House Sponsors: MOORE,ANDREA-FLOWERS-KRAUSE-DART-SAVIANO. Senate Sponsors: WALSH,T-GARCIA-LINK-KLEMM Short description: HMO COVER DEVELOPMENTL THERAPY Synopsis of Bill as introduced: Amends the Health Maintenance Organization Act to require coverage for developmental therapy for children not more than 3 years old who have developmental disabilities. FISCAL NOTE (Dpt. of Insurance) HB974 will have no fiscal impact on the Department. STATE MANDATES FISCAL NOTE HB 974 fails to meet the definition of a State mandate. HOME RULE NOTE HB 974 does not preempt home rule authority. HOUSE AMENDMENT NO. 1. Adds reference to: 5 ILCS 375/6.9 new 30 ILCS 805/8.21 new 55 ILCS 5/5-1069.3 new 65 ILCS 5/10-4-2.3 new 105 ILCS 5/10-22.3f new 215 ILCS 5/356t new 215 ILCS 105/8.7 new 215 ILCS 165/10 from Ch. 32, par. 604 Replaces the title and everything after the enacting clause. Amends the State Employees Group Insurance Law of 1971, Counties Code, Illinois Municipal Code, School Code, Illinois Insurance Code, Comprehensive Health Insurance Plan Act, Health Maintenance Organization Act, and Voluntary Health Services Plans Act. Provides that health care benefits under those Acts and under managed care plans must provide coverage for developmental therapies for children who are under the age of 4 years and have developmental disabilities. Amends the State Mandates Act to provide that reimbursement for developmental therapy benefits is not required under that Act. FISCAL NOTE, H-AM 1 (Dept. of Insurance) No change from previous fiscal note. STATE MANDATES ACT FISCAL NOTE, H-AM 1 HB 974, with H-am 1, creates a "personnel mandate" for which a 100% reimbursement by the State would normally be required; however, the State Mandates Act is amended to relieve the State of reimbursement liability. HOME RULE NOTE, H-AM 1 No change from previous home rule note. HOUSE AMENDMENT NO. 2. Deletes reference to: 5 ILCS 375/6.9 new 30 ILCS 805/8.21 new 55 ILCS 5/5-1069.3 new 65 ILCS 5/10-4-2.3 new 105 ILCS 5/10-22.3f new 215 ILCS 5/356t new 215 ILCS 105/8.7 new 215 ILCS 125/4-6.5 new 215 ILCS 165/10 from Ch. 32, par. 604 Adds reference to: 105 ILCS 110/3 from Ch. 122, par. 863 Replaces everything. Amends the Critical Health Problems and Comprehensive Health Education Act. Requires the comprehensive health education program in grades K through 8 to include training in basic first aid and cardiopulmonary resuscitation. Requires the State Board of Education to make materials and guidelines available. Allows school districts to arrange training through local police and fire departments, emergency medical services agencies, and related service organizations. Effective immediately. HOME RULE NOTE, H-AM 2 No change from previous home rule note. SENATE AMENDMENT NO. 1. Deletes reference to: 105 ILCS 110/3 Adds reference to: New Act 5 ILCS 375/6.12 new 30 ILCS 805/8.22 new 55 ILCS 5/5-1069.8 new 65 ILCS 5/10-4-2.8 new 215 ILCS 5/155.36 new 215 ILCS 5/370g from Ch. 73, par. 982g 215 ILCS 5/370s new 215 ILCS 5/511.118 new 215 ILCS 105/8.6 new 215 ILCS 123/15 215 ILCS 123/20 215 ILCS 125/2-2 from Ch. 111 1/2, par. 1404 215 ILCS 125/5-3.6 new 215 ILCS 125/6-7 from Ch. 111 1/2, par. 1418.7 215 ILCS 130/4002.6 new 215 ILCS 165/15.30 new 305 ILCS 5/5-16.12 new Replaces the title and everything after the enacting clause. Creates the Managed Care Patient Rights Act. Enumerates certain information and quality of care standards to which a patient is entitled. Requires health care plans to disclose to enrollees and prospective enrollees specific information concerning benefits and coverages, emergency services, out-of-area coverages, service area covered, access to specialists, and grievance procedures. Sets forth requirements for continuity of care. Prohibits restraints on communications between health care providers and enrollees and others regarding care alternatives, quality, and utilization review issues. Establishes requirements for access to specialists and the mechanisms for second opinions. Requires health care plans to have a consumer advisory committee made up of enrollees and to establish a quality assessment program. Provides for the registration of utilization review programs. Amends the Health Care Purchasing Group Act to provide that the purchasing group may be formed by 2 or more employers having no more than 500 covered employees each rather than having an aggregate limit of 2,500 covered individuals. Authorizes the sponsorship of health care purchasing groups with up to 100,000 rather than 10,000 covered individuals. Amends the State Employees Group Insurance Plan of 1971, the Counties Code, the Illinois Municipal Code, the Comprehensive Health Insurance Plan Act, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code to require that health care coverage under those Acts comply with Managed Care Patient Rights Act. Amends the Illinois Insurance Code to require compliance with provisions of the Managed Care Patient Rights Act concerning utilization review and complaint procedures. Amends the State Mandates Act to provide reimbursement by the State is not required. Effective January 1, 1999. Last action on Bill: SESSION SINE DIE Last action date: 99-01-12 Location: House Amendments to Bill: AMENDMENTS ADOPTED: HOUSE - 2 SENATE - 1 END OF INQUIRY Full Text Bill Status