HB3509 101ST GENERAL ASSEMBLY

LRB101 09808 RAB 54909 b

101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB3509

Introduced , by Rep. Katie Stuart

SYNOPSIS AS INTRODUCED:

5 ILCS 375/6.16 new
215 ILCS 5/356z.33 new
305 ILCS 5/5-40 new

Amends the State Employees Group Insurance Act of 1971, Illinois Insurance Code, and the Illinois Public Aid Code. Provides that pasteurized donated human breast milk shall be covered under health insurance and the medical assistance program under the Illinois Public Aid Code. Describes the requirements that must be met to have pasteurized human breast milk covered under health insurance and the medical assistance program. Effective January 1, 2020.

A BILL FOR

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 adding Section 6.16 as follows:

(5 ILCS 375/6.16 new)

Sec. 6.16. Human breast milk coverage. Notwithstanding any other provision of this Act, pasteurized donated human breast milk, which may include human milk fortifiers if indicated by a prescribing licensed medical practitioner, shall be covered under a health plan for persons who are otherwise eligible for coverage under this Act, if the covered person is an infant under the age of 6 months, a physician prescribes the milk for the covered person, and:

(1) the milk is obtained from a human milk bank that meets quality guidelines established by the Human Milk Banking Association of North America, or that is licensed by the Department of Public Health;

(2) a licensed medical practitioner has issued an order for an infant who is medically or physically unable to receive maternal breast milk or participate in breast feeding or whose mother is medically or physically unable to produce maternal breast milk in sufficient quantities or participate in breast feeding despite optimal lactation support; or

(3) a licensed medical practitioner has issued an order for an infant who meets any of the following conditions:

(A) a body weight below healthy levels determined by the licensed medical practitioner;

(B) a congenital or acquired condition that places the infant at a high risk for development of necrotizing enterocolitis; or

(C) a congenital or acquired condition that may benefit from the use of donor breast milk as determined by the Department of Public Health.

Section 10. The Illinois Insurance Code is amended by adding Section 356z.33 as follows:

(215 ILCS 5/356z.33 new)

Sec. 356z.33. Human breast milk coverage. Notwithstanding any other provision of this Act, pasteurized donated human breast milk, which may include human milk fortifiers if indicated by a prescribing licensed medical practitioner, shall be covered under an individual or group health insurance for persons who are otherwise eligible for coverage under this Act, if the covered person is an infant under the age of 6 months, a physician prescribes the milk for the covered person, and:

(1) the milk is obtained from a human milk bank that meets quality guidelines established by the Human Milk Banking Association of North America, or that is licensed by the Department of Public Health;

(2) a licensed medical practitioner has issued an order for an infant who is medically or physically unable to receive maternal breast milk or participate in breast feeding or whose mother is medically or physically unable to produce maternal breast milk in sufficient quantities or participate in breast feeding despite optimal lactation support; or

(3) a licensed medical practitioner has issued an order for an infant who meets any of the following conditions:

(A) a body weight below healthy levels determined by the licensed medical practitioner;

(B) a congenital or acquired condition that places the infant at a high risk for development of necrotizing enterocolitis; or

(C) a congenital or acquired condition that may benefit from the use of donor breast milk as determined by the Department of Public Health.

Section 15. The Illinois Public Aid Code is amended by adding Section 5-40 as follows:

(305 ILCS 5/5-40 new)

Sec. 5-40. Human breast milk coverage. Notwithstanding any other provision of this Act, pasteurized donated human breast milk, which may include human milk fortifiers if indicated by a prescribing licensed medical practitioner, shall be covered under a health plan for persons who are otherwise eligible for coverage under this Act, if the covered person is an infant under the age of 6 months, a physician prescribes the milk for the covered person, and:

(1) the milk is obtained from a human milk bank that meets quality guidelines established by the Human Milk Banking Association of North America, or that is licensed by the Department of Public Health;

(2) a licensed medical practitioner has issued an order for an infant who is medically or physically unable to receive maternal breast milk or participate in breast feeding or whose mother is medically or physically unable to produce maternal breast milk in sufficient quantities or participate in breast feeding despite optimal lactation support; or

(3) a licensed medical practitioner has issued an order for an infant who meets any of the following conditions:

(A) a body weight below healthy levels determined by the licensed medical practitioner;

(B) a congenital or acquired condition that places the infant at a high risk for development of necrotizing enterocolitis; or

(C) a congenital or acquired condition that may benefit from the use of donor breast milk as determined by the Department of Public Health.

Section 99. Effective date. This Act takes effect January 1, 2020.