Full Text of SB1854 102nd General Assembly
SB1854enr 102ND GENERAL ASSEMBLY |
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| 1 | | AN ACT concerning regulation.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Illinois Insurance Code is amended by | 5 | | adding Sections 356z.43 and 356z.44 as follows: | 6 | | (215 ILCS 5/356z.43 new) | 7 | | Sec. 356z.43. A1C testing. | 8 | | (a) As used in this Section, "A1C testing" means blood | 9 | | sugar level testing used to diagnose prediabetes, type 1 | 10 | | diabetes, and type 2 diabetes and to monitor management of | 11 | | blood sugar levels. | 12 | | (b) A group or individual policy of accident and health | 13 | | insurance or managed care plan amended, delivered, issued, or | 14 | | renewed on or after the effective date of this amendatory Act | 15 | | of the 102nd General Assembly shall provide coverage for A1C | 16 | | testing recommended by a health care provider for prediabetes, | 17 | | type 1 diabetes, and type 2 diabetes in accordance with | 18 | | prediabetes and diabetes risk factors identified by the United | 19 | | States Centers for Disease Control and Prevention. | 20 | | (1) Risk factors for prediabetes may include, but are | 21 | | not limited to, being overweight or obese, being aged 35 | 22 | | or older, having an immediate family member with type 2 | 23 | | diabetes, previous diagnosis of gestational diabetes and |
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| 1 | | being African American, Hispanic or Latino American, | 2 | | American Indian, or Alaska Native. | 3 | | (2) Risk factors for type 1 diabetes may include, but | 4 | | are not limited to, family history of diabetes. | 5 | | (3) Risk factors for type 2 diabetes may include, but | 6 | | are not limited to, having prediabetes, being overweight | 7 | | or obese, being aged 35 or older, having an immediate | 8 | | family member with type 1 or type 2 diabetes, previous | 9 | | diagnosis of gestational diabetes and being African | 10 | | American, Hispanic or Latino American, American Indian, or | 11 | | Alaska Native. | 12 | | (215 ILCS 5/356z.44 new) | 13 | | Sec. 356z.44. Vitamin D testing. | 14 | | (a) As used in this Section, "vitamin D testing" means | 15 | | vitamin D blood testing that measures the level of vitamin D in | 16 | | an individual's blood. | 17 | | (b) A group or individual policy of accident and health | 18 | | insurance or managed care plan amended, delivered, issued, or | 19 | | renewed on or after the effective date of this amendatory Act | 20 | | of the 102nd General Assembly shall provide coverage for | 21 | | vitamin D testing recommended by a health care provider in | 22 | | accordance with vitamin D deficiency risk factors identified | 23 | | by the United States Centers for Disease Control and | 24 | | Prevention. Risk factors for vitamin D deficiency include, but | 25 | | are not limited to: |
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| 1 | | (1) having osteoporosis or other bone-health problems; | 2 | | (2) having conditions that affect fat absorption, | 3 | | including celiac disease or weight loss surgery; | 4 | | (3) routinely taking medications that interfere with | 5 | | vitamin D activity, including anticonvulsants and | 6 | | glucocorticoids; | 7 | | (4) beneficiaries aged 55 and older; | 8 | | (5) having a darker skin color; | 9 | | (6) inadequate sunlight exposure; | 10 | | (7) being obese; | 11 | | (8) previous diagnosis of diabetes or kidney disease; | 12 | | and | 13 | | (9) exhibiting poor muscle strength or constant | 14 | | tiredness. | 15 | | Section 10. The Illinois Public Aid Code is amended by | 16 | | changing Section 5-16.8 as follows:
| 17 | | (305 ILCS 5/5-16.8)
| 18 | | Sec. 5-16.8. Required health benefits. The medical | 19 | | assistance program
shall
(i) provide the post-mastectomy care | 20 | | benefits required to be covered by a policy of
accident and | 21 | | health insurance under Section 356t and the coverage required
| 22 | | under Sections 356g.5, 356u, 356w, 356x, 356z.6, 356z.26, | 23 | | 356z.29, 356z.32, 356z.33, 356z.34, and 356z.35 of the | 24 | | Illinois
Insurance Code and (ii) be subject to the provisions |
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| 1 | | of Sections 356z.19, 356z.43, 356z.44, 364.01, 370c, and | 2 | | 370c.1 of the Illinois
Insurance Code.
| 3 | | The Department, by rule, shall adopt a model similar to | 4 | | the requirements of Section 356z.39 of the Illinois Insurance | 5 | | Code. | 6 | | On and after July 1, 2012, the Department shall reduce any | 7 | | rate of reimbursement for services or other payments or alter | 8 | | any methodologies authorized by this Code to reduce any rate | 9 | | of reimbursement for services or other payments in accordance | 10 | | with Section 5-5e. | 11 | | To ensure full access to the benefits set forth in this | 12 | | Section, on and after January 1, 2016, the Department shall | 13 | | ensure that provider and hospital reimbursement for | 14 | | post-mastectomy care benefits required under this Section are | 15 | | no lower than the Medicare reimbursement rate. | 16 | | (Source: P.A. 100-138, eff. 8-18-17; 100-863, eff. 8-14-18; | 17 | | 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. | 18 | | 7-12-19; 101-218, eff. 1-1-20; 101-281, eff. 1-1-20; 101-371, | 19 | | eff. 1-1-20; 101-574, eff. 1-1-20; 101-649, eff. 7-7-20.)
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