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Public Act 91-0777
HB4176 Enrolled LRB9109951JSpc
AN ACT concerning prescription drug information cards.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 1. Short title. This Act may be cited as the
Uniform Prescription Drug Information Card Act.
Section 5. Legislative intent. It is the intent of the
legislature to lessen patients' waiting times, decrease
administrative burdens for pharmacies, and improve care to
patients by minimizing confusion, eliminating unnecessary
paperwork, and streamlining the dispensing of prescription
products paid for by third-party payors. This Act shall be
broadly applied and interpreted to effectuate this purpose.
Section 10. Definitions. As used in this Act, the
following terms have the meanings given in this Section.
"Department" means the Department of Insurance.
"Director" means the Director of Insurance.
"Health benefit plan" means an accident and health
insurance policy or certificate subject to the Illinois
Insurance Code, a voluntary health services plan subject to
the Voluntary Health Services Plans Act, a health maintenance
organization subscriber contract subject to the Health
Maintenance Organization Act, a plan provided by a multiple
employer welfare arrangement, or a plan provided by another
benefit arrangement. Without limitation, "health benefit
plan" does not mean any of the following types of insurance:
(1) accident;
(2) credit;
(3) disability income;
(4) long-term or nursing home care;
(5) specified disease;
(6) dental or vision;
(7) coverage issued as a supplement to liability
insurance;
(8) medical payments under automobile or
homeowners;
(9) insurance under which benefits are payable with
or without regard to fault as statutorily required to be
contained in any liability policy or equivalent
self-insurance;
(10) hospital income or indemnity;
(11) self-insured health benefit plans under the
federal Employee Retirement Income Security Act of 1974.
Section 15. Uniform prescription drug information cards
required.
(a) A health benefit plan that issues a card or other
technology and provides coverage for prescription drugs or
devices and an administrator of such a plan including, but
not limited to, third-party administrators for self-insured
plans and state-administered plans shall issue to its
insureds a card or other technology containing uniform
prescription drug information. The uniform prescription drug
information card or other technology shall specifically
identify and display the following mandatory data elements on
the front of the card:
(1) BIN number;
(2) Processor control number if required for claims
adjudication;
(3) Group number;
(4) Card issuer identifier;
(5) Cardholder ID number; and
(6) Cardholder name.
The uniform prescription drug information card or other
technology shall specifically identify and display the
following mandatory data elements on the back of the card:
(1) Claims submission names and addresses; and
(2) Help desk telephone numbers and names.
(b) A new uniform prescription drug information card or
other technology shall be issued by a health benefit plan
upon enrollment and reissued upon any change in the insured's
coverage that affects mandatory data elements contained on
the card.
Section 20. Applicability and enforcement.
(a) This Act applies to health benefit plans that are
amended, delivered, issued, or renewed on and after the
effective date of this amendatory Act of the 91st General
Assembly.
(b) The Director may adopt rules necessary to implement
the Department's responsibilities under this Act. To enforce
the provisions of this Act, the Director may issue a cease
and desist order or require a health benefit plan to submit a
plan of correction for violations of this Act, or both.
Subject to the provisions of the Illinois Administrative
Procedure Act, the Director may, pursuant to Section 403A of
the Illinois Insurance Code, impose upon a health benefit
plan an administrative fine not to exceed $250,000 for
failure to submit a requested plan of correction, failure to
comply with its plan or correction, or repeated violations of
this Act.
Section 99. Effective date. This Act takes effect on
January 1, 2001.
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