Organization and
15    the group or enrollment unit may agree that the profitable
16    or unprofitable experience may be calculated taking into
17    account the refund period and the immediately preceding 2
18    plan years.
19    The Health Maintenance Organization shall include a
20statement in the evidence of coverage issued to each enrollee
21describing the possibility of a refund or additional premium,
22and upon request of any group or enrollment unit, provide to
23the group or enrollment unit a description of the method used
24to calculate (1) the Health Maintenance Organization's
25profitable experience with respect to the group or enrollment
26unit and the resulting refund to the group or enrollment unit

 

 

10300SB1561ham001- 27 -LRB103 27713 BMS 62257 a

1or (2) the Health Maintenance Organization's unprofitable
2experience with respect to the group or enrollment unit and
3the resulting additional premium to be paid by the group or
4enrollment unit.
5    In no event shall the Illinois Health Maintenance
6Organization Guaranty Association be liable to pay any
7contractual obligation of an insolvent organization to pay any
8refund authorized under this Section.
9    (g) Rulemaking authority to implement Public Act 95-1045,
10if any, is conditioned on the rules being adopted in
11accordance with all provisions of the Illinois Administrative
12Procedure Act and all rules and procedures of the Joint
13Committee on Administrative Rules; any purported rule not so
14adopted, for whatever reason, is unauthorized.
15(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
16101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-393, eff.
171-1-20; 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625,
18eff. 1-1-21; 102-30, eff. 1-1-22; 102-34, eff. 6-25-21;
19102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
201-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665,
21eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
22102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff.
231-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093,
24eff. 1-1-23; 102-1117, eff. 1-13-23; revised 1-22-23.)
 
25    Section 45. The Voluntary Health Services Plans Act is

 

 

10300SB1561ham001- 28 -LRB103 27713 BMS 62257 a

1amended by changing Section 10 as follows:
 
2    (215 ILCS 165/10)  (from Ch. 32, par. 604)
3    Sec. 10. Application of Insurance Code provisions. Health
4services plan corporations and all persons interested therein
5or dealing therewith shall be subject to the provisions of
6Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,
7143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b,
8356g, 356g.5, 356g.5-1, 356q, 356r, 356t, 356u, 356v, 356w,
9356x, 356y, 356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5,
10356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
11356z.14, 356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
12356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
13356z.40, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,
14356z.56, 356z.57, 356z.59, 356z.60, 356z.62, 364.01, 364.3,
15367.2, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
16and paragraphs (7) and (15) of Section 367 of the Illinois
17Insurance Code.
18    Rulemaking authority to implement Public Act 95-1045, if
19any, is conditioned on the rules being adopted in accordance
20with all provisions of the Illinois Administrative Procedure
21Act and all rules and procedures of the Joint Committee on
22Administrative Rules; any purported rule not so adopted, for
23whatever reason, is unauthorized.
24(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
25101-281, eff. 1-1-20; 101-393, eff. 1-1-20; 101-625, eff.

 

 

10300SB1561ham001- 29 -LRB103 27713 BMS 62257 a

11-1-21; 102-30, eff. 1-1-22; 102-203, eff. 1-1-22; 102-306,
2eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21;
3102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 102-804, eff.
41-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
5eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, eff. 1-1-23;
6102-1117, eff. 1-13-23.)
 
7    Section 50. The Medical Practice Act of 1987 is amended by
8changing Section 18 as follows:
 
9    (225 ILCS 60/18)  (from Ch. 111, par. 4400-18)
10    (Section scheduled to be repealed on January 1, 2027)
11    Sec. 18. Visiting professor, physician, or resident
12permits.
13    (A) Visiting professor permit.
14        (1) A visiting professor permit shall entitle a person
15    to practice medicine in all of its branches or to practice
16    the treatment of human ailments without the use of drugs
17    and without operative surgery provided:
18            (a) the person maintains an equivalent
19        authorization to practice medicine in all of its
20        branches or to practice the treatment of human
21        ailments without the use of drugs and without
22        operative surgery in good standing in his or her
23        native licensing jurisdiction during the period of the
24        visiting professor permit;

 

 

10300SB1561ham001- 30 -LRB103 27713 BMS 62257 a

1            (b) the person has received a faculty appointment
2        to teach in a medical, osteopathic or chiropractic
3        school in Illinois; and
4            (c) the Department may prescribe the information
5        necessary to establish an applicant's eligibility for
6        a permit. This information shall include without
7        limitation (i) a statement from the dean of the
8        medical school at which the applicant will be employed
9        describing the applicant's qualifications and (ii) a
10        statement from the dean of the medical school listing
11        every affiliated institution in which the applicant
12        will be providing instruction as part of the medical
13        school's education program and justifying any clinical
14        activities at each of the institutions listed by the
15        dean.
16        (2) Application for visiting professor permits shall
17    be made to the Department, in writing, on forms prescribed
18    by the Department and shall be accompanied by the required
19    fee established by rule, which shall not be refundable.
20    Any application shall require the information as, in the
21    judgment of the Department, will enable the Department to
22    pass on the qualifications of the applicant.
23        (3) A visiting professor permit shall be valid for no
24    longer than 2 years from the date of issuance or until the
25    time the faculty appointment is terminated, whichever
26    occurs first, and may be renewed only in accordance with

 

 

10300SB1561ham001- 31 -LRB103 27713 BMS 62257 a

1    subdivision (A)(6) of this Section.
2        (4) The applicant may be required to appear before the
3    Medical Board for an interview prior to, and as a
4    requirement for, the issuance of the original permit and
5    the renewal.
6        (5) Persons holding a permit under this Section shall
7    only practice medicine in all of its branches or practice
8    the treatment of human ailments without the use of drugs
9    and without operative surgery in the State of Illinois in
10    their official capacity under their contract within the
11    medical school itself and any affiliated institution in
12    which the permit holder is providing instruction as part
13    of the medical school's educational program and for which
14    the medical school has assumed direct responsibility.
15        (6) After the initial renewal of a visiting professor
16    permit, a visiting professor permit shall be valid until
17    the last day of the next physician license renewal period,
18    as set by rule, and may only be renewed for applicants who
19    meet the following requirements:
20            (i) have obtained the required continuing
21        education hours as set by rule; and
22            (ii) have paid the fee prescribed for a license
23        under Section 21 of this Act.
24    For initial renewal, the visiting professor must
25successfully pass a general competency examination authorized
26by the Department by rule, unless he or she was issued an

 

 

10300SB1561ham001- 32 -LRB103 27713 BMS 62257 a

1initial visiting professor permit on or after January 1, 2007,
2but prior to July 1, 2007.
 
3    (B) Visiting physician permit.
4        (1) The Department may, in its discretion, issue a
5    temporary visiting physician permit, without examination,
6    provided:
7            (a) (blank);
8            (b) that the person maintains an equivalent
9        authorization to practice medicine in all of its
10        branches or to practice the treatment of human
11        ailments without the use of drugs and without
12        operative surgery in good standing in his or her
13        native licensing jurisdiction during the period of the
14        temporary visiting physician permit;
15            (c) that the person has received an invitation or
16        appointment to study, demonstrate, or perform a
17        specific medical, osteopathic, chiropractic or
18        clinical subject or technique in a medical,
19        osteopathic, or chiropractic school, a state or
20        national medical, osteopathic, or chiropractic
21        professional association or society conference or
22        meeting, a hospital licensed under the Hospital
23        Licensing Act, a hospital organized under the
24        University of Illinois Hospital Act, or a facility
25        operated pursuant to the Ambulatory Surgical Treatment

 

 

10300SB1561ham001- 33 -LRB103 27713 BMS 62257 a

1        Center Act; and
2            (d) that the temporary visiting physician permit
3        shall only permit the holder to practice medicine in
4        all of its branches or practice the treatment of human
5        ailments without the use of drugs and without
6        operative surgery within the scope of the medical,
7        osteopathic, chiropractic, or clinical studies, or in
8        conjunction with the state or national medical,
9        osteopathic, or chiropractic professional association
10        or society conference or meeting, for which the holder
11        was invited or appointed.
12        (2) The application for the temporary visiting
13    physician permit shall be made to the Department, in
14    writing, on forms prescribed by the Department, and shall
15    be accompanied by the required fee established by rule,
16    which shall not be refundable. The application shall
17    require information that, in the judgment of the
18    Department, will enable the Department to pass on the
19    qualification of the applicant, and the necessity for the
20    granting of a temporary visiting physician permit.
21        (3) A temporary visiting physician permit shall be
22    valid for no longer than (i) 180 days from the date of
23    issuance or (ii) until the time the medical, osteopathic,
24    chiropractic, or clinical studies are completed, or the
25    state or national medical, osteopathic, or chiropractic
26    professional association or society conference or meeting

 

 

10300SB1561ham001- 34 -LRB103 27713 BMS 62257 a

1    has concluded, whichever occurs first. The temporary
2    visiting physician permit may be issued multiple times to
3    a visiting physician under this paragraph (3) as long as
4    the total number of days it is active do not exceed 180
5    days within a 365-day period.
6        (4) The applicant for a temporary visiting physician
7    permit may be required to appear before the Medical Board
8    for an interview prior to, and as a requirement for, the
9    issuance of a temporary visiting physician permit.
10        (5) A limited temporary visiting physician permit
11    shall be issued to a physician licensed in another state
12    who has been requested to perform emergency procedures in
13    Illinois if he or she meets the requirements as
14    established by rule.
 
15    (C) Visiting resident permit.
16        (1) The Department may, in its discretion, issue a
17    temporary visiting resident permit, without examination,
18    provided:
19            (a) (blank);
20            (b) that the person maintains an equivalent
21        authorization to practice medicine in all of its
22        branches or to practice the treatment of human
23        ailments without the use of drugs and without
24        operative surgery in good standing in his or her
25        native licensing jurisdiction during the period of the

 

 

10300SB1561ham001- 35 -LRB103 27713 BMS 62257 a

1        temporary visiting resident permit;
2            (c) that the applicant is enrolled in a
3        postgraduate clinical training program outside the
4        State of Illinois that is approved by the Department;
5            (d) that the individual has been invited or
6        appointed for a specific period of time to perform a
7        portion of that post graduate clinical training
8        program under the supervision of an Illinois licensed
9        physician in an Illinois patient care clinic or
10        facility that is affiliated with the out-of-State post
11        graduate training program; and
12            (e) that the temporary visiting resident permit
13        shall only permit the holder to practice medicine in
14        all of its branches or practice the treatment of human
15        ailments without the use of drugs and without
16        operative surgery within the scope of the medical,
17        osteopathic, chiropractic or clinical studies for
18        which the holder was invited or appointed.
19        (2) The application for the temporary visiting
20    resident permit shall be made to the Department, in
21    writing, on forms prescribed by the Department, and shall
22    be accompanied by the required fee established by rule.
23    The application shall require information that, in the
24    judgment of the Department, will enable the Department to
25    pass on the qualifications of the applicant.
26        (3) A temporary visiting resident permit shall be

 

 

10300SB1561ham001- 36 -LRB103 27713 BMS 62257 a

1    valid for 180 days from the date of issuance or until the
2    time the medical, osteopathic, chiropractic, or clinical
3    studies are completed, whichever occurs first.
4        (4) The applicant for a temporary visiting resident
5    permit may be required to appear before the Medical Board
6    for an interview prior to, and as a requirement for, the
7    issuance of a temporary visiting resident permit.
 
8    (D) Postgraduate training exemption period; visiting
9rotations. A person may participate in visiting rotations in
10an approved postgraduate training program, not to exceed a
11total of 90 days for all rotations, if the following
12information is submitted in writing or electronically to the
13Department by the patient care clinics or facilities where the
14person will be performing the training or by an affiliated
15program:
16        (1) The person who has been invited or appointed to
17    perform a portion of their postgraduate clinical training
18    program in Illinois.
19        (2) The name and address of the primary patient care
20    clinic or facility, the date the training is to begin, and
21    the length of time of the invitation or appointment.
22        (3) The name and license number of the Illinois
23    physician who will be responsible for supervising the
24    trainee and the medical director or division director of
25    the department or facility.

 

 

10300SB1561ham001- 37 -LRB103 27713 BMS 62257 a

1        (4) Certification from the postgraduate training
2    program that the person is approved and enrolled in an
3    graduate training program approved by the Department in
4    their home state.
5(Source: P.A. 102-20, eff. 1-1-22.)
 
6    Section 95. No acceleration or delay. Where this Act makes
7changes in a statute that is represented in this Act by text
8that is not yet or no longer in effect (for example, a Section
9represented by multiple versions), the use of that text does
10not accelerate or delay the taking effect of (i) the changes
11made by this Act or (ii) provisions derived from any other
12Public Act.
 
13    Section 99. Effective date. This Act takes effect upon
14becoming law.".