SB1854 EngrossedLRB102 16436 BMS 21828 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
5adding Sections 356z.43 and 356z.44 as follows:
6    (215 ILCS 5/356z.43 new)
7    Sec. 356z.43. A1C testing.
8    (a) As used in this Section, "A1C testing" means blood
9sugar level testing used to diagnose prediabetes, type 1
10diabetes, and type 2 diabetes and to monitor management of
11blood sugar levels.
12    (b) A group or individual policy of accident and health
13insurance or managed care plan amended, delivered, issued, or
14renewed on or after the effective date of this amendatory Act
15of the 102nd General Assembly shall provide coverage for A1C
16testing recommended by a health care provider for prediabetes,
17type 1 diabetes, and type 2 diabetes in accordance with
18prediabetes and diabetes risk factors identified by the United
19States Centers for Disease Control and Prevention.
20        (1) Risk factors for prediabetes may include, but are
21    not limited to, being overweight or obese, being aged 35
22    or older, having an immediate family member with type 2
23    diabetes, previous diagnosis of gestational diabetes and



SB1854 Engrossed- 2 -LRB102 16436 BMS 21828 b

1    being African American, Hispanic or Latino American,
2    American Indian, or Alaska Native.
3        (2) Risk factors for type 1 diabetes may include, but
4    are not limited to, family history of diabetes.
5        (3) Risk factors for type 2 diabetes may include, but
6    are not limited to, having prediabetes, being overweight
7    or obese, being aged 35 or older, having an immediate
8    family member with type 1 or type 2 diabetes, previous
9    diagnosis of gestational diabetes and being African
10    American, Hispanic or Latino American, American Indian, or
11    Alaska Native.
12    (215 ILCS 5/356z.44 new)
13    Sec. 356z.44. Vitamin D testing.
14    (a) As used in this Section, "vitamin D testing" means
15vitamin D blood testing that measures the level of vitamin D in
16an individual's blood.
17    (b) A group or individual policy of accident and health
18insurance or managed care plan amended, delivered, issued, or
19renewed on or after the effective date of this amendatory Act
20of the 102nd General Assembly shall provide coverage for
21vitamin D testing recommended by a health care provider in
22accordance with vitamin D deficiency risk factors identified
23by the United States Centers for Disease Control and
24Prevention. Risk factors for vitamin D deficiency include, but
25are not limited to:



SB1854 Engrossed- 3 -LRB102 16436 BMS 21828 b

1        (1) having osteoporosis or other bone-health problems;
2        (2) having conditions that affect fat absorption,
3    including celiac disease or weight loss surgery;
4        (3) routinely taking medications that interfere with
5    vitamin D activity, including anticonvulsants and
6    glucocorticoids;
7        (4) beneficiaries aged 55 and older;
8        (5) having a darker skin color;
9        (6) inadequate sunlight exposure;
10        (7) being obese;
11        (8) previous diagnosis of diabetes or kidney disease;
12    and
13        (9) exhibiting poor muscle strength or constant
14    tiredness.
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
22under Sections 356g.5, 356u, 356w, 356x, 356z.6, 356z.26,
23356z.29, 356z.32, 356z.33, 356z.34, and 356z.35 of the
24Illinois Insurance Code and (ii) be subject to the provisions



SB1854 Engrossed- 4 -LRB102 16436 BMS 21828 b

1of Sections 356z.19, 356z.43, 356z.44, 364.01, 370c, and
2370c.1 of the Illinois Insurance Code.
3    The Department, by rule, shall adopt a model similar to
4the requirements of Section 356z.39 of the Illinois Insurance
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
9of reimbursement for services or other payments in accordance
10with Section 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; 101-649, eff. 7-7-20.)