Full Text of HB0122 101st General Assembly
HB0122eng 101ST GENERAL ASSEMBLY |
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| 1 | | AN ACT concerning government.
| 2 | | Be it enacted by the People of the State of Illinois, | 3 | | represented in the General Assembly:
| 4 | | Section 5. The Substance Use Disorder Act is amended by | 5 | | adding Article 7 as follows: | 6 | | (20 ILCS 301/Art. 7 heading new) | 7 | | ARTICLE 7. BEHAVIORAL HEALTH ACCESS TO CARE OMBUDSMAN | 8 | | (20 ILCS 301/7-5 new) | 9 | | Sec. 7-5. Definitions. As used in this Article: | 10 | | (a) "Health care provider" or "provider" means: | 11 | | (1) a physician licensed under the Medical Practice Act | 12 | | of 1987 to practice medicine in all of its branches; a | 13 | | clinical psychologist licensed under the Clinical | 14 | | Psychologist Licensing Act; | 15 | | (2) a mental health professional who is licensed or | 16 | | registered to provide mental health services by the | 17 | | Department of Financial and Professional Regulation; | 18 | | (3) any other health care provider regulated by the | 19 | | State when engaged in assisting consumers with behavioral | 20 | | health care access and coverage issues; or | 21 | | (4) a health care facility licensed or regulated by the | 22 | | State, when the facility is engaged in assisting consumers |
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| 1 | | with behavioral health care access and coverage issues, | 2 | | excluding any facility that is listed under subsection (b) | 3 | | of Section 4.04 of the Illinois Act on the Aging. | 4 | | (b) "Office" means the Office of the Ombudsman for | 5 | | Behavioral Health Access to Care created in Section 7-10. | 6 | | (c) "Ombudsman" means the individual designated under | 7 | | Section 7-10 as the Ombudsman for Behavioral Health Access to | 8 | | Care. | 9 | | (20 ILCS 301/7-10 new) | 10 | | Sec. 7-10. Office of the Ombudsman for Behavioral Health | 11 | | Access to Care; appointment; duties. | 12 | | (a) Subject to appropriation, the Department of Human | 13 | | Services shall establish the Office of the Ombudsman for | 14 | | Behavioral Health Access to Care for the purpose of assisting | 15 | | residents of Illinois in accessing behavioral health care. | 16 | | (b) The Office and the Department shall operate in | 17 | | accordance with a memorandum of understanding between the 2 | 18 | | entities. The memorandum of understanding shall contain, at a | 19 | | minimum: | 20 | | (1) a requirement that the Office has its own personnel | 21 | | rules; | 22 | | (2) a requirement that the Ombudsman has independent | 23 | | hiring and termination authority over Office employees; | 24 | | (3) a requirement that the Office must follow State | 25 | | fiscal rules; |
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| 1 | | (4) a requirement that the Department of Human | 2 | | Services' Division of Mental Health shall offer the Office | 3 | | limited support with respect to: | 4 | | (A) personnel matters; | 5 | | (B) recruitment; | 6 | | (C) payroll; | 7 | | (D) benefits; | 8 | | (E) budget submission, as needed; | 9 | | (F) accounting; | 10 | | (G) office space, facilities, and technical | 11 | | support; and | 12 | | (H) other provisions regarding administrative | 13 | | support that will help maintain the independence of the | 14 | | Office. | 15 | | (c) The Office shall operate with full independence and has | 16 | | complete autonomy, control, and authority over operations, | 17 | | budget, and personnel decisions related to the Office and the | 18 | | Ombudsman. | 19 | | (d) By November 1, 2019, the Governor shall designate an | 20 | | Ombudsman for Behavioral Health Access to Care, who shall serve | 21 | | as Director of the Office. The Ombudsman shall serve as a | 22 | | neutral party to help consumers, including consumers who are | 23 | | uninsured or have public or private health benefit coverage, | 24 | | including coverage that is not subject to State regulation, and | 25 | | health care providers, acting on their own behalf, on behalf of | 26 | | a consumer with the consumer's written permission, or on behalf |
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| 1 | | of a group of health care providers, navigate and resolve | 2 | | issues related to consumer access to behavioral health care, | 3 | | including care for mental health conditions and substance use | 4 | | disorders. | 5 | | (e) The Ombudsman shall: | 6 | | (1) interact with consumers and health care providers | 7 | | with concerns or complaints to help the consumers and | 8 | | providers resolve behavioral health care access and | 9 | | coverage issues; | 10 | | (2) identify, track, and report to the appropriate | 11 | | regulatory or oversight agency concerns, complaints, and | 12 | | potential violations of State or federal rules, | 13 | | regulations, or statutes concerning the availability of, | 14 | | and terms and conditions of, benefits for mental health | 15 | | conditions or substance use disorders, including potential | 16 | | violations related to quantitative and non-quantitative | 17 | | treatment limitations; | 18 | | (3) receive and assist consumers and providers in | 19 | | reporting concerns and filing complaints with appropriate | 20 | | regulatory or oversight agencies relating to inappropriate | 21 | | care or involuntary admissions or judicial admissions | 22 | | under the Mental Health and Developmental Disabilities | 23 | | Code; | 24 | | (4) provide appropriate information to help consumers | 25 | | obtain behavioral health care; | 26 | | (5) develop appropriate points of contact for |
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| 1 | | referrals to other State and federal agencies; and | 2 | | (6) provide appropriate information to help consumers | 3 | | or health care providers file appeals or complaints with | 4 | | the appropriate entities, including insurers and other | 5 | | State and federal agencies. | 6 | | (f) The Ombudsman, employees of the Office, and any persons | 7 | | acting on behalf of the Office shall comply with all State and | 8 | | federal confidentiality laws that govern the Department of | 9 | | Human Services with respect to the treatment of confidential | 10 | | information or records and the disclosure of such information | 11 | | and records. | 12 | | (g) In the performance of his or her duties, the Ombudsman | 13 | | shall act independently of the Department of Human Services' | 14 | | Division of Mental Health. Any recommendations made or | 15 | | positions taken by the Ombudsman do not reflect those of the | 16 | | Department of Human Services or the Division of Mental Health. | 17 | | (20 ILCS 301/7-15 new) | 18 | | Sec. 7-15. Liaisons. The Director of Insurance and the | 19 | | Secretary of Human Services shall each appoint a liaison to the | 20 | | Ombudsman to receive reports of concerns, complaints, and | 21 | | potential violations described in paragraph (2) of subsection | 22 | | (e) of Section 7-10 from the Ombudsman, consumers, or health | 23 | | care providers. | 24 | | (20 ILCS 301/7-20 new) |
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| 1 | | Sec. 7-20. Qualified immunity. The Ombudsman and employees | 2 | | or persons acting on behalf of the Office are immune from suit | 3 | | and liability, either personally or in their official | 4 | | capacities, for any claim for damage to or loss of property, or | 5 | | for personal injury or other civil liability caused by or | 6 | | arising out of any actual or alleged act, error, or omission | 7 | | that occurred within the scope of employment, duties, or | 8 | | responsibilities pertaining to the Office, including issuing | 9 | | reports or recommendations; except that nothing in this Section | 10 | | protects those persons from suit or liability for damage, loss, | 11 | | injury, or liability caused by the intentional or willful and | 12 | | wanton misconduct of the person. | 13 | | (20 ILCS 301/7-25 new) | 14 | | Sec. 7-25. Annual report. | 15 | | (a) On or before September 1, 2021, and on or before | 16 | | September 1 of each year thereafter, the Ombudsman shall | 17 | | prepare and submit, in accordance with subsection (b), a | 18 | | written report that includes information from the preceding | 19 | | fiscal year concerning actions taken by the Ombudsman relating | 20 | | to the duties of the Office set forth in Section 7-10. | 21 | | (b) The Ombudsman shall submit the report required by this | 22 | | Section to the Governor, the Secretary of Human Services, the | 23 | | Director of Insurance, the Senate Human Services Committee or | 24 | | any successor committee, and the House Committees on Human | 25 | | Services, Insurance, Energy & Environment, and Mental Health or |
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| 1 | | any successor committees. | 2 | | (c) The Ombudsman shall post the annual report on the | 3 | | Department of Human Services' website. | 4 | | (d) The Ombudsman shall not include in the report required | 5 | | by this Section any personally identifying information about an | 6 | | individual consumer or health care provider or identifying | 7 | | information about a health care facility licensed by the State | 8 | | or an emergency medical services system as defined in Section | 9 | | 3.20 of the Emergency Medical Services (EMS) Systems Act.
| 10 | | Section 10. The Illinois Insurance Code is amended by | 11 | | adding Section 370c.2 as follows: | 12 | | (215 ILCS 5/370c.2 new) | 13 | | Sec. 370c.2. Parity reporting. | 14 | | (a) By March 1, 2020, and every other March 1 thereafter, | 15 | | the Director shall submit a written report and provide a | 16 | | presentation of the report to the General Assembly that: | 17 | | (1) specifies the methodology the Director uses to | 18 | | verify that insurance carriers are complying with Section | 19 | | 370c and rules adopted under that Section and with the | 20 | | federal Paul Wellstone and Pete Domenici Mental Health | 21 | | Parity and Addiction Equity Act of 2008, Public Law | 22 | | 110-343, as amended, any regulations adopted in accordance | 23 | | with that Act, or guidance related to compliance with and | 24 | | oversight of that Act; |
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| 1 | | (2) identifies market conduct examinations initiated, | 2 | | conducted, or completed during the preceding 12 months | 3 | | regarding compliance with Section 370c and rules adopted | 4 | | under that Section and with the Paul Wellstone and Pete | 5 | | Domenici Mental Health Parity and Addiction Equity Act of | 6 | | 2008 and regulations adopted under that Act and summarizes | 7 | | the outcomes of those market conduct examinations; and | 8 | | (3) details any educational or corrective actions the | 9 | | Director has taken to ensure insurance carrier compliance | 10 | | with Section 370c and rules adopted under that Section and | 11 | | with the Paul Wellstone and Pete Domenici Mental Health | 12 | | Parity and Addiction Equity Act of 2008 and regulations | 13 | | adopted under that Act. | 14 | | (b) The Director shall ensure that the report is written in | 15 | | plain language and is made available to the public by, at a | 16 | | minimum, posting the report on the Department's website. | 17 | | Section 99. Effective date. This Act takes effect upon | 18 | | becoming law. |
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