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| Public Act 102-0530 | ||||
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AN ACT concerning regulation.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Illinois Insurance Code is amended by | ||||
adding Sections 356z.43 and 356z.44 as follows: | ||||
(215 ILCS 5/356z.43 new) | ||||
Sec. 356z.43. A1C testing. | ||||
(a) As used in this Section, "A1C testing" means blood | ||||
sugar level testing used to diagnose prediabetes, type 1 | ||||
diabetes, and type 2 diabetes and to monitor management of | ||||
blood sugar levels. | ||||
(b) A group or individual policy of accident and health | ||||
insurance or managed care plan amended, delivered, issued, or | ||||
renewed on or after the effective date of this amendatory Act | ||||
of the 102nd General Assembly shall provide coverage for A1C | ||||
testing recommended by a health care provider for prediabetes, | ||||
type 1 diabetes, and type 2 diabetes in accordance with | ||||
prediabetes and diabetes risk factors identified by the United | ||||
States Centers for Disease Control and Prevention. | ||||
(1) Risk factors for prediabetes may include, but are | ||||
not limited to, being overweight or obese, being aged 35 | ||||
or older, having an immediate family member with type 2 | ||||
diabetes, previous diagnosis of gestational diabetes and | ||||
being African American, Hispanic or Latino American, | ||
American Indian, or Alaska Native. | ||
(2) Risk factors for type 1 diabetes may include, but | ||
are not limited to, family history of diabetes. | ||
(3) Risk factors for type 2 diabetes may include, but | ||
are not limited to, having prediabetes, being overweight | ||
or obese, being aged 35 or older, having an immediate | ||
family member with type 1 or type 2 diabetes, previous | ||
diagnosis of gestational diabetes and being African | ||
American, Hispanic or Latino American, American Indian, or | ||
Alaska Native. | ||
(215 ILCS 5/356z.44 new) | ||
Sec. 356z.44. Vitamin D testing. | ||
(a) As used in this Section, "vitamin D testing" means | ||
vitamin D blood testing that measures the level of vitamin D in | ||
an individual's blood. | ||
(b) A group or individual policy of accident and health | ||
insurance or managed care plan amended, delivered, issued, or | ||
renewed on or after the effective date of this amendatory Act | ||
of the 102nd General Assembly shall provide coverage for | ||
vitamin D testing recommended by a health care provider in | ||
accordance with vitamin D deficiency risk factors identified | ||
by the United States Centers for Disease Control and | ||
Prevention. Risk factors for vitamin D deficiency include, but | ||
are not limited to: | ||
(1) having osteoporosis or other bone-health problems; | ||
(2) having conditions that affect fat absorption, | ||
including celiac disease or weight loss surgery; | ||
(3) routinely taking medications that interfere with | ||
vitamin D activity, including anticonvulsants and | ||
glucocorticoids; | ||
(4) beneficiaries aged 55 and older; | ||
(5) having a darker skin color; | ||
(6) inadequate sunlight exposure; | ||
(7) being obese; | ||
(8) previous diagnosis of diabetes or kidney disease; | ||
and | ||
(9) exhibiting poor muscle strength or constant | ||
tiredness. | ||
Section 10. The Illinois Public Aid Code is amended by | ||
changing Section 5-16.8 as follows:
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(305 ILCS 5/5-16.8)
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Sec. 5-16.8. Required health benefits. The medical | ||
assistance program
shall
(i) provide the post-mastectomy care | ||
benefits required to be covered by a policy of
accident and | ||
health insurance under Section 356t and the coverage required
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under Sections 356g.5, 356u, 356w, 356x, 356z.6, 356z.26, | ||
356z.29, 356z.32, 356z.33, 356z.34, and 356z.35 of the | ||
Illinois
Insurance Code and (ii) be subject to the provisions | ||
of Sections 356z.19, 356z.43, 356z.44, 364.01, 370c, and | ||
370c.1 of the Illinois
Insurance Code.
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The Department, by rule, shall adopt a model similar to | ||
the requirements of Section 356z.39 of the Illinois Insurance | ||
Code. | ||
On and after July 1, 2012, the Department shall reduce any | ||
rate of reimbursement for services or other payments or alter | ||
any methodologies authorized by this Code to reduce any rate | ||
of reimbursement for services or other payments in accordance | ||
with Section 5-5e. | ||
To ensure full access to the benefits set forth in this | ||
Section, on and after January 1, 2016, the Department shall | ||
ensure that provider and hospital reimbursement for | ||
post-mastectomy care benefits required under this Section are | ||
no lower than the Medicare reimbursement rate. | ||
(Source: P.A. 100-138, eff. 8-18-17; 100-863, eff. 8-14-18; | ||
100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. | ||
7-12-19; 101-218, eff. 1-1-20; 101-281, eff. 1-1-20; 101-371, | ||
eff. 1-1-20; 101-574, eff. 1-1-20; 101-649, eff. 7-7-20.)
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