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Public Act 100-1102


 

Public Act 1102 100TH GENERAL ASSEMBLY

  
  
  

 


 
Public Act 100-1102
 
HB2617 EnrolledLRB100 08150 SMS 18244 b

    AN ACT concerning regulation.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The State Employees Group Insurance Act of 1971
is amended by changing Section 6.11 as follows:
 
    (5 ILCS 375/6.11)
    Sec. 6.11. Required health benefits; Illinois Insurance
Code requirements. The program of health benefits shall provide
the post-mastectomy care benefits required to be covered by a
policy of accident and health insurance under Section 356t of
the Illinois Insurance Code. The program of health benefits
shall provide the coverage required under Sections 356g,
356g.5, 356g.5-1, 356m, 356u, 356w, 356x, 356z.2, 356z.4,
356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
356z.14, 356z.15, 356z.17, 356z.22, and 356z.25, 356z.26, and
356z.29 of the Illinois Insurance Code. The program of health
benefits must comply with Sections 155.22a, 155.37, 355b,
356z.19, 370c, and 370c.1 of the Illinois Insurance Code.
    Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17;
100-138, eff. 8-18-17; revised 10-3-17.)
 
    Section 10. The Counties Code is amended by changing
Section 5-1069.3 as follows:
 
    (55 ILCS 5/5-1069.3)
    Sec. 5-1069.3. Required health benefits. If a county,
including a home rule county, is a self-insurer for purposes of
providing health insurance coverage for its employees, the
coverage shall include coverage for 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, 356g.5, 356g.5-1, 356u, 356w, 356x,
356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
356z.14, 356z.15, 356z.22, and 356z.25, 356z.26, and 356z.29 of
the Illinois Insurance Code. The coverage shall comply with
Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
Insurance Code. The requirement that health benefits be covered
as provided in this Section is an exclusive power and function
of the State and is a denial and limitation under Article VII,
Section 6, subsection (h) of the Illinois Constitution. A home
rule county to which this Section applies must comply with
every provision of this Section.
    Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17;
100-138, eff. 8-18-17; revised 10-5-17.)
 
    Section 15. The Illinois Municipal Code is amended by
changing Section 10-4-2.3 as follows:
 
    (65 ILCS 5/10-4-2.3)
    Sec. 10-4-2.3. Required health benefits. If a
municipality, including a home rule municipality, is a
self-insurer for purposes of providing health insurance
coverage for its employees, the coverage shall include coverage
for 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, 356g.5,
356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.10,
356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, and
356z.25, 356z.26, and 356z.29 of the Illinois Insurance Code.
The coverage shall comply with Sections 155.22a, 355b, 356z.19,
and 370c of the Illinois Insurance Code. The requirement that
health benefits be covered as provided in this is an exclusive
power and function of the State and is a denial and limitation
under Article VII, Section 6, subsection (h) of the Illinois
Constitution. A home rule municipality to which this Section
applies must comply with every provision of this Section.
    Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17;
100-138, eff. 8-18-17; revised 10-5-17.)
 
    Section 20. The School Code is amended by changing Section
10-22.3f as follows:
 
    (105 ILCS 5/10-22.3f)
    Sec. 10-22.3f. Required health benefits. Insurance
protection and benefits for employees shall 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, 356g.5, 356g.5-1,
356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.11, 356z.12,
356z.13, 356z.14, 356z.15, 356z.22, and 356z.25, 356z.26, and
356z.29 of the Illinois Insurance Code. Insurance policies
shall comply with Section 356z.19 of the Illinois Insurance
Code. The coverage shall comply with Sections 155.22a and 355b
of the Illinois Insurance Code.
    Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
revised 9-25-17.)
 
    Section 25. The Illinois Insurance Code is amended by
changing Section 356z.4 and adding Section 356z.29 as follows:
 
    (215 ILCS 5/356z.4)
    Sec. 356z.4. Coverage for contraceptives.
    (a)(1) The General Assembly hereby finds and declares all
of the following:
        (A) Illinois has a long history of expanding timely
    access to birth control to prevent unintended pregnancy.
        (B) The federal Patient Protection and Affordable Care
    Act includes a contraceptive coverage guarantee as part of
    a broader requirement for health insurance to cover key
    preventive care services without out-of-pocket costs for
    patients.
        (C) The General Assembly intends to build on existing
    State and federal law to promote gender equity and women's
    health and to ensure greater contraceptive coverage equity
    and timely access to all federal Food and Drug
    Administration approved methods of birth control for all
    individuals covered by an individual or group health
    insurance policy in Illinois.
        (D) Medical management techniques such as denials,
    step therapy, or prior authorization in public and private
    health care coverage can impede access to the most
    effective contraceptive methods.
    (2) As used in this subsection (a):
    "Contraceptive services" includes consultations,
examinations, procedures, and medical services related to the
use of contraceptive methods (including natural family
planning) to prevent an unintended pregnancy.
    "Medical necessity", for the purposes of this subsection
(a), includes, but is not limited to, considerations such as
severity of side effects, differences in permanence and
reversibility of contraceptive, and ability to adhere to the
appropriate use of the item or service, as determined by the
attending provider.
    "Therapeutic equivalent version" means drugs, devices, or
products that can be expected to have the same clinical effect
and safety profile when administered to patients under the
conditions specified in the labeling and satisfy the following
general criteria:
        (i) they are approved as safe and effective;
        (ii) they are pharmaceutical equivalents in that they
    (A) contain identical amounts of the same active drug
    ingredient in the same dosage form and route of
    administration and (B) meet compendial or other applicable
    standards of strength, quality, purity, and identity;
        (iii) they are bioequivalent in that (A) they do not
    present a known or potential bioequivalence problem and
    they meet an acceptable in vitro standard or (B) if they do
    present such a known or potential problem, they are shown
    to meet an appropriate bioequivalence standard;
        (iv) they are adequately labeled; and
        (v) they are manufactured in compliance with Current
    Good Manufacturing Practice regulations.
    (3) An individual or group policy of accident and health
insurance amended, delivered, issued, or renewed in this State
after the effective date of this amendatory Act of the 99th
General Assembly shall provide coverage for all of the
following services and contraceptive methods:
        (A) All contraceptive drugs, devices, and other
    products approved by the United States Food and Drug
    Administration. This includes all over-the-counter
    contraceptive drugs, devices, and products approved by the
    United States Food and Drug Administration, excluding male
    condoms. The following apply:
            (i) If the United States Food and Drug
        Administration has approved one or more therapeutic
        equivalent versions of a contraceptive drug, device,
        or product, a policy is not required to include all
        such therapeutic equivalent versions in its formulary,
        so long as at least one is included and covered without
        cost-sharing and in accordance with this Section.
            (ii) If an individual's attending provider
        recommends a particular service or item approved by the
        United States Food and Drug Administration based on a
        determination of medical necessity with respect to
        that individual, the plan or issuer must cover that
        service or item without cost sharing. The plan or
        issuer must defer to the determination of the attending
        provider.
            (iii) If a drug, device, or product is not covered,
        plans and issuers must have an easily accessible,
        transparent, and sufficiently expedient process that
        is not unduly burdensome on the individual or a
        provider or other individual acting as a patient's
        authorized representative to ensure coverage without
        cost sharing.
            (iv) This coverage must provide for the dispensing
        of 12 months' worth of contraception at one time.
        (B) Voluntary sterilization procedures.
        (C) Contraceptive services, patient education, and
    counseling on contraception.
        (D) Follow-up services related to the drugs, devices,
    products, and procedures covered under this Section,
    including, but not limited to, management of side effects,
    counseling for continued adherence, and device insertion
    and removal.
    (4) Except as otherwise provided in this subsection (a), a
policy subject to this subsection (a) shall not impose a
deductible, coinsurance, copayment, or any other cost-sharing
requirement on the coverage provided. The provisions of this
paragraph do not apply to coverage of voluntary male
sterilization procedures to the extent such coverage would
disqualify a high-deductible health plan from eligibility for a
health savings account pursuant to the federal Internal Revenue
Code, 26 U.S.C. 223.
    (5) Except as otherwise authorized under this subsection
(a), a policy shall not impose any restrictions or delays on
the coverage required under this subsection (a).
    (6) If, at any time, the Secretary of the United States
Department of Health and Human Services, or its successor
agency, promulgates rules or regulations to be published in the
Federal Register or publishes a comment in the Federal Register
or issues an opinion, guidance, or other action that would
require the State, pursuant to any provision of the Patient
Protection and Affordable Care Act (Public Law 111-148),
including, but not limited to, 42 U.S.C. 18031(d)(3)(B) or any
successor provision, to defray the cost of any coverage
outlined in this subsection (a), then this subsection (a) is
inoperative with respect to all coverage outlined in this
subsection (a) other than that authorized under Section 1902 of
the Social Security Act, 42 U.S.C. 1396a, and the State shall
not assume any obligation for the cost of the coverage set
forth in this subsection (a).
    (b) This subsection (b) shall become operative if and only
if subsection (a) becomes inoperative.
    An individual or group policy of accident and health
insurance amended, delivered, issued, or renewed in this State
after the date this subsection (b) becomes operative that
provides coverage for outpatient services and outpatient
prescription drugs or devices must provide coverage for the
insured and any dependent of the insured covered by the policy
for all outpatient contraceptive services and all outpatient
contraceptive drugs and devices approved by the Food and Drug
Administration. Coverage required under this Section may not
impose any deductible, coinsurance, waiting period, or other
cost-sharing or limitation that is greater than that required
for any outpatient service or outpatient prescription drug or
device otherwise covered by the policy.
    Nothing in this subsection (b) shall be construed to
require an insurance company to cover services related to
permanent sterilization that requires a surgical procedure.
    As used in this subsection (b), "outpatient contraceptive
service" means consultations, examinations, procedures, and
medical services, provided on an outpatient basis and related
to the use of contraceptive methods (including natural family
planning) to prevent an unintended pregnancy.
    (c) Nothing in this Section shall be construed to require
an insurance company to cover services related to an abortion
as the term "abortion" is defined in the Illinois Abortion Law
of 1975.
    (d) If a plan or issuer utilizes a network of providers,
nothing in this Section shall be construed to require coverage
or to prohibit the plan or issuer from imposing cost-sharing
for items or services described in this Section that are
provided or delivered by an out-of-network provider, unless the
plan or issuer does not have in its network a provider who is
able to or is willing to provide the applicable items or
services.
(Source: P.A. 99-672, eff. 1-1-17.)
 
    (215 ILCS 5/356z.29 new)
    Sec. 356z.29. Coverage for fertility preservation
services.
    (a) As used in this Section:
        "Iatrogenic infertility" means in impairment of
    fertility by surgery, radiation, chemotherapy, or other
    medical treatment affecting reproductive organs or
    processes.
        "May directly or indirectly cause" means the likely
    possibility that treatment will cause a side effect of
    infertility, based upon current evidence-based standards
    of care established by the American Society for
    Reproductive Medicine, the American Society of Clinical
    Oncology, or other national medical associations that
    follow current evidence-based standards of care.
        "Standard fertility preservation services" means
    procedures based upon current evidence-based standards of
    care established by the American Society for Reproductive
    Medicine, the American Society of Clinical Oncology, or
    other national medical associations that follow current
    evidence-based standards of care.
    (b) An individual or group policy of accident and health
insurance amended, delivered, issued, or renewed in this State
after the effective date of this amendatory Act of the 100th
General Assembly must provide coverage for medically necessary
expenses for standard fertility preservation services when a
necessary medical treatment may directly or indirectly cause
iatrogenic infertility to an enrollee.
    (c) In determining coverage pursuant to this Section, an
insurer shall not discriminate based on an individual's
expected length of life, present or predicted disability,
degree of medical dependency, quality of life, or other health
conditions, nor based on personal characteristics, including
age, sex, sexual orientation, or marital status.
    (d) If, at any time before or after the effective date of
this amendatory Act of the 100th General Assembly, the
Secretary of the United States Department of Health and Human
Services, or its successor agency, promulgates rules or
regulations to be published in the Federal Register, publishes
a comment in the Federal Register, or issues an opinion,
guidance, or other action that would require the State,
pursuant to any provision of the Patient Protection and
Affordable Care Act (Pub. L. 111148), including, but not
limited to, 42 U.S.C. 18031(d)(3)(B) or any successor
provision, to defray the cost of coverage for fertility
preservation services, then this Section is inoperative with
respect to all such coverage other than that authorized under
Section 1902 of the Social Security Act, 42 U.S.C. 1396a, and
the State shall not assume any obligation for the cost of
coverage for fertility preservation services.
 
    Section 30. The Health Maintenance Organization Act is
amended by changing Section 5-3 as follows:
 
    (215 ILCS 125/5-3)  (from Ch. 111 1/2, par. 1411.2)
    Sec. 5-3. Insurance Code provisions.
    (a) Health Maintenance Organizations shall be subject to
the provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154,
154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 355.2, 355.3,
355b, 356g.5-1, 356m, 356v, 356w, 356x, 356y, 356z.2, 356z.4,
356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12,
356z.13, 356z.14, 356z.15, 356z.17, 356z.18, 356z.19, 356z.21,
356z.22, 356z.25, 356z.26, 356z.29, 364, 364.01, 367.2,
367.2-5, 367i, 368a, 368b, 368c, 368d, 368e, 370c, 370c.1, 401,
401.1, 402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1,
paragraph (c) of subsection (2) of Section 367, and Articles
IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, and XXVI of
the Illinois Insurance Code.
    (b) For purposes of the Illinois Insurance Code, except for
Sections 444 and 444.1 and Articles XIII and XIII 1/2, Health
Maintenance Organizations in the following categories are
deemed to be "domestic companies":
        (1) a corporation authorized under the Dental Service
    Plan Act or the Voluntary Health Services Plans Act;
        (2) a corporation organized under the laws of this
    State; or
        (3) a corporation organized under the laws of another
    state, 30% or more of the enrollees of which are residents
    of this State, except a corporation subject to
    substantially the same requirements in its state of
    organization as is a "domestic company" under Article VIII
    1/2 of the Illinois Insurance Code.
    (c) In considering the merger, consolidation, or other
acquisition of control of a Health Maintenance Organization
pursuant to Article VIII 1/2 of the Illinois Insurance Code,
        (1) the Director shall give primary consideration to
    the continuation of benefits to enrollees and the financial
    conditions of the acquired Health Maintenance Organization
    after the merger, consolidation, or other acquisition of
    control takes effect;
        (2)(i) the criteria specified in subsection (1)(b) of
    Section 131.8 of the Illinois Insurance Code shall not
    apply and (ii) the Director, in making his determination
    with respect to the merger, consolidation, or other
    acquisition of control, need not take into account the
    effect on competition of the merger, consolidation, or
    other acquisition of control;
        (3) the Director shall have the power to require the
    following information:
            (A) certification by an independent actuary of the
        adequacy of the reserves of the Health Maintenance
        Organization sought to be acquired;
            (B) pro forma financial statements reflecting the
        combined balance sheets of the acquiring company and
        the Health Maintenance Organization sought to be
        acquired as of the end of the preceding year and as of
        a date 90 days prior to the acquisition, as well as pro
        forma financial statements reflecting projected
        combined operation for a period of 2 years;
            (C) a pro forma business plan detailing an
        acquiring party's plans with respect to the operation
        of the Health Maintenance Organization sought to be
        acquired for a period of not less than 3 years; and
            (D) such other information as the Director shall
        require.
    (d) The provisions of Article VIII 1/2 of the Illinois
Insurance Code and this Section 5-3 shall apply to the sale by
any health maintenance organization of greater than 10% of its
enrollee population (including without limitation the health
maintenance organization's right, title, and interest in and to
its health care certificates).
    (e) In considering any management contract or service
agreement subject to Section 141.1 of the Illinois Insurance
Code, the Director (i) shall, in addition to the criteria
specified in Section 141.2 of the Illinois Insurance Code, take
into account the effect of the management contract or service
agreement on the continuation of benefits to enrollees and the
financial condition of the health maintenance organization to
be managed or serviced, and (ii) need not take into account the
effect of the management contract or service agreement on
competition.
    (f) Except for small employer groups as defined in the
Small Employer Rating, Renewability and Portability Health
Insurance Act and except for medicare supplement policies as
defined in Section 363 of the Illinois Insurance Code, a Health
Maintenance Organization may by contract agree with a group or
other enrollment unit to effect refunds or charge additional
premiums under the following terms and conditions:
        (i) the amount of, and other terms and conditions with
    respect to, the refund or additional premium are set forth
    in the group or enrollment unit contract agreed in advance
    of the period for which a refund is to be paid or
    additional premium is to be charged (which period shall not
    be less than one year); and
        (ii) the amount of the refund or additional premium
    shall not exceed 20% of the Health Maintenance
    Organization's profitable or unprofitable experience with
    respect to the group or other enrollment unit for the
    period (and, for purposes of a refund or additional
    premium, the profitable or unprofitable experience shall
    be calculated taking into account a pro rata share of the
    Health Maintenance Organization's administrative and
    marketing expenses, but shall not include any refund to be
    made or additional premium to be paid pursuant to this
    subsection (f)). The Health Maintenance Organization and
    the group or enrollment unit may agree that the profitable
    or unprofitable experience may be calculated taking into
    account the refund period and the immediately preceding 2
    plan years.
    The Health Maintenance Organization shall include a
statement in the evidence of coverage issued to each enrollee
describing the possibility of a refund or additional premium,
and upon request of any group or enrollment unit, provide to
the group or enrollment unit a description of the method used
to calculate (1) the Health Maintenance Organization's
profitable experience with respect to the group or enrollment
unit and the resulting refund to the group or enrollment unit
or (2) the Health Maintenance Organization's unprofitable
experience with respect to the group or enrollment unit and the
resulting additional premium to be paid by the group or
enrollment unit.
    In no event shall the Illinois Health Maintenance
Organization Guaranty Association be liable to pay any
contractual obligation of an insolvent organization to pay any
refund authorized under this Section.
    (g) Rulemaking authority to implement Public Act 95-1045,
if any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
(Source: P.A. 99-761, eff. 1-1-18; 100-24, eff. 7-18-17;
100-138, eff. 8-18-17; revised 10-5-17.)
 
    Section 35. The Limited Health Service Organization Act is
amended by changing Section 4003 as follows:
 
    (215 ILCS 130/4003)  (from Ch. 73, par. 1504-3)
    Sec. 4003. Illinois Insurance Code provisions. Limited
health service organizations shall be subject to the provisions
of Sections 133, 134, 136, 137, 139, 140, 141.1, 141.2, 141.3,
143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5, 154.6,
154.7, 154.8, 155.04, 155.37, 355.2, 355.3, 355b, 356v,
356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 368a,
401, 401.1, 402, 403, 403A, 408, 408.2, 409, 412, 444, and
444.1 and Articles IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2,
XXV, and XXVI of the Illinois Insurance Code. For purposes of
the Illinois Insurance Code, except for Sections 444 and 444.1
and Articles XIII and XIII 1/2, limited health service
organizations in the following categories are deemed to be
domestic companies:
        (1) a corporation under the laws of this State; or
        (2) a corporation organized under the laws of another
    state, 30% or more of the enrollees of which are residents
    of this State, except a corporation subject to
    substantially the same requirements in its state of
    organization as is a domestic company under Article VIII
    1/2 of the Illinois Insurance Code.
(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
100-201, eff. 8-18-17; revised 10-5-17.)
 
    Section 40. The Voluntary Health Services Plans Act is
amended by changing Section 10 as follows:
 
    (215 ILCS 165/10)  (from Ch. 32, par. 604)
    Sec. 10. Application of Insurance Code provisions. Health
services plan corporations and all persons interested therein
or dealing therewith shall be subject to the provisions of
Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,
143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b, 356g,
356g.5, 356g.5-1, 356r, 356t, 356u, 356v, 356w, 356x, 356y,
356z.1, 356z.2, 356z.4, 356z.5, 356z.6, 356z.8, 356z.9,
356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.18,
356z.19, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 364.01,
367.2, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
and paragraphs (7) and (15) of Section 367 of the Illinois
Insurance Code.
    Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
revised 10-5-17.)
 
    Section 45. 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, and
356z.29 and 356z.25 of the Illinois Insurance Code and (ii) be
subject to the provisions of Sections 356z.19, 364.01, 370c,
and 370c.1 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. 99-433, eff. 8-21-15; 99-480, eff. 9-9-15;
99-642, eff. 7-28-16; 100-138, eff. 8-18-17; revised 1-29-18.)

Effective Date: 1/1/2019