State of Illinois
90th General Assembly

   [ Search ]   [ Legislation ]   [ Bill Summary ]
[ Home ]   [ Back ]   [ Bottom ]


      215 ILCS 5/356K        from Ch. 73, par. 968K
          Amends the Illinois  Insurance  Code.   Requires  certain
      organizations to respond to written requests concerning organ
      transplantation procedures within 90 calendar days.
 1        AN  ACT  to amend the Illinois Insurance Code by changing
 2    Section 356K.
 3        Be it enacted by the People of  the  State  of  Illinois,
 4    represented in the General Assembly:
 5        Section  5.  The  Illinois  Insurance  Code is amended by
 6    changing Section 356K as follows:
 7        (215 ILCS 5/356K) (from Ch. 73, par. 968K)
 8        Sec. 356K. Coverage for Organ Transplantation Procedures.
 9    No accident and health insurer providing coverage under  this
10    Act for hospital or medical expenses shall deny reimbursement
11    for  an  otherwise  covered  expense  incurred  for any organ
12    transplantation procedure  solely  on  the  basis  that  such
13    procedure  is  deemed  experimental or investigational unless
14    supported by the determination of the Office of  Health  Care
15    Technology  Assessment  within  the  Agency  for  Health Care
16    Policy and Research within the federal Department  of  Health
17    and Human Services that such procedure is either experimental
18    or  investigational  or  that  there  is insufficient data or
19    experience to  determine  whether  an  organ  transplantation
20    procedure is clinically acceptable. If an accident and health
21    insurer  has  made  written  request,  or had one made on its
22    behalf by a national organization, for determination  by  the
23    Office of Health Care Technology Assessment within the Agency
24    for  Health  Care  Policy  and  Research  within  the federal
25    Department of Health and  Human  Services  as  to  whether  a
26    specific   organ   transplantation  procedure  is  clinically
27    acceptable and said organization fails to respond to  such  a
28    request  within  a period of 90 calendar days, the failure to
29    act may be deemed  a  determination  that  the  procedure  is
30    deemed to be experimental or investigational.
31    (Source: P.A. 87-218.)
                            -2-              SDS/bill0042/bkp

[ Top ]