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91_SB0476
LRB9102760SMdv
1 AN ACT regarding pharmaceutical expenses for long-term
2 care facility residents.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Illinois Health Finance Reform Act is
6 amended by changing Section 2-2 as follows:
7 (20 ILCS 2215/2-2) (from Ch. 111 1/2, par. 6502-2)
8 Sec. 2-2. Council Duties. The Council shall be
9 responsible for:
10 (a) Collecting and publicizing hospital financing and
11 cost data pursuant to Article IV for the purposes of carrying
12 out its duties under this Act.
13 (b) Studying the health care financing system in the
14 State of Illinois, and recommending to the General Assembly
15 what it deems to be the most appropriate and comprehensive
16 cost containment system for the State. In its deliberations,
17 the Council shall consider:
18 (1) The health care delivery system in the State of
19 Illinois and hospitals' role in that system;
20 (2) Minimizing cost shifting between publicly supported
21 patients and private payors;
22 (3) The quality of care provided by hospitals as it
23 relates to their level of reimbursement;
24 (4) Cost containment alternatives for Illinois State
25 employees' health benefit plans currently available under
26 Illinois law;
27 (5) The efficacy of current certificate of need
28 processes under the Illinois Health Facilities Planning Act
29 and possible alternative measures to contain costs, including
30 capital expenditure caps;
31 (6) The efficacy of the current State health planning
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1 process;
2 (7) The efficacy of State bonding authorities for health
3 facilities construction and development;
4 (8) The financial hardships experienced by hospitals
5 primarily serving the poor; and
6 (9) Accessibility of hospital care.
7 (c) Monitoring the extent to which hospitals in general
8 and each individual hospital in the State limit price
9 increases to the rate of increase of prices in the general
10 economy.
11 (d) Promoting and counseling the general public on more
12 effective procurement and utilization of health services,
13 through a special Health Care Consumer Affairs Advisor to be
14 employed by the Council.
15 (e) Prescribing by rule the standards for a bill from a
16 long-term care facility (as that term is defined in the
17 Nursing Home Care Act) as the bill relates to pharmaceuticals
18 dispensed to a resident. The rules, at a minimum, shall
19 require that a long-term care facility itemize in the billing
20 statement to a resident the cost, per dosage, of any
21 pharmaceutical product dispensed to the resident.
22 (Source: P.A. 83-1243.)
23 Section 10. The Medical Patient Rights Act is amended by
24 changing Section 3 as follows:
25 (410 ILCS 50/3) (from Ch. 111 1/2, par. 5403)
26 Sec. 3. The following rights are hereby established:
27 (a) The right of each patient to care consistent with
28 sound nursing and medical practices, to be informed of the
29 name of the physician responsible for coordinating his or her
30 care, to receive information concerning his or her condition
31 and proposed treatment, to refuse any treatment to the extent
32 permitted by law, and to privacy and confidentiality of
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1 records except as otherwise provided by law.
2 (b) The right of each patient, regardless of source of
3 payment, to examine and receive a reasonable explanation of
4 his total bill for services rendered by his physician or
5 health care provider, including the itemized charges for
6 specific services received. Each physician or health care
7 provider shall be responsible only for a reasonable
8 explanation of those specific services provided by such
9 physician or health care provider.
10 (b-5) The right of a resident of a long-term care
11 facility (as that term is defined in the Nursing Home Care
12 Act) to receive, in his or her monthly billing statement, an
13 itemized list of the cost, per dosage, of any pharmaceutical
14 product dispensed to the resident.
15 (c) In the event an insurance company or health services
16 corporation cancels or refuses to renew an individual policy
17 or plan, the insured patient shall be entitled to timely,
18 prior notice of the termination of such policy or plan.
19 An insurance company or health services corporation that
20 requires any insured patient or applicant for new or
21 continued insurance or coverage to be tested for infection
22 with human immunodeficiency virus (HIV) or any other
23 identified causative agent of acquired immunodeficiency
24 syndrome (AIDS) shall (1) give the patient or applicant prior
25 written notice of such requirement, (2) proceed with such
26 testing only upon the written authorization of the applicant
27 or patient, and (3) keep the results of such testing
28 confidential. Notice of an adverse underwriting or coverage
29 decision may be given to any appropriately interested party,
30 but the insurer may only disclose the test result itself to a
31 physician designated by the applicant or patient, and any
32 such disclosure shall be in a manner that assures
33 confidentiality.
34 The Department of Insurance shall enforce the provisions
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1 of this subsection.
2 (d) The right of each patient to privacy and
3 confidentiality in health care. Each physician, health care
4 provider, health services corporation and insurance company
5 shall refrain from disclosing the nature or details of
6 services provided to patients, except that such information
7 may be disclosed to the patient, the party making treatment
8 decisions if the patient is incapable of making decisions
9 regarding the health services provided, those parties
10 directly involved with providing treatment to the patient or
11 processing the payment for that treatment, those parties
12 responsible for peer review, utilization review and quality
13 assurance, and those parties required to be notified under
14 the Abused and Neglected Child Reporting Act, the Illinois
15 Sexually Transmissible Disease Control Act or where otherwise
16 authorized or required by law. This right may be waived in
17 writing by the patient or the patient's guardian, but a
18 physician or other health care provider may not condition the
19 provision of services on the patient's or guardian's
20 agreement to sign such a waiver.
21 (Source: P.A. 86-895; 86-902; 86-1028; 87-334.)