100TH GENERAL ASSEMBLY
State of Illinois
2017 and 2018
HB2617

 

Introduced , by Rep. Robyn Gabel

 

SYNOPSIS AS INTRODUCED:
 
5 ILCS 375/6.11
55 ILCS 5/5-1069.3
65 ILCS 5/10-4-2.3
105 ILCS 5/10-22.3f
215 ILCS 5/356z.25 new
215 ILCS 125/5-3  from Ch. 111 1/2, par. 1411.2
215 ILCS 130/4003  from Ch. 73, par. 1504-3
215 ILCS 165/10  from Ch. 32, par. 604
305 ILCS 5/5-16.8

    Amends the Illinois Insurance Code to provide that a policy of accident or health insurance shall 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. Defines "iatrogenic infertility". Provides that in determining coverage for these expenses, 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. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code.


LRB100 08150 SMS 18244 b

FISCAL NOTE ACT MAY APPLY
STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT

 

 

A BILL FOR

 

HB2617LRB100 08150 SMS 18244 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The State Employees Group Insurance Act of 1971
5is amended by changing Section 6.11 as follows:
 
6    (5 ILCS 375/6.11)
7    Sec. 6.11. Required health benefits; Illinois Insurance
8Code requirements. The program of health benefits shall provide
9the post-mastectomy care benefits required to be covered by a
10policy of accident and health insurance under Section 356t of
11the Illinois Insurance Code. The program of health benefits
12shall provide the coverage required under Sections 356g,
13356g.5, 356g.5-1, 356m, 356u, 356w, 356x, 356z.2, 356z.4,
14356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
15356z.14, 356z.15, 356z.17, and 356z.22, and 356z.25 of the
16Illinois Insurance Code. The program of health benefits must
17comply with Sections 155.22a, 155.37, 355b, 356z.19, 370c, and
18370c.1 of the Illinois Insurance Code.
19    Rulemaking authority to implement Public Act 95-1045, if
20any, is conditioned on the rules being adopted in accordance
21with all provisions of the Illinois Administrative Procedure
22Act and all rules and procedures of the Joint Committee on
23Administrative Rules; any purported rule not so adopted, for

 

 

HB2617- 2 -LRB100 08150 SMS 18244 b

1whatever reason, is unauthorized.
2(Source: P.A. 98-189, eff. 1-1-14; 98-1091, eff. 1-1-15;
399-480, eff. 9-9-15.)
 
4    Section 10. The Counties Code is amended by changing
5Section 5-1069.3 as follows:
 
6    (55 ILCS 5/5-1069.3)
7    Sec. 5-1069.3. Required health benefits. If a county,
8including a home rule county, is a self-insurer for purposes of
9providing health insurance coverage for its employees, the
10coverage shall include coverage for the post-mastectomy care
11benefits required to be covered by a policy of accident and
12health insurance under Section 356t and the coverage required
13under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x,
14356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
15356z.14, 356z.15, and 356z.22, and 356z.25 of the Illinois
16Insurance Code. The coverage shall comply with Sections
17155.22a, 355b, 356z.19, and 370c of the Illinois Insurance
18Code. The requirement that health benefits be covered as
19provided in this Section is an exclusive power and function of
20the State and is a denial and limitation under Article VII,
21Section 6, subsection (h) of the Illinois Constitution. A home
22rule county to which this Section applies must comply with
23every provision of this Section.
24    Rulemaking authority to implement Public Act 95-1045, if

 

 

HB2617- 3 -LRB100 08150 SMS 18244 b

1any, is conditioned on the rules being adopted in accordance
2with all provisions of the Illinois Administrative Procedure
3Act and all rules and procedures of the Joint Committee on
4Administrative Rules; any purported rule not so adopted, for
5whatever reason, is unauthorized.
6(Source: P.A. 98-189, eff. 1-1-14; 98-1091, eff. 1-1-15;
799-480, eff. 9-9-15.)
 
8    Section 15. The Illinois Municipal Code is amended by
9changing Section 10-4-2.3 as follows:
 
10    (65 ILCS 5/10-4-2.3)
11    Sec. 10-4-2.3. Required health benefits. If a
12municipality, including a home rule municipality, is a
13self-insurer for purposes of providing health insurance
14coverage for its employees, the coverage shall include coverage
15for the post-mastectomy care benefits required to be covered by
16a policy of accident and health insurance under Section 356t
17and the coverage required under Sections 356g, 356g.5,
18356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.10,
19356z.11, 356z.12, 356z.13, 356z.14, 356z.15, and 356z.22 , and
20356z.25 of the Illinois Insurance Code. The coverage shall
21comply with Sections 155.22a, 355b, 356z.19, and 370c of the
22Illinois Insurance Code. The requirement that health benefits
23be covered as provided in this is an exclusive power and
24function of the State and is a denial and limitation under

 

 

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1Article VII, Section 6, subsection (h) of the Illinois
2Constitution. A home rule municipality to which this Section
3applies must comply with every provision of this Section.
4    Rulemaking authority to implement Public Act 95-1045, if
5any, is conditioned on the rules being adopted in accordance
6with all provisions of the Illinois Administrative Procedure
7Act and all rules and procedures of the Joint Committee on
8Administrative Rules; any purported rule not so adopted, for
9whatever reason, is unauthorized.
10(Source: P.A. 98-189, eff. 1-1-14; 98-1091, eff. 1-1-15;
1199-480, eff. 9-9-15.)
 
12    Section 20. The School Code is amended by changing Section
1310-22.3f as follows:
 
14    (105 ILCS 5/10-22.3f)
15    Sec. 10-22.3f. Required health benefits. Insurance
16protection and benefits for employees shall provide the
17post-mastectomy care benefits required to be covered by a
18policy of accident and health insurance under Section 356t and
19the coverage required under Sections 356g, 356g.5, 356g.5-1,
20356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.11, 356z.12,
21356z.13, 356z.14, 356z.15, and 356z.22, and 356z.25 of the
22Illinois Insurance Code. Insurance policies shall comply with
23Section 356z.19 of the Illinois Insurance Code. The coverage
24shall comply with Sections 155.22a and 355b of the Illinois

 

 

HB2617- 5 -LRB100 08150 SMS 18244 b

1Insurance Code.
2    Rulemaking authority to implement Public Act 95-1045, if
3any, is conditioned on the rules being adopted in accordance
4with all provisions of the Illinois Administrative Procedure
5Act and all rules and procedures of the Joint Committee on
6Administrative Rules; any purported rule not so adopted, for
7whatever reason, is unauthorized.
8(Source: P.A. 97-282, eff. 8-9-11; 97-343, eff. 1-1-12; 97-813,
9eff. 7-13-12; 98-189, eff. 1-1-14; 98-1091, eff. 1-1-15.)
 
10    Section 25. The Illinois Insurance Code is amended by
11adding Section 356z.25 as follows:
 
12    (215 ILCS 5/356z.25 new)
13    Sec. 356z.25. Coverage for fertility preservation
14treatments.
15    (a) As used in this Section, "iatrogenic infertility" means
16in impairment of fertility by surgery, radiation,
17chemotherapy, or other medical treatment affecting
18reproductive organs or processes.
19    (b) An individual or group policy of accident and health
20insurance amended, delivered, issued, or renewed in this State
21after the effective date of this amendatory Act of the 100th
22General Assembly must provide coverage for medically necessary
23expenses for standard fertility preservation services when a
24necessary medical treatment may directly or indirectly cause

 

 

HB2617- 6 -LRB100 08150 SMS 18244 b

1iatrogenic infertility to an enrollee.
2    (c) In determining coverage pursuant to this Section, an
3insurer shall not discriminate based on an individuals expected
4length of life, present or predicted disability, degree of
5medical dependency, quality of life, or other health
6conditions, nor based on personal characteristics, including
7age, sex, sexual orientation, or marital status.
 
8    Section 30. The Health Maintenance Organization Act is
9amended by changing Section 5-3 as follows:
 
10    (215 ILCS 125/5-3)  (from Ch. 111 1/2, par. 1411.2)
11    (Text of Section before amendment by P.A. 99-761)
12    Sec. 5-3. Insurance Code provisions.
13    (a) Health Maintenance Organizations shall be subject to
14the provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
15141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154,
16154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 355.2, 355.3,
17355b, 356g.5-1, 356m, 356v, 356w, 356x, 356y, 356z.2, 356z.4,
18356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12,
19356z.13, 356z.14, 356z.15, 356z.17, 356z.18, 356z.19, 356z.21,
20356z.22, 356z.25, 364.01, 367.2, 367.2-5, 367i, 368a, 368b,
21368c, 368d, 368e, 370c, 370c.1, 401, 401.1, 402, 403, 403A,
22408, 408.2, 409, 412, 444, and 444.1, paragraph (c) of
23subsection (2) of Section 367, and Articles IIA, VIII 1/2, XII,
24XII 1/2, XIII, XIII 1/2, XXV, and XXVI of the Illinois

 

 

HB2617- 7 -LRB100 08150 SMS 18244 b

1Insurance Code.
2    (b) For purposes of the Illinois Insurance Code, except for
3Sections 444 and 444.1 and Articles XIII and XIII 1/2, Health
4Maintenance Organizations in the following categories are
5deemed to be "domestic companies":
6        (1) a corporation authorized under the Dental Service
7    Plan Act or the Voluntary Health Services Plans Act;
8        (2) a corporation organized under the laws of this
9    State; or
10        (3) a corporation organized under the laws of another
11    state, 30% or more of the enrollees of which are residents
12    of this State, except a corporation subject to
13    substantially the same requirements in its state of
14    organization as is a "domestic company" under Article VIII
15    1/2 of the Illinois Insurance Code.
16    (c) In considering the merger, consolidation, or other
17acquisition of control of a Health Maintenance Organization
18pursuant to Article VIII 1/2 of the Illinois Insurance Code,
19        (1) the Director shall give primary consideration to
20    the continuation of benefits to enrollees and the financial
21    conditions of the acquired Health Maintenance Organization
22    after the merger, consolidation, or other acquisition of
23    control takes effect;
24        (2)(i) the criteria specified in subsection (1)(b) of
25    Section 131.8 of the Illinois Insurance Code shall not
26    apply and (ii) the Director, in making his determination

 

 

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1    with respect to the merger, consolidation, or other
2    acquisition of control, need not take into account the
3    effect on competition of the merger, consolidation, or
4    other acquisition of control;
5        (3) the Director shall have the power to require the
6    following information:
7            (A) certification by an independent actuary of the
8        adequacy of the reserves of the Health Maintenance
9        Organization sought to be acquired;
10            (B) pro forma financial statements reflecting the
11        combined balance sheets of the acquiring company and
12        the Health Maintenance Organization sought to be
13        acquired as of the end of the preceding year and as of
14        a date 90 days prior to the acquisition, as well as pro
15        forma financial statements reflecting projected
16        combined operation for a period of 2 years;
17            (C) a pro forma business plan detailing an
18        acquiring party's plans with respect to the operation
19        of the Health Maintenance Organization sought to be
20        acquired for a period of not less than 3 years; and
21            (D) such other information as the Director shall
22        require.
23    (d) The provisions of Article VIII 1/2 of the Illinois
24Insurance Code and this Section 5-3 shall apply to the sale by
25any health maintenance organization of greater than 10% of its
26enrollee population (including without limitation the health

 

 

HB2617- 9 -LRB100 08150 SMS 18244 b

1maintenance organization's right, title, and interest in and to
2its health care certificates).
3    (e) In considering any management contract or service
4agreement subject to Section 141.1 of the Illinois Insurance
5Code, the Director (i) shall, in addition to the criteria
6specified in Section 141.2 of the Illinois Insurance Code, take
7into account the effect of the management contract or service
8agreement on the continuation of benefits to enrollees and the
9financial condition of the health maintenance organization to
10be managed or serviced, and (ii) need not take into account the
11effect of the management contract or service agreement on
12competition.
13    (f) Except for small employer groups as defined in the
14Small Employer Rating, Renewability and Portability Health
15Insurance Act and except for medicare supplement policies as
16defined in Section 363 of the Illinois Insurance Code, a Health
17Maintenance Organization may by contract agree with a group or
18other enrollment unit to effect refunds or charge additional
19premiums under the following terms and conditions:
20        (i) the amount of, and other terms and conditions with
21    respect to, the refund or additional premium are set forth
22    in the group or enrollment unit contract agreed in advance
23    of the period for which a refund is to be paid or
24    additional premium is to be charged (which period shall not
25    be less than one year); and
26        (ii) the amount of the refund or additional premium

 

 

HB2617- 10 -LRB100 08150 SMS 18244 b

1    shall not exceed 20% of the Health Maintenance
2    Organization's profitable or unprofitable experience with
3    respect to the group or other enrollment unit for the
4    period (and, for purposes of a refund or additional
5    premium, the profitable or unprofitable experience shall
6    be calculated taking into account a pro rata share of the
7    Health Maintenance Organization's administrative and
8    marketing expenses, but shall not include any refund to be
9    made or additional premium to be paid pursuant to this
10    subsection (f)). The Health Maintenance Organization and
11    the group or enrollment unit may agree that the profitable
12    or unprofitable experience may be calculated taking into
13    account the refund period and the immediately preceding 2
14    plan years.
15    The Health Maintenance Organization shall include a
16statement in the evidence of coverage issued to each enrollee
17describing the possibility of a refund or additional premium,
18and upon request of any group or enrollment unit, provide to
19the group or enrollment unit a description of the method used
20to calculate (1) the Health Maintenance Organization's
21profitable experience with respect to the group or enrollment
22unit and the resulting refund to the group or enrollment unit
23or (2) the Health Maintenance Organization's unprofitable
24experience with respect to the group or enrollment unit and the
25resulting additional premium to be paid by the group or
26enrollment unit.

 

 

HB2617- 11 -LRB100 08150 SMS 18244 b

1    In no event shall the Illinois Health Maintenance
2Organization Guaranty Association be liable to pay any
3contractual obligation of an insolvent organization to pay any
4refund authorized under this Section.
5    (g) Rulemaking authority to implement Public Act 95-1045,
6if any, is conditioned on the rules being adopted in accordance
7with all provisions of the Illinois Administrative Procedure
8Act and all rules and procedures of the Joint Committee on
9Administrative Rules; any purported rule not so adopted, for
10whatever reason, is unauthorized.
11(Source: P.A. 97-282, eff. 8-9-11; 97-343, eff. 1-1-12; 97-437,
12eff. 8-18-11; 97-486, eff. 1-1-12; 97-592, eff. 1-1-12; 97-805,
13eff. 1-1-13; 97-813, eff. 7-13-12; 98-189, eff. 1-1-14;
1498-1091, eff. 1-1-15.)
 
15    (Text of Section after amendment by P.A. 99-761)
16    Sec. 5-3. Insurance Code provisions.
17    (a) Health Maintenance Organizations shall be subject to
18the provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
19141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154,
20154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 355.2, 355.3,
21355b, 356g.5-1, 356m, 356v, 356w, 356x, 356y, 356z.2, 356z.4,
22356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12,
23356z.13, 356z.14, 356z.15, 356z.17, 356z.18, 356z.19, 356z.21,
24356z.22, 356z.25, 364, 364.01, 367.2, 367.2-5, 367i, 368a,
25368b, 368c, 368d, 368e, 370c, 370c.1, 401, 401.1, 402, 403,

 

 

HB2617- 12 -LRB100 08150 SMS 18244 b

1403A, 408, 408.2, 409, 412, 444, and 444.1, paragraph (c) of
2subsection (2) of Section 367, and Articles IIA, VIII 1/2, XII,
3XII 1/2, XIII, XIII 1/2, XXV, and XXVI of the Illinois
4Insurance Code.
5    (b) For purposes of the Illinois Insurance Code, except for
6Sections 444 and 444.1 and Articles XIII and XIII 1/2, Health
7Maintenance Organizations in the following categories are
8deemed to be "domestic companies":
9        (1) a corporation authorized under the Dental Service
10    Plan Act or the Voluntary Health Services Plans Act;
11        (2) a corporation organized under the laws of this
12    State; or
13        (3) a corporation organized under the laws of another
14    state, 30% or more of the enrollees of which are residents
15    of this State, except a corporation subject to
16    substantially the same requirements in its state of
17    organization as is a "domestic company" under Article VIII
18    1/2 of the Illinois Insurance Code.
19    (c) In considering the merger, consolidation, or other
20acquisition of control of a Health Maintenance Organization
21pursuant to Article VIII 1/2 of the Illinois Insurance Code,
22        (1) the Director shall give primary consideration to
23    the continuation of benefits to enrollees and the financial
24    conditions of the acquired Health Maintenance Organization
25    after the merger, consolidation, or other acquisition of
26    control takes effect;

 

 

HB2617- 13 -LRB100 08150 SMS 18244 b

1        (2)(i) the criteria specified in subsection (1)(b) of
2    Section 131.8 of the Illinois Insurance Code shall not
3    apply and (ii) the Director, in making his determination
4    with respect to the merger, consolidation, or other
5    acquisition of control, need not take into account the
6    effect on competition of the merger, consolidation, or
7    other acquisition of control;
8        (3) the Director shall have the power to require the
9    following information:
10            (A) certification by an independent actuary of the
11        adequacy of the reserves of the Health Maintenance
12        Organization sought to be acquired;
13            (B) pro forma financial statements reflecting the
14        combined balance sheets of the acquiring company and
15        the Health Maintenance Organization sought to be
16        acquired as of the end of the preceding year and as of
17        a date 90 days prior to the acquisition, as well as pro
18        forma financial statements reflecting projected
19        combined operation for a period of 2 years;
20            (C) a pro forma business plan detailing an
21        acquiring party's plans with respect to the operation
22        of the Health Maintenance Organization sought to be
23        acquired for a period of not less than 3 years; and
24            (D) such other information as the Director shall
25        require.
26    (d) The provisions of Article VIII 1/2 of the Illinois

 

 

HB2617- 14 -LRB100 08150 SMS 18244 b

1Insurance Code and this Section 5-3 shall apply to the sale by
2any health maintenance organization of greater than 10% of its
3enrollee population (including without limitation the health
4maintenance organization's right, title, and interest in and to
5its health care certificates).
6    (e) In considering any management contract or service
7agreement subject to Section 141.1 of the Illinois Insurance
8Code, the Director (i) shall, in addition to the criteria
9specified in Section 141.2 of the Illinois Insurance Code, take
10into account the effect of the management contract or service
11agreement on the continuation of benefits to enrollees and the
12financial condition of the health maintenance organization to
13be managed or serviced, and (ii) need not take into account the
14effect of the management contract or service agreement on
15competition.
16    (f) Except for small employer groups as defined in the
17Small Employer Rating, Renewability and Portability Health
18Insurance Act and except for medicare supplement policies as
19defined in Section 363 of the Illinois Insurance Code, a Health
20Maintenance Organization may by contract agree with a group or
21other enrollment unit to effect refunds or charge additional
22premiums under the following terms and conditions:
23        (i) the amount of, and other terms and conditions with
24    respect to, the refund or additional premium are set forth
25    in the group or enrollment unit contract agreed in advance
26    of the period for which a refund is to be paid or

 

 

HB2617- 15 -LRB100 08150 SMS 18244 b

1    additional premium is to be charged (which period shall not
2    be less than one year); and
3        (ii) the amount of the refund or additional premium
4    shall not exceed 20% of the Health Maintenance
5    Organization's profitable or unprofitable experience with
6    respect to the group or other enrollment unit for the
7    period (and, for purposes of a refund or additional
8    premium, the profitable or unprofitable experience shall
9    be calculated taking into account a pro rata share of the
10    Health Maintenance Organization's administrative and
11    marketing expenses, but shall not include any refund to be
12    made or additional premium to be paid pursuant to this
13    subsection (f)). The Health Maintenance Organization and
14    the group or enrollment unit may agree that the profitable
15    or unprofitable experience may be calculated taking into
16    account the refund period and the immediately preceding 2
17    plan years.
18    The Health Maintenance Organization shall include a
19statement in the evidence of coverage issued to each enrollee
20describing the possibility of a refund or additional premium,
21and upon request of any group or enrollment unit, provide to
22the group or enrollment unit a description of the method used
23to calculate (1) the Health Maintenance Organization's
24profitable experience with respect to the group or enrollment
25unit and the resulting refund to the group or enrollment unit
26or (2) the Health Maintenance Organization's unprofitable

 

 

HB2617- 16 -LRB100 08150 SMS 18244 b

1experience with respect to the group or enrollment unit and the
2resulting additional premium to be paid by the group or
3enrollment unit.
4    In no event shall the Illinois Health Maintenance
5Organization Guaranty Association be liable to pay any
6contractual obligation of an insolvent organization to pay any
7refund authorized under this Section.
8    (g) Rulemaking authority to implement Public Act 95-1045,
9if any, is conditioned on the rules being adopted in accordance
10with all provisions of the Illinois Administrative Procedure
11Act and all rules and procedures of the Joint Committee on
12Administrative Rules; any purported rule not so adopted, for
13whatever reason, is unauthorized.
14(Source: P.A. 98-189, eff. 1-1-14; 98-1091, eff. 1-1-15;
1599-761, eff. 1-1-18.)
 
16    Section 35. The Limited Health Service Organization Act is
17amended by changing Section 4003 as follows:
 
18    (215 ILCS 130/4003)  (from Ch. 73, par. 1504-3)
19    Sec. 4003. Illinois Insurance Code provisions. Limited
20health service organizations shall be subject to the provisions
21of Sections 133, 134, 136, 137, 139, 140, 141.1, 141.2, 141.3,
22143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5, 154.6,
23154.7, 154.8, 155.04, 155.37, 355.2, 355.3, 355b, 356v,
24356z.10, 356z.21, 356z.22, 356z.25, 368a, 401, 401.1, 402, 403,

 

 

HB2617- 17 -LRB100 08150 SMS 18244 b

1403A, 408, 408.2, 409, 412, 444, and 444.1 and Articles IIA,
2VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, and XXVI of the
3Illinois Insurance Code. For purposes of the Illinois Insurance
4Code, except for Sections 444 and 444.1 and Articles XIII and
5XIII 1/2, limited health service organizations in the following
6categories are deemed to be domestic companies:
7        (1) a corporation under the laws of this State; or
8        (2) a corporation organized under the laws of another
9    state, 30% or of more of the enrollees of which are
10    residents of this State, except a corporation subject to
11    substantially the same requirements in its state of
12    organization as is a domestic company under Article VIII
13    1/2 of the Illinois Insurance Code.
14(Source: P.A. 97-486, eff. 1-1-12; 97-592, 1-1-12; 97-805, eff.
151-1-13; 97-813, eff. 7-13-12; 98-189, eff. 1-1-14; 98-1091,
16eff. 1-1-15; revised 10-5-16.)
 
17    Section 40. The Voluntary Health Services Plans Act is
18amended by changing Section 10 as follows:
 
19    (215 ILCS 165/10)  (from Ch. 32, par. 604)
20    Sec. 10. Application of Insurance Code provisions. Health
21services plan corporations and all persons interested therein
22or dealing therewith shall be subject to the provisions of
23Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,
24143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b, 356g,

 

 

HB2617- 18 -LRB100 08150 SMS 18244 b

1356g.5, 356g.5-1, 356r, 356t, 356u, 356v, 356w, 356x, 356y,
2356z.1, 356z.2, 356z.4, 356z.5, 356z.6, 356z.8, 356z.9,
3356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.18,
4356z.19, 356z.21, 356z.22, 356z.25, 364.01, 367.2, 368a, 401,
5401.1, 402, 403, 403A, 408, 408.2, and 412, and paragraphs (7)
6and (15) of Section 367 of the Illinois Insurance Code.
7    Rulemaking authority to implement Public Act 95-1045, if
8any, is conditioned on the rules being adopted in accordance
9with all provisions of the Illinois Administrative Procedure
10Act and all rules and procedures of the Joint Committee on
11Administrative Rules; any purported rule not so adopted, for
12whatever reason, is unauthorized.
13(Source: P.A. 97-282, eff. 8-9-11; 97-343, eff. 1-1-12; 97-486,
14eff. 1-1-12; 97-592, eff. 1-1-12; 97-805, eff. 1-1-13; 97-813,
15eff. 7-13-12; 98-189, eff. 1-1-14; 98-1091, eff. 1-1-15.)
 
16    Section 45. The Illinois Public Aid Code is amended by
17changing Section 5-16.8 as follows:
 
18    (305 ILCS 5/5-16.8)
19    Sec. 5-16.8. Required health benefits. The medical
20assistance program shall (i) provide the post-mastectomy care
21benefits required to be covered by a policy of accident and
22health insurance under Section 356t and the coverage required
23under Sections 356g.5, 356u, 356w, 356x, and 356z.6, and
24356z.25 of the Illinois Insurance Code and (ii) be subject to

 

 

HB2617- 19 -LRB100 08150 SMS 18244 b

1the provisions of Sections 356z.19, 364.01, 370c, and 370c.1 of
2the Illinois Insurance Code.
3    On and after July 1, 2012, the Department shall reduce any
4rate of reimbursement for services or other payments or alter
5any methodologies authorized by this Code to reduce any rate of
6reimbursement for services or other payments in accordance with
7Section 5-5e.
8    To ensure full access to the benefits set forth in this
9Section, on and after January 1, 2016, the Department shall
10ensure that provider and hospital reimbursement for
11post-mastectomy care benefits required under this Section are
12no lower than the Medicare reimbursement rate.
13(Source: P.A. 99-433, eff. 8-21-15; 99-480, eff. 9-9-15;
1499-642, eff. 7-28-16.)
 
15    Section 95. No acceleration or delay. Where this Act makes
16changes in a statute that is represented in this Act by text
17that is not yet or no longer in effect (for example, a Section
18represented by multiple versions), the use of that text does
19not accelerate or delay the taking effect of (i) the changes
20made by this Act or (ii) provisions derived from any other
21Public Act.