Rep. Kelly M. Cassidy

Filed: 4/10/2024

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 5417

2    AMENDMENT NO. ______. Amend House Bill 5417 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Illinois Insurance Code is amended by
5adding Section 356z.71 as follows:
 
6    (215 ILCS 5/356z.71 new)
7    Sec. 356z.71. Coverage for home test kits for sexually
8transmitted infections (STIs).
9    (a) As used in this Section, "home test kit" means a
10product used for a test recommended by the federal Centers for
11Disease Control and Prevention guidelines or the United States
12Preventive Services Task Force that has received a certificate
13of waiver under the Clinical Laboratory Improvement Amendments
14to the federal Public Health Services Act, has been cleared or
15approved by the United States Food and Drug Administration, or
16has been developed by a laboratory in accordance with

 

 

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1established regulations and quality standards, to allow
2individuals to self-collect specimens for STIs, including HIV,
3remotely at a location outside of a clinical setting.
4    (b) An individual or group policy of accident and health
5insurance amended, delivered, issued, or renewed in this State
6after January 1, 2026 shall provide coverage for home test
7kits for sexually transmitted infections, including any
8laboratory costs of processing the kit, that are deemed
9medically necessary or appropriate and ordered directly by a
10clinician for patient use based on clinical guidelines and
11individual patient health needs.
12        (1) A commercial health care plan is required to cover
13    the services outlined in this subsection when ordered for
14    an enrollee by an in-network provider.
15        (2) Except as otherwise provided in this subsection, a
16    policy subject to this subsection shall not impose a
17    deductible, coinsurance, copayment, or any other
18    cost-sharing requirement on the coverage provided. The
19    provisions of this subsection do not apply to coverage of
20    procedures to the extent such coverage would disqualify a
21    high-deductible health plan from eligibility for a health
22    savings account pursuant to the federal Internal Revenue
23    Code, 26 U.S.C. 223.
24        (3) Except as otherwise authorized under this Section,
25    a policy shall not impose any restrictions or delays on
26    the coverage required under this Section.

 

 

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1        (4) If a plan or issuer uses a network of providers,
2    nothing in this Section shall be construed to require
3    coverage or to prohibit the plan or issuer from imposing
4    cost-sharing for items or services described in this
5    Section that are provided or delivered by an
6    out-of-network provider, unless the plan or issuer does
7    not have in its network a provider who is able to or is
8    willing to provide the applicable items or services.
 
9    Section 10. The Illinois Public Aid Code is amended by
10changing Section 5-16.8 as follows:
 
11    (305 ILCS 5/5-16.8)
12    Sec. 5-16.8. Required health benefits. The medical
13assistance program shall (i) provide the post-mastectomy care
14benefits required to be covered by a policy of accident and
15health insurance under Section 356t and the coverage required
16under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6,
17356z.26, 356z.29, 356z.32, 356z.33, 356z.34, 356z.35, 356z.46,
18356z.47, 356z.51, 356z.53, 356z.56, 356z.59, 356z.60, and
19356z.61, 356z.64, 356z.67, and 356z.71 of the Illinois
20Insurance Code, (ii) be subject to the provisions of Sections
21356z.19, 356z.44, 356z.49, 364.01, 370c, and 370c.1 of the
22Illinois Insurance Code, and (iii) be subject to the
23provisions of subsection (d-5) of Section 10 of the Network
24Adequacy and Transparency Act.

 

 

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1    The Department, by rule, shall adopt a model similar to
2the requirements of Section 356z.39 of the Illinois Insurance
3Code.
4    On and after July 1, 2012, the Department shall reduce any
5rate of reimbursement for services or other payments or alter
6any methodologies authorized by this Code to reduce any rate
7of reimbursement for services or other payments in accordance
8with Section 5-5e.
9    To ensure full access to the benefits set forth in this
10Section, on and after January 1, 2016, the Department shall
11ensure that provider and hospital reimbursement for
12post-mastectomy care benefits required under this Section are
13no lower than the Medicare reimbursement rate.
14(Source: P.A. 102-30, eff. 1-1-22; 102-144, eff. 1-1-22;
15102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-530, eff.
161-1-22; 102-642, eff. 1-1-22; 102-804, eff. 1-1-23; 102-813,
17eff. 5-13-22; 102-816, eff. 1-1-23; 102-1093, eff. 1-1-23;
18102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, eff.
191-1-24; 103-420, eff. 1-1-24; revised 12-15-23.)
 
20    Section 15. The AIDS Confidentiality Act is amended by
21adding Section 5.6 as follows:
 
22    (410 ILCS 305/5.6 new)
23    Sec. 5.6. Illinois AIDS Drug Assistance Program.
24    (a) The purpose of this Section is to expand and assist

 

 

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1with implementation of the Rapid Start for HIV treatment
2model. The pilot sites will allow the development of a
3coordinated system of health care services to provide timely
4and quality HIV treatment. This will occur by increasing the
5capacity of the Department of Public Health and build toward
6establishing the Rapid Start model as the standard of care for
7HIV treatment. This program shall be known as the Illinois
8AIDS Drug Assistance Program or Illinois ADAP.
9    (b) In this Section:
10    "Conditional approval" means Illinois ADAP approval within
11one business day after submission of documentation of Illinois
12residency, a program agreement form, and an attestation of
13remaining eligibility requirements.
14    "Rapid Start for HIV Treatment" means initiating
15antiretroviral therapy within 7 days after initial diagnosis
16or within 7 days after referral to HIV medical care as defined
17by the Centers for Disease Control and Prevention
18recommendations for HIV treatment.
19    (c) Beginning January 1, 2026, Illinois ADAP shall
20establish a pathway for conditional approval of Illinois ADAP
21enrollment for new applicants seeking to enter or reenter
22medical care. Applicants receiving conditional approval on or
23after January 1, 2026 will have 30 days to submit a complete
24Illinois ADAP application, addressing all remaining
25eligibility requirements.
26    (d) The Department of Public Health shall establish one

 

 

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1Rapid Start for HIV Treatment pilot site per HIV Care Connect
2Region. The Department may implement processes and adopt rules
3to implement this pilot program in accordance with industry
4standards informed by the most current Centers for Disease
5Control and Prevention and Health Resources and Services
6Administration guidance on HIV care and treatment.
7    (e) The pilot sites shall abide by the following
8principles:
9        (1) Nothing About Us Without Us: Pilot site programs
10    and services shall be formulated with transparency,
11    community involvement, and direct ongoing input by people
12    living with and vulnerable to HIV.
13        (2) Equity: Pilot site programs and services shall
14    provide equitable support, services, and resources to all
15    participants and ensure accessibility to the greatest
16    extent possible.
17        (3) Self-Determination: Pilot site programs and
18    services shall prioritize individual dignity and autonomy
19    in decision-making while encouraging people to connect
20    with additional services that promote health and
21    well-being.
22        (4) Reduce Stigma: Pilot site programs and services
23    shall affirm the humanity and dignity of people living
24    with or vulnerable to HIV and shall operate in a way that
25    is welcoming to reduce stigma and build trust.
26        (5) Safe Spaces: Pilot site programs and services

 

 

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1    shall prioritize relationship-building and trust among
2    partners, staff, and participants to create safe spaces.
3    (f) The Department shall compile reports from each of the
4pilot sites on the operation of the pilot program upon
5completion of the pilot period. The Department shall share a
6comprehensive report summarizing the findings of the pilot
7period with the General Assembly and the Governor's Office and
8shall make it publicly available on its Internet website. The
9report may include:
10        (1) the number offers made for enrollment;
11        (2) the number of enrolled participants;
12        (3) the number and reasons of patients declined for
13    service, when available; and
14        (4) the length of time from initial diagnosis or
15    referral to the start of HIV treatment, and, when
16    available, the length of time participants were able to
17    achieve an undetectable viral load.
18    Data shall also include demographic data on the race,
19ethnicity, age, sex, disability status, sexual orientation,
20gender identity, and primary or preferred language of program
21participants in accordance with the Data Governance and
22Organization to Support Equity and Racial Justice Act. The
23reports shall inform the Department's decisions concerning the
24continued operation of the Rapid Start for HIV treatment pilot
25program and its expansion, modification, discontinuation, or
26progress towards becoming the standard of care for HIV

 

 

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1treatment. The contents of the report shall be in accordance
2with the AIDS Confidentiality Act.
3    Implementation of this Section is subject to
4appropriations made to the Illinois Department of Public
5Health for that purpose.
 
6    Section 20. The County Jail Act is amended by changing
7Section 17.10 as follows:
 
8    (730 ILCS 125/17.10)
9    Sec. 17.10. Requirements in connection with HIV/AIDS.
10    (a) In each county other than Cook, during the medical
11admissions exam, the warden of the jail, a correctional
12officer at the jail, or a member of the jail medical staff must
13provide the prisoner with appropriate written information
14concerning human immunodeficiency virus (HIV) and acquired
15immunodeficiency syndrome (AIDS). The Department of Public
16Health and community-based organizations certified to provide
17HIV/AIDS testing must provide these informational materials to
18the warden at no cost to the county. The warden, a correctional
19officer, or a member of the jail medical staff must inform the
20prisoner of the option of being tested for infection with HIV
21by a certified local community-based agency or other available
22medical provider at no charge to the prisoner.
23    (b) In Cook County, during the medical admissions exam, an
24employee of the Cook County Health & Hospitals System must

 

 

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1provide the prisoner with appropriate information in writing,
2verbally or by video or other electronic means concerning
3human immunodeficiency virus (HIV) and acquired
4immunodeficiency syndrome (AIDS) and must also provide the
5prisoner with option of testing for infection with HIV or any
6other identified causative agent of AIDS, as well as
7counseling in connection with such testing. The Cook County
8Health & Hospitals System may provide the inmate with opt-out
9human immunodeficiency virus (HIV) testing, as defined in
10Section 4 of the AIDS Confidentiality Act, unless the inmate
11refuses. If opt-out HIV testing is conducted, the Cook County
12Health & Hospitals System shall place signs in English,
13Spanish, and other languages as needed in multiple, highly
14visible locations in the area where HIV testing is conducted
15informing inmates that they will be tested for HIV unless they
16refuse, and refusal or acceptance of testing shall be
17documented in the inmate's medical record. Pre-test
18information shall be provided to the inmate and informed
19consent obtained from the inmate as required in subsection (q)
20of Section 3 and Section 5 of the AIDS Confidentiality Act. The
21Cook County Health & Hospitals System shall follow procedures
22established by the Department of Public Health to conduct HIV
23testing and testing to confirm positive HIV test results. All
24aspects of HIV testing shall comply with the requirements of
25the AIDS Confidentiality Act, including delivery of test
26results, as determined by the Cook County Health & Hospitals

 

 

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1System in consultation with the Illinois Department of Public
2Health. Nothing in this Section shall require the Cook County
3Health & Hospitals System to offer HIV testing to inmates who
4are known to be infected with HIV. The Department of Public
5Health and community-based organizations certified to provide
6HIV/AIDS testing may provide these informational materials to
7the Bureau at no cost to the county. The testing provided under
8this subsection (b) shall consist of a test approved by the
9Illinois Department of Public Health to determine the presence
10of HIV infection, based upon recommendations of the United
11States Centers for Disease Control and Prevention. If the test
12result is positive, a reliable supplemental test based upon
13recommendations of the United States Centers for Disease
14Control and Prevention shall be administered.
15    (b-5) The Department of Corrections shall include the
16following information in the annual adult correctional
17facility public inspection report for each county:
18        (1) whether the warden of the jail, a correctional
19    officer at the jail, or a member of the jail medical staff
20    provide the prisoner with appropriate written information
21    concerning HIV and AIDS during the medical admissions
22    exam;
23        (2) whether the warden, a correctional officer, or a
24    member of the jail medical staff informs the prisoner of
25    the option of being tested for infection with HIV by a
26    certified local community-based agency or other available

 

 

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1    medical provider at no charge to the prisoner;
2        (3) whether the warden of the jail makes appropriate
3    written information or visual aids concerning HIV/AIDS
4    available to every visitor to the jail;
5        (4) for Cook County, whether an employee of the Cook
6    County Health and Hospitals System provides the prisoner
7    with appropriate information in writing, verbally, or by
8    video or other electronic means concerning HIV and AIDS
9    during the medical admissions exam; and
10        (5) for Cook County, whether an employee of the Cook
11    County Health and Hospitals System provides the prisoner
12    with the option of testing for infection with HIV or any
13    other identified causative agent of AIDS, as well as
14    counseling in connection with such testing;
15    The Department of Public Health and community-based
16organizations certified to provide HIV/AIDS testing shall
17provide these informational materials to the warden at no cost
18to the office of the county sheriff.
19    (c) In each county, the warden of the jail must make
20appropriate written information concerning HIV/AIDS available
21to every visitor to the jail. This information must include
22information concerning persons or entities to contact for
23local counseling and testing. The Department of Public Health
24and community-based organizations certified to provide
25HIV/AIDS testing must provide these informational materials to
26the warden at no cost to the office of the county sheriff.

 

 

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1    (d) Implementation of this Section is subject to
2appropriation.
3(Source: P.A. 97-244, eff. 8-4-11; 97-323, eff. 8-12-11;
497-813, eff. 7-13-12; 98-1046, eff. 1-1-15.)".