102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB4337
 
Introduced 1/5/2022, by Rep. Kelly M. Cassidy
 
SYNOPSIS AS INTRODUCED:
 

 
  
215 ILCS 5/356z.53 new
305 ILCS 5/5-16.8

     Amends the Illinois Insurance Code. Provides that an individual or group policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after the effective date of the amendatory Act shall provide coverage for aesthetic services and restorative care provided for the treatment of physical injuries to victims of domestic violence when medically necessary as determined by a physician licensed to practice medicine in all its branches. Defines "domestic violence". Makes a conforming change in the Medical Assistance Article of the Illinois Public Aid Code.
  


LRB102 21325 BMS 32066 b

FISCAL NOTE ACT MAY APPLY
 
 
A BILL FOR
 

  
HB4337LRB102 21325 BMS 32066 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 Section 356z.53 as follows:
 
6    (215 ILCS 5/356z.53 new)
7    Sec. 356z.53. Coverage for treatment for survivors of 
8domestic violence.
9    (a)   As used in this Section, "domestic violence" has the 
10meaning ascribed to that term in Section 103 of the Illinois 
11Domestic Violence Act of 1986.
12    (b)   An individual or group policy of accident and health 
13insurance or managed care plan that is amended, delivered, 
14issued, or renewed on or after the effective date of this 
15amendatory Act of the 102nd General Assembly shall provide 
16coverage for aesthetic services and restorative care provided 
17for the treatment of physical injuries to victims of domestic 
18violence when medically necessary as determined by a physician 
19licensed to practice medicine in all its branches.
 
20    Section 10. The Illinois Public Aid Code is amended  by 
21changing Section 5-16.8 as follows:
 


 
 
HB4337- 2 -LRB102 21325 BMS 32066 b

1    (305 ILCS 5/5-16.8)


2    Sec. 5-16.8. Required health benefits. The medical 
3assistance program
shall
(i) provide the post-mastectomy care 
4benefits required to be covered by a policy of
accident and 
5health insurance under Section 356t and the coverage required

6under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6, 
7356z.26, 356z.29, 356z.32, 356z.33, 356z.34, 356z.35, 356z.43, 
8356z.46, 356z.47, 356z.51, and 356z.53 and 356z.43 of the 
9Illinois
Insurance Code, (ii) be subject to the provisions of 
10Sections 356z.19, 356z.43, 356z.44, 356z.49, 364.01, 370c, and 
11370c.1 of the Illinois
Insurance Code, and (iii) be subject to 
12the provisions of subsection (d-5) of Section 10 of the 
13Network Adequacy and Transparency Act.

14    The Department, by rule, shall adopt a model similar to 
15the requirements of Section 356z.39 of the Illinois Insurance 
16Code. 
17    On and after July 1, 2012, the Department shall reduce any 
18rate of reimbursement for services or other payments or alter 
19any methodologies authorized by this Code to reduce any rate 
20of reimbursement for services or other payments in accordance 
21with Section 5-5e. 
22    To ensure full access to the benefits set forth in this 
23Section, on and after January 1, 2016, the Department shall 
24ensure that provider and hospital reimbursement  for 
25post-mastectomy care benefits required under this Section are 
26no lower than the Medicare reimbursement rate. 
 
 
HB4337- 3 -LRB102 21325 BMS 32066 b

1(Source: P.A. 101-81, eff. 7-12-19; 101-218, eff. 1-1-20; 
2101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-574, eff. 
31-1-20; 101-649, eff. 7-7-20; 102-30, eff. 1-1-22; 102-144, 
4eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 
5102-530, eff. 1-1-22; 102-642, eff. 1-1-22; revised 10-27-21.)