Illinois General Assembly - Full Text of HB3509
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Full Text of HB3509  101st General Assembly

HB3509enr 101ST GENERAL ASSEMBLY

  
  
  

 


 
HB3509 EnrolledLRB101 09808 RAB 54909 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 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
17    meets quality guidelines established by the Human Milk
18    Banking Association of North America or is licensed by the
19    Department of Public Health;
20        (2) the infant's mother is medically or physically
21    unable to produce maternal breast milk or produce maternal
22    breast milk in sufficient quantities to meet the infant's
23    needs or the maternal breast milk is contraindicated;

 

 

HB3509 Enrolled- 2 -LRB101 09808 RAB 54909 b

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

 

 

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1    Banking Association of North America or is licensed by the
2    Department of Public Health;
3        (2) the child's mother is medically or physically
4    unable to produce maternal breast milk or produce maternal
5    breast milk in sufficient quantities to meet the child's
6    needs or the maternal breast milk is contraindicated;
7        (3) the milk has been determined to be medically
8    necessary for the child; and
9        (4) one or more of the following applies:
10            (A) the child has spinal muscular atrophy;
11            (B) the child's birth weight was below 1,500 grams
12        and he or she has long-term feeding or gastrointestinal
13        complications related to prematurity;
14            (C) the child has had or will have an organ
15        transplant; or
16            (D) the child has a congenital or acquired
17        condition for which the use of donated human breast
18        milk is medically necessary and supports the treatment
19        and recovery of the child.
 
20    Section 10. The Illinois Insurance Code is amended by
21adding Section 356z.33 as follows:
 
22    (215 ILCS 5/356z.33 new)
23    Sec. 356z.33. Human breast milk coverage.
24    (a) Notwithstanding any other provision of this Act,

 

 

HB3509 Enrolled- 4 -LRB101 09808 RAB 54909 b

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

 

 

HB3509 Enrolled- 5 -LRB101 09808 RAB 54909 b

1        transplant;
2            (F) the infant has sepsis; or
3            (G) the infant has any other serious congenital or
4        acquired condition for which the use of donated human
5        breast milk is medically necessary and supports the
6        treatment and recovery of the infant.
7    (b) Notwithstanding any other provision of this Act,
8pasteurized donated human breast milk, which may include human
9milk fortifiers if indicated by a prescribing licensed medical
10practitioner, shall be covered under an individual or group
11health insurance for persons who are otherwise eligible for
12coverage under this Act if the covered person is a child 6
13months through 12 months of age, a licensed medical
14practitioner prescribes the milk for the covered person, and
15all of the following conditions are met:
16        (1) the milk is obtained from a human milk bank that
17    meets quality guidelines established by the Human Milk
18    Banking Association of North America or is licensed by the
19    Department of Public Health;
20        (2) the child's mother is medically or physically
21    unable to produce maternal breast milk or produce maternal
22    breast milk in sufficient quantities to meet the child's
23    needs or the maternal breast milk is contraindicated;
24        (3) the milk has been determined to be medically
25    necessary for the child; and
26        (4) one or more of the following applies:

 

 

HB3509 Enrolled- 6 -LRB101 09808 RAB 54909 b

1            (A) the child has spinal muscular atrophy;
2            (B) the child's birth weight was below 1,500 grams
3        and he or she has long-term feeding or gastrointestinal
4        complications related to prematurity;
5            (C) the child has had or will have an organ
6        transplant; or
7            (D) the child has a congenital or acquired
8        condition for which the use of donated human breast
9        milk is medically necessary and supports the treatment
10        and recovery of the child.
 
11    Section 15. The Illinois Public Aid Code is amended by
12adding Section 5-40 as follows:
 
13    (305 ILCS 5/5-40 new)
14    Sec. 5-40. Human breast milk coverage.
15    (a) Notwithstanding any other provision of this Act,
16pasteurized donated human breast milk, which may include human
17milk fortifiers if indicated by a prescribing licensed medical
18practitioner, shall be covered under a health plan for persons
19who are otherwise eligible for coverage under this Act if the
20covered person is an infant under the age of 6 months, a
21licensed medical practitioner prescribes the milk for the
22covered person, and all of the following conditions are met:
23        (1) the milk is obtained from a human milk bank that
24    meets quality guidelines established by the Human Milk

 

 

HB3509 Enrolled- 7 -LRB101 09808 RAB 54909 b

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

 

 

HB3509 Enrolled- 8 -LRB101 09808 RAB 54909 b

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

 

 

HB3509 Enrolled- 9 -LRB101 09808 RAB 54909 b

1pasteurized donated human breast milk, which may include human
2milk fortifiers if indicated by a prescribing licensed medical
3practitioner, shall be covered under a health plan for persons
4who are otherwise eligible for coverage under this Act if the
5covered person is a child 12 months of age or older, a licensed
6medical practitioner prescribes the milk for the covered
7person, and all of the following conditions are met:
8        (1) the milk is obtained from a human milk bank that
9    meets quality guidelines established by the Human Milk
10    Banking Association of North America or is licensed by the
11    Department of Public Health;
12        (2) the child's mother is medically or physically
13    unable to produce maternal breast milk or produce maternal
14    breast milk in sufficient quantities to meet the child's
15    needs or the maternal breast milk is contraindicated;
16        (3) the milk has been determined to be medically
17    necessary for the child; and
18        (4) the child has spinal muscular atrophy.
 
19    Section 99. Effective date. This Act takes effect January
201, 2020.