101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
SB2470

 

Introduced 1/19/2020, by Sen. Laura M. Murphy

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 5/356z.41 new
305 ILCS 5/5-16.8

    Amends the Illinois Insurance Code. Provides that no individual or group policy of accident and health insurance or managed care organization shall change an insured's eligibility or coverage during a contract period. Provides that during a contract period, insureds shall have the protection and continuity of their providers, medication, covered benefits, and formulary during the contract period. Amends the Illinois Public Aid Code making conforming changes.


LRB101 17158 BMS 66559 b

 

 

A BILL FOR

 

SB2470LRB101 17158 BMS 66559 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 Illinois Insurance Code is amended by adding
5Section 356z.41 as follows:
 
6    (215 ILCS 5/356z.41 new)
7    Sec. 356z.41. Contract terms; coverage. No individual or
8group policy of accident and health insurance or managed care
9organization shall amend, deliver, issue, or renew a policy in
10a way that changes an insured's eligibility or coverage during
11a contract period. During a contract period, an insured shall
12have the protection and continuity of his or her providers, his
13or her medication, his or her covered benefits, and the
14formulary during the contract period.
 
15    Section 10. The Illinois Public Aid Code is amended by
16changing Section 5-16.8 as follows:
 
17    (305 ILCS 5/5-16.8)
18    Sec. 5-16.8. Required health benefits. The medical
19assistance program shall (i) provide the post-mastectomy care
20benefits required to be covered by a policy of accident and
21health insurance under Section 356t and the coverage required

 

 

SB2470- 2 -LRB101 17158 BMS 66559 b

1under Sections 356g.5, 356u, 356w, 356x, 356z.6, 356z.26,
2356z.29, and 356z.32, and 356z.33, 356z.34, 356z.35, 356z.39,
3and 356z.41 of the Illinois Insurance Code and (ii) be subject
4to the provisions of Sections 356z.19, 364.01, 370c, and 370c.1
5of the Illinois Insurance Code.
6    On and after July 1, 2012, the Department shall reduce any
7rate of reimbursement for services or other payments or alter
8any methodologies authorized by this Code to reduce any rate of
9reimbursement for services or other payments in accordance with
10Section 5-5e.
11    To ensure full access to the benefits set forth in this
12Section, on and after January 1, 2016, the Department shall
13ensure that provider and hospital reimbursement for
14post-mastectomy care benefits required under this Section are
15no lower than the Medicare reimbursement rate.
16(Source: P.A. 100-138, eff. 8-18-17; 100-863, eff. 8-14-18;
17100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff.
187-12-19; 101-218, eff. 1-1-20; 101-281, eff. 1-1-20; 101-371,
19eff. 1-1-20; 101-574, eff. 1-1-20; revised 10-16-19.)