Full Text of HB0147 95th General Assembly
HB0147enr 95TH GENERAL ASSEMBLY
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HB0147 Enrolled |
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LRB095 03747 DRJ 23776 b |
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| AN ACT concerning regulation.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Section 1. The State Employees Group Insurance Act of 1971 | 5 |
| is amended by changing Section 6.11 as follows:
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| (5 ILCS 375/6.11)
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| Sec. 6.11. Required health benefits; Illinois Insurance | 8 |
| Code
requirements. The program of health
benefits shall provide | 9 |
| the post-mastectomy care benefits required to be covered
by a | 10 |
| policy of accident and health insurance under Section 356t of | 11 |
| the Illinois
Insurance Code. The program of health benefits | 12 |
| shall provide the coverage
required under Sections 356g.5,
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| 356u, 356w, 356x, 356z.2, 356z.4, and 356z.6 of the
Illinois | 14 |
| Insurance Code.
The program of health benefits must comply with | 15 |
| Section 155.37 of the
Illinois Insurance Code.
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| (Source: P.A. 92-440, eff. 8-17-01; 92-764, eff. 1-1-03; | 17 |
| 93-102, eff. 1-1-04; 93-853, eff. 1-1-05.)
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| Section 2. The Department of Public Health Powers and | 19 |
| Duties Law of the
Civil Administrative Code of Illinois is | 20 |
| amended by changing Section 2310-345 as follows:
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| (20 ILCS 2310/2310-345) (was 20 ILCS 2310/55.49)
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LRB095 03747 DRJ 23776 b |
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| Sec. 2310-345. Breast cancer; written summary regarding | 2 |
| early detection and
treatment. | 3 |
| (a) From funds made available for this purpose, the
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| Department shall publish, in layman's language, a
standardized | 5 |
| written summary outlining methods for the early detection and
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| diagnosis of breast cancer. The summary shall include | 7 |
| recommended
guidelines for screening and detection of breast | 8 |
| cancer through the use of
techniques that shall include but not | 9 |
| be limited to self-examination , clinical breast exams, and
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| diagnostic radiology.
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| (b) The summary shall also suggest that women seek | 12 |
| mammography
services from facilities that
are certified to | 13 |
| perform mammography as required by the
federal Mammography | 14 |
| Quality Standards Act of 1992.
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| (c) The summary shall also include the medically viable
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| alternative
methods for the treatment of breast cancer, | 17 |
| including, but not limited to,
hormonal, radiological, | 18 |
| chemotherapeutic, or surgical treatments or
combinations | 19 |
| thereof. The summary shall contain information on breast
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| reconstructive surgery, including, but not limited to, the use | 21 |
| of breast
implants and their side effects.
The summary shall | 22 |
| inform the
patient of the advantages, disadvantages, risks, and | 23 |
| dangers of the various
procedures.
The summary shall include | 24 |
| (i) a statement that mammography is the most
accurate method | 25 |
| for making an early detection of breast cancer, however, no
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| diagnostic tool is 100% effective , (ii) the benefits of |
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LRB095 03747 DRJ 23776 b |
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| clinical breast exams, and (iii)
and (ii) instructions for
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| instructions for performing breast self-examination and a | 3 |
| statement that
it is
important to perform a breast | 4 |
| self-examination monthly.
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| (c-5) The summary shall specifically address the benefits
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| of early detection and review the clinical standard | 7 |
| recommendations by the Centers for Disease Control and | 8 |
| Prevention and the American Cancer Society for mammography, | 9 |
| clinical breast exams, and breast self-exams.
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| (c-10) The summary shall also inform individuals that | 11 |
| public and private insurance providers shall pay for clinical | 12 |
| breast exams as part of an exam, as indicated by guidelines of | 13 |
| practice.
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| (d) In developing the summary, the Department shall consult | 15 |
| with the
Advisory Board of Cancer Control, the Illinois State | 16 |
| Medical Society and
consumer groups. The summary shall be | 17 |
| updated by the Department every 2 years.
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| (e) The summaries shall additionally be translated into | 19 |
| Spanish, and
the Department shall conduct a public information | 20 |
| campaign to distribute
the summaries to the Hispanic women of | 21 |
| this State in order to inform them
of the importance of early | 22 |
| detection and mammograms.
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| (f) The Department shall distribute the summary to | 24 |
| hospitals, public
health centers, and physicians who are likely | 25 |
| to perform or order
diagnostic
tests for breast disease or | 26 |
| treat breast cancer by surgical or other
medical methods. Those |
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LRB095 03747 DRJ 23776 b |
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| hospitals, public health centers, and physicians
shall make the | 2 |
| summaries available to the public. The Department shall
also | 3 |
| distribute the summaries to any person, organization, or other
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| interested parties upon request. The summaries may be | 5 |
| duplicated by any
person, provided the copies are identical to | 6 |
| the current summary
prepared
by the Department.
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| (g) The summary shall display, on the inside of its cover, | 8 |
| printed in
capital letters, in bold face type, the following | 9 |
| paragraph:
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| "The information contained in this brochure regarding | 11 |
| recommendations for
early detection and diagnosis of breast | 12 |
| disease and alternative breast
disease treatments is only for | 13 |
| the purpose of assisting you, the patient,
in understanding the | 14 |
| medical information and advice offered by your
physician. This | 15 |
| brochure cannot serve as a substitute for the sound
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| professional advice of your physician. The availability of this | 17 |
| brochure
or the information contained within is not intended to | 18 |
| alter, in any way,
the existing physician-patient | 19 |
| relationship, nor the existing professional
obligations of | 20 |
| your physician in the delivery of medical services to you,
the | 21 |
| patient."
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| (h) The summary shall be updated when necessary.
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| (Source: P.A. 91-239, eff. 1-1-00; revised 10-19-05.)
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| Section 3. The Counties Code is amended by changing Section | 25 |
| 5-1069.3 as follows: |
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| (55 ILCS 5/5-1069.3)
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| Sec. 5-1069.3. Required health benefits. If a county, | 3 |
| including a home
rule
county, is a self-insurer for purposes of | 4 |
| providing health insurance coverage
for its employees, the | 5 |
| coverage shall include coverage for the post-mastectomy
care | 6 |
| benefits required to be covered by a policy of accident and | 7 |
| health
insurance under Section 356t and the coverage required | 8 |
| under Sections 356g.5, 356u,
356w, 356x and 356z.6 of
the | 9 |
| Illinois Insurance Code. The requirement that health benefits | 10 |
| be covered
as provided in this Section is an
exclusive power | 11 |
| and function of the State and is a denial and limitation under
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| Article VII, Section 6, subsection (h) of the Illinois | 13 |
| Constitution. A home
rule county to which this Section applies | 14 |
| must comply with every provision of
this Section.
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| (Source: P.A. 93-853, eff. 1-1-05.)
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| Section 3.5. The Illinois Municipal Code is amended by | 17 |
| changing Section 10-4-2.3 as follows: | 18 |
| (65 ILCS 5/10-4-2.3)
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| 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 |
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HB0147 Enrolled |
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LRB095 03747 DRJ 23776 b |
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| a policy of
accident and health insurance under Section 356t | 2 |
| and the coverage required
under Sections 356g.5, 356u, 356w, | 3 |
| 356x and 356z.6 of the Illinois
Insurance
Code. The requirement | 4 |
| that health
benefits be covered as provided in this is an | 5 |
| exclusive power and function of
the State and is a denial and | 6 |
| limitation under Article VII, Section 6,
subsection (h) of the | 7 |
| Illinois Constitution. A home rule municipality to which
this | 8 |
| Section applies must comply with every provision of this | 9 |
| Section.
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| (Source: P.A. 93-853, eff. 1-1-05.)
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| Section 4. The School Code is amended by changing Section | 12 |
| 10-22.3f as follows: | 13 |
| (105 ILCS 5/10-22.3f)
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| Sec. 10-22.3f. Required health benefits. Insurance | 15 |
| protection and
benefits
for employees shall provide the | 16 |
| post-mastectomy care benefits required to be
covered by a | 17 |
| policy of accident and health insurance under Section 356t and | 18 |
| the
coverage required under Sections 356g.5, 356u, 356w, 356x | 19 |
| and 356z.6 of
the
Illinois Insurance Code.
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| (Source: P.A. 93-853, eff. 1-1-05.)
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| Section 5. The Illinois Insurance Code is amended by adding | 22 |
| Section 356g.5 as follows: |
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HB0147 Enrolled |
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LRB095 03747 DRJ 23776 b |
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| (215 ILCS 5/356g.5 new) | 2 |
| Sec. 356g.5. Clinical breast exam. | 3 |
| (a) The General Assembly finds that clinical breast | 4 |
| examinations are a critical tool in the early detection of | 5 |
| breast cancer, while the disease is in its earlier and | 6 |
| potentially more treatable stages. Insurer reimbursement of | 7 |
| clinical breast examinations is essential to the effort to | 8 |
| reduce breast cancer deaths in Illinois. | 9 |
| (b) Every insurer shall provide, in each group or | 10 |
| individual policy, contract, or certificate of accident or | 11 |
| health insurance issued or renewed for persons who are | 12 |
| residents of Illinois, coverage for complete and thorough | 13 |
| clinical breast examinations as indicated by guidelines of | 14 |
| practice, performed by a physician licensed to practice | 15 |
| medicine in all its branches, an advanced practice nurse who | 16 |
| has a collaborative agreement with a collaborating physician | 17 |
| that authorizes breast
examinations, or a physician assistant | 18 |
| who has been delegated authority to provide breast | 19 |
| examinations, to check for lumps and other changes for the | 20 |
| purpose of early detection and prevention of breast cancer as | 21 |
| follows: | 22 |
| (1) at least every 3 years for women at least 20 years | 23 |
| of age but less than 40 years of age; and | 24 |
| (2) annually for women 40 years of age or older. | 25 |
| (c) Upon approval of a nationally recognized separate and | 26 |
| distinct clinical breast exam code that is compliant with all |
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| State and federal laws, rules, and regulations, public and | 2 |
| private insurance plans shall take action to cover clinical | 3 |
| breast exams on a separate and distinct basis. | 4 |
| Section 10. The Health Maintenance Organization Act is | 5 |
| amended by changing Section 4-6.5 as follows:
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| (215 ILCS 125/4-6.5)
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| Sec. 4-6.5. Required health benefits; Illinois Insurance | 8 |
| Code
requirements. A health maintenance organization is | 9 |
| subject to the provisions
of Sections 155.37, 356g.5, 356t, | 10 |
| 356u, and 356z.1 of the Illinois Insurance Code.
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| (Source: P.A. 92-130, eff. 7-20-01; 92-440, eff. 8-17-01; | 12 |
| 92-651, eff.
7-11-02.)
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| Section 15. The Voluntary Health Services Plans Act is | 14 |
| amended by changing Section 10 as follows:
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| (215 ILCS 165/10) (from Ch. 32, par. 604)
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| Sec. 10. Application of Insurance Code provisions. Health | 17 |
| services
plan corporations and all persons interested therein | 18 |
| or dealing therewith
shall be subject to the provisions of | 19 |
| Articles IIA and XII 1/2 and Sections
3.1, 133, 140, 143, 143c, | 20 |
| 149, 155.37, 354, 355.2, 356g.5, 356r, 356t, 356u, 356v,
356w, | 21 |
| 356x, 356y, 356z.1, 356z.2, 356z.4, 356z.5, 356z.6, 364.01, | 22 |
| 367.2, 368a, 401, 401.1,
402,
403, 403A, 408,
408.2, and 412, |
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LRB095 03747 DRJ 23776 b |
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| and paragraphs (7) and (15) of Section 367 of the Illinois
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| Insurance Code.
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| (Source: P.A. 92-130, eff. 7-20-01; 92-440, eff. 8-17-01; | 4 |
| 92-651, eff. 7-11-02; 92-764, eff. 1-1-03; 93-102, eff. 1-1-04; | 5 |
| 93-529, eff. 8-14-03; 93-853, eff. 1-1-05; 93-1000, eff. | 6 |
| 1-1-05; revised 10-14-04.)
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| Section 20. The Illinois Public Aid Code is amended by | 8 |
| changing Section 5-16.8 as follows:
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| (305 ILCS 5/5-16.8)
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| Sec. 5-16.8. Required health benefits. The medical | 11 |
| assistance program
shall
(i) provide the post-mastectomy care | 12 |
| benefits required to be covered by a policy of
accident and | 13 |
| health insurance under Section 356t and the coverage required
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| under Sections 356g.5, 356u, 356w, 356x, and 356z.6 of the | 15 |
| Illinois
Insurance Code and (ii) be subject to the provisions | 16 |
| of Section 364.01 of the Illinois
Insurance Code.
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| (Source: P.A. 93-853, eff. 1-1-05; 93-1000, eff. 1-1-05; | 18 |
| revised 10-14-04.)
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| Section 99. Effective date. This Act takes effect upon | 20 |
| becoming law.
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