State of Illinois
91st General Assembly
Legislation

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91_HB4176enr

 
HB4176 Enrolled                                LRB9109951JSpc

 1        AN ACT concerning prescription drug information cards.

 2        Be  it  enacted  by  the People of the State of Illinois,
 3    represented in the General Assembly:

 4        Section 1.  Short title.  This Act may be  cited  as  the
 5    Uniform Prescription Drug Information Card Act.

 6        Section  5.  Legislative intent.  It is the intent of the
 7    legislature  to  lessen  patients'  waiting  times,  decrease
 8    administrative burdens for pharmacies, and  improve  care  to
 9    patients  by  minimizing  confusion,  eliminating unnecessary
10    paperwork, and streamlining the  dispensing  of  prescription
11    products  paid  for  by third-party payors. This Act shall be
12    broadly applied and interpreted to effectuate this purpose.

13        Section 10.   Definitions.  As  used  in  this  Act,  the
14    following terms have the meanings given in this Section.
15        "Department" means the Department of Insurance.
16        "Director" means the Director of Insurance.
17        "Health  benefit  plan"  means  an  accident  and  health
18    insurance  policy  or  certificate  subject  to  the Illinois
19    Insurance Code, a voluntary health services plan  subject  to
20    the Voluntary Health Services Plans Act, a health maintenance
21    organization   subscriber  contract  subject  to  the  Health
22    Maintenance Organization Act, a plan provided by  a  multiple
23    employer  welfare  arrangement, or a plan provided by another
24    benefit  arrangement.  Without  limitation,  "health  benefit
25    plan" does not mean any of the following types of insurance:
26             (1)  accident;
27             (2)  credit;
28             (3)  disability income;
29             (4)  long-term or nursing home care;
30             (5)  specified disease;
 
HB4176 Enrolled            -2-                 LRB9109951JSpc
 1             (6)  dental or vision;
 2             (7)  coverage issued as a  supplement  to  liability
 3        insurance;
 4             (8)  medical    payments    under    automobile   or
 5        homeowners;
 6             (9)  insurance under which benefits are payable with
 7        or without regard to fault as statutorily required to  be
 8        contained   in   any   liability   policy  or  equivalent
 9        self-insurance;
10             (10)  hospital income or indemnity;
11             (11)  self-insured health benefit  plans  under  the
12        federal Employee Retirement Income Security Act of 1974.

13        Section  15.  Uniform prescription drug information cards
14    required.
15        (a)  A health benefit plan that issues a  card  or  other
16    technology  and  provides  coverage for prescription drugs or
17    devices and an administrator of such a  plan  including,  but
18    not  limited  to, third-party administrators for self-insured
19    plans  and  state-administered  plans  shall  issue  to   its
20    insureds  a  card  or  other  technology  containing  uniform
21    prescription drug information.  The uniform prescription drug
22    information  card  or  other  technology  shall  specifically
23    identify and display the following mandatory data elements on
24    the front of the card:
25             (1)  BIN number;
26             (2)  Processor control number if required for claims
27        adjudication;
28             (3)  Group number;
29             (4)  Card issuer identifier;
30             (5)  Cardholder ID number; and
31             (6)  Cardholder name.
32        The  uniform  prescription drug information card or other
33    technology  shall  specifically  identify  and  display   the
 
HB4176 Enrolled            -3-                 LRB9109951JSpc
 1    following mandatory data elements on the back of the card:
 2             (1)  Claims submission names and addresses; and
 3             (2)  Help desk telephone numbers and names.
 4        (b)  A  new uniform prescription drug information card or
 5    other technology shall be issued by  a  health  benefit  plan
 6    upon enrollment and reissued upon any change in the insured's
 7    coverage  that  affects  mandatory data elements contained on
 8    the card.

 9        Section 20.  Applicability and enforcement.
10        (a)  This Act applies to health benefit  plans  that  are
11    amended,  delivered,  issued,  or  renewed  on  and after the
12    effective date of this amendatory Act  of  the  91st  General
13    Assembly.
14        (b)  The  Director may adopt rules necessary to implement
15    the Department's responsibilities under this Act.  To enforce
16    the provisions of this Act, the Director may  issue  a  cease
17    and desist order or require a health benefit plan to submit a
18    plan  of  correction  for  violations  of  this Act, or both.
19    Subject to the  provisions  of  the  Illinois  Administrative
20    Procedure  Act, the Director may, pursuant to Section 403A of
21    the Illinois Insurance Code, impose  upon  a  health  benefit
22    plan  an  administrative  fine  not  to  exceed  $250,000 for
23    failure to submit a requested plan of correction, failure  to
24    comply with its plan or correction, or repeated violations of
25    this Act.

26        Section  99.  Effective  date.   This Act takes effect on
27    January 1, 2001.

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