Illinois General Assembly - Full Text of HB2649
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Full Text of HB2649  102nd General Assembly




HB2649 EngrossedLRB102 13887 BMS 19238 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 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
9provide the post-mastectomy care benefits required to be
10covered by a policy of accident and health insurance under
11Section 356t of the Illinois Insurance Code. The program of
12health benefits shall provide the coverage required under
13Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
14356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
15356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
16356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
17356z.36, and 356z.41 of the Illinois Insurance Code. The
18program of health benefits must comply with Sections 155.22a,
19155.37, 355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of
20the Illinois Insurance Code. The Department of Insurance shall
21enforce the requirements of this Section with respect to
22Sections 370c and 370c.1 of the Illinois Insurance Code; all
23other requirements of this Section shall be enforced by the



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1Department of Central Management Services.
2    Rulemaking authority to implement Public Act 95-1045, if
3any, is conditioned on the rules being adopted in accordance
4with all provisions of the Illinois Administrative Procedure
5Act and all rules and procedures of the Joint Committee on
6Administrative Rules; any purported rule not so adopted, for
7whatever reason, is unauthorized.
8(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
9100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
101-1-19; 100-1102, eff. 1-1-19; 100-1170, eff. 6-1-19; 101-13,
11eff. 6-12-19; 101-281, eff. 1-1-20; 101-393, eff. 1-1-20;
12101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
14    Section 10. The Illinois Insurance Code is amended by
15changing Section 356q as follows:
16    (215 ILCS 5/356q)
17    Sec. 356q. Temporomandibular joint disorder and
18craniomandibular disorder. On or after the effective date of
19this amendatory Act of the 102nd General Assembly On or after
20the effective date of this Section, every insurer which
21delivers or issues for delivery in this State a group accident
22and health policy providing coverage for hospital, medical, or
23surgical treatment on an expense-incurred basis shall offer,
24for an additional premium and subject to the insurer's



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1standard of insurability, optional coverage for the reasonable
2and necessary medical treatment of temporomandibular joint
3disorder and craniomandibular disorder. The group policyholder
4shall accept or reject the coverage in writing on the
5application or an amendment thereto for the master group
6policy. Benefits may be subject to the same pre-existing
7conditions, limitations, deductibles, co-payments and
8co-insurance that generally apply to any other sickness. The
9maximum lifetime benefits for temporomandibular joint disorder
10and craniomandibular treatment shall be no less than $2,500.
11Nothing herein shall prevent an insurer from including such
12coverage for temporomandibular joint disorder and
13craniomandibular disorder as part of a policy's basic
14coverage, in lieu of offering optional coverage.
15(Source: P.A. 88-592, eff. 1-1-95.)
16    Section 15. The Illinois Public Aid Code is amended by
17changing Section 5-16.8 as follows:
18    (305 ILCS 5/5-16.8)
19    Sec. 5-16.8. Required health benefits. The medical
20assistance program shall (i) provide the post-mastectomy care
21benefits required to be covered by a policy of accident and
22health insurance under Section 356t and the coverage required
23under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6,
24356z.26, 356z.29, 356z.32, 356z.33, 356z.34, and 356z.35 of



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1the Illinois Insurance Code and (ii) be subject to the
2provisions of Sections 356z.19, 364.01, 370c, and 370c.1 of
3the Illinois Insurance Code.
4    The Department, by rule, shall adopt a model similar to
5the requirements of Section 356z.39 of the Illinois Insurance
7    On and after July 1, 2012, the Department shall reduce any
8rate of reimbursement for services or other payments or alter
9any methodologies authorized by this Code to reduce any rate
10of reimbursement for services or other payments in accordance
11with Section 5-5e.
12    To ensure full access to the benefits set forth in this
13Section, on and after January 1, 2016, the Department shall
14ensure that provider and hospital reimbursement for
15post-mastectomy care benefits required under this Section are
16no lower than the Medicare reimbursement rate.
17(Source: P.A. 100-138, eff. 8-18-17; 100-863, eff. 8-14-18;
18100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff.
197-12-19; 101-218, eff. 1-1-20; 101-281, eff. 1-1-20; 101-371,
20eff. 1-1-20; 101-574, eff. 1-1-20; 101-649, eff. 7-7-20.)