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Rep. Mary E. Flowers
Filed: 3/4/2015
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1 | | AMENDMENT TO HOUSE BILL 122
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2 | | AMENDMENT NO. ______. Amend House Bill 122 by replacing |
3 | | everything after the enacting clause with the following:
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4 | | "Section 5. The Counties Code is amended by changing |
5 | | Section 5-1069.3 as
follows:
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6 | | (55 ILCS 5/5-1069.3)
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7 | | Sec. 5-1069.3. Required health benefits. If a county, |
8 | | including a home
rule
county, is a self-insurer for purposes of |
9 | | providing health insurance coverage
for its employees, the |
10 | | coverage shall include coverage for the post-mastectomy
care |
11 | | benefits required to be covered by a policy of accident and |
12 | | health
insurance under Section 356t and the coverage required |
13 | | under Sections 356g, 356g.5, 356g.5-1, 356u,
356w, 356x, |
14 | | 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, |
15 | | 356z.14, 356z.15, and 356z.22 , 356z.23, 356z.24, and 356z.25 of
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16 | | the Illinois Insurance Code. The coverage shall comply with |
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1 | | Sections 155.22a, 355b, and 356z.19 of
the Illinois Insurance |
2 | | Code. The requirement that health benefits be covered
as |
3 | | provided in this Section is an
exclusive power and function of |
4 | | the State and is a denial and limitation under
Article VII, |
5 | | Section 6, subsection (h) of the Illinois Constitution. A home
|
6 | | rule county to which this Section applies must comply with |
7 | | every provision of
this Section.
|
8 | | Rulemaking authority to implement Public Act 95-1045, if |
9 | | any, is conditioned on the rules being adopted in accordance |
10 | | with all provisions of the Illinois Administrative Procedure |
11 | | Act and all rules and procedures of the Joint Committee on |
12 | | Administrative Rules; any purported rule not so adopted, for |
13 | | whatever reason, is unauthorized. |
14 | | (Source: P.A. 97-282, eff. 8-9-11; 97-343, eff. 1-1-12; 97-813, |
15 | | eff. 7-13-12; 98-189, eff. 1-1-14; 98-1091, eff. 1-1-15 .)
|
16 | | Section 10. The Illinois Municipal Code is amended by |
17 | | changing Section
10-4-2.3 as follows:
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18 | | (65 ILCS 5/10-4-2.3)
|
19 | | Sec. 10-4-2.3. Required health benefits. If a |
20 | | municipality, including a
home rule municipality, is a |
21 | | self-insurer for purposes of providing health
insurance |
22 | | coverage for its employees, the coverage shall include coverage |
23 | | for
the post-mastectomy care benefits required to be covered by |
24 | | a policy of
accident and health insurance under Section 356t |
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1 | | and the coverage required
under Sections 356g, 356g.5, |
2 | | 356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.10, |
3 | | 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, and 356z.22 , |
4 | | 356z.23, 356z.24, and 356z.25 of the Illinois
Insurance
Code. |
5 | | The coverage shall comply with Sections 155.22a, 355b, and |
6 | | 356z.19 of
the Illinois Insurance Code. The requirement that |
7 | | health
benefits be covered as provided in this is an exclusive |
8 | | power and function of
the State and is a denial and limitation |
9 | | under Article VII, Section 6,
subsection (h) of the Illinois |
10 | | Constitution. A home rule municipality to which
this Section |
11 | | applies must comply with every provision of this Section.
|
12 | | Rulemaking authority to implement Public Act 95-1045, if |
13 | | any, is conditioned on the rules being adopted in accordance |
14 | | with all provisions of the Illinois Administrative Procedure |
15 | | Act and all rules and procedures of the Joint Committee on |
16 | | Administrative Rules; any purported rule not so adopted, for |
17 | | whatever reason, is unauthorized. |
18 | | (Source: P.A. 97-282, eff. 8-9-11; 97-343, eff. 1-1-12; 97-813, |
19 | | eff. 7-13-12; 98-189, eff. 1-1-14; 98-1091, eff. 1-1-15 .)
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20 | | Section 15. The School Code is amended by changing Section |
21 | | 10-22.3f as
follows:
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22 | | (105 ILCS 5/10-22.3f)
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23 | | Sec. 10-22.3f. Required health benefits. Insurance |
24 | | protection and
benefits
for employees shall provide the |
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1 | | post-mastectomy care benefits required to be
covered by a |
2 | | policy of accident and health insurance under Section 356t and |
3 | | the
coverage required under Sections 356g, 356g.5, 356g.5-1, |
4 | | 356u, 356w, 356x,
356z.6, 356z.8, 356z.9, 356z.11, 356z.12, |
5 | | 356z.13, 356z.14, 356z.15, and 356z.22 , 356z.23, and 356z.24 of
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6 | | the
Illinois Insurance Code.
Insurance policies shall comply |
7 | | with Section 356z.19 of the Illinois Insurance Code. The |
8 | | coverage shall comply with Sections 155.22a and 355b of
the |
9 | | Illinois Insurance Code.
|
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. 97-282, eff. 8-9-11; 97-343, eff. 1-1-12; 97-813, |
17 | | eff. 7-13-12; 98-189, eff. 1-1-14; 98-1091, eff. 1-1-15 .)
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18 | | Section 20. The Emergency Medical Treatment Act is amended |
19 | | by changing Section 1 as follows:
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20 | | (210 ILCS 70/1) (from Ch. 111 1/2, par. 6151)
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21 | | Sec. 1.
No hospital, physician, dentist or other provider |
22 | | of professional
health care licensed under the laws of this |
23 | | State may refuse to provide
needed emergency treatment to any |
24 | | person whose life would be threatened
in the absence of such |
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1 | | treatment, because of that person's inability to
pay therefor, |
2 | | nor because of the source of any payment promised therefor. |
3 | | Every hospital licensed under the Hospital Licensing Act shall |
4 | | comply with the Hospital Emergency Service Act.
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5 | | (Source: P.A. 83-723.)
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6 | | Section 25. The Hospital Emergency Service Act is amended |
7 | | by changing Section 1 as follows:
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8 | | (210 ILCS 80/1) (from Ch. 111 1/2, par. 86)
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9 | | Sec. 1.
Every hospital required to be licensed by the |
10 | | Department of Public
Health pursuant to the Hospital Licensing |
11 | | Act which provides general medical
and surgical
hospital |
12 | | services , except long-term acute care hospitals and |
13 | | rehabilitation hospitals identified in Section 1.3 of this Act, |
14 | | shall provide a hospital emergency service in accordance
with |
15 | | rules and regulations adopted by the Department of Public |
16 | | Health which shall be consistent with the federal Emergency |
17 | | Medical Treatment and Active Labor Act (42 U.S.C. 1395dd) and
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18 | | shall furnish such hospital emergency services to any applicant |
19 | | who applies
for the same in case of injury or acute medical |
20 | | condition where the same is
liable to cause death or severe |
21 | | injury or serious illness.
For purposes of this Act, |
22 | | "applicant" includes any person who is brought
to a hospital by |
23 | | ambulance or specialized emergency medical services
vehicle as |
24 | | defined in the Emergency Medical Services (EMS) Systems Act.
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1 | | (Source: P.A. 97-667, eff. 1-13-12; 98-683, eff. 6-30-14.)
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2 | | Section 30. The Illinois Insurance Code is amended by |
3 | | adding Sections
356z.23, 356z.24, and 356z.25
as
follows:
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4 | | (215 ILCS 5/356z.23 new) |
5 | | Sec. 356z.23. Intravenous feeding. A group or individual |
6 | | policy of
accident and health insurance or managed care plan |
7 | | amended, delivered, issued,
or renewed after the effective date |
8 | | of this amendatory Act of the 99th General
Assembly must |
9 | | provide coverage for intravenous feeding. The benefits under
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10 | | this Section shall be at least as favorable as for other |
11 | | coverages under the
policy and may be subject to the same |
12 | | dollar amount limits, deductibles, and
co-insurance |
13 | | requirements applicable generally to other coverages under the
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14 | | policy. |
15 | | (215 ILCS 5/356z.24 new) |
16 | | Sec. 356z.24. Prescription nutritional supplements. A |
17 | | group or individual
policy of
accident and health insurance or |
18 | | managed care plan amended, delivered, issued,
or renewed
after |
19 | | the effective date of this amendatory Act of the 99th General |
20 | | Assembly
that provides
coverage for prescription drugs must |
21 | | provide coverage for reimbursement for
medically
appropriate |
22 | | prescription nutritional supplements when ordered by a |
23 | | physician
licensed to
practice medicine in all its branches and |
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1 | | the insured suffers from a condition
that prevents
him or her |
2 | | from taking sufficient oral nourishment to sustain life. |
3 | | (215 ILCS 5/356z.25 new) |
4 | | Sec. 356z.25. Hospital patient assessments. A group or |
5 | | individual policy of accident and health insurance or managed |
6 | | care plan amended, delivered, issued, or renewed after the |
7 | | effective date of this amendatory Act of the 99th General |
8 | | Assembly that provides coverage for hospital care shall include |
9 | | in that coverage all services ordered by a physician and |
10 | | provided in the hospital that are considered medically |
11 | | necessary for the evaluation, assessment, and diagnosis of the |
12 | | illness or condition that resulted in the hospital stay of the |
13 | | enrollee or recipient. Such services are subject to reasonable |
14 | | review and utilization standards required by the policy or plan |
15 | | for all hospital services, as defined by the Department of |
16 | | Insurance or its successor agency.
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17 | | Section 35. The Health Maintenance Organization Act is |
18 | | amended by changing
Section 5-3 as follows:
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19 | | (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
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20 | | Sec. 5-3. Insurance Code provisions.
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21 | | (a) Health Maintenance Organizations
shall be subject to |
22 | | the provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
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23 | | 141.2, 141.3, 143, 143c, 147, 148, 149, 151,
152, 153, 154, |
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1 | | 154.5, 154.6,
154.7, 154.8, 155.04, 155.22a, 355.2, 355.3, |
2 | | 355b, 356g.5-1, 356m, 356v, 356w, 356x, 356y,
356z.2, 356z.4, |
3 | | 356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, |
4 | | 356z.13, 356z.14, 356z.15, 356z.17, 356z.18, 356z.19, 356z.21, |
5 | | 356z.22, 356z.23, 356z.24, 364.01, 367.2, 367.2-5, 367i, 368a, |
6 | | 368b, 368c, 368d, 368e, 370c,
370c.1, 401, 401.1, 402, 403, |
7 | | 403A,
408, 408.2, 409, 412, 444,
and
444.1,
paragraph (c) of |
8 | | subsection (2) of Section 367, and Articles IIA, VIII 1/2,
XII,
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9 | | XII 1/2, XIII, XIII 1/2, XXV, and XXVI of the Illinois |
10 | | Insurance Code.
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11 | | (b) For purposes of the Illinois Insurance Code, except for |
12 | | Sections 444
and 444.1 and Articles XIII and XIII 1/2, Health |
13 | | Maintenance Organizations in
the following categories are |
14 | | deemed to be "domestic companies":
|
15 | | (1) a corporation authorized under the
Dental Service |
16 | | Plan Act or the Voluntary Health Services Plans Act;
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17 | | (2) a corporation organized under the laws of this |
18 | | State; or
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19 | | (3) a corporation organized under the laws of another |
20 | | state, 30% or more
of the enrollees of which are residents |
21 | | of this State, except a
corporation subject to |
22 | | substantially the same requirements in its state of
|
23 | | organization as is a "domestic company" under Article VIII |
24 | | 1/2 of the
Illinois Insurance Code.
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25 | | (c) In considering the merger, consolidation, or other |
26 | | acquisition of
control of a Health Maintenance Organization |
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1 | | pursuant to Article VIII 1/2
of the Illinois Insurance Code,
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2 | | (1) the Director shall give primary consideration to |
3 | | the continuation of
benefits to enrollees and the financial |
4 | | conditions of the acquired Health
Maintenance Organization |
5 | | after the merger, consolidation, or other
acquisition of |
6 | | control takes effect;
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7 | | (2)(i) the criteria specified in subsection (1)(b) of |
8 | | Section 131.8 of
the Illinois Insurance Code shall not |
9 | | apply and (ii) the Director, in making
his determination |
10 | | with respect to the merger, consolidation, or other
|
11 | | acquisition of control, need not take into account the |
12 | | effect on
competition of the merger, consolidation, or |
13 | | other acquisition of control;
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14 | | (3) the Director shall have the power to require the |
15 | | following
information:
|
16 | | (A) certification by an independent actuary of the |
17 | | adequacy
of the reserves of the Health Maintenance |
18 | | Organization sought to be acquired;
|
19 | | (B) pro forma financial statements reflecting the |
20 | | combined balance
sheets of the acquiring company and |
21 | | the Health Maintenance Organization sought
to be |
22 | | acquired as of the end of the preceding year and as of |
23 | | a date 90 days
prior to the acquisition, as well as pro |
24 | | forma financial statements
reflecting projected |
25 | | combined operation for a period of 2 years;
|
26 | | (C) a pro forma business plan detailing an |
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1 | | acquiring party's plans with
respect to the operation |
2 | | of the Health Maintenance Organization sought to
be |
3 | | acquired for a period of not less than 3 years; and
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4 | | (D) such other information as the Director shall |
5 | | require.
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6 | | (d) The provisions of Article VIII 1/2 of the Illinois |
7 | | Insurance Code
and this Section 5-3 shall apply to the sale by |
8 | | any health maintenance
organization of greater than 10% of its
|
9 | | enrollee population (including without limitation the health |
10 | | maintenance
organization's right, title, and interest in and to |
11 | | its health care
certificates).
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12 | | (e) In considering any management contract or service |
13 | | agreement subject
to Section 141.1 of the Illinois Insurance |
14 | | Code, the Director (i) shall, in
addition to the criteria |
15 | | specified in Section 141.2 of the Illinois
Insurance Code, take |
16 | | into account the effect of the management contract or
service |
17 | | agreement on the continuation of benefits to enrollees and the
|
18 | | financial condition of the health maintenance organization to |
19 | | be managed or
serviced, and (ii) need not take into account the |
20 | | effect of the management
contract or service agreement on |
21 | | competition.
|
22 | | (f) Except for small employer groups as defined in the |
23 | | Small Employer
Rating, Renewability and Portability Health |
24 | | Insurance Act and except for
medicare supplement policies as |
25 | | defined in Section 363 of the Illinois
Insurance Code, a Health |
26 | | Maintenance Organization may by contract agree with a
group or |
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1 | | other enrollment unit to effect refunds or charge additional |
2 | | premiums
under the following terms and conditions:
|
3 | | (i) the amount of, and other terms and conditions with |
4 | | respect to, the
refund or additional premium are set forth |
5 | | in the group or enrollment unit
contract agreed in advance |
6 | | of the period for which a refund is to be paid or
|
7 | | additional premium is to be charged (which period shall not |
8 | | be less than one
year); and
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9 | | (ii) the amount of the refund or additional premium |
10 | | shall not exceed 20%
of the Health Maintenance |
11 | | Organization's profitable or unprofitable experience
with |
12 | | respect to the group or other enrollment unit for the |
13 | | period (and, for
purposes of a refund or additional |
14 | | premium, the profitable or unprofitable
experience shall |
15 | | be calculated taking into account a pro rata share of the
|
16 | | Health Maintenance Organization's administrative and |
17 | | marketing expenses, but
shall not include any refund to be |
18 | | made or additional premium to be paid
pursuant to this |
19 | | subsection (f)). The Health Maintenance Organization and |
20 | | the
group or enrollment unit may agree that the profitable |
21 | | or unprofitable
experience may be calculated taking into |
22 | | account the refund period and the
immediately preceding 2 |
23 | | plan years.
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24 | | The Health Maintenance Organization shall include a |
25 | | statement in the
evidence of coverage issued to each enrollee |
26 | | describing the possibility of a
refund or additional premium, |
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1 | | and upon request of any group or enrollment unit,
provide to |
2 | | the group or enrollment unit a description of the method used |
3 | | to
calculate (1) the Health Maintenance Organization's |
4 | | profitable experience with
respect to the group or enrollment |
5 | | unit and the resulting refund to the group
or enrollment unit |
6 | | or (2) the Health Maintenance Organization's unprofitable
|
7 | | experience with respect to the group or enrollment unit and the |
8 | | resulting
additional premium to be paid by the group or |
9 | | enrollment unit.
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10 | | In no event shall the Illinois Health Maintenance |
11 | | Organization
Guaranty Association be liable to pay any |
12 | | contractual obligation of an
insolvent organization to pay any |
13 | | refund authorized under this Section.
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14 | | (g) Rulemaking authority to implement Public Act 95-1045, |
15 | | if 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. 97-282, eff. 8-9-11; 97-343, eff. 1-1-12; 97-437, |
21 | | eff. 8-18-11; 97-486, eff. 1-1-12; 97-592, eff. 1-1-12; 97-805, |
22 | | eff. 1-1-13; 97-813, eff. 7-13-12; 98-189, eff. 1-1-14; |
23 | | 98-1091, eff. 1-1-15 .)
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24 | | Section 40. The Voluntary Health Services Plans Act is |
25 | | amended by changing
Section 10 as follows:
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1 | | (215 ILCS 165/10) (from Ch. 32, par. 604)
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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,
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9 | | 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.18, |
10 | | 356z.19, 356z.21, 356z.22, 356z.23, 356z.24, 364.01, 367.2, |
11 | | 368a, 401, 401.1,
402,
403, 403A, 408,
408.2, and 412, and |
12 | | paragraphs (7) and (15) of Section 367 of the Illinois
|
13 | | 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. 97-282, eff. 8-9-11; 97-343, eff. 1-1-12; 97-486, |
21 | | eff. 1-1-12; 97-592, eff. 1-1-12; 97-805, eff. 1-1-13; 97-813, |
22 | | eff. 7-13-12; 98-189, eff. 1-1-14; 98-1091, eff. 1-1-15 .)
|
23 | | Section 45. The Health Carrier External Review Act is |
24 | | amended by changing Section 35 and by adding Sections 25.1, |
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1 | | 25.2, 25.3, 25.4, 25.5, and 25.6 as follows: |
2 | | (215 ILCS 180/25.1 new) |
3 | | Sec. 25.1. Standard
information for application forms. |
4 | | (a) The Director shall establish standard
information and |
5 | | health history questions that shall be used by all
health care |
6 | | service plans for their individual health care coverage
|
7 | | application forms for individual health plan contracts and
|
8 | | individual health insurance policies. The health care service |
9 | | plan
and health insurance application forms for individual |
10 | | health plan
contracts and health insurance policies may only |
11 | | contain questions
approved by the Director. |
12 | | (b) The standard information and health history questions
|
13 | | developed by the Director shall contain clear and unambiguous
|
14 | | information and questions designed to ascertain the health |
15 | | history of
the applicant and shall be based on the medical |
16 | | information that is
reasonable and necessary for medical |
17 | | underwriting purposes. |
18 | | (c) The application form shall include a prominently |
19 | | displayed
notice that shall read:
"Illinois law prohibits an |
20 | | HIV test from being required or used
by health care service |
21 | | plans as a condition of obtaining coverage.". |
22 | | (d) No later than 6 months after the adoption of the |
23 | | regulation
under subsection (a) of this Section, all individual |
24 | | health care service plan
application forms shall utilize only |
25 | | the pool of approved questions
and the standardized information |
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1 | | established pursuant to subsection (a). |
2 | | (e) On and after January 1, 2015, all individual health |
3 | | care
service plan applications shall be reviewed and approved |
4 | | by the
Director before they may be used by a health care |
5 | | service plan. |
6 | | (215 ILCS 180/25.2 new) |
7 | | Sec. 25.2. Medical
underwriting. |
8 | | (a) "Medical underwriting" means the completion of a |
9 | | reasonable
investigation of the applicant's health history |
10 | | information, which
includes, but is not limited to, the |
11 | | following: |
12 | | (1) Ensuring that the information submitted on the |
13 | | application
form and the material submitted with the |
14 | | application form are
complete and accurate. |
15 | | (2) Resolving all reasonable questions arising from |
16 | | the
application form or any materials submitted with the |
17 | | application form or
any information obtained by the health |
18 | | care service plan as part of
its verification of the |
19 | | accuracy and completeness of the application
form. |
20 | | (b) A health care service plan shall complete medical
|
21 | | underwriting prior to issuing an enrollee or subscriber health |
22 | | care
service plan contract. |
23 | | (c) A health care service plan shall adopt and implement |
24 | | written
medical underwriting policies and procedures to ensure |
25 | | that the
health care service plan does all of the following |
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1 | | with respect to an
application for health care coverage: |
2 | | (1) Reviews all of the following:
|
3 | | (A) Information on the application and any |
4 | | materials submitted
with the application form for |
5 | | accuracy and completeness.
|
6 | | (B) Claims information about the applicant that is |
7 | | within the
health care service plan's own claims |
8 | | information.
|
9 | | (C) At least one commercially available |
10 | | prescription drug database
for information about the |
11 | | applicant.
|
12 | | (2) Identifies and makes inquiries, including |
13 | | contacting the
applicant about any questions raised by |
14 | | omissions, ambiguities, or
inconsistencies based upon the |
15 | | information collected pursuant to
item (1) of this |
16 | | subsection (c).
|
17 | | (d) The plan shall document all information collected |
18 | | during the
underwriting review process.
|
19 | | (e) On or before January 1, 2015, a health care service |
20 | | plan shall
file its medical underwriting policies and |
21 | | procedures with the
Department.
|
22 | | (215 ILCS 180/25.3 new) |
23 | | Sec. 25.3. Copies of application and contract; notice. |
24 | | (a) Within 10 business days after issuing a health care
|
25 | | service plan contract, the health care service plan shall send |
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1 | | a copy
of the completed written application to the applicant |
2 | | with a copy of
the health care service plan contract issued by |
3 | | the health care
service plan, along with a notice that states |
4 | | all of the following:
|
5 | | (1) The applicant should review the completed |
6 | | application
carefully and notify the health care service |
7 | | plan within 30 days of
any inaccuracy in the application.
|
8 | | (2) Any intentional material misrepresentation or |
9 | | intentional
material omission in the information submitted |
10 | | in the application may
result in the cancellation or |
11 | | rescission of the plan contract.
|
12 | | (3) The applicant should retain a copy of the completed |
13 | | written
application for the applicant's records.
|
14 | | (b) If new information is provided by the applicant within |
15 | | the
30-day period permitted by subsection (a), then the |
16 | | provisions concerning medical underwriting shall apply to the |
17 | | new information.
|
18 | | (215 ILCS 180/25.4 new) |
19 | | Sec. 25.4. Rescission; cancellation. |
20 | | (a) Once a plan has issued an individual health care
|
21 | | service plan contract, the health care service plan shall not |
22 | | rescind
or cancel the health care service plan contract unless |
23 | | all of the
following apply:
|
24 | | (1) There was a material misrepresentation or material |
25 | | omission in
the information submitted by the applicant in |
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1 | | the written
application to the health care service plan |
2 | | prior to the issuance of
the health care service plan |
3 | | contract that would have prevented the
contract from being |
4 | | entered into.
|
5 | | (2) The health care service plan completed medical |
6 | | underwriting before issuing the plan contract.
|
7 | | (3) The health care service plan demonstrates that the |
8 | | applicant
intentionally misrepresented or intentionally |
9 | | omitted material
information on the application prior to |
10 | | the issuance of the plan
contract with the purpose of |
11 | | misrepresenting his or her health
history in order to |
12 | | obtain health care coverage.
|
13 | | (4) The application form was approved by the |
14 | | Department.
|
15 | | (5) The health care service plan sent a copy of the |
16 | | completed
written application to the applicant with a copy |
17 | | of the health care
service plan contract issued by the |
18 | | health care service plan.
|
19 | | (b) Notwithstanding subsection (a) of this Section, an |
20 | | enrollment or subscription
may be canceled or not renewed for |
21 | | failure to pay the fees for
that coverage.
|
22 | | (215 ILCS 180/25.5 new) |
23 | | Sec. 25.5. Postcontract investigation. |
24 | | (a) If a health care service plan obtains information
after |
25 | | issuing an individual health care service plan contract that
|
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1 | | the subscriber or enrollee may have intentionally omitted or
|
2 | | intentionally misrepresented material information during the
|
3 | | application for coverage process, then the health care service |
4 | | plan may
investigate the potential omissions or |
5 | | misrepresentations in order to
determine whether the |
6 | | subscriber's or enrollee's health care service
plan contract |
7 | | may be rescinded or canceled.
|
8 | | (b) The following provisions shall apply to a postcontract |
9 | | issuance investigation: |
10 | | (1) Upon initiating a postcontract issuance |
11 | | investigation for
potential rescission or cancellation of |
12 | | health care coverage, the
plan shall provide a written |
13 | | notice to the enrollee or subscriber by
regular and |
14 | | certified mail that it has initiated an investigation of
|
15 | | intentional material misrepresentation or intentional |
16 | | material
omission on the part of the enrollee or subscriber |
17 | | and that the
investigation could lead to the rescission or |
18 | | cancellation of the
enrollee's or subscriber's health care |
19 | | service plan contract. The
notice shall be provided by the |
20 | | health care service plan within 5
days of the initiation of |
21 | | the investigation.
|
22 | | (2) The written notice required under item (1) of this |
23 | | subsection (b) shall include
full disclosure of the |
24 | | allegedly intentional material omission or
|
25 | | misrepresentation and a clear and concise explanation of |
26 | | why the
information has resulted in the health care service |
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1 | | plan's initiation
of an investigation to determine whether |
2 | | rescission or cancellation
is warranted. The notice shall |
3 | | invite the enrollee or subscriber to
provide any evidence |
4 | | or information within 45 business days to negate
the plan's |
5 | | reasons for initiating the postissuance investigation.
|
6 | | (3) The plan shall complete its investigation no later |
7 | | than 90
days after the date that the notice is sent to the |
8 | | enrollee or subscriber
pursuant to item (1) of this |
9 | | subsection (b).
|
10 | | (4) Upon completion of its postissuance investigation, |
11 | | the plan
shall provide written notice by regular and |
12 | | certified mail to the
subscriber or enrollee that it has |
13 | | concluded its investigation and
has made one of the |
14 | | following determinations:
|
15 | | (A) The plan has determined that the enrollee or |
16 | | subscriber did
not intentionally misrepresent or |
17 | | intentionally omit material
information during the |
18 | | application process and that the subscriber's
or |
19 | | enrollee's health care coverage will not be canceled or |
20 | | rescinded.
|
21 | | (B) The plan intends to seek approval from the |
22 | | Director to cancel
or rescind the enrollee's or |
23 | | subscriber's health care service plan
contract for |
24 | | intentional misrepresentation or intentional omission |
25 | | of
material information during the application for |
26 | | coverage process.
|
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1 | | (5) The written notice required under paragraph (B) of
|
2 | | item (4) of this subsection (b) shall do all of the |
3 | | following:
|
4 | | (A) Include full disclosure of the nature and |
5 | | substance of any
information that led to the plan's |
6 | | determination that the enrollee or
subscriber |
7 | | intentionally misrepresented or intentionally omitted
|
8 | | material information on the application form.
|
9 | | (B) Provide the enrollee or subscriber with |
10 | | information indicating
that the health plan's |
11 | | determination shall not become final until it
is |
12 | | reviewed and approved by the Department's independent |
13 | | review
process.
|
14 | | (C) Provide the enrollee or subscriber with |
15 | | information regarding
the Department's independent |
16 | | review process and the right of the
enrollee or |
17 | | subscriber to opt out of that review process within 45
|
18 | | days of the date upon which an independent review |
19 | | organization
receives a request for independent |
20 | | review.
|
21 | | (D) Provide a statement that the health care |
22 | | service plan's
proposed decision to cancel or rescind |
23 | | the health care service plan
contract shall not become |
24 | | effective unless the Department's
independent review |
25 | | organization upholds the health care service plan's |
26 | | decision or unless the enrollee or subscriber has opted |
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1 | | out of the
independent review. |
2 | | (215 ILCS 180/25.6 new) |
3 | | Sec. 25.6. Continuation. |
4 | | (a) A health care service plan shall continue to
authorize |
5 | | and provide all medically necessary health care services
|
6 | | required to be covered under an enrollee's or subscriber's |
7 | | health
care service plan contract until the effective date of |
8 | | cancellation
or rescission.
|
9 | | (b) The effective date of the health care service plan's
|
10 | | cancellation or the date upon which the plan may initiate a
|
11 | | rescission shall be no earlier than the date that the enrollee |
12 | | or
subscriber receives notification via regular and certified |
13 | | mail that
the independent review organization has made a |
14 | | determination
upholding the health care service plan's |
15 | | decision to rescind or
cancel.
|
16 | | (215 ILCS 180/35)
|
17 | | Sec. 35. Standard external review. |
18 | | (a) Within 4 months after the date of receipt of a notice |
19 | | of an adverse determination or final adverse determination, a |
20 | | covered person or the covered person's authorized |
21 | | representative may file a request for an external review with |
22 | | the Director. Within one business day after the date of receipt |
23 | | of a request for external review, the Director shall send a |
24 | | copy of the request to the health carrier. |
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1 | | (b) Within 5 business days following the date of receipt of |
2 | | the external review request, the health carrier shall complete |
3 | | a preliminary review of the request to determine whether:
|
4 | | (1) the individual is or was a covered person in the |
5 | | health benefit plan at the time the health care service was |
6 | | requested or at the time the health care service was |
7 | | provided; |
8 | | (2) the health care service that is the subject of the |
9 | | adverse determination or the final adverse determination |
10 | | is a covered service under the covered person's health |
11 | | benefit plan, but the health carrier has determined that |
12 | | the health care service is not covered; |
13 | | (3) the covered person has exhausted the health |
14 | | carrier's internal appeal process unless the covered |
15 | | person is not required to exhaust the health carrier's |
16 | | internal appeal process pursuant to this Act; |
17 | | (4) (blank); and |
18 | | (5) the covered person has provided all the information |
19 | | and forms required to process an external review, as |
20 | | specified in this Act. |
21 | | (c) Within one business day after completion of the |
22 | | preliminary review, the health carrier shall notify the |
23 | | Director and covered person and, if applicable, the covered |
24 | | person's authorized representative in writing whether the |
25 | | request is complete and eligible for external review. If the |
26 | | request: |
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1 | | (1) is not complete, the health carrier shall inform |
2 | | the Director and covered person and, if applicable, the |
3 | | covered person's authorized representative in writing and |
4 | | include in the notice what information or materials are |
5 | | required by this Act to make the request complete; or |
6 | | (2) is not eligible for external review, the health |
7 | | carrier shall inform the Director and covered person and, |
8 | | if applicable, the covered person's authorized |
9 | | representative in writing and include in the notice the |
10 | | reasons for its ineligibility.
|
11 | | The Department may specify the form for the health |
12 | | carrier's notice of initial determination under this |
13 | | subsection (c) and any supporting information to be included in |
14 | | the notice. |
15 | | The notice of initial determination of ineligibility shall |
16 | | include a statement informing the covered person and, if |
17 | | applicable, the covered person's authorized representative |
18 | | that a health carrier's initial determination that the external |
19 | | review request is ineligible for review may be appealed to the |
20 | | Director by filing a complaint with the Director. |
21 | | Notwithstanding a health carrier's initial determination |
22 | | that the request is ineligible for external review, the |
23 | | Director may determine that a request is eligible for external |
24 | | review and require that it be referred for external review. In |
25 | | making such determination, the Director's decision shall be in |
26 | | accordance with the terms of the covered person's health |
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1 | | benefit plan, unless such terms are inconsistent with |
2 | | applicable law, and shall be subject to all applicable |
3 | | provisions of this Act. |
4 | | (d) Whenever the Director receives notice that a request is |
5 | | eligible for external review following the preliminary review |
6 | | conducted pursuant to this Section, within one business day |
7 | | after the date of receipt of the notice, the Director shall: |
8 | | (1) assign an independent review organization from the |
9 | | list of approved independent review organizations compiled |
10 | | and maintained by the Director pursuant to this Act and |
11 | | notify the health carrier of the name of the assigned |
12 | | independent review organization; and |
13 | | (2) notify in writing the covered person and, if |
14 | | applicable, the covered person's authorized representative |
15 | | of the request's eligibility and acceptance for external |
16 | | review and the name of the independent review organization. |
17 | | The Director shall include in the notice provided to the |
18 | | covered person and, if applicable, the covered person's |
19 | | authorized representative a statement that the covered person |
20 | | or the covered person's authorized representative may, within 5 |
21 | | business days following the date of receipt of the notice |
22 | | provided pursuant to item (2) of this subsection (d), submit in |
23 | | writing to the assigned independent review organization |
24 | | additional information that the independent review |
25 | | organization shall consider when conducting the external |
26 | | review. The independent review organization is not required to, |
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1 | | but may, accept and consider additional information submitted |
2 | | after 5 business days. |
3 | | (e) The assignment by the Director of an approved |
4 | | independent review organization to conduct an external review |
5 | | in accordance with this Section shall be done on a random basis |
6 | | among those independent review organizations approved by the |
7 | | Director pursuant to this Act. |
8 | | (f) Within 5 business days after the date of receipt of the |
9 | | notice provided pursuant to item (1) of subsection (d) of this |
10 | | Section, the health carrier or its designee utilization review |
11 | | organization shall provide to the assigned independent review |
12 | | organization the documents and any information considered in |
13 | | making the adverse determination or final adverse |
14 | | determination; in such cases, the following provisions shall |
15 | | apply: |
16 | | (1) Except as provided in item (2) of this subsection |
17 | | (f), failure by the health carrier or its utilization |
18 | | review organization to provide the documents and |
19 | | information within the specified time frame shall not delay |
20 | | the conduct of the external review. |
21 | | (2) If the health carrier or its utilization review |
22 | | organization fails to provide the documents and |
23 | | information within the specified time frame, the assigned |
24 | | independent review organization may terminate the external |
25 | | review and make a decision to reverse the adverse |
26 | | determination or final adverse determination. |
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1 | | (3) Within one business day after making the decision |
2 | | to terminate the external review and make a decision to |
3 | | reverse the adverse determination or final adverse |
4 | | determination under item (2) of this subsection (f), the |
5 | | independent review organization shall notify the Director, |
6 | | the health carrier, the covered person and, if applicable, |
7 | | the covered person's authorized representative, of its |
8 | | decision to reverse the adverse determination. |
9 | | (g) Upon receipt of the information from the health carrier |
10 | | or its utilization review organization, the assigned |
11 | | independent review organization shall review all of the |
12 | | information and documents and any other information submitted |
13 | | in writing to the independent review organization by the |
14 | | covered person and the covered person's authorized |
15 | | representative. |
16 | | (h) Upon receipt of any information submitted by the |
17 | | covered person or the covered person's authorized |
18 | | representative, the independent review organization shall |
19 | | forward the information to the health carrier within 1 business |
20 | | day. |
21 | | (1) Upon receipt of the information, if any, the health |
22 | | carrier may reconsider its adverse determination or final |
23 | | adverse determination that is the subject of the external |
24 | | review.
|
25 | | (2) Reconsideration by the health carrier of its |
26 | | adverse determination or final adverse determination shall |
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1 | | not delay or terminate the external review.
|
2 | | (3) The external review may only be terminated if the |
3 | | health carrier decides, upon completion of its |
4 | | reconsideration, to reverse its adverse determination or |
5 | | final adverse determination and provide coverage or |
6 | | payment for the health care service that is the subject of |
7 | | the adverse determination or final adverse determination. |
8 | | In such cases, the following provisions shall apply: |
9 | | (A) Within one business day after making the |
10 | | decision to reverse its adverse determination or final |
11 | | adverse determination, the health carrier shall notify |
12 | | the Director, the covered person and, if applicable, |
13 | | the covered person's authorized representative, and |
14 | | the assigned independent review organization in |
15 | | writing of its decision. |
16 | | (B) Upon notice from the health carrier that the |
17 | | health carrier has made a decision to reverse its |
18 | | adverse determination or final adverse determination, |
19 | | the assigned independent review organization shall |
20 | | terminate the external review. |
21 | | (i) In addition to the documents and information provided |
22 | | by the health carrier or its utilization review organization |
23 | | and the covered person and the covered person's authorized |
24 | | representative, if any, the independent review organization, |
25 | | to the extent the information or documents are available and |
26 | | the independent review organization considers them |
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1 | | appropriate, shall consider the following in reaching a |
2 | | decision: |
3 | | (1) the covered person's pertinent medical records; |
4 | | (2) the covered person's health care provider's |
5 | | recommendation; |
6 | | (3) consulting reports from appropriate health care |
7 | | providers and other documents submitted by the health |
8 | | carrier or its designee utilization review organization, |
9 | | the covered person, the covered person's authorized |
10 | | representative, or the covered person's treating provider; |
11 | | (4) the terms of coverage under the covered person's |
12 | | health benefit plan with the health carrier to ensure that |
13 | | the independent review organization's decision is not |
14 | | contrary to the terms of coverage under the covered |
15 | | person's health benefit plan with the health carrier, |
16 | | unless the terms are inconsistent with applicable law; |
17 | | (5) the most appropriate practice guidelines, which |
18 | | shall include applicable evidence-based standards and may |
19 | | include any other practice guidelines developed by the |
20 | | federal government, national or professional medical |
21 | | societies, boards, and associations; |
22 | | (6) any applicable clinical review criteria developed |
23 | | and used by the health carrier or its designee utilization |
24 | | review organization; |
25 | | (7) the opinion of the independent review |
26 | | organization's clinical reviewer or reviewers after |
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1 | | considering items (1) through (6) of this subsection (i) to |
2 | | the extent the information or documents are available and |
3 | | the clinical reviewer or reviewers considers the |
4 | | information or documents appropriate; and |
5 | | (8) (blank). |
6 | | (j) Within 5 days after the date of receipt of all |
7 | | necessary information, but in no event more than 45 days after |
8 | | the date of receipt of the request for an external review, the |
9 | | assigned independent review organization shall provide written |
10 | | notice of its decision to uphold or reverse the adverse |
11 | | determination or the final adverse determination to the |
12 | | Director, the health carrier, the covered person, and, if |
13 | | applicable, the covered person's authorized representative. In |
14 | | reaching a decision, the assigned independent review |
15 | | organization is not bound by any claim determinations reached |
16 | | prior to the submission of information to the independent |
17 | | review organization. The assigned independent review |
18 | | organization shall independently determine if the health care |
19 | | services under review are the medically necessary health care |
20 | | services that a physician, exercising prudent clinical |
21 | | judgment, would provide to a patient for the purpose of |
22 | | preventing, evaluating, diagnosing, or treating an illness, |
23 | | injury, disease, or its symptoms and are: (i) in accordance |
24 | | with generally accepted standards of medical practice; (ii) |
25 | | clinically appropriate, in terms of type, frequency, extent, |
26 | | site, and duration and considered effective for the patient's |
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1 | | illness, injury, or disease; and (iii) not primarily for the |
2 | | convenience of the patient, physician, or other health care |
3 | | provider. For the purposes of this subsection (j), "generally |
4 | | accepted standards of medical practice" means standards that |
5 | | are based on credible scientific evidence published in |
6 | | peer-reviewed medical literature generally recognized by the |
7 | | relevant medical community, physician specialty society |
8 | | recommendations, and the views of physicians practicing in |
9 | | relevant clinical areas and any other relevant factors. In such |
10 | | cases, the following provisions shall apply: |
11 | | (1) The independent review organization shall include |
12 | | in the notice: |
13 | | (A) a general description of the reason for the |
14 | | request for external review; |
15 | | (B) the date the independent review organization |
16 | | received the assignment from the Director to conduct |
17 | | the external review; |
18 | | (C) the time period during which the external |
19 | | review was conducted; |
20 | | (D) references to the evidence or documentation, |
21 | | including the evidence-based standards, considered in |
22 | | reaching its decision; |
23 | | (E) the date of its decision; |
24 | | (F) the principal reason or reasons for its |
25 | | decision, including what applicable, if any, |
26 | | evidence-based standards that were a basis for its |
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1 | | decision; and
|
2 | | (G) the rationale for its decision. |
3 | | (2) (Blank). |
4 | | (3) (Blank). |
5 | | (4) Upon receipt of a notice of a decision reversing |
6 | | the adverse determination or final adverse determination, |
7 | | the health carrier immediately shall approve the coverage |
8 | | that was the subject of the adverse determination or final |
9 | | adverse determination.
|
10 | | (Source: P.A. 96-857, eff. 7-1-10; 96-967, eff. 1-1-11; 97-574, |
11 | | eff. 8-26-11.) |
12 | | Section 50. The Illinois Public Aid Code is amended by |
13 | | changing Section 5-16.8 as follows:
|
14 | | (305 ILCS 5/5-16.8)
|
15 | | Sec. 5-16.8. Required health benefits. The medical |
16 | | assistance program
shall
(i) provide the post-mastectomy care |
17 | | benefits required to be covered by a policy of
accident and |
18 | | health insurance under Section 356t and the coverage required
|
19 | | under Sections 356g.5, 356u, 356w, 356x, and 356z.6 , and |
20 | | 356z.25 of the Illinois
Insurance Code and (ii) be subject to |
21 | | the provisions of Sections 356z.19 and 364.01 of the Illinois
|
22 | | Insurance Code.
|
23 | | On and after July 1, 2012, the Department shall reduce any |
24 | | rate of reimbursement for services or other payments or alter |
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1 | | any methodologies authorized by this Code to reduce any rate of |
2 | | reimbursement for services or other payments in accordance with |
3 | | Section 5-5e. |
4 | | (Source: P.A. 97-282, eff. 8-9-11; 97-689, eff. 6-14-12.)
|
5 | | Section 55. The Medical Patient Rights Act is amended by |
6 | | changing Sections 2.04 and 3 and by adding Section 2.06 as |
7 | | follows:
|
8 | | (410 ILCS 50/2.04) (from Ch. 111 1/2, par. 5402.04)
|
9 | | Sec. 2.04.
"Insurance company" means (1) an insurance |
10 | | company, fraternal
benefit society, and any other insurer |
11 | | subject to regulation under the
Illinois Insurance Code; or (2) |
12 | | a health maintenance organization , a limited health service |
13 | | organization under the Limited Health Service Organization |
14 | | Act, or a voluntary health services plan under the Voluntary |
15 | | Health Services Plans Act .
|
16 | | (Source: P.A. 85-677; 85-679.)
|
17 | | (410 ILCS 50/2.06 new) |
18 | | Sec. 2.06. Health insurance policy or health care plan. |
19 | | "Health insurance policy or health care plan" means any policy |
20 | | of health or accident insurance provided by a health insurance |
21 | | company or under the Counties Code, or the Illinois Municipal |
22 | | Code or medical assistance provided under the Illinois Public |
23 | | Aid Code.
|
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1 | | (410 ILCS 50/3) (from Ch. 111 1/2, par. 5403)
|
2 | | Sec. 3. The following rights are hereby established:
|
3 | | (a) The right of each patient to care consistent with sound |
4 | | nursing and
medical practices, to be informed of the name of |
5 | | the physician responsible
for coordinating his or her care, to |
6 | | receive information concerning his or
her condition and |
7 | | proposed treatment, to refuse any treatment to the extent
|
8 | | permitted by law, and to privacy and confidentiality of records |
9 | | except as
otherwise provided by law. Each patient has a right |
10 | | to be informed of his or her inpatient or outpatient status |
11 | | while undergoing evaluation, assessment, diagnosis, treatment, |
12 | | or observation in a hospital. The patient must be informed of |
13 | | this status and put on notice that this admission status may |
14 | | affect coverage by his or her health insurance policy or health |
15 | | care plan or his or her personal responsibility for payment.
|
16 | | (b) The right of each patient, regardless of source of |
17 | | payment, to examine
and receive a reasonable explanation of his |
18 | | total bill for services rendered
by his physician or health |
19 | | care provider, including the itemized charges
for specific |
20 | | services received. Each physician or health care provider
shall |
21 | | be responsible only for a reasonable explanation of those |
22 | | specific
services provided by such physician or health care |
23 | | provider.
|
24 | | (c) In the event an insurance company or health services |
25 | | corporation cancels
or refuses to renew an individual policy or |
|
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1 | | plan, the insured patient shall
be entitled to timely, prior |
2 | | notice of the termination of such policy or plan.
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3 | | An insurance company or health services corporation that |
4 | | requires any
insured patient or applicant for new or continued |
5 | | insurance or coverage to
be tested for infection with human |
6 | | immunodeficiency virus (HIV) or any
other identified causative |
7 | | agent of acquired immunodeficiency syndrome
(AIDS) shall (1) |
8 | | give the patient or applicant prior written notice of such
|
9 | | requirement, (2) proceed with such testing only upon the |
10 | | written
authorization of the applicant or patient, and (3) keep |
11 | | the results of such
testing confidential. Notice of an adverse |
12 | | underwriting or coverage
decision may be given to any |
13 | | appropriately interested party, but the
insurer may only |
14 | | disclose the test result itself to a physician designated
by |
15 | | the applicant or patient, and any such disclosure shall be in a |
16 | | manner
that assures confidentiality.
|
17 | | The Department of Insurance shall enforce the provisions of |
18 | | this subsection.
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19 | | (d) The right of each patient to privacy and |
20 | | confidentiality in health
care. Each physician, health care |
21 | | provider, health services corporation and
insurance company |
22 | | shall refrain from disclosing the nature or details of
services |
23 | | provided to patients, except that such information may be |
24 | | disclosed: (1) to the
patient, (2) to the party making |
25 | | treatment decisions if the patient is incapable
of making |
26 | | decisions regarding the health services provided, (3) for |
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1 | | treatment in accordance with 45 CFR 164.501 and 164.506, (4) |
2 | | for
payment in accordance with 45 CFR 164.501 and 164.506, (5) |
3 | | to those parties responsible for peer review,
utilization |
4 | | review, and quality assurance, (6) for health care operations |
5 | | in accordance with 45 CFR 164.501 and 164.506, (7) to those |
6 | | parties required to
be notified under the Abused and Neglected |
7 | | Child Reporting Act or the
Illinois Sexually Transmissible |
8 | | Disease Control Act, or (8) as otherwise permitted,
authorized, |
9 | | or required by State or federal law. This right may be waived |
10 | | in writing by the
patient or the patient's guardian or legal |
11 | | representative, but a physician or other health care
provider |
12 | | may not condition the provision of services on the patient's,
|
13 | | guardian's, or legal representative's agreement to sign such a |
14 | | waiver. In the interest of public health, safety, and welfare, |
15 | | patient information, including, but not limited to, health |
16 | | information, demographic information, and information about |
17 | | the services provided to patients, may be transmitted to or |
18 | | through a health information exchange, as that term is defined |
19 | | in Section 2 of the Mental Health and Developmental |
20 | | Disabilities Confidentiality Act, in accordance with the |
21 | | disclosures permitted pursuant to this Section. Patients shall |
22 | | be provided the opportunity to opt out of their health |
23 | | information being transmitted to or through a health |
24 | | information exchange in accordance with the regulations, |
25 | | standards, or contractual obligations adopted by the Illinois |
26 | | Health Information Exchange Authority in accordance with |
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1 | | Section 9.6 of the Mental Health and Developmental Disabilities |
2 | | Confidentiality Act, Section 9.6 of the AIDS Confidentiality |
3 | | Act, or Section 31.8 of the Genetic Information Privacy Act, as |
4 | | applicable. In the case of a patient choosing to opt out of |
5 | | having his or her information available on an HIE, nothing in |
6 | | this Act shall cause the physician or health care provider to |
7 | | be liable for the release of a patient's health information by |
8 | | other entities that may possess such information, including, |
9 | | but not limited to, other health professionals, providers, |
10 | | laboratories, pharmacies, hospitals, ambulatory surgical |
11 | | centers, and nursing homes.
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12 | | (Source: P.A. 98-1046, eff. 1-1-15 .)
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13 | | Section 90. The State Mandates Act is amended by adding |
14 | | Section 8.39 as follows: |
15 | | (30 ILCS 805/8.39 new) |
16 | | Sec. 8.39. Exempt mandate. Notwithstanding Sections 6 and 8 |
17 | | of this Act, no reimbursement by the State is required for the |
18 | | implementation of any mandate created by this amendatory Act of |
19 | | the 99th General Assembly.
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20 | | (210 ILCS 80/1.3 rep.) |
21 | | Section 95. The Hospital Emergency Service Act is amended |
22 | | by repealing Section 1.3. |