Full Text of HB2649 102nd General Assembly
HB2649eng 102ND GENERAL ASSEMBLY |
| | HB2649 Engrossed | | LRB102 13887 BMS 19238 b |
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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 State Employees Group Insurance Act of 1971 | 5 | | is amended by changing Section 6.11 as follows:
| 6 | | (5 ILCS 375/6.11)
| 7 | | Sec. 6.11. Required health benefits; Illinois Insurance | 8 | | Code
requirements. The program of health
benefits shall | 9 | | provide the post-mastectomy care benefits required to be | 10 | | covered
by a policy of accident and health insurance under | 11 | | Section 356t of the Illinois
Insurance Code. The program of | 12 | | health benefits shall provide the coverage
required under | 13 | | Sections 356g, 356g.5, 356g.5-1, 356m, 356q,
356u, 356w, 356x, | 14 | | 356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, | 15 | | 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22, | 16 | | 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, | 17 | | 356z.36, and 356z.41 of the
Illinois Insurance Code.
The | 18 | | program of health benefits must comply with Sections 155.22a, | 19 | | 155.37, 355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of | 20 | | the
Illinois Insurance Code. The Department of Insurance shall | 21 | | enforce the requirements of this Section with respect to | 22 | | Sections 370c and 370c.1 of the Illinois Insurance Code; all | 23 | | other requirements of this Section shall be enforced by the |
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| 1 | | Department of Central Management Services.
| 2 | | Rulemaking authority to implement Public Act 95-1045, if | 3 | | any, is conditioned on the rules being adopted in accordance | 4 | | with all provisions of the Illinois Administrative Procedure | 5 | | Act and all rules and procedures of the Joint Committee on | 6 | | Administrative Rules; any purported rule not so adopted, for | 7 | | whatever reason, is unauthorized. | 8 | | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; | 9 | | 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. | 10 | | 1-1-19; 100-1102, eff. 1-1-19; 100-1170, eff. 6-1-19; 101-13, | 11 | | eff. 6-12-19; 101-281, eff. 1-1-20; 101-393, eff. 1-1-20; | 12 | | 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff. | 13 | | 1-1-21 .)
| 14 | | Section 10. The Illinois Insurance Code is amended by | 15 | | changing Section 356q as follows:
| 16 | | (215 ILCS 5/356q)
| 17 | | Sec. 356q. Temporomandibular joint disorder and
| 18 | | craniomandibular disorder. On or after the effective date of | 19 | | this amendatory Act of the 102nd General Assembly On or after | 20 | | the effective date of this Section , every insurer
which | 21 | | delivers or issues for delivery in this State a group accident | 22 | | and health
policy providing coverage for hospital, medical, or | 23 | | surgical treatment on an
expense-incurred basis shall offer , | 24 | | for an additional premium and subject to
the insurer's |
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| 1 | | standard of insurability, optional coverage for the reasonable
| 2 | | and necessary medical treatment of temporomandibular joint | 3 | | disorder and
craniomandibular disorder. The group policyholder | 4 | | shall accept or reject the
coverage in writing on the | 5 | | application or an amendment thereto for the master
group | 6 | | policy. Benefits may be subject to the same pre-existing
| 7 | | conditions, limitations, deductibles, co-payments and | 8 | | co-insurance that
generally apply to any other sickness. The | 9 | | maximum lifetime benefits for
temporomandibular joint disorder | 10 | | and craniomandibular treatment shall be no
less than $2,500. | 11 | | Nothing herein shall prevent an insurer from including such
| 12 | | coverage for temporomandibular joint disorder and | 13 | | craniomandibular disorder as
part of a policy's basic | 14 | | coverage, in lieu of offering optional coverage.
| 15 | | (Source: P.A. 88-592, eff. 1-1-95.)
| 16 | | Section 15. The Illinois Public Aid Code is amended by | 17 | | changing Section 5-16.8 as follows:
| 18 | | (305 ILCS 5/5-16.8)
| 19 | | Sec. 5-16.8. Required health benefits. The medical | 20 | | assistance program
shall
(i) provide the post-mastectomy care | 21 | | benefits required to be covered by a policy of
accident and | 22 | | health insurance under Section 356t and the coverage required
| 23 | | under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6, | 24 | | 356z.26, 356z.29, 356z.32, 356z.33, 356z.34, and 356z.35 of |
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| 1 | | the Illinois
Insurance Code and (ii) be subject to the | 2 | | provisions of Sections 356z.19, 364.01, 370c, and 370c.1 of | 3 | | the Illinois
Insurance Code.
| 4 | | The Department, by rule, shall adopt a model similar to | 5 | | the requirements of Section 356z.39 of the Illinois Insurance | 6 | | Code. | 7 | | On and after July 1, 2012, the Department shall reduce any | 8 | | rate of reimbursement for services or other payments or alter | 9 | | any methodologies authorized by this Code to reduce any rate | 10 | | of reimbursement for services or other payments in accordance | 11 | | with Section 5-5e. | 12 | | To ensure full access to the benefits set forth in this | 13 | | Section, on and after January 1, 2016, the Department shall | 14 | | ensure that provider and hospital reimbursement for | 15 | | post-mastectomy care benefits required under this Section are | 16 | | no lower than the Medicare reimbursement rate. | 17 | | (Source: P.A. 100-138, eff. 8-18-17; 100-863, eff. 8-14-18; | 18 | | 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. | 19 | | 7-12-19; 101-218, eff. 1-1-20; 101-281, eff. 1-1-20; 101-371, | 20 | | eff. 1-1-20; 101-574, eff. 1-1-20; 101-649, eff. 7-7-20.)
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