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Public Act 102-0530


 

Public Act 0530 102ND GENERAL ASSEMBLY

  
  
  

 


 
Public Act 102-0530
 
SB1854 EnrolledLRB102 16436 BMS 21828 b

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

Effective Date: 1/1/2022