90th General Assembly
Summary of HB0974
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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 
                                                                               



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