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1    AN ACT concerning insurance.
 
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, and 356z.17, and 356z.19 of the Illinois
16Insurance Code. The program of health benefits must comply with
17Section 155.37 of the Illinois Insurance Code.
18    Rulemaking authority to implement Public Act 95-1045, if
19any, is conditioned on the rules being adopted in accordance
20with all provisions of the Illinois Administrative Procedure
21Act and all rules and procedures of the Joint Committee on
22Administrative Rules; any purported rule not so adopted, for
23whatever reason, is unauthorized.

 

 

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1(Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07;
295-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-958, eff.
36-1-09; 95-978, eff. 1-1-09; 95-1005, eff. 12-12-08; 95-1044,
4eff. 3-26-09; 95-1045, eff. 3-27-09; 95-1049, eff. 1-1-10;
596-139, eff. 1-1-10; 96-328, eff. 8-11-09; 96-639, eff. 1-1-10;
696-1000, eff. 7-2-10.)
 
7    Section 10. The Counties Code is amended by changing
8Section 5-1069.3 as follows:
 
9    (55 ILCS 5/5-1069.3)
10    Sec. 5-1069.3. Required health benefits. If a county,
11including a home rule county, is a self-insurer for purposes of
12providing health insurance coverage for its employees, the
13coverage shall include coverage for 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, 356g.5, 356g.5-1, 356u, 356w, 356x,
17356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
18356z.14, and 356z.15, and 356z.19 of the Illinois Insurance
19Code. The requirement that health benefits be covered as
20provided in this Section is an exclusive power and function of
21the State and is a denial and limitation under Article VII,
22Section 6, subsection (h) of the Illinois Constitution. A home
23rule county to which this Section applies must comply with
24every provision of this Section.

 

 

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1    Rulemaking authority to implement Public Act 95-1045, if
2any, is conditioned on the rules being adopted in accordance
3with all provisions of the Illinois Administrative Procedure
4Act and all rules and procedures of the Joint Committee on
5Administrative Rules; any purported rule not so adopted, for
6whatever reason, is unauthorized.
7(Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07;
895-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-958, eff.
96-1-09; 95-978, eff. 1-1-09; 95-1005, eff. 12-12-08; 95-1045,
10eff. 3-27-09; 95-1049, eff. 1-1-10; 96-139, eff. 1-1-10;
1196-328, eff. 8-11-09; 96-1000, eff. 7-2-10.)
 
12    Section 15. The Illinois Municipal Code is amended by
13changing Section 10-4-2.3 as follows:
 
14    (65 ILCS 5/10-4-2.3)
15    Sec. 10-4-2.3. Required health benefits. If a
16municipality, including a home rule municipality, is a
17self-insurer for purposes of providing health insurance
18coverage for its employees, the coverage shall include coverage
19for the post-mastectomy care benefits required to be covered by
20a policy of accident and health insurance under Section 356t
21and the coverage required under Sections 356g, 356g.5,
22356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.10,
23356z.11, 356z.12, 356z.13, 356z.14, and 356z.15, and 356z.19 of
24the Illinois Insurance Code. The requirement that health

 

 

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1benefits be covered as provided in this is an exclusive power
2and function of the State and is a denial and limitation under
3Article VII, Section 6, subsection (h) of the Illinois
4Constitution. A home rule municipality to which this Section
5applies must comply with every provision of this Section.
6    Rulemaking authority to implement Public Act 95-1045, if
7any, is conditioned on the rules being adopted in accordance
8with all provisions of the Illinois Administrative Procedure
9Act and all rules and procedures of the Joint Committee on
10Administrative Rules; any purported rule not so adopted, for
11whatever reason, is unauthorized.
12(Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07;
1395-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-958, eff.
146-1-09; 95-978, eff. 1-1-09; 95-1005, eff. 12-12-08; 95-1045,
15eff. 3-27-09; 95-1049, eff. 1-1-10; 96-139, eff. 1-1-10;
1696-328, eff. 8-11-09; 96-1000, eff. 7-2-10.)
 
17    Section 20. The Illinois Insurance Code is amended by
18adding Section 356z.19 as follows:
 
19    (215 ILCS 5/356z.19 new)
20    Sec. 356z.19. Hospital patient assessments. A group or
21individual major medical policy of accident and health
22insurance or managed care plan amended, delivered, issued, or
23renewed after the effective date of this amendatory Act of the
2497th General Assembly that provides coverage for hospital care

 

 

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1shall include coverage for observation care services
2considered to be medically necessary as covered by Medicare.
3The services are subject to relevant notification on and
4reasonable review and utilization standards required by the
5policy or plan for hospital services.
 
6    Section 25. The Illinois Public Aid Code is amended by
7changing Section 5-16.8 as follows:
 
8    (305 ILCS 5/5-16.8)
9    Sec. 5-16.8. Required health benefits. The medical
10assistance program shall (i) provide 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.5, 356u, 356w, 356x, and 356z.6, and
14356z.19 of the Illinois Insurance Code and (ii) be subject to
15the provisions of Section 364.01 of the Illinois Insurance
16Code.
17(Source: P.A. 95-189, eff. 8-16-07; 95-331, eff. 8-21-07.)
 
18    Section 30. The Medical Patient Rights Act is amended by
19changing Sections 2.04 and 5 and adding Sections 5.1 and 5.2 as
20follows:
 
21    (410 ILCS 50/2.04)  (from Ch. 111 1/2, par. 5402.04)
22    Sec. 2.04. "Insurance company" means (1) an insurance

 

 

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1company, fraternal benefit society, and any other insurer
2subject to regulation under the Illinois Insurance Code; or (2)
3a health maintenance organization, a limited health service
4organization under the Limited Health Service Organization
5Act, or a voluntary health services plan under the Voluntary
6Health Services Plans Act.
7(Source: P.A. 85-677; 85-679.)
 
8    (410 ILCS 50/5)
9    Sec. 5. Statement of hospital patient's rights.
10    (a) Each patient admitted to a hospital, and the guardian
11or authorized representative or parent of a minor patient,
12shall be given a written statement of all the rights enumerated
13in this Act, or a similar statement of patients' rights
14required of the hospital by the Joint Commission on
15Accreditation of Healthcare Organizations or a similar
16accrediting organization. The statement shall be given at the
17time of admission or as soon thereafter as the condition of the
18patient permits.
19    (b) If a patient is unable to read the written statement, a
20hospital shall make a reasonable effort to provide it to the
21guardian or authorized representative of the patient.
22    (c) The statement shall also include the right not to be
23discriminated against by the hospital due to the patient's
24race, color, or national origin where such characteristics are
25not relevant to the patient's medical diagnosis and treatment.

 

 

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1The statement shall further provide each admitted patient or
2the patient's representative or guardian with notice of how to
3initiate a grievance regarding improper discrimination with
4the hospital and how the patient may lodge a grievance with the
5Department of Public Health regardless of whether the patient
6has first used the hospital's grievance process.
7(Source: P.A. 88-56; 88-670, eff. 12-2-94.)
 
8    (410 ILCS 50/5.1 new)
9    Sec. 5.1. Discrimination grievance procedures. Upon
10receipt of a grievance alleging unlawful discrimination on the
11basis of race, color, or national origin, the hospital must
12investigate the claim and work with the patient to address
13valid or proven concerns in accordance with the hospital's
14grievance process. At the conclusion of the hospital's
15grievance process, the hospital shall inform the patient that
16such grievances may be reported to the Department of Public
17Health if not resolved to the patient's satisfaction at the
18hospital level.
 
19    (410 ILCS 50/5.2 new)
20    Sec. 5.2. Emergency room antidiscrimination notice. Every
21hospital shall post a sign next to or in close proximity of its
22sign required by Section 489.20 (q)(1) of Title 42 of the Code
23of Federal Regulations stating the following:
24        "You have the right not to be discriminated against by

 

 

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1    the hospital due to your race, color, or national origin if
2    these characteristics are unrelated to your diagnosis or
3    treatment. If you believe this right has been violated,
4    please call (insert number for hospital grievance
5    officer).".
 
6    Section 99. Effective date. This Act takes effect upon
7becoming law.