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90_SB1047
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.
SDS/bill0042/bkp
SDS/bill0042/bkp
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.)
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