Sen. Rachelle Crowe

Filed: 5/8/2019

 

 


 

 


 
10100HB3509sam002LRB101 09808 RPS 60425 a

1
AMENDMENT TO HOUSE BILL 3509

2    AMENDMENT NO. ______. Amend House Bill 3509 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The State Employees Group Insurance Act of 1971
5is amended by adding Section 6.16 as follows:
 
6    (5 ILCS 375/6.16 new)
7    Sec. 6.16. Human breast milk coverage.
8    (a) Notwithstanding any other provision of this Act,
9pasteurized donated human breast milk, which may include human
10milk fortifiers if indicated by a prescribing licensed medical
11practitioner, shall be covered under a health plan for persons
12who are otherwise eligible for coverage under this Act if the
13covered person is an infant under the age of 6 months, a
14licensed medical practitioner prescribes the milk for the
15covered person, and all of the following conditions are met:
16        (1) the milk is obtained from a human milk bank that

 

 

10100HB3509sam002- 2 -LRB101 09808 RPS 60425 a

1    meets quality guidelines established by the Human Milk
2    Banking Association of North America or is licensed by the
3    Department of Public Health;
4        (2) the infant's mother is medically or physically
5    unable to produce maternal breast milk or produce maternal
6    breast milk in sufficient quantities to meet the infant's
7    needs or the maternal breast milk is contraindicated;
8        (3) the milk has been determined to be medically
9    necessary for the infant; and
10        (4) one or more of the following applies:
11            (A) the infant's birth weight is below 1,500 grams;
12            (B) the infant has a congenital or acquired
13        condition that places the infant at a high risk for
14        development of necrotizing enterocolitis;
15            (C) the infant has infant hypoglycemia;
16            (D) the infant has congenital heart disease;
17            (E) the infant has had or will have an organ
18        transplant;
19            (F) the infant has sepsis; or
20            (G) the infant has any other serious congenital or
21        acquired condition for which the use of donated human
22        breast milk is medically necessary and supports the
23        treatment and recovery of the infant.
24    (b) Notwithstanding any other provision of this Act,
25pasteurized donated human breast milk, which may include human
26milk fortifiers if indicated by a prescribing licensed medical

 

 

10100HB3509sam002- 3 -LRB101 09808 RPS 60425 a

1practitioner, shall be covered under a health plan for persons
2who are otherwise eligible for coverage under this Act if the
3covered person is a child 6 months of age or older, a licensed
4medical practitioner prescribes the milk for the covered
5person, and all of the following conditions are met:
6        (1) the milk is obtained from a human milk bank that
7    meets quality guidelines established by the Human Milk
8    Banking Association of North America or is licensed by the
9    Department of Public Health;
10        (2) the child's mother is medically or physically
11    unable to produce maternal breast milk or produce maternal
12    breast milk in sufficient quantities to meet the child's
13    needs or the maternal breast milk is contraindicated;
14        (3) the milk has been determined to be medically
15    necessary for the child; and
16        (4) one or more of the following applies:
17            (A) the child has spinal muscular atrophy;
18            (B) the child's birth weight was below 1,500 grams
19        and he or she has long-term feeding or gastrointestinal
20        complications related to prematurity;
21            (C) the child has had or will have an organ
22        transplant; or
23            (D) the child has a congenital or acquired
24        condition for which the use of donated human breast
25        milk is medically necessary and supports the treatment
26        and recovery of the child.
 

 

 

10100HB3509sam002- 4 -LRB101 09808 RPS 60425 a

1    Section 10. The Illinois Insurance Code is amended by
2adding Section 356z.33 as follows:
 
3    (215 ILCS 5/356z.33 new)
4    Sec. 356z.33. Human breast milk coverage.
5    (a) Notwithstanding any other provision of this Act,
6pasteurized donated human breast milk, which may include human
7milk fortifiers if indicated by a prescribing licensed medical
8practitioner, shall be covered under an individual or group
9health insurance for persons who are otherwise eligible for
10coverage under this Act if the covered person is an infant
11under the age of 6 months, a licensed medical practitioner
12prescribes the milk for the covered person, and all of the
13following conditions are met:
14        (1) the milk is obtained from a human milk bank that
15    meets quality guidelines established by the Human Milk
16    Banking Association of North America or is licensed by the
17    Department of Public Health;
18        (2) the infant's mother is medically or physically
19    unable to produce maternal breast milk or produce maternal
20    breast milk in sufficient quantities to meet the infant's
21    needs or the maternal breast milk is contraindicated;
22        (3) the milk has been determined to be medically
23    necessary for the infant; and
24        (4) one or more of the following applies:

 

 

10100HB3509sam002- 5 -LRB101 09808 RPS 60425 a

1            (A) the infant's birth weight is below 1,500 grams;
2            (B) the infant has a congenital or acquired
3        condition that places the infant at a high risk for
4        development of necrotizing enterocolitis;
5            (C) the infant has infant hypoglycemia;
6            (D) the infant has congenital heart disease;
7            (E) the infant has had or will have an organ
8        transplant;
9            (F) the infant has sepsis; or
10            (G) the infant has any other serious congenital or
11        acquired condition for which the use of donated human
12        breast milk is medically necessary and supports the
13        treatment and recovery of the infant.
14    (b) Notwithstanding any other provision of this Act,
15pasteurized donated human breast milk, which may include human
16milk fortifiers if indicated by a prescribing licensed medical
17practitioner, shall be covered under an individual or group
18health insurance for persons who are otherwise eligible for
19coverage under this Act if the covered person is a child 6
20months of age or older, a licensed medical practitioner
21prescribes the milk for the covered person, and all of the
22following conditions are met:
23        (1) the milk is obtained from a human milk bank that
24    meets quality guidelines established by the Human Milk
25    Banking Association of North America or is licensed by the
26    Department of Public Health;

 

 

10100HB3509sam002- 6 -LRB101 09808 RPS 60425 a

1        (2) the child's mother is medically or physically
2    unable to produce maternal breast milk or produce maternal
3    breast milk in sufficient quantities to meet the child's
4    needs or the maternal breast milk is contraindicated;
5        (3) the milk has been determined to be medically
6    necessary for the child; and
7        (4) one or more of the following applies:
8            (A) the child has spinal muscular atrophy;
9            (B) the child's birth weight was below 1,500 grams
10        and he or she has long-term feeding or gastrointestinal
11        complications related to prematurity;
12            (C) the child has had or will have an organ
13        transplant; or
14            (D) the child has a congenital or acquired
15        condition for which the use of donated human breast
16        milk is medically necessary and supports the treatment
17        and recovery of the child.
 
18    Section 15. The Illinois Public Aid Code is amended by
19adding Section 5-40 as follows:
 
20    (305 ILCS 5/5-40 new)
21    Sec. 5-40. Human breast milk coverage.
22    (a) Notwithstanding any other provision of this Act,
23pasteurized donated human breast milk, which may include human
24milk fortifiers if indicated by a prescribing licensed medical

 

 

10100HB3509sam002- 7 -LRB101 09808 RPS 60425 a

1practitioner, shall be covered under a health plan for persons
2who are otherwise eligible for coverage under this Act if the
3covered person is an infant under the age of 6 months, a
4licensed medical practitioner prescribes the milk for the
5covered person, and all of the following conditions are met:
6        (1) the milk is obtained from a human milk bank that
7    meets quality guidelines established by the Human Milk
8    Banking Association of North America or is licensed by the
9    Department of Public Health;
10        (2) the infant's mother is medically or physically
11    unable to produce maternal breast milk or produce maternal
12    breast milk in sufficient quantities to meet the infant's
13    needs or the maternal breast milk is contraindicated;
14        (3) the milk has been determined to be medically
15    necessary for the infant; and
16        (4) one or more of the following applies:
17            (A) the infant's birth weight is below 1,500 grams;
18            (B) the infant has a congenital or acquired
19        condition that places the infant at a high risk for
20        development of necrotizing enterocolitis;
21            (C) the infant has infant hypoglycemia;
22            (D) the infant has congenital heart disease;
23            (E) the infant has had or will have an organ
24        transplant;
25            (F) the infant has sepsis; or
26            (G) the infant has any other serious congenital or

 

 

10100HB3509sam002- 8 -LRB101 09808 RPS 60425 a

1        acquired condition for which the use of donated human
2        breast milk is medically necessary and supports the
3        treatment and recovery of the infant.
4    (b) Notwithstanding any other provision of this Act,
5pasteurized donated human breast milk, which may include human
6milk fortifiers if indicated by a prescribing licensed medical
7practitioner, shall be covered under a health plan for persons
8who are otherwise eligible for coverage under this Act if the
9covered person is a child 6 months of age or older, a licensed
10medical practitioner prescribes the milk for the covered
11person, and all of the following conditions are met:
12        (1) the milk is obtained from a human milk bank that
13    meets quality guidelines established by the Human Milk
14    Banking Association of North America or is licensed by the
15    Department of Public Health;
16        (2) the child's mother is medically or physically
17    unable to produce maternal breast milk or produce maternal
18    breast milk in sufficient quantities to meet the child's
19    needs or the maternal breast milk is contraindicated;
20        (3) the milk has been determined to be medically
21    necessary for the child; and
22        (4) one or more of the following applies:
23            (A) the child has spinal muscular atrophy;
24            (B) the child's birth weight was below 1,500 grams
25        and he or she has long-term feeding or gastrointestinal
26        complications related to prematurity;

 

 

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1            (C) the child has had or will have an organ
2        transplant; or
3            (D) the child has a congenital or acquired
4        condition for which the use of donated human breast
5        milk is medically necessary and supports the treatment
6        and recovery of the child.
 
7    Section 99. Effective date. This Act takes effect January
81, 2020.".