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1 | AN ACT concerning health, which may be referred to as the | ||||||
2 | Reducing Breast Cancer Disparities Act.
| ||||||
3 | Be it enacted by the People of the State of Illinois,
| ||||||
4 | represented in the General Assembly:
| ||||||
5 | Article 1. Legislative Intent | ||||||
6 | Section 1-1. Legislative intent. The General Assembly | ||||||
7 | finds that the mortality associated with breast cancer for | ||||||
8 | minority women in Illinois is significantly higher compared to | ||||||
9 | non-minority women. This disparity has grown over the last 2 | ||||||
10 | decades and is unacceptable. A recent New England Journal of | ||||||
11 | Medicine article found that even modest cost-sharing deters | ||||||
12 | women from getting a mammogram. The reduction was most | ||||||
13 | pronounced for those with lower income and less education. Many | ||||||
14 | other studies have found that women with lower family income | ||||||
15 | and those relying on public programs for healthcare access | ||||||
16 | mammography at a lower rate. It is, therefore, the intent of | ||||||
17 | this legislation to decrease health disparities as they relate | ||||||
18 | to breast cancer and to improve access for all women to quality | ||||||
19 | breast cancer screening and treatment where necessary. | ||||||
20 | Article 5. Improving State Healthcare Programs | ||||||
21 | With Respect To | ||||||
22 | Mammography And Breast Cancer Treatment |
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| |||||||
1 | Section 5-5. The Illinois Public Aid Code is amended by | ||||||
2 | changing Section 5-5 as follows: | ||||||
3 | (305 ILCS 5/5-5) (from Ch. 23, par. 5-5)
| ||||||
4 | Sec. 5-5. Medical services. The Illinois Department, by | ||||||
5 | rule, shall
determine the quantity and quality of and the rate | ||||||
6 | of reimbursement for the
medical assistance for which
payment | ||||||
7 | will be authorized, and the medical services to be provided,
| ||||||
8 | which may include all or part of the following: (1) inpatient | ||||||
9 | hospital
services; (2) outpatient hospital services; (3) other | ||||||
10 | laboratory and
X-ray services; (4) skilled nursing home | ||||||
11 | services; (5) physicians'
services whether furnished in the | ||||||
12 | office, the patient's home, a
hospital, a skilled nursing home, | ||||||
13 | or elsewhere; (6) medical care, or any
other type of remedial | ||||||
14 | care furnished by licensed practitioners; (7)
home health care | ||||||
15 | services; (8) private duty nursing service; (9) clinic
| ||||||
16 | services; (10) dental services, including prevention and | ||||||
17 | treatment of periodontal disease and dental caries disease for | ||||||
18 | pregnant women; (11) physical therapy and related
services; | ||||||
19 | (12) prescribed drugs, dentures, and prosthetic devices; and
| ||||||
20 | eyeglasses prescribed by a physician skilled in the diseases of | ||||||
21 | the eye,
or by an optometrist, whichever the person may select; | ||||||
22 | (13) other
diagnostic, screening, preventive, and | ||||||
23 | rehabilitative services; (14)
transportation and such other | ||||||
24 | expenses as may be necessary; (15) medical
treatment of sexual |
| |||||||
| |||||||
1 | assault survivors, as defined in
Section 1a of the Sexual | ||||||
2 | Assault Survivors Emergency Treatment Act, for
injuries | ||||||
3 | sustained as a result of the sexual assault, including
| ||||||
4 | examinations and laboratory tests to discover evidence which | ||||||
5 | may be used in
criminal proceedings arising from the sexual | ||||||
6 | assault; (16) the
diagnosis and treatment of sickle cell | ||||||
7 | anemia; and (17)
any other medical care, and any other type of | ||||||
8 | remedial care recognized
under the laws of this State, but not | ||||||
9 | including abortions, or induced
miscarriages or premature | ||||||
10 | births, unless, in the opinion of a physician,
such procedures | ||||||
11 | are necessary for the preservation of the life of the
woman | ||||||
12 | seeking such treatment, or except an induced premature birth
| ||||||
13 | intended to produce a live viable child and such procedure is | ||||||
14 | necessary
for the health of the mother or her unborn child. The | ||||||
15 | Illinois Department,
by rule, shall prohibit any physician from | ||||||
16 | providing medical assistance
to anyone eligible therefor under | ||||||
17 | this Code where such physician has been
found guilty of | ||||||
18 | performing an abortion procedure in a wilful and wanton
manner | ||||||
19 | upon a woman who was not pregnant at the time such abortion
| ||||||
20 | procedure was performed. The term "any other type of remedial | ||||||
21 | care" shall
include nursing care and nursing home service for | ||||||
22 | persons who rely on
treatment by spiritual means alone through | ||||||
23 | prayer for healing.
| ||||||
24 | Notwithstanding any other provision of this Section, a | ||||||
25 | comprehensive
tobacco use cessation program that includes | ||||||
26 | purchasing prescription drugs or
prescription medical devices |
| |||||||
| |||||||
1 | approved by the Food and Drug administration shall
be covered | ||||||
2 | under the medical assistance
program under this Article for | ||||||
3 | persons who are otherwise eligible for
assistance under this | ||||||
4 | Article.
| ||||||
5 | Notwithstanding any other provision of this Code, the | ||||||
6 | Illinois
Department may not require, as a condition of payment | ||||||
7 | for any laboratory
test authorized under this Article, that a | ||||||
8 | physician's handwritten signature
appear on the laboratory | ||||||
9 | test order form. The Illinois Department may,
however, impose | ||||||
10 | other appropriate requirements regarding laboratory test
order | ||||||
11 | documentation.
| ||||||
12 | The Department of Healthcare and Family Services shall | ||||||
13 | provide the following services to
persons
eligible for | ||||||
14 | assistance under this Article who are participating in
| ||||||
15 | education, training or employment programs operated by the | ||||||
16 | Department of Human
Services as successor to the Department of | ||||||
17 | Public Aid:
| ||||||
18 | (1) dental services, which shall include but not be | ||||||
19 | limited to
prosthodontics; and
| ||||||
20 | (2) eyeglasses prescribed by a physician skilled in the | ||||||
21 | diseases of the
eye, or by an optometrist, whichever the | ||||||
22 | person may select.
| ||||||
23 | The Illinois Department, by rule, may distinguish and | ||||||
24 | classify the
medical services to be provided only in accordance | ||||||
25 | with the classes of
persons designated in Section 5-2.
| ||||||
26 | The Department of Healthcare and Family Services must |
| |||||||
| |||||||
1 | provide coverage and reimbursement for amino acid-based | ||||||
2 | elemental formulas, regardless of delivery method, for the | ||||||
3 | diagnosis and treatment of (i) eosinophilic disorders and (ii) | ||||||
4 | short bowel syndrome when the prescribing physician has issued | ||||||
5 | a written order stating that the amino acid-based elemental | ||||||
6 | formula is medically necessary.
| ||||||
7 | The Illinois Department shall authorize the provision of, | ||||||
8 | and shall
authorize payment for, screening by low-dose | ||||||
9 | mammography for the presence of
occult breast cancer for women | ||||||
10 | 35 years of age or older who are eligible
for medical | ||||||
11 | assistance under this Article, as follows: | ||||||
12 | (A) A a baseline
mammogram for women 35 to 39 years of | ||||||
13 | age . and an
| ||||||
14 | (B) An annual mammogram for women 40 years of age or | ||||||
15 | older. | ||||||
16 | (C) A mammogram at the age and intervals considered | ||||||
17 | medically necessary by the woman's health care provider for | ||||||
18 | women under 40 years of age and having a family history of | ||||||
19 | breast cancer, prior personal history of breast cancer, | ||||||
20 | positive genetic testing, or other risk factors. | ||||||
21 | (D) A comprehensive ultrasound screening of an entire | ||||||
22 | breast or breasts if a mammogram demonstrates | ||||||
23 | heterogeneous or dense breast tissue, when medically | ||||||
24 | necessary as determined by a physician licensed to practice | ||||||
25 | medicine in all of its branches. | ||||||
26 | All screenings
shall
include a physical breast exam, |
| |||||||
| |||||||
1 | instruction on self-examination and
information regarding the | ||||||
2 | frequency of self-examination and its value as a
preventative | ||||||
3 | tool. For purposes of As used in this Section, "low-dose | ||||||
4 | mammography" means
the x-ray examination of the breast using | ||||||
5 | equipment dedicated specifically
for mammography, including | ||||||
6 | the x-ray tube, filter, compression device,
and image receptor, | ||||||
7 | and cassettes, with an average radiation exposure delivery
of | ||||||
8 | less than one rad per breast for mid-breast, with 2 views of an | ||||||
9 | average size for each breast. The term also includes digital | ||||||
10 | mammography.
| ||||||
11 | On and after July 1, 2008, screening and diagnostic | ||||||
12 | mammography shall be reimbursed at the same rate as the | ||||||
13 | Medicare program's rates, including the increased | ||||||
14 | reimbursement for digital mammography. | ||||||
15 | The Department shall convene an expert panel including | ||||||
16 | representatives of hospitals, free-standing mammography | ||||||
17 | facilities, and doctors, including radiologists, to establish | ||||||
18 | quality standards. Based on these quality standards, the | ||||||
19 | Department shall provide for bonus payments to mammography | ||||||
20 | facilities meeting the standards for screening and diagnosis. | ||||||
21 | The bonus payments shall be at least 15% higher than the | ||||||
22 | Medicare rates for mammography. | ||||||
23 | Subject to federal approval, the Department shall | ||||||
24 | establish a rate methodology for mammography at federally | ||||||
25 | qualified health centers and other encounter-rate clinics. | ||||||
26 | These clinics or centers may also collaborate with other |
| |||||||
| |||||||
1 | hospital-based mammography facilities. | ||||||
2 | The Department shall establish a methodology to remind | ||||||
3 | women who are age-appropriate for screening mammography, but | ||||||
4 | who have not received a mammogram within the previous 18 | ||||||
5 | months, of the importance and benefit of screening mammography. | ||||||
6 | The Department shall establish a performance goal for | ||||||
7 | primary care providers with respect to their female patients | ||||||
8 | over age 40 receiving an annual mammogram. This performance | ||||||
9 | goal shall be used to provide additional reimbursement in the | ||||||
10 | form of a quality performance bonus to primary care providers | ||||||
11 | who meet that goal. | ||||||
12 | The Department shall devise a means of case-managing or | ||||||
13 | patient navigation for beneficiaries diagnosed with breast | ||||||
14 | cancer. This program shall initially operate as a pilot program | ||||||
15 | in areas of the State with the highest incidence of mortality | ||||||
16 | related to breast cancer. At least one pilot program site shall | ||||||
17 | be in the metropolitan Chicago area and at least one site shall | ||||||
18 | be outside the metropolitan Chicago area. An evaluation of the | ||||||
19 | pilot program shall be carried out measuring health outcomes | ||||||
20 | and cost of care for those served by the pilot program compared | ||||||
21 | to similarly situated patients who are not served by the pilot | ||||||
22 | program. | ||||||
23 | Any medical or health care provider shall immediately | ||||||
24 | recommend, to
any pregnant woman who is being provided prenatal | ||||||
25 | services and is suspected
of drug abuse or is addicted as | ||||||
26 | defined in the Alcoholism and Other Drug Abuse
and Dependency |
| |||||||
| |||||||
1 | Act, referral to a local substance abuse treatment provider
| ||||||
2 | licensed by the Department of Human Services or to a licensed
| ||||||
3 | hospital which provides substance abuse treatment services. | ||||||
4 | The Department of Healthcare and Family Services
shall assure | ||||||
5 | coverage for the cost of treatment of the drug abuse or
| ||||||
6 | addiction for pregnant recipients in accordance with the | ||||||
7 | Illinois Medicaid
Program in conjunction with the Department of | ||||||
8 | Human Services.
| ||||||
9 | All medical providers providing medical assistance to | ||||||
10 | pregnant women
under this Code shall receive information from | ||||||
11 | the Department on the
availability of services under the Drug | ||||||
12 | Free Families with a Future or any
comparable program providing | ||||||
13 | case management services for addicted women,
including | ||||||
14 | information on appropriate referrals for other social services
| ||||||
15 | that may be needed by addicted women in addition to treatment | ||||||
16 | for addiction.
| ||||||
17 | The Illinois Department, in cooperation with the | ||||||
18 | Departments of Human
Services (as successor to the Department | ||||||
19 | of Alcoholism and Substance
Abuse) and Public Health, through a | ||||||
20 | public awareness campaign, may
provide information concerning | ||||||
21 | treatment for alcoholism and drug abuse and
addiction, prenatal | ||||||
22 | health care, and other pertinent programs directed at
reducing | ||||||
23 | the number of drug-affected infants born to recipients of | ||||||
24 | medical
assistance.
| ||||||
25 | Neither the Department of Healthcare and Family Services | ||||||
26 | nor the Department of Human
Services shall sanction the |
| |||||||
| |||||||
1 | recipient solely on the basis of
her substance abuse.
| ||||||
2 | The Illinois Department shall establish such regulations | ||||||
3 | governing
the dispensing of health services under this Article | ||||||
4 | as it shall deem
appropriate. The Department
should
seek the | ||||||
5 | advice of formal professional advisory committees appointed by
| ||||||
6 | the Director of the Illinois Department for the purpose of | ||||||
7 | providing regular
advice on policy and administrative matters, | ||||||
8 | information dissemination and
educational activities for | ||||||
9 | medical and health care providers, and
consistency in | ||||||
10 | procedures to the Illinois Department.
| ||||||
11 | The Illinois Department may develop and contract with | ||||||
12 | Partnerships of
medical providers to arrange medical services | ||||||
13 | for persons eligible under
Section 5-2 of this Code. | ||||||
14 | Implementation of this Section may be by
demonstration projects | ||||||
15 | in certain geographic areas. The Partnership shall
be | ||||||
16 | represented by a sponsor organization. The Department, by rule, | ||||||
17 | shall
develop qualifications for sponsors of Partnerships. | ||||||
18 | Nothing in this
Section shall be construed to require that the | ||||||
19 | sponsor organization be a
medical organization.
| ||||||
20 | The sponsor must negotiate formal written contracts with | ||||||
21 | medical
providers for physician services, inpatient and | ||||||
22 | outpatient hospital care,
home health services, treatment for | ||||||
23 | alcoholism and substance abuse, and
other services determined | ||||||
24 | necessary by the Illinois Department by rule for
delivery by | ||||||
25 | Partnerships. Physician services must include prenatal and
| ||||||
26 | obstetrical care. The Illinois Department shall reimburse |
| |||||||
| |||||||
1 | medical services
delivered by Partnership providers to clients | ||||||
2 | in target areas according to
provisions of this Article and the | ||||||
3 | Illinois Health Finance Reform Act,
except that:
| ||||||
4 | (1) Physicians participating in a Partnership and | ||||||
5 | providing certain
services, which shall be determined by | ||||||
6 | the Illinois Department, to persons
in areas covered by the | ||||||
7 | Partnership may receive an additional surcharge
for such | ||||||
8 | services.
| ||||||
9 | (2) The Department may elect to consider and negotiate | ||||||
10 | financial
incentives to encourage the development of | ||||||
11 | Partnerships and the efficient
delivery of medical care.
| ||||||
12 | (3) Persons receiving medical services through | ||||||
13 | Partnerships may receive
medical and case management | ||||||
14 | services above the level usually offered
through the | ||||||
15 | medical assistance program.
| ||||||
16 | Medical providers shall be required to meet certain | ||||||
17 | qualifications to
participate in Partnerships to ensure the | ||||||
18 | delivery of high quality medical
services. These | ||||||
19 | qualifications shall be determined by rule of the Illinois
| ||||||
20 | Department and may be higher than qualifications for | ||||||
21 | participation in the
medical assistance program. Partnership | ||||||
22 | sponsors may prescribe reasonable
additional qualifications | ||||||
23 | for participation by medical providers, only with
the prior | ||||||
24 | written approval of the Illinois Department.
| ||||||
25 | Nothing in this Section shall limit the free choice of | ||||||
26 | practitioners,
hospitals, and other providers of medical |
| |||||||
| |||||||
1 | services by clients.
In order to ensure patient freedom of | ||||||
2 | choice, the Illinois Department shall
immediately promulgate | ||||||
3 | all rules and take all other necessary actions so that
provided | ||||||
4 | services may be accessed from therapeutically certified | ||||||
5 | optometrists
to the full extent of the Illinois Optometric | ||||||
6 | Practice Act of 1987 without
discriminating between service | ||||||
7 | providers.
| ||||||
8 | The Department shall apply for a waiver from the United | ||||||
9 | States Health
Care Financing Administration to allow for the | ||||||
10 | implementation of
Partnerships under this Section.
| ||||||
11 | The Illinois Department shall require health care | ||||||
12 | providers to maintain
records that document the medical care | ||||||
13 | and services provided to recipients
of Medical Assistance under | ||||||
14 | this Article. The Illinois Department shall
require health care | ||||||
15 | providers to make available, when authorized by the
patient, in | ||||||
16 | writing, the medical records in a timely fashion to other
| ||||||
17 | health care providers who are treating or serving persons | ||||||
18 | eligible for
Medical Assistance under this Article. All | ||||||
19 | dispensers of medical services
shall be required to maintain | ||||||
20 | and retain business and professional records
sufficient to | ||||||
21 | fully and accurately document the nature, scope, details and
| ||||||
22 | receipt of the health care provided to persons eligible for | ||||||
23 | medical
assistance under this Code, in accordance with | ||||||
24 | regulations promulgated by
the Illinois Department. The rules | ||||||
25 | and regulations shall require that proof
of the receipt of | ||||||
26 | prescription drugs, dentures, prosthetic devices and
|
| |||||||
| |||||||
1 | eyeglasses by eligible persons under this Section accompany | ||||||
2 | each claim
for reimbursement submitted by the dispenser of such | ||||||
3 | medical services.
No such claims for reimbursement shall be | ||||||
4 | approved for payment by the Illinois
Department without such | ||||||
5 | proof of receipt, unless the Illinois Department
shall have put | ||||||
6 | into effect and shall be operating a system of post-payment
| ||||||
7 | audit and review which shall, on a sampling basis, be deemed | ||||||
8 | adequate by
the Illinois Department to assure that such drugs, | ||||||
9 | dentures, prosthetic
devices and eyeglasses for which payment | ||||||
10 | is being made are actually being
received by eligible | ||||||
11 | recipients. Within 90 days after the effective date of
this | ||||||
12 | amendatory Act of 1984, the Illinois Department shall establish | ||||||
13 | a
current list of acquisition costs for all prosthetic devices | ||||||
14 | and any
other items recognized as medical equipment and | ||||||
15 | supplies reimbursable under
this Article and shall update such | ||||||
16 | list on a quarterly basis, except that
the acquisition costs of | ||||||
17 | all prescription drugs shall be updated no
less frequently than | ||||||
18 | every 30 days as required by Section 5-5.12.
| ||||||
19 | The rules and regulations of the Illinois Department shall | ||||||
20 | require
that a written statement including the required opinion | ||||||
21 | of a physician
shall accompany any claim for reimbursement for | ||||||
22 | abortions, or induced
miscarriages or premature births. This | ||||||
23 | statement shall indicate what
procedures were used in providing | ||||||
24 | such medical services.
| ||||||
25 | The Illinois Department shall require all dispensers of | ||||||
26 | medical
services, other than an individual practitioner or |
| |||||||
| |||||||
1 | group of practitioners,
desiring to participate in the Medical | ||||||
2 | Assistance program
established under this Article to disclose | ||||||
3 | all financial, beneficial,
ownership, equity, surety or other | ||||||
4 | interests in any and all firms,
corporations, partnerships, | ||||||
5 | associations, business enterprises, joint
ventures, agencies, | ||||||
6 | institutions or other legal entities providing any
form of | ||||||
7 | health care services in this State under this Article.
| ||||||
8 | The Illinois Department may require that all dispensers of | ||||||
9 | medical
services desiring to participate in the medical | ||||||
10 | assistance program
established under this Article disclose, | ||||||
11 | under such terms and conditions as
the Illinois Department may | ||||||
12 | by rule establish, all inquiries from clients
and attorneys | ||||||
13 | regarding medical bills paid by the Illinois Department, which
| ||||||
14 | inquiries could indicate potential existence of claims or liens | ||||||
15 | for the
Illinois Department.
| ||||||
16 | Enrollment of a vendor that provides non-emergency medical | ||||||
17 | transportation,
defined by the Department by rule,
shall be
| ||||||
18 | conditional for 180 days. During that time, the Department of | ||||||
19 | Healthcare and Family Services may
terminate the vendor's | ||||||
20 | eligibility to participate in the medical assistance
program | ||||||
21 | without cause. That termination of eligibility is not subject | ||||||
22 | to the
Department's hearing process.
| ||||||
23 | The Illinois Department shall establish policies, | ||||||
24 | procedures,
standards and criteria by rule for the acquisition, | ||||||
25 | repair and replacement
of orthotic and prosthetic devices and | ||||||
26 | durable medical equipment. Such
rules shall provide, but not be |
| |||||||
| |||||||
1 | limited to, the following services: (1)
immediate repair or | ||||||
2 | replacement of such devices by recipients without
medical | ||||||
3 | authorization; and (2) rental, lease, purchase or | ||||||
4 | lease-purchase of
durable medical equipment in a | ||||||
5 | cost-effective manner, taking into
consideration the | ||||||
6 | recipient's medical prognosis, the extent of the
recipient's | ||||||
7 | needs, and the requirements and costs for maintaining such
| ||||||
8 | equipment. Such rules shall enable a recipient to temporarily | ||||||
9 | acquire and
use alternative or substitute devices or equipment | ||||||
10 | pending repairs or
replacements of any device or equipment | ||||||
11 | previously authorized for such
recipient by the Department.
| ||||||
12 | The Department shall execute, relative to the nursing home | ||||||
13 | prescreening
project, written inter-agency agreements with the | ||||||
14 | Department of Human
Services and the Department on Aging, to | ||||||
15 | effect the following: (i) intake
procedures and common | ||||||
16 | eligibility criteria for those persons who are receiving
| ||||||
17 | non-institutional services; and (ii) the establishment and | ||||||
18 | development of
non-institutional services in areas of the State | ||||||
19 | where they are not currently
available or are undeveloped.
| ||||||
20 | The Illinois Department shall develop and operate, in | ||||||
21 | cooperation
with other State Departments and agencies and in | ||||||
22 | compliance with
applicable federal laws and regulations, | ||||||
23 | appropriate and effective
systems of health care evaluation and | ||||||
24 | programs for monitoring of
utilization of health care services | ||||||
25 | and facilities, as it affects
persons eligible for medical | ||||||
26 | assistance under this Code.
|
| |||||||
| |||||||
1 | The Illinois Department shall report annually to the | ||||||
2 | General Assembly,
no later than the second Friday in April of | ||||||
3 | 1979 and each year
thereafter, in regard to:
| ||||||
4 | (a) actual statistics and trends in utilization of | ||||||
5 | medical services by
public aid recipients;
| ||||||
6 | (b) actual statistics and trends in the provision of | ||||||
7 | the various medical
services by medical vendors;
| ||||||
8 | (c) current rate structures and proposed changes in | ||||||
9 | those rate structures
for the various medical vendors; and
| ||||||
10 | (d) efforts at utilization review and control by the | ||||||
11 | Illinois Department.
| ||||||
12 | The period covered by each report shall be the 3 years | ||||||
13 | ending on the June
30 prior to the report. The report shall | ||||||
14 | include suggested legislation
for consideration by the General | ||||||
15 | Assembly. The filing of one copy of the
report with the | ||||||
16 | Speaker, one copy with the Minority Leader and one copy
with | ||||||
17 | the Clerk of the House of Representatives, one copy with the | ||||||
18 | President,
one copy with the Minority Leader and one copy with | ||||||
19 | the Secretary of the
Senate, one copy with the Legislative | ||||||
20 | Research Unit, and such additional
copies
with the State | ||||||
21 | Government Report Distribution Center for the General
Assembly | ||||||
22 | as is required under paragraph (t) of Section 7 of the State
| ||||||
23 | Library Act shall be deemed sufficient to comply with this | ||||||
24 | Section.
| ||||||
25 | Notwithstanding any other rulemaking authority that may | ||||||
26 | exist, neither the Governor nor any agency or agency head under |
| |||||||
| |||||||
1 | the jurisdiction of the Governor has any authority to make or | ||||||
2 | promulgate rules to implement or enforce the provisions of this | ||||||
3 | amendatory Act of the 95th General Assembly. If, however, the | ||||||
4 | Governor believes that rules are necessary to implement or | ||||||
5 | enforce the provisions of this amendatory Act of the 95th | ||||||
6 | General Assembly, the Governor may suggest rules to the General | ||||||
7 | Assembly by filing them with the Clerk of the House and the | ||||||
8 | Secretary of the Senate and by requesting that the General | ||||||
9 | Assembly authorize such rulemaking by law, enact those | ||||||
10 | suggested rules into law, or take any other appropriate action | ||||||
11 | in the General Assembly's discretion. Nothing contained in this | ||||||
12 | amendatory Act of the 95th General Assembly shall be | ||||||
13 | interpreted to grant rulemaking authority under any other | ||||||
14 | Illinois statute where such authority is not otherwise | ||||||
15 | explicitly given. For the purposes of this amendatory Act of | ||||||
16 | the 95th General Assembly, "rules" is given the meaning | ||||||
17 | contained in Section 1-70 of the Illinois Administrative | ||||||
18 | Procedure Act, and "agency" and "agency head" are given the | ||||||
19 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
20 | Administrative Procedure Act to the extent that such | ||||||
21 | definitions apply to agencies or agency heads under the | ||||||
22 | jurisdiction of the Governor. | ||||||
23 | (Source: P.A. 95-331, eff. 8-21-07; 95-520, eff. 8-28-07.)
| ||||||
24 | Article 10. Breast Cancer Patients' | ||||||
25 | Access To Pain Relief |
| |||||||
| |||||||
1 | Section 10-5. The Illinois Insurance Code is amended by | ||||||
2 | adding Section 356g.5-1 as follows: | ||||||
3 | (215 ILCS 5/356g.5-1 new) | ||||||
4 | Sec. 356g.5-1. Breast cancer pain medication and therapy. A | ||||||
5 | group or individual policy of accident and health insurance or | ||||||
6 | managed care plan that is amended, delivered, issued, or | ||||||
7 | renewed after the effective date of this amendatory Act of the | ||||||
8 | 95th General Assembly must provide coverage for all medically | ||||||
9 | necessary pain medication and pain therapy related to the | ||||||
10 | treatment of breast cancer on the same terms and conditions | ||||||
11 | that are generally applicable to coverage for other conditions. | ||||||
12 | For purposes of this Section, "pain therapy" means pain therapy | ||||||
13 | that is medically based and includes reasonably defined goals, | ||||||
14 | including, but not limited to, stabilizing or reducing pain, | ||||||
15 | with periodic evaluations of the efficacy of the pain therapy | ||||||
16 | against these goals. The provisions of this Section do not | ||||||
17 | apply to short-term travel, accident-only, limited, or | ||||||
18 | specified-disease policies, or to policies or contracts | ||||||
19 | designed for issuance to persons eligible for coverage under | ||||||
20 | Title XVIII of the Social Security Act, known as Medicare, or | ||||||
21 | any other similar coverage under State or federal governmental | ||||||
22 | plans. | ||||||
23 | Notwithstanding any other rulemaking authority that may | ||||||
24 | exist, neither the Governor nor any agency or agency head under |
| |||||||
| |||||||
1 | the jurisdiction of the Governor has any authority to make or | ||||||
2 | promulgate rules to implement or enforce the provisions of this | ||||||
3 | amendatory Act of the 95th General Assembly. If, however, the | ||||||
4 | Governor believes that rules are necessary to implement or | ||||||
5 | enforce the provisions of this amendatory Act of the 95th | ||||||
6 | General Assembly, the Governor may suggest rules to the General | ||||||
7 | Assembly by filing them with the Clerk of the House and the | ||||||
8 | Secretary of the Senate and by requesting that the General | ||||||
9 | Assembly authorize such rulemaking by law, enact those | ||||||
10 | suggested rules into law, or take any other appropriate action | ||||||
11 | in the General Assembly's discretion. Nothing contained in this | ||||||
12 | amendatory Act of the 95th General Assembly shall be | ||||||
13 | interpreted to grant rulemaking authority under any other | ||||||
14 | Illinois statute where such authority is not otherwise | ||||||
15 | explicitly given. For the purposes of this amendatory Act of | ||||||
16 | the 95th General Assembly, "rules" is given the meaning | ||||||
17 | contained in Section 1-70 of the Illinois Administrative | ||||||
18 | Procedure Act, and "agency" and "agency head" are given the | ||||||
19 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
20 | Administrative Procedure Act to the extent that such | ||||||
21 | definitions apply to agencies or agency heads under the | ||||||
22 | jurisdiction of the Governor. | ||||||
23 | Section 10-10. The State Employees Group Insurance Act of | ||||||
24 | 1971 is amended by changing Section 6.11 as follows:
|
| |||||||
| |||||||
1 | (5 ILCS 375/6.11)
| ||||||
2 | Sec. 6.11. Required health benefits; Illinois Insurance | ||||||
3 | Code
requirements. The program of health
benefits shall provide | ||||||
4 | the post-mastectomy care benefits required to be covered
by a | ||||||
5 | policy of accident and health insurance under Section 356t of | ||||||
6 | the Illinois
Insurance Code. The program of health benefits | ||||||
7 | shall provide the coverage
required under Sections 356g.5, | ||||||
8 | 356g.5-1,
356u, 356w, 356x, 356z.2, 356z.4, 356z.6, and 356z.9, | ||||||
9 | and 356z.10
356z.9 of the
Illinois Insurance Code.
The program | ||||||
10 | of health benefits must comply with Section 155.37 of the
| ||||||
11 | Illinois Insurance Code.
| ||||||
12 | Notwithstanding any other rulemaking authority that may | ||||||
13 | exist, neither the Governor nor any agency or agency head under | ||||||
14 | the jurisdiction of the Governor has any authority to make or | ||||||
15 | promulgate rules to implement or enforce the provisions of this | ||||||
16 | amendatory Act of the 95th General Assembly. If, however, the | ||||||
17 | Governor believes that rules are necessary to implement or | ||||||
18 | enforce the provisions of this amendatory Act of the 95th | ||||||
19 | General Assembly, the Governor may suggest rules to the General | ||||||
20 | Assembly by filing them with the Clerk of the House and the | ||||||
21 | Secretary of the Senate and by requesting that the General | ||||||
22 | Assembly authorize such rulemaking by law, enact those | ||||||
23 | suggested rules into law, or take any other appropriate action | ||||||
24 | in the General Assembly's discretion. Nothing contained in this | ||||||
25 | amendatory Act of the 95th General Assembly shall be | ||||||
26 | interpreted to grant rulemaking authority under any other |
| |||||||
| |||||||
1 | Illinois statute where such authority is not otherwise | ||||||
2 | explicitly given. For the purposes of this amendatory Act of | ||||||
3 | the 95th General Assembly, "rules" is given the meaning | ||||||
4 | contained in Section 1-70 of the Illinois Administrative | ||||||
5 | Procedure Act, and "agency" and "agency head" are given the | ||||||
6 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
7 | Administrative Procedure Act to the extent that such | ||||||
8 | definitions apply to agencies or agency heads under the | ||||||
9 | jurisdiction of the Governor. | ||||||
10 | (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | ||||||
11 | 95-520, eff. 8-28-07; revised 12-4-07.)
| ||||||
12 | Section 10-15. The Counties Code is amended by changing | ||||||
13 | Section 5-1069.3 as follows: | ||||||
14 | (55 ILCS 5/5-1069.3)
| ||||||
15 | Sec. 5-1069.3. Required health benefits. If a county, | ||||||
16 | including a home
rule
county, is a self-insurer for purposes of | ||||||
17 | providing health insurance coverage
for its employees, the | ||||||
18 | coverage shall include coverage for the post-mastectomy
care | ||||||
19 | benefits required to be covered by a policy of accident and | ||||||
20 | health
insurance under Section 356t and the coverage required | ||||||
21 | under Sections 356g.5, 356g.5-1, 356u,
356w, 356x, 356z.6, and | ||||||
22 | 356z.9, and 356z.10
356z.9 of
the Illinois Insurance Code. The | ||||||
23 | requirement that health benefits be covered
as provided in this | ||||||
24 | Section is an
exclusive power and function of the State and is |
| |||||||
| |||||||
1 | a denial and limitation under
Article VII, Section 6, | ||||||
2 | subsection (h) of the Illinois Constitution. A home
rule county | ||||||
3 | to which this Section applies must comply with every provision | ||||||
4 | of
this Section.
| ||||||
5 | Notwithstanding any other rulemaking authority that may | ||||||
6 | exist, neither the Governor nor any agency or agency head under | ||||||
7 | the jurisdiction of the Governor has any authority to make or | ||||||
8 | promulgate rules to implement or enforce the provisions of this | ||||||
9 | amendatory Act of the 95th General Assembly. If, however, the | ||||||
10 | Governor believes that rules are necessary to implement or | ||||||
11 | enforce the provisions of this amendatory Act of the 95th | ||||||
12 | General Assembly, the Governor may suggest rules to the General | ||||||
13 | Assembly by filing them with the Clerk of the House and the | ||||||
14 | Secretary of the Senate and by requesting that the General | ||||||
15 | Assembly authorize such rulemaking by law, enact those | ||||||
16 | suggested rules into law, or take any other appropriate action | ||||||
17 | in the General Assembly's discretion. Nothing contained in this | ||||||
18 | amendatory Act of the 95th General Assembly shall be | ||||||
19 | interpreted to grant rulemaking authority under any other | ||||||
20 | Illinois statute where such authority is not otherwise | ||||||
21 | explicitly given. For the purposes of this amendatory Act of | ||||||
22 | the 95th General Assembly, "rules" is given the meaning | ||||||
23 | contained in Section 1-70 of the Illinois Administrative | ||||||
24 | Procedure Act, and "agency" and "agency head" are given the | ||||||
25 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
26 | Administrative Procedure Act to the extent that such |
| |||||||
| |||||||
1 | definitions apply to agencies or agency heads under the | ||||||
2 | jurisdiction of the Governor. | ||||||
3 | (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | ||||||
4 | 95-520, eff. 8-28-07; revised 12-4-07.)
| ||||||
5 | Section 10-20. The Illinois Municipal Code is amended by | ||||||
6 | changing Section 10-4-2.3 as follows: | ||||||
7 | (65 ILCS 5/10-4-2.3)
| ||||||
8 | Sec. 10-4-2.3. Required health benefits. If a | ||||||
9 | municipality, including a
home rule municipality, is a | ||||||
10 | self-insurer for purposes of providing health
insurance | ||||||
11 | coverage for its employees, the coverage shall include coverage | ||||||
12 | for
the post-mastectomy care benefits required to be covered by | ||||||
13 | a policy of
accident and health insurance under Section 356t | ||||||
14 | and the coverage required
under Sections 356g.5, 356g.5-1, | ||||||
15 | 356u, 356w, 356x, 356z.6, and 356z.9, and 356z.10
356z.9 of the | ||||||
16 | Illinois
Insurance
Code. The requirement that health
benefits | ||||||
17 | be covered as provided in this is an exclusive power and | ||||||
18 | function of
the State and is a denial and limitation under | ||||||
19 | Article VII, Section 6,
subsection (h) of the Illinois | ||||||
20 | Constitution. A home rule municipality to which
this Section | ||||||
21 | applies must comply with every provision of this Section.
| ||||||
22 | Notwithstanding any other rulemaking authority that may | ||||||
23 | exist, neither the Governor nor any agency or agency head under | ||||||
24 | the jurisdiction of the Governor has any authority to make or |
| |||||||
| |||||||
1 | promulgate rules to implement or enforce the provisions of this | ||||||
2 | amendatory Act of the 95th General Assembly. If, however, the | ||||||
3 | Governor believes that rules are necessary to implement or | ||||||
4 | enforce the provisions of this amendatory Act of the 95th | ||||||
5 | General Assembly, the Governor may suggest rules to the General | ||||||
6 | Assembly by filing them with the Clerk of the House and the | ||||||
7 | Secretary of the Senate and by requesting that the General | ||||||
8 | Assembly authorize such rulemaking by law, enact those | ||||||
9 | suggested rules into law, or take any other appropriate action | ||||||
10 | in the General Assembly's discretion. Nothing contained in this | ||||||
11 | amendatory Act of the 95th General Assembly shall be | ||||||
12 | interpreted to grant rulemaking authority under any other | ||||||
13 | Illinois statute where such authority is not otherwise | ||||||
14 | explicitly given. For the purposes of this amendatory Act of | ||||||
15 | the 95th General Assembly, "rules" is given the meaning | ||||||
16 | contained in Section 1-70 of the Illinois Administrative | ||||||
17 | Procedure Act, and "agency" and "agency head" are given the | ||||||
18 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
19 | Administrative Procedure Act to the extent that such | ||||||
20 | definitions apply to agencies or agency heads under the | ||||||
21 | jurisdiction of the Governor. | ||||||
22 | (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | ||||||
23 | 95-520, eff. 8-28-07; revised 12-4-07.)
| ||||||
24 | Section 10-25. The School Code is amended by changing | ||||||
25 | Section 10-22.3f as follows: |
| |||||||
| |||||||
1 | (105 ILCS 5/10-22.3f)
| ||||||
2 | Sec. 10-22.3f. Required health benefits. Insurance | ||||||
3 | protection and
benefits
for employees shall provide the | ||||||
4 | post-mastectomy care benefits required to be
covered by a | ||||||
5 | policy of accident and health insurance under Section 356t and | ||||||
6 | the
coverage required under Sections 356g.5, 356g.5-1, 356u, | ||||||
7 | 356w, 356x,
356z.6, and 356z.9 of
the
Illinois Insurance Code.
| ||||||
8 | Notwithstanding any other rulemaking authority that may | ||||||
9 | exist, neither the Governor nor any agency or agency head under | ||||||
10 | the jurisdiction of the Governor has any authority to make or | ||||||
11 | promulgate rules to implement or enforce the provisions of this | ||||||
12 | amendatory Act of the 95th General Assembly. If, however, the | ||||||
13 | Governor believes that rules are necessary to implement or | ||||||
14 | enforce the provisions of this amendatory Act of the 95th | ||||||
15 | General Assembly, the Governor may suggest rules to the General | ||||||
16 | Assembly by filing them with the Clerk of the House and the | ||||||
17 | Secretary of the Senate and by requesting that the General | ||||||
18 | Assembly authorize such rulemaking by law, enact those | ||||||
19 | suggested rules into law, or take any other appropriate action | ||||||
20 | in the General Assembly's discretion. Nothing contained in this | ||||||
21 | amendatory Act of the 95th General Assembly shall be | ||||||
22 | interpreted to grant rulemaking authority under any other | ||||||
23 | Illinois statute where such authority is not otherwise | ||||||
24 | explicitly given. For the purposes of this amendatory Act of | ||||||
25 | the 95th General Assembly, "rules" is given the meaning |
| |||||||
| |||||||
1 | contained in Section 1-70 of the Illinois Administrative | ||||||
2 | Procedure Act, and "agency" and "agency head" are given the | ||||||
3 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
4 | Administrative Procedure Act to the extent that such | ||||||
5 | definitions apply to agencies or agency heads under the | ||||||
6 | jurisdiction of the Governor. | ||||||
7 | (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | ||||||
8 | revised 12-4-07.)
| ||||||
9 | Section 10-30. The Health Maintenance Organization Act is | ||||||
10 | amended by changing Section 5-3 as follows:
| ||||||
11 | (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
| ||||||
12 | Sec. 5-3. Insurance Code provisions.
| ||||||
13 | (a) Health Maintenance Organizations
shall be subject to | ||||||
14 | the provisions of Sections 133, 134, 137, 140, 141.1,
141.2, | ||||||
15 | 141.3, 143, 143c, 147, 148, 149, 151,
152, 153, 154, 154.5, | ||||||
16 | 154.6,
154.7, 154.8, 155.04, 355.2, 356g.5-1, 356m, 356v, 356w, | ||||||
17 | 356x, 356y,
356z.2, 356z.4, 356z.5, 356z.6, 356z.8, 356z.9, | ||||||
18 | 356z.10
356z.9 , 364.01, 367.2, 367.2-5, 367i, 368a, 368b, 368c, | ||||||
19 | 368d, 368e, 370c,
401, 401.1, 402, 403, 403A,
408, 408.2, 409, | ||||||
20 | 412, 444,
and
444.1,
paragraph (c) of subsection (2) of Section | ||||||
21 | 367, and Articles IIA, VIII 1/2,
XII,
XII 1/2, XIII, XIII 1/2, | ||||||
22 | XXV, and XXVI of the Illinois Insurance Code.
| ||||||
23 | (b) For purposes of the Illinois Insurance Code, except for | ||||||
24 | Sections 444
and 444.1 and Articles XIII and XIII 1/2, Health |
| |||||||
| |||||||
1 | Maintenance Organizations in
the following categories are | ||||||
2 | deemed to be "domestic companies":
| ||||||
3 | (1) a corporation authorized under the
Dental Service | ||||||
4 | Plan Act or the Voluntary Health Services Plans Act;
| ||||||
5 | (2) a corporation organized under the laws of this | ||||||
6 | State; or
| ||||||
7 | (3) a corporation organized under the laws of another | ||||||
8 | state, 30% or more
of the enrollees of which are residents | ||||||
9 | of this State, except a
corporation subject to | ||||||
10 | substantially the same requirements in its state of
| ||||||
11 | organization as is a "domestic company" under Article VIII | ||||||
12 | 1/2 of the
Illinois Insurance Code.
| ||||||
13 | (c) In considering the merger, consolidation, or other | ||||||
14 | acquisition of
control of a Health Maintenance Organization | ||||||
15 | pursuant to Article VIII 1/2
of the Illinois Insurance Code,
| ||||||
16 | (1) the Director shall give primary consideration to | ||||||
17 | the continuation of
benefits to enrollees and the financial | ||||||
18 | conditions of the acquired Health
Maintenance Organization | ||||||
19 | after the merger, consolidation, or other
acquisition of | ||||||
20 | control takes effect;
| ||||||
21 | (2)(i) the criteria specified in subsection (1)(b) of | ||||||
22 | Section 131.8 of
the Illinois Insurance Code shall not | ||||||
23 | apply and (ii) the Director, in making
his determination | ||||||
24 | with respect to the merger, consolidation, or other
| ||||||
25 | acquisition of control, need not take into account the | ||||||
26 | effect on
competition of the merger, consolidation, or |
| |||||||
| |||||||
1 | other acquisition of control;
| ||||||
2 | (3) the Director shall have the power to require the | ||||||
3 | following
information:
| ||||||
4 | (A) certification by an independent actuary of the | ||||||
5 | adequacy
of the reserves of the Health Maintenance | ||||||
6 | Organization sought to be acquired;
| ||||||
7 | (B) pro forma financial statements reflecting the | ||||||
8 | combined balance
sheets of the acquiring company and | ||||||
9 | the Health Maintenance Organization sought
to be | ||||||
10 | acquired as of the end of the preceding year and as of | ||||||
11 | a date 90 days
prior to the acquisition, as well as pro | ||||||
12 | forma financial statements
reflecting projected | ||||||
13 | combined operation for a period of 2 years;
| ||||||
14 | (C) a pro forma business plan detailing an | ||||||
15 | acquiring party's plans with
respect to the operation | ||||||
16 | of the Health Maintenance Organization sought to
be | ||||||
17 | acquired for a period of not less than 3 years; and
| ||||||
18 | (D) such other information as the Director shall | ||||||
19 | require.
| ||||||
20 | (d) The provisions of Article VIII 1/2 of the Illinois | ||||||
21 | Insurance Code
and this Section 5-3 shall apply to the sale by | ||||||
22 | any health maintenance
organization of greater than 10% of its
| ||||||
23 | enrollee population (including without limitation the health | ||||||
24 | maintenance
organization's right, title, and interest in and to | ||||||
25 | its health care
certificates).
| ||||||
26 | (e) In considering any management contract or service |
| |||||||
| |||||||
1 | agreement subject
to Section 141.1 of the Illinois Insurance | ||||||
2 | Code, the Director (i) shall, in
addition to the criteria | ||||||
3 | specified in Section 141.2 of the Illinois
Insurance Code, take | ||||||
4 | into account the effect of the management contract or
service | ||||||
5 | agreement on the continuation of benefits to enrollees and the
| ||||||
6 | financial condition of the health maintenance organization to | ||||||
7 | be managed or
serviced, and (ii) need not take into account the | ||||||
8 | effect of the management
contract or service agreement on | ||||||
9 | competition.
| ||||||
10 | (f) Except for small employer groups as defined in the | ||||||
11 | Small Employer
Rating, Renewability and Portability Health | ||||||
12 | Insurance Act and except for
medicare supplement policies as | ||||||
13 | defined in Section 363 of the Illinois
Insurance Code, a Health | ||||||
14 | Maintenance Organization may by contract agree with a
group or | ||||||
15 | other enrollment unit to effect refunds or charge additional | ||||||
16 | premiums
under the following terms and conditions:
| ||||||
17 | (i) the amount of, and other terms and conditions with | ||||||
18 | respect to, the
refund or additional premium are set forth | ||||||
19 | in the group or enrollment unit
contract agreed in advance | ||||||
20 | of the period for which a refund is to be paid or
| ||||||
21 | additional premium is to be charged (which period shall not | ||||||
22 | be less than one
year); and
| ||||||
23 | (ii) the amount of the refund or additional premium | ||||||
24 | shall not exceed 20%
of the Health Maintenance | ||||||
25 | Organization's profitable or unprofitable experience
with | ||||||
26 | respect to the group or other enrollment unit for the |
| |||||||
| |||||||
1 | period (and, for
purposes of a refund or additional | ||||||
2 | premium, the profitable or unprofitable
experience shall | ||||||
3 | be calculated taking into account a pro rata share of the
| ||||||
4 | Health Maintenance Organization's administrative and | ||||||
5 | marketing expenses, but
shall not include any refund to be | ||||||
6 | made or additional premium to be paid
pursuant to this | ||||||
7 | subsection (f)). The Health Maintenance Organization and | ||||||
8 | the
group or enrollment unit may agree that the profitable | ||||||
9 | or unprofitable
experience may be calculated taking into | ||||||
10 | account the refund period and the
immediately preceding 2 | ||||||
11 | plan years.
| ||||||
12 | The Health Maintenance Organization shall include a | ||||||
13 | statement in the
evidence of coverage issued to each enrollee | ||||||
14 | describing the possibility of a
refund or additional premium, | ||||||
15 | and upon request of any group or enrollment unit,
provide to | ||||||
16 | the group or enrollment unit a description of the method used | ||||||
17 | to
calculate (1) the Health Maintenance Organization's | ||||||
18 | profitable experience with
respect to the group or enrollment | ||||||
19 | unit and the resulting refund to the group
or enrollment unit | ||||||
20 | or (2) the Health Maintenance Organization's unprofitable
| ||||||
21 | experience with respect to the group or enrollment unit and the | ||||||
22 | resulting
additional premium to be paid by the group or | ||||||
23 | enrollment unit.
| ||||||
24 | In no event shall the Illinois Health Maintenance | ||||||
25 | Organization
Guaranty Association be liable to pay any | ||||||
26 | contractual obligation of an
insolvent organization to pay any |
| |||||||
| |||||||
1 | refund authorized under this Section.
| ||||||
2 | (g) Notwithstanding any other rulemaking authority that | ||||||
3 | may exist, neither the Governor nor any agency or agency head | ||||||
4 | under the jurisdiction of the Governor has any authority to | ||||||
5 | make or promulgate rules to implement or enforce the provisions | ||||||
6 | of this amendatory Act of the 95th General Assembly. If, | ||||||
7 | however, the Governor believes that rules are necessary to | ||||||
8 | implement or enforce the provisions of this amendatory Act of | ||||||
9 | the 95th General Assembly, the Governor may suggest rules to | ||||||
10 | the General Assembly by filing them with the Clerk of the House | ||||||
11 | and the Secretary of the Senate and by requesting that the | ||||||
12 | General Assembly authorize such rulemaking by law, enact those | ||||||
13 | suggested rules into law, or take any other appropriate action | ||||||
14 | in the General Assembly's discretion. Nothing contained in this | ||||||
15 | amendatory Act of the 95th General Assembly shall be | ||||||
16 | interpreted to grant rulemaking authority under any other | ||||||
17 | Illinois statute where such authority is not otherwise | ||||||
18 | explicitly given. For the purposes of this amendatory Act of | ||||||
19 | the 95th General Assembly, "rules" is given the meaning | ||||||
20 | contained in Section 1-70 of the Illinois Administrative | ||||||
21 | Procedure Act, and "agency" and "agency head" are given the | ||||||
22 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
23 | Administrative Procedure Act to the extent that such | ||||||
24 | definitions apply to agencies or agency heads under the | ||||||
25 | jurisdiction of the Governor. | ||||||
26 | (Source: P.A. 94-906, eff. 1-1-07; 94-1076, eff. 12-29-06; |
| |||||||
| |||||||
1 | 95-422, eff. 8-24-07; 95-520, eff. 8-28-07; revised 12-4-07.)
| ||||||
2 | Section 10-35. The Voluntary Health Services Plans Act is | ||||||
3 | amended by changing Section 10 as follows:
| ||||||
4 | (215 ILCS 165/10) (from Ch. 32, par. 604)
| ||||||
5 | Sec. 10. Application of Insurance Code provisions. Health | ||||||
6 | services
plan corporations and all persons interested therein | ||||||
7 | or dealing therewith
shall be subject to the provisions of | ||||||
8 | Articles IIA and XII 1/2 and Sections
3.1, 133, 140, 143, 143c, | ||||||
9 | 149, 155.37, 354, 355.2, 356g.5, 356g.5-1, 356r, 356t, 356u, | ||||||
10 | 356v,
356w, 356x, 356y, 356z.1, 356z.2, 356z.4, 356z.5, 356z.6, | ||||||
11 | 356z.8, 356z.9,
356z.10
356z.9 , 364.01, 367.2, 368a, 401, | ||||||
12 | 401.1,
402,
403, 403A, 408,
408.2, and 412, and paragraphs (7) | ||||||
13 | and (15) of Section 367 of the Illinois
Insurance Code.
| ||||||
14 | Notwithstanding any other rulemaking authority that may | ||||||
15 | exist, neither the Governor nor any agency or agency head under | ||||||
16 | the jurisdiction of the Governor has any authority to make or | ||||||
17 | promulgate rules to implement or enforce the provisions of this | ||||||
18 | amendatory Act of the 95th General Assembly. If, however, the | ||||||
19 | Governor believes that rules are necessary to implement or | ||||||
20 | enforce the provisions of this amendatory Act of the 95th | ||||||
21 | General Assembly, the Governor may suggest rules to the General | ||||||
22 | Assembly by filing them with the Clerk of the House and the | ||||||
23 | Secretary of the Senate and by requesting that the General | ||||||
24 | Assembly authorize such rulemaking by law, enact those |
| |||||||
| |||||||
1 | suggested rules into law, or take any other appropriate action | ||||||
2 | in the General Assembly's discretion. Nothing contained in this | ||||||
3 | amendatory Act of the 95th General Assembly shall be | ||||||
4 | interpreted to grant rulemaking authority under any other | ||||||
5 | Illinois statute where such authority is not otherwise | ||||||
6 | explicitly given. For the purposes of this amendatory Act of | ||||||
7 | the 95th General Assembly, "rules" is given the meaning | ||||||
8 | contained in Section 1-70 of the Illinois Administrative | ||||||
9 | Procedure Act, and "agency" and "agency head" are given the | ||||||
10 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
11 | Administrative Procedure Act to the extent that such | ||||||
12 | definitions apply to agencies or agency heads under the | ||||||
13 | jurisdiction of the Governor. | ||||||
14 | (Source: P.A. 94-1076, eff. 12-29-06; 95-189, eff. 8-16-07; | ||||||
15 | 95-331, eff. 8-21-07; 95-422, eff. 8-24-07; 95-520, eff. | ||||||
16 | 8-28-07; revised 12-5-07.)
| ||||||
17 | Article 15. Reducing Financial Barriers To Mammography | ||||||
18 | Section 15-5. The Illinois Insurance Code is amended by | ||||||
19 | changing Section 356g as follows:
| ||||||
20 | (215 ILCS 5/356g) (from Ch. 73, par. 968g)
| ||||||
21 | Sec. 356g. Mammograms; mastectomies.
| ||||||
22 | (a) Every insurer shall provide in each group or individual
| ||||||
23 | policy, contract, or certificate of insurance issued or renewed |
| |||||||
| |||||||
1 | for persons
who are residents of this State, coverage for | ||||||
2 | screening by low-dose
mammography for all women 35 years of age | ||||||
3 | or older for the presence of
occult breast cancer within the | ||||||
4 | provisions of the policy, contract, or
certificate. The | ||||||
5 | coverage shall be as follows:
| ||||||
6 | (1) A baseline mammogram for women 35 to 39 years of | ||||||
7 | age.
| ||||||
8 | (2) An annual mammogram for women 40 years of age or | ||||||
9 | older.
| ||||||
10 | (3) A mammogram at the age and intervals considered | ||||||
11 | medically necessary by the woman's health care provider for | ||||||
12 | women under 40 years of age and having a family history of | ||||||
13 | breast cancer, prior personal history of breast cancer, | ||||||
14 | positive genetic testing, or other risk factors.
| ||||||
15 | (4) A comprehensive ultrasound screening of an entire | ||||||
16 | breast or breasts if a mammogram demonstrates | ||||||
17 | heterogeneous or dense breast tissue, when medically | ||||||
18 | necessary as determined by a physician licensed to practice | ||||||
19 | medicine in all of its branches.
| ||||||
20 | These benefits shall be at least as favorable as for other | ||||||
21 | radiological
examinations and subject to the same dollar | ||||||
22 | limits, deductibles, and
co-insurance factors. For purposes of | ||||||
23 | this Section, "low-dose mammography"
means the x-ray | ||||||
24 | examination of the breast using equipment dedicated
| ||||||
25 | specifically for mammography, including the x-ray tube, | ||||||
26 | filter, compression
device, and image receptor, with radiation |
| |||||||
| |||||||
1 | exposure delivery of less than
1 rad per breast for 2 views of | ||||||
2 | an average size breast. The term also includes digital | ||||||
3 | mammography.
| ||||||
4 | (a-5) Coverage as described by subsection (a) shall be | ||||||
5 | provided at no cost to the insured and shall not be applied to | ||||||
6 | an annual or lifetime maximum benefit. | ||||||
7 | (a-10) When health care services are available through | ||||||
8 | contracted providers and a person does not comply with plan | ||||||
9 | provisions specific to the use of contracted providers, the | ||||||
10 | requirements of subsection (a-5) are not applicable. When a | ||||||
11 | person does not comply with plan provisions specific to the use | ||||||
12 | of contracted providers, plan provisions specific to the use of | ||||||
13 | non-contracted providers must be applied without distinction | ||||||
14 | for coverage required by this Section and shall be at least as | ||||||
15 | favorable as for other radiological examinations covered by the | ||||||
16 | policy or contract. | ||||||
17 | (b) No policy of accident or health insurance that provides | ||||||
18 | for
the surgical procedure known as a mastectomy shall be | ||||||
19 | issued, amended,
delivered, or renewed in this State unless
| ||||||
20 | that coverage also provides for prosthetic devices
or | ||||||
21 | reconstructive surgery
incident to the mastectomy.
Coverage | ||||||
22 | for breast reconstruction in connection with a mastectomy shall
| ||||||
23 | include:
| ||||||
24 | (1) reconstruction of the breast upon which the | ||||||
25 | mastectomy has been
performed;
| ||||||
26 | (2) surgery and reconstruction of the other breast to |
| |||||||
| |||||||
1 | produce a
symmetrical appearance; and
| ||||||
2 | (3) prostheses and treatment for physical | ||||||
3 | complications at all stages of
mastectomy, including | ||||||
4 | lymphedemas.
| ||||||
5 | Care shall be determined in consultation with the attending | ||||||
6 | physician and the
patient.
The offered coverage for prosthetic | ||||||
7 | devices and
reconstructive surgery shall be subject to the | ||||||
8 | deductible and coinsurance
conditions applied to the | ||||||
9 | mastectomy, and all other terms and conditions
applicable to | ||||||
10 | other benefits. When a mastectomy is performed and there is
no | ||||||
11 | evidence of malignancy then the offered coverage may be limited | ||||||
12 | to the
provision of prosthetic devices and reconstructive | ||||||
13 | surgery to within 2
years after the date of the mastectomy. As | ||||||
14 | used in this Section,
"mastectomy" means the removal of all or | ||||||
15 | part of the breast for medically
necessary reasons, as | ||||||
16 | determined by a licensed physician.
| ||||||
17 | Written notice of the availability of coverage under this | ||||||
18 | Section shall be
delivered to the insured upon enrollment and | ||||||
19 | annually thereafter. An insurer
may not deny to an insured | ||||||
20 | eligibility, or continued eligibility, to enroll or
to renew | ||||||
21 | coverage under the terms of the plan solely for the purpose of
| ||||||
22 | avoiding the requirements of this Section. An insurer may not | ||||||
23 | penalize or
reduce or
limit the reimbursement of an attending | ||||||
24 | provider or provide incentives
(monetary or otherwise) to an | ||||||
25 | attending provider to induce the provider to
provide care to an | ||||||
26 | insured in a manner inconsistent with this Section.
|
| |||||||
| |||||||
1 | (c) Notwithstanding any other rulemaking authority that | ||||||
2 | may exist, neither the Governor nor any agency or agency head | ||||||
3 | under the jurisdiction of the Governor has any authority to | ||||||
4 | make or promulgate rules to implement or enforce the provisions | ||||||
5 | of this amendatory Act of the 95th General Assembly. If, | ||||||
6 | however, the Governor believes that rules are necessary to | ||||||
7 | implement or enforce the provisions of this amendatory Act of | ||||||
8 | the 95th General Assembly, the Governor may suggest rules to | ||||||
9 | the General Assembly by filing them with the Clerk of the House | ||||||
10 | and the Secretary of the Senate and by requesting that the | ||||||
11 | General Assembly authorize such rulemaking by law, enact those | ||||||
12 | suggested rules into law, or take any other appropriate action | ||||||
13 | in the General Assembly's discretion. Nothing contained in this | ||||||
14 | amendatory Act of the 95th General Assembly shall be | ||||||
15 | interpreted to grant rulemaking authority under any other | ||||||
16 | Illinois statute where such authority is not otherwise | ||||||
17 | explicitly given. For the purposes of this amendatory Act of | ||||||
18 | the 95th General Assembly, "rules" is given the meaning | ||||||
19 | contained in Section 1-70 of the Illinois Administrative | ||||||
20 | Procedure Act, and "agency" and "agency head" are given the | ||||||
21 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
22 | Administrative Procedure Act to the extent that such | ||||||
23 | definitions apply to agencies or agency heads under the | ||||||
24 | jurisdiction of the Governor. | ||||||
25 | (Source: P.A. 94-121, eff. 7-6-05; 95-431, eff. 8-24-07.)
|
| |||||||
| |||||||
1 | Section 15-10. The State Employees Group Insurance Act of | ||||||
2 | 1971 is amended by changing Section 6.11 as follows:
| ||||||
3 | (5 ILCS 375/6.11)
| ||||||
4 | Sec. 6.11. Required health benefits; Illinois Insurance | ||||||
5 | Code
requirements. The program of health
benefits shall provide | ||||||
6 | the post-mastectomy care benefits required to be covered
by a | ||||||
7 | policy of accident and health insurance under Section 356t of | ||||||
8 | the Illinois
Insurance Code. The program of health benefits | ||||||
9 | shall provide the coverage
required under Sections 356g, | ||||||
10 | 356g.5,
356u, 356w, 356x, 356z.2, 356z.4, 356z.6, and 356z.9, | ||||||
11 | and 356z.10
356z.9 of the
Illinois Insurance Code.
The program | ||||||
12 | of health benefits must comply with Section 155.37 of the
| ||||||
13 | Illinois Insurance Code.
| ||||||
14 | Notwithstanding any other rulemaking authority that may | ||||||
15 | exist, neither the Governor nor any agency or agency head under | ||||||
16 | the jurisdiction of the Governor has any authority to make or | ||||||
17 | promulgate rules to implement or enforce the provisions of this | ||||||
18 | amendatory Act of the 95th General Assembly. If, however, the | ||||||
19 | Governor believes that rules are necessary to implement or | ||||||
20 | enforce the provisions of this amendatory Act of the 95th | ||||||
21 | General Assembly, the Governor may suggest rules to the General | ||||||
22 | Assembly by filing them with the Clerk of the House and the | ||||||
23 | Secretary of the Senate and by requesting that the General | ||||||
24 | Assembly authorize such rulemaking by law, enact those | ||||||
25 | suggested rules into law, or take any other appropriate action |
| |||||||
| |||||||
1 | in the General Assembly's discretion. Nothing contained in this | ||||||
2 | amendatory Act of the 95th General Assembly shall be | ||||||
3 | interpreted to grant rulemaking authority under any other | ||||||
4 | Illinois statute where such authority is not otherwise | ||||||
5 | explicitly given. For the purposes of this amendatory Act of | ||||||
6 | the 95th General Assembly, "rules" is given the meaning | ||||||
7 | contained in Section 1-70 of the Illinois Administrative | ||||||
8 | Procedure Act, and "agency" and "agency head" are given the | ||||||
9 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
10 | Administrative Procedure Act to the extent that such | ||||||
11 | definitions apply to agencies or agency heads under the | ||||||
12 | jurisdiction of the Governor. | ||||||
13 | (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | ||||||
14 | 95-520, eff. 8-28-07; revised 12-4-07.)
| ||||||
15 | Section 15-15. The Counties Code is amended by changing | ||||||
16 | Sections 5-1069 and 5-1069.3 as follows:
| ||||||
17 | (55 ILCS 5/5-1069) (from Ch. 34, par. 5-1069)
| ||||||
18 | Sec. 5-1069. Group life, health, accident, hospital, and | ||||||
19 | medical
insurance.
| ||||||
20 | (a) The county board of any county may arrange to provide, | ||||||
21 | for
the benefit of employees of the county, group life, health, | ||||||
22 | accident, hospital,
and medical insurance, or any one or any | ||||||
23 | combination of those types of
insurance, or the county board | ||||||
24 | may self-insure, for the benefit of its
employees, all or a |
| |||||||
| |||||||
1 | portion of the employees' group life, health, accident,
| ||||||
2 | hospital, and medical insurance, or any one or any combination | ||||||
3 | of those
types of insurance, including a combination of | ||||||
4 | self-insurance and other
types of insurance authorized by this | ||||||
5 | Section, provided that the county
board complies with all other | ||||||
6 | requirements of this Section. The insurance
may include | ||||||
7 | provision for employees who rely on treatment by prayer or
| ||||||
8 | spiritual means alone for healing in accordance with the tenets | ||||||
9 | and
practice of a well recognized religious denomination. The | ||||||
10 | county board may
provide for payment by the county of a portion | ||||||
11 | or all of the premium or
charge for the insurance with the | ||||||
12 | employee paying the balance of the
premium or charge, if any. | ||||||
13 | If the county board undertakes a plan under
which the county | ||||||
14 | pays only a portion of the premium or charge, the county
board | ||||||
15 | shall provide for withholding and deducting from the | ||||||
16 | compensation of
those employees who consent to join the plan | ||||||
17 | the balance of the premium or
charge for the insurance.
| ||||||
18 | (b) If the county board does not provide for self-insurance | ||||||
19 | or for a plan
under which the county pays a portion or all of | ||||||
20 | the premium or charge for a
group insurance plan, the county | ||||||
21 | board may provide for withholding and
deducting from the | ||||||
22 | compensation of those employees who consent thereto the
total | ||||||
23 | premium or charge for any group life, health, accident, | ||||||
24 | hospital, and
medical insurance.
| ||||||
25 | (c) The county board may exercise the powers granted in | ||||||
26 | this Section only if
it provides for self-insurance or, where |
| |||||||
| |||||||
1 | it makes arrangements to provide
group insurance through an | ||||||
2 | insurance carrier, if the kinds of group
insurance are obtained | ||||||
3 | from an insurance company authorized to do business
in the | ||||||
4 | State of Illinois. The county board may enact an ordinance
| ||||||
5 | prescribing the method of operation of the insurance program.
| ||||||
6 | (d) If a county, including a home rule county, is a | ||||||
7 | self-insurer for
purposes of providing health insurance | ||||||
8 | coverage for its employees, the
insurance coverage shall | ||||||
9 | include screening by low-dose mammography for all
women 35 | ||||||
10 | years of age or older for the presence of occult breast cancer
| ||||||
11 | unless the county elects to provide mammograms itself under | ||||||
12 | Section
5-1069.1. The coverage shall be as follows:
| ||||||
13 | (1) A baseline mammogram for women 35 to 39 years of | ||||||
14 | age.
| ||||||
15 | (2) An annual mammogram for women 40 years of age or | ||||||
16 | older.
| ||||||
17 | (3) A mammogram at the age and intervals considered | ||||||
18 | medically necessary by the woman's health care provider for | ||||||
19 | women under 40 years of age and having a family history of | ||||||
20 | breast cancer, prior personal history of breast cancer, | ||||||
21 | positive genetic testing, or other risk factors. | ||||||
22 | (4) A comprehensive ultrasound screening of an entire | ||||||
23 | breast or breasts if a mammogram demonstrates | ||||||
24 | heterogeneous or dense breast tissue, when medically | ||||||
25 | necessary as determined by a physician licensed to practice | ||||||
26 | medicine in all of its branches. |
| |||||||
| |||||||
1 | Those benefits shall be at least as favorable as for other | ||||||
2 | radiological
examinations and subject to the same dollar | ||||||
3 | limits, deductibles, and
co-insurance factors. For purposes of | ||||||
4 | this subsection, "low-dose mammography"
means the x-ray | ||||||
5 | examination of the breast using equipment dedicated
| ||||||
6 | specifically for mammography, including the x-ray tube, | ||||||
7 | filter, compression
device, screens, and image receptor | ||||||
8 | receptors , with an average radiation exposure
delivery of less | ||||||
9 | than one rad per breast for mid-breast, with 2 views of an | ||||||
10 | average size for each breast. The term also includes digital | ||||||
11 | mammography. | ||||||
12 | (d-5) Coverage as described by subsection (d) shall be | ||||||
13 | provided at no cost to the insured and shall not be applied to | ||||||
14 | an annual or lifetime maximum benefit. | ||||||
15 | (d-10) When health care services are available through | ||||||
16 | contracted providers and a person does not comply with plan | ||||||
17 | provisions specific to the use of contracted providers, the | ||||||
18 | requirements of subsection (d-5) are not applicable. When a | ||||||
19 | person does not comply with plan provisions specific to the use | ||||||
20 | of contracted providers, plan provisions specific to the use of | ||||||
21 | non-contracted providers must be applied without distinction | ||||||
22 | for coverage required by this Section and shall be at least as | ||||||
23 | favorable as for other radiological examinations covered by the | ||||||
24 | policy or contract. | ||||||
25 | (d-15) If a county, including a home rule county, is a | ||||||
26 | self-insurer for purposes of providing health insurance |
| |||||||
| |||||||
1 | coverage for its employees, the insurance coverage shall | ||||||
2 | include mastectomy coverage, which includes coverage for | ||||||
3 | prosthetic devices or reconstructive surgery incident to the | ||||||
4 | mastectomy. Coverage for breast reconstruction in connection | ||||||
5 | with a mastectomy shall include: | ||||||
6 | (1) reconstruction of the breast upon which the | ||||||
7 | mastectomy has been performed; | ||||||
8 | (2) surgery and reconstruction of the other breast to | ||||||
9 | produce a symmetrical appearance; and | ||||||
10 | (3) prostheses and treatment for physical | ||||||
11 | complications at all stages of mastectomy, including | ||||||
12 | lymphedemas. | ||||||
13 | Care shall be determined in consultation with the attending | ||||||
14 | physician and the patient. The offered coverage for prosthetic | ||||||
15 | devices and reconstructive surgery shall be subject to the | ||||||
16 | deductible and coinsurance conditions applied to the | ||||||
17 | mastectomy, and all other terms and conditions applicable to | ||||||
18 | other benefits. When a mastectomy is performed and there is no | ||||||
19 | evidence of malignancy then the offered coverage may be limited | ||||||
20 | to the provision of prosthetic devices and reconstructive | ||||||
21 | surgery to within 2 years after the date of the mastectomy. As | ||||||
22 | used in this Section, "mastectomy" means the removal of all or | ||||||
23 | part of the breast for medically necessary reasons, as | ||||||
24 | determined by a licensed physician. | ||||||
25 | A county, including a home rule county, that is a | ||||||
26 | self-insurer for purposes of providing health insurance |
| |||||||
| |||||||
1 | coverage for its employees, may not penalize or reduce or limit | ||||||
2 | the reimbursement of an attending provider or provide | ||||||
3 | incentives (monetary or otherwise) to an attending provider to | ||||||
4 | induce the provider to provide care to an insured in a manner | ||||||
5 | inconsistent with this Section. | ||||||
6 | (d-20) The
requirement that mammograms be included in | ||||||
7 | health insurance coverage as
provided in subsections this | ||||||
8 | subsection (d) through (d-15) is an exclusive power and | ||||||
9 | function of the
State and is a denial and limitation under | ||||||
10 | Article VII, Section 6,
subsection (h) of the Illinois | ||||||
11 | Constitution of home rule county powers. A
home rule county to | ||||||
12 | which subsections (d) through (d-15) apply this subsection | ||||||
13 | applies must comply with every
provision of those subsections | ||||||
14 | this subsection .
| ||||||
15 | (e) The term "employees" as used in this Section includes | ||||||
16 | elected or
appointed officials but does not include temporary | ||||||
17 | employees.
| ||||||
18 | (f) The county board may, by ordinance, arrange to provide | ||||||
19 | group life,
health, accident, hospital, and medical insurance, | ||||||
20 | or any one or a combination
of those types of insurance, under | ||||||
21 | this Section to retired former employees and
retired former | ||||||
22 | elected or appointed officials of the county.
| ||||||
23 | (g) Notwithstanding any other rulemaking authority that | ||||||
24 | may exist, neither the Governor nor any agency or agency head | ||||||
25 | under the jurisdiction of the Governor has any authority to | ||||||
26 | make or promulgate rules to implement or enforce the provisions |
| |||||||
| |||||||
1 | of this amendatory Act of the 95th General Assembly. If, | ||||||
2 | however, the Governor believes that rules are necessary to | ||||||
3 | implement or enforce the provisions of this amendatory Act of | ||||||
4 | the 95th General Assembly, the Governor may suggest rules to | ||||||
5 | the General Assembly by filing them with the Clerk of the House | ||||||
6 | and the Secretary of the Senate and by requesting that the | ||||||
7 | General Assembly authorize such rulemaking by law, enact those | ||||||
8 | suggested rules into law, or take any other appropriate action | ||||||
9 | in the General Assembly's discretion. Nothing contained in this | ||||||
10 | amendatory Act of the 95th General Assembly shall be | ||||||
11 | interpreted to grant rulemaking authority under any other | ||||||
12 | Illinois statute where such authority is not otherwise | ||||||
13 | explicitly given. For the purposes of this amendatory Act of | ||||||
14 | the 95th General Assembly, "rules" is given the meaning | ||||||
15 | contained in Section 1-70 of the Illinois Administrative | ||||||
16 | Procedure Act, and "agency" and "agency head" are given the | ||||||
17 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
18 | Administrative Procedure Act to the extent that such | ||||||
19 | definitions apply to agencies or agency heads under the | ||||||
20 | jurisdiction of the Governor. | ||||||
21 | (Source: P.A. 90-7, eff. 6-10-97; 91-217, eff. 1-1-00.)
| ||||||
22 | (55 ILCS 5/5-1069.3)
| ||||||
23 | Sec. 5-1069.3. Required health benefits. If a county, | ||||||
24 | including a home
rule
county, is a self-insurer for purposes of | ||||||
25 | providing health insurance coverage
for its employees, the |
| |||||||
| |||||||
1 | coverage shall include coverage for the post-mastectomy
care | ||||||
2 | benefits required to be covered by a policy of accident and | ||||||
3 | health
insurance under Section 356t and the coverage required | ||||||
4 | under Sections 356g, 356g.5, 356u,
356w, 356x, 356z.6, and | ||||||
5 | 356z.9, and 356z.10
356z.9 of
the Illinois Insurance Code. The | ||||||
6 | requirement that health benefits be covered
as provided in this | ||||||
7 | Section is an
exclusive power and function of the State and is | ||||||
8 | a denial and limitation under
Article VII, Section 6, | ||||||
9 | subsection (h) of the Illinois Constitution. A home
rule county | ||||||
10 | to which this Section applies must comply with every provision | ||||||
11 | of
this Section.
| ||||||
12 | Notwithstanding any other rulemaking authority that may | ||||||
13 | exist, neither the Governor nor any agency or agency head under | ||||||
14 | the jurisdiction of the Governor has any authority to make or | ||||||
15 | promulgate rules to implement or enforce the provisions of this | ||||||
16 | amendatory Act of the 95th General Assembly. If, however, the | ||||||
17 | Governor believes that rules are necessary to implement or | ||||||
18 | enforce the provisions of this amendatory Act of the 95th | ||||||
19 | General Assembly, the Governor may suggest rules to the General | ||||||
20 | Assembly by filing them with the Clerk of the House and the | ||||||
21 | Secretary of the Senate and by requesting that the General | ||||||
22 | Assembly authorize such rulemaking by law, enact those | ||||||
23 | suggested rules into law, or take any other appropriate action | ||||||
24 | in the General Assembly's discretion. Nothing contained in this | ||||||
25 | amendatory Act of the 95th General Assembly shall be | ||||||
26 | interpreted to grant rulemaking authority under any other |
| |||||||
| |||||||
1 | Illinois statute where such authority is not otherwise | ||||||
2 | explicitly given. For the purposes of this amendatory Act of | ||||||
3 | the 95th General Assembly, "rules" is given the meaning | ||||||
4 | contained in Section 1-70 of the Illinois Administrative | ||||||
5 | Procedure Act, and "agency" and "agency head" are given the | ||||||
6 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
7 | Administrative Procedure Act to the extent that such | ||||||
8 | definitions apply to agencies or agency heads under the | ||||||
9 | jurisdiction of the Governor. | ||||||
10 | (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | ||||||
11 | 95-520, eff. 8-28-07; revised 12-4-07.)
| ||||||
12 | Section 15-20. The Illinois Municipal Code is amended by | ||||||
13 | changing Sections 10-4-2 and 10-4-2.3 as follows:
| ||||||
14 | (65 ILCS 5/10-4-2) (from Ch. 24, par. 10-4-2)
| ||||||
15 | Sec. 10-4-2. Group insurance.
| ||||||
16 | (a) The corporate authorities of any municipality may | ||||||
17 | arrange
to provide, for the benefit of employees of the | ||||||
18 | municipality, group life,
health, accident, hospital, and | ||||||
19 | medical insurance, or any one or any
combination of those types | ||||||
20 | of insurance, and may arrange to provide that
insurance for the | ||||||
21 | benefit of the spouses or dependents of those employees.
The | ||||||
22 | insurance may include provision for employees or other insured | ||||||
23 | persons
who rely on treatment by prayer or spiritual means | ||||||
24 | alone for healing in
accordance with the tenets and practice of |
| |||||||
| |||||||
1 | a well recognized religious
denomination. The corporate | ||||||
2 | authorities may provide for payment by the
municipality of a | ||||||
3 | portion of the premium or charge for the insurance with
the | ||||||
4 | employee paying the balance of the premium or charge. If the | ||||||
5 | corporate
authorities undertake a plan under which the | ||||||
6 | municipality pays a portion of
the premium or charge, the | ||||||
7 | corporate authorities shall provide for
withholding and | ||||||
8 | deducting from the compensation of those municipal
employees | ||||||
9 | who consent to join the plan the balance of the premium or | ||||||
10 | charge
for the insurance.
| ||||||
11 | (b) If the corporate authorities do not provide for a plan | ||||||
12 | under which
the municipality pays a portion of the premium or | ||||||
13 | charge for a group
insurance plan, the corporate authorities | ||||||
14 | may provide for withholding
and deducting from the compensation | ||||||
15 | of those employees who consent thereto
the premium or charge | ||||||
16 | for any group life, health, accident, hospital, and
medical | ||||||
17 | insurance.
| ||||||
18 | (c) The corporate authorities may exercise the powers | ||||||
19 | granted in this
Section only if the kinds of group insurance | ||||||
20 | are obtained from an
insurance company authorized to do | ||||||
21 | business
in the State of Illinois,
or are obtained through an
| ||||||
22 | intergovernmental joint self-insurance pool as authorized | ||||||
23 | under the
Intergovernmental Cooperation Act.
The
corporate | ||||||
24 | authorities may enact an ordinance prescribing the method of
| ||||||
25 | operation of the insurance program.
| ||||||
26 | (d) If a municipality, including a home rule municipality, |
| |||||||
| |||||||
1 | is a
self-insurer for purposes of providing health insurance | ||||||
2 | coverage for its
employees, the insurance coverage shall | ||||||
3 | include screening by low-dose
mammography for all women 35 | ||||||
4 | years of age or older for the presence of
occult breast cancer | ||||||
5 | unless the municipality elects to provide mammograms
itself | ||||||
6 | under Section 10-4-2.1. The coverage shall be as follows:
| ||||||
7 | (1) A baseline mammogram for women 35 to 39 years of | ||||||
8 | age.
| ||||||
9 | (2) An annual mammogram for women 40 years of age or | ||||||
10 | older.
| ||||||
11 | (3) A mammogram at the age and intervals considered | ||||||
12 | medically necessary by the woman's health care provider for | ||||||
13 | women under 40 years of age and having a family history of | ||||||
14 | breast cancer, prior personal history of breast cancer, | ||||||
15 | positive genetic testing, or other risk factors. | ||||||
16 | (4) A comprehensive ultrasound screening of an entire | ||||||
17 | breast or breasts if a mammogram demonstrates | ||||||
18 | heterogeneous or dense breast tissue, when medically | ||||||
19 | necessary as determined by a physician licensed to practice | ||||||
20 | medicine in all of its branches. | ||||||
21 | Those benefits shall be at least as favorable as for other | ||||||
22 | radiological
examinations and subject to the same dollar | ||||||
23 | limits, deductibles, and
co-insurance factors. For purposes of | ||||||
24 | this subsection, "low-dose mammography"
means the x-ray | ||||||
25 | examination of the breast using equipment dedicated
| ||||||
26 | specifically for mammography, including the x-ray tube, |
| |||||||
| |||||||
1 | filter, compression
device, screens, and image receptor | ||||||
2 | receptors , with an average radiation exposure
delivery of less | ||||||
3 | than one rad per breast for mid-breast, with 2 views of an | ||||||
4 | average size for each breast. The term also includes digital | ||||||
5 | mammography. | ||||||
6 | (d-5) Coverage as described by subsection (d) shall be | ||||||
7 | provided at no cost to the insured and shall not be applied to | ||||||
8 | an annual or lifetime maximum benefit. | ||||||
9 | (d-10) When health care services are available through | ||||||
10 | contracted providers and a person does not comply with plan | ||||||
11 | provisions specific to the use of contracted providers, the | ||||||
12 | requirements of subsection (d-5) are not applicable. When a | ||||||
13 | person does not comply with plan provisions specific to the use | ||||||
14 | of contracted providers, plan provisions specific to the use of | ||||||
15 | non-contracted providers must be applied without distinction | ||||||
16 | for coverage required by this Section and shall be at least as | ||||||
17 | favorable as for other radiological examinations covered by the | ||||||
18 | policy or contract. | ||||||
19 | (d-15) If a municipality, including a home rule | ||||||
20 | municipality, is a self-insurer for purposes of providing | ||||||
21 | health insurance coverage for its employees, the insurance | ||||||
22 | coverage shall include mastectomy coverage, which includes | ||||||
23 | coverage for prosthetic devices or reconstructive surgery | ||||||
24 | incident to the mastectomy. Coverage for breast reconstruction | ||||||
25 | in connection with a mastectomy shall include: | ||||||
26 | (1) reconstruction of the breast upon which the |
| |||||||
| |||||||
1 | mastectomy has been performed; | ||||||
2 | (2) surgery and reconstruction of the other breast to | ||||||
3 | produce a symmetrical appearance; and | ||||||
4 | (3) prostheses and treatment for physical | ||||||
5 | complications at all stages of mastectomy, including | ||||||
6 | lymphedemas. | ||||||
7 | Care shall be determined in consultation with the attending | ||||||
8 | physician and the patient. The offered coverage for prosthetic | ||||||
9 | devices and reconstructive surgery shall be subject to the | ||||||
10 | deductible and coinsurance conditions applied to the | ||||||
11 | mastectomy, and all other terms and conditions applicable to | ||||||
12 | other benefits. When a mastectomy is performed and there is no | ||||||
13 | evidence of malignancy then the offered coverage may be limited | ||||||
14 | to the provision of prosthetic devices and reconstructive | ||||||
15 | surgery to within 2 years after the date of the mastectomy. As | ||||||
16 | used in this Section, "mastectomy" means the removal of all or | ||||||
17 | part of the breast for medically necessary reasons, as | ||||||
18 | determined by a licensed physician. | ||||||
19 | A municipality, including a home rule municipality, that is | ||||||
20 | a self-insurer for purposes of providing health insurance | ||||||
21 | coverage for its employees, may not penalize or reduce or limit | ||||||
22 | the reimbursement of an attending provider or provide | ||||||
23 | incentives (monetary or otherwise) to an attending provider to | ||||||
24 | induce the provider to provide care to an insured in a manner | ||||||
25 | inconsistent with this Section. | ||||||
26 | (d-20) The
requirement that mammograms be included in |
| |||||||
| |||||||
1 | health insurance coverage as
provided in subsections this | ||||||
2 | subsection (d) through (d-15) is an exclusive power and | ||||||
3 | function of the
State and is a denial and limitation under | ||||||
4 | Article VII, Section 6,
subsection (h) of the Illinois | ||||||
5 | Constitution of home rule municipality
powers. A home rule | ||||||
6 | municipality to which subsections (d) through (d-15) apply this | ||||||
7 | subsection applies must
comply with every provision of through | ||||||
8 | subsections this subsection .
| ||||||
9 | (e) Notwithstanding any other rulemaking authority that | ||||||
10 | may exist, neither the Governor nor any agency or agency head | ||||||
11 | under the jurisdiction of the Governor has any authority to | ||||||
12 | make or promulgate rules to implement or enforce the provisions | ||||||
13 | of this amendatory Act of the 95th General Assembly. If, | ||||||
14 | however, the Governor believes that rules are necessary to | ||||||
15 | implement or enforce the provisions of this amendatory Act of | ||||||
16 | the 95th General Assembly, the Governor may suggest rules to | ||||||
17 | the General Assembly by filing them with the Clerk of the House | ||||||
18 | and the Secretary of the Senate and by requesting that the | ||||||
19 | General Assembly authorize such rulemaking by law, enact those | ||||||
20 | suggested rules into law, or take any other appropriate action | ||||||
21 | in the General Assembly's discretion. Nothing contained in this | ||||||
22 | amendatory Act of the 95th General Assembly shall be | ||||||
23 | interpreted to grant rulemaking authority under any other | ||||||
24 | Illinois statute where such authority is not otherwise | ||||||
25 | explicitly given. For the purposes of this amendatory Act of | ||||||
26 | the 95th General Assembly, "rules" is given the meaning |
| |||||||
| |||||||
1 | contained in Section 1-70 of the Illinois Administrative | ||||||
2 | Procedure Act, and "agency" and "agency head" are given the | ||||||
3 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
4 | Administrative Procedure Act to the extent that such | ||||||
5 | definitions apply to agencies or agency heads under the | ||||||
6 | jurisdiction of the Governor. | ||||||
7 | (Source: P.A. 90-7, eff. 6-10-97; 91-160, eff. 1-1-00.)
| ||||||
8 | (65 ILCS 5/10-4-2.3)
| ||||||
9 | Sec. 10-4-2.3. Required health benefits. If a | ||||||
10 | municipality, including a
home rule municipality, is a | ||||||
11 | self-insurer for purposes of providing health
insurance | ||||||
12 | coverage for its employees, the coverage shall include coverage | ||||||
13 | for
the post-mastectomy care benefits required to be covered by | ||||||
14 | a policy of
accident and health insurance under Section 356t | ||||||
15 | and the coverage required
under Sections 356g, 356g.5, 356u, | ||||||
16 | 356w, 356x, 356z.6, and 356z.9, and 356z.10
356z.9 of the | ||||||
17 | Illinois
Insurance
Code. The requirement that health
benefits | ||||||
18 | be covered as provided in this is an exclusive power and | ||||||
19 | function of
the State and is a denial and limitation under | ||||||
20 | Article VII, Section 6,
subsection (h) of the Illinois | ||||||
21 | Constitution. A home rule municipality to which
this Section | ||||||
22 | applies must comply with every provision of this Section.
| ||||||
23 | Notwithstanding any other rulemaking authority that may | ||||||
24 | exist, neither the Governor nor any agency or agency head under | ||||||
25 | the jurisdiction of the Governor has any authority to make or |
| |||||||
| |||||||
1 | promulgate rules to implement or enforce the provisions of this | ||||||
2 | amendatory Act of the 95th General Assembly. If, however, the | ||||||
3 | Governor believes that rules are necessary to implement or | ||||||
4 | enforce the provisions of this amendatory Act of the 95th | ||||||
5 | General Assembly, the Governor may suggest rules to the General | ||||||
6 | Assembly by filing them with the Clerk of the House and the | ||||||
7 | Secretary of the Senate and by requesting that the General | ||||||
8 | Assembly authorize such rulemaking by law, enact those | ||||||
9 | suggested rules into law, or take any other appropriate action | ||||||
10 | in the General Assembly's discretion. Nothing contained in this | ||||||
11 | amendatory Act of the 95th General Assembly shall be | ||||||
12 | interpreted to grant rulemaking authority under any other | ||||||
13 | Illinois statute where such authority is not otherwise | ||||||
14 | explicitly given. For the purposes of this amendatory Act of | ||||||
15 | the 95th General Assembly, "rules" is given the meaning | ||||||
16 | contained in Section 1-70 of the Illinois Administrative | ||||||
17 | Procedure Act, and "agency" and "agency head" are given the | ||||||
18 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
19 | Administrative Procedure Act to the extent that such | ||||||
20 | definitions apply to agencies or agency heads under the | ||||||
21 | jurisdiction of the Governor. | ||||||
22 | (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | ||||||
23 | 95-520, eff. 8-28-07; revised 12-4-07.)
| ||||||
24 | Section 15-25. The School Code is amended by changing | ||||||
25 | Section 10-22.3f as follows: |
| |||||||
| |||||||
1 | (105 ILCS 5/10-22.3f)
| ||||||
2 | Sec. 10-22.3f. Required health benefits. Insurance | ||||||
3 | protection and
benefits
for employees shall provide the | ||||||
4 | post-mastectomy care benefits required to be
covered by a | ||||||
5 | policy of accident and health insurance under Section 356t and | ||||||
6 | the
coverage required under Sections 356g, 356g.5, 356u, 356w, | ||||||
7 | 356x,
356z.6, and 356z.9 of
the
Illinois Insurance Code.
| ||||||
8 | Notwithstanding any other rulemaking authority that may | ||||||
9 | exist, neither the Governor nor any agency or agency head under | ||||||
10 | the jurisdiction of the Governor has any authority to make or | ||||||
11 | promulgate rules to implement or enforce the provisions of this | ||||||
12 | amendatory Act of the 95th General Assembly. If, however, the | ||||||
13 | Governor believes that rules are necessary to implement or | ||||||
14 | enforce the provisions of this amendatory Act of the 95th | ||||||
15 | General Assembly, the Governor may suggest rules to the General | ||||||
16 | Assembly by filing them with the Clerk of the House and the | ||||||
17 | Secretary of the Senate and by requesting that the General | ||||||
18 | Assembly authorize such rulemaking by law, enact those | ||||||
19 | suggested rules into law, or take any other appropriate action | ||||||
20 | in the General Assembly's discretion. Nothing contained in this | ||||||
21 | amendatory Act of the 95th General Assembly shall be | ||||||
22 | interpreted to grant rulemaking authority under any other | ||||||
23 | Illinois statute where such authority is not otherwise | ||||||
24 | explicitly given. For the purposes of this amendatory Act of | ||||||
25 | the 95th General Assembly, "rules" is given the meaning |
| |||||||
| |||||||
1 | contained in Section 1-70 of the Illinois Administrative | ||||||
2 | Procedure Act, and "agency" and "agency head" are given the | ||||||
3 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
4 | Administrative Procedure Act to the extent that such | ||||||
5 | definitions apply to agencies or agency heads under the | ||||||
6 | jurisdiction of the Governor. | ||||||
7 | (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | ||||||
8 | revised 12-4-07.)
| ||||||
9 | Section 15-30. The Health Maintenance Organization Act is | ||||||
10 | amended by changing Section 4-6.1 as follows:
| ||||||
11 | (215 ILCS 125/4-6.1) (from Ch. 111 1/2, par. 1408.7)
| ||||||
12 | Sec. 4-6.1. Mammograms; mastectomies.
| ||||||
13 | (a) Every contract or evidence of coverage
issued by a | ||||||
14 | Health Maintenance Organization for persons who are residents | ||||||
15 | of
this State shall contain coverage for screening by low-dose | ||||||
16 | mammography
for all women 35 years of age or older for the | ||||||
17 | presence of occult breast
cancer. The coverage shall be as | ||||||
18 | follows:
| ||||||
19 | (1) A baseline mammogram for women 35 to 39 years of | ||||||
20 | age.
| ||||||
21 | (2) An annual mammogram for women 40 years of age or | ||||||
22 | older.
| ||||||
23 | (3) A mammogram at the age and intervals considered | ||||||
24 | medically necessary by the woman's health care provider for |
| |||||||
| |||||||
1 | women under 40 years of age and having a family history of | ||||||
2 | breast cancer, prior personal history of breast cancer, | ||||||
3 | positive genetic testing, or other risk factors. | ||||||
4 | (4) A comprehensive ultrasound screening of an entire | ||||||
5 | breast or breasts if a mammogram demonstrates | ||||||
6 | heterogeneous or dense breast tissue, when medically | ||||||
7 | necessary as determined by a physician licensed to practice | ||||||
8 | medicine in all of its branches.
| ||||||
9 | These benefits shall be at least as favorable as for other | ||||||
10 | radiological
examinations and subject to the same dollar | ||||||
11 | limits, deductibles, and
co-insurance factors. For purposes of | ||||||
12 | this Section, "low-dose mammography"
means the x-ray | ||||||
13 | examination of the breast using equipment dedicated
| ||||||
14 | specifically for mammography, including the x-ray tube, | ||||||
15 | filter, compression
device, and image receptor, with radiation | ||||||
16 | exposure delivery of less than 1
rad per breast for 2 views of | ||||||
17 | an average size breast. The term also includes digital | ||||||
18 | mammography.
| ||||||
19 | (a-5) Coverage as described in subsection (a) shall be | ||||||
20 | provided at no cost to the enrollee and shall not be applied to | ||||||
21 | an annual or lifetime maximum benefit. | ||||||
22 | (b) No contract or evidence of coverage issued by a health | ||||||
23 | maintenance
organization that provides for the
surgical | ||||||
24 | procedure known as a mastectomy shall be issued, amended, | ||||||
25 | delivered,
or renewed in this State on or after the effective | ||||||
26 | date of this amendatory Act
of the 92nd General Assembly unless |
| |||||||
| |||||||
1 | that coverage also provides for prosthetic
devices or | ||||||
2 | reconstructive surgery incident to the mastectomy, providing | ||||||
3 | that
the mastectomy is performed after the effective date of | ||||||
4 | this amendatory Act.
Coverage for breast reconstruction in | ||||||
5 | connection
with a mastectomy shall
include:
| ||||||
6 | (1) reconstruction of the breast upon which the | ||||||
7 | mastectomy has been
performed;
| ||||||
8 | (2) surgery and reconstruction of the other breast to | ||||||
9 | produce a
symmetrical appearance; and
| ||||||
10 | (3) prostheses and treatment for physical | ||||||
11 | complications at all stages of
mastectomy, including | ||||||
12 | lymphedemas.
| ||||||
13 | Care shall be determined in consultation with the attending | ||||||
14 | physician and the
patient.
The offered coverage for prosthetic | ||||||
15 | devices and
reconstructive surgery shall be subject to the | ||||||
16 | deductible and coinsurance
conditions applied to the | ||||||
17 | mastectomy and all other terms and conditions
applicable to | ||||||
18 | other benefits. When a mastectomy is performed and there is
no | ||||||
19 | evidence of malignancy, then the offered coverage may be | ||||||
20 | limited to the
provision of prosthetic devices and | ||||||
21 | reconstructive surgery to within 2
years after the date of the | ||||||
22 | mastectomy. As used in this Section,
"mastectomy" means the | ||||||
23 | removal of all or part of the breast for medically
necessary | ||||||
24 | reasons, as determined by a licensed physician.
| ||||||
25 | Written notice of the availability of coverage under this | ||||||
26 | Section shall be
delivered to the enrollee upon enrollment and |
| |||||||
| |||||||
1 | annually thereafter. A
health maintenance organization may not | ||||||
2 | deny to an enrollee eligibility, or
continued eligibility, to | ||||||
3 | enroll or
to renew coverage under the terms of the plan solely | ||||||
4 | for the purpose of
avoiding the requirements of this Section. A | ||||||
5 | health maintenance organization
may not penalize or
reduce or
| ||||||
6 | limit the reimbursement of an attending provider or provide | ||||||
7 | incentives
(monetary or otherwise) to an attending provider to | ||||||
8 | induce the provider to
provide care to an insured in a manner | ||||||
9 | inconsistent with this Section.
| ||||||
10 | (c) Notwithstanding any other rulemaking authority that | ||||||
11 | may exist, neither the Governor nor any agency or agency head | ||||||
12 | under the jurisdiction of the Governor has any authority to | ||||||
13 | make or promulgate rules to implement or enforce the provisions | ||||||
14 | of this amendatory Act of the 95th General Assembly. If, | ||||||
15 | however, the Governor believes that rules are necessary to | ||||||
16 | implement or enforce the provisions of this amendatory Act of | ||||||
17 | the 95th General Assembly, the Governor may suggest rules to | ||||||
18 | the General Assembly by filing them with the Clerk of the House | ||||||
19 | and the Secretary of the Senate and by requesting that the | ||||||
20 | General Assembly authorize such rulemaking by law, enact those | ||||||
21 | suggested rules into law, or take any other appropriate action | ||||||
22 | in the General Assembly's discretion. Nothing contained in this | ||||||
23 | amendatory Act of the 95th General Assembly shall be | ||||||
24 | interpreted to grant rulemaking authority under any other | ||||||
25 | Illinois statute where such authority is not otherwise | ||||||
26 | explicitly given. For the purposes of this amendatory Act of |
| |||||||
| |||||||
1 | the 95th General Assembly, "rules" is given the meaning | ||||||
2 | contained in Section 1-70 of the Illinois Administrative | ||||||
3 | Procedure Act, and "agency" and "agency head" are given the | ||||||
4 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
5 | Administrative Procedure Act to the extent that such | ||||||
6 | definitions apply to agencies or agency heads under the | ||||||
7 | jurisdiction of the Governor. | ||||||
8 | (Source: P.A. 94-121, eff. 7-6-05; 95-431, eff. 8-24-07.)
| ||||||
9 | Section 15-35. The Voluntary Health Services Plans Act is | ||||||
10 | amended by changing Section 10 as follows:
| ||||||
11 | (215 ILCS 165/10) (from Ch. 32, par. 604)
| ||||||
12 | Sec. 10. Application of Insurance Code provisions. Health | ||||||
13 | services
plan corporations and all persons interested therein | ||||||
14 | or dealing therewith
shall be subject to the provisions of | ||||||
15 | Articles IIA and XII 1/2 and Sections
3.1, 133, 140, 143, 143c, | ||||||
16 | 149, 155.37, 354, 355.2, 356g, 356g.5, 356r, 356t, 356u, 356v,
| ||||||
17 | 356w, 356x, 356y, 356z.1, 356z.2, 356z.4, 356z.5, 356z.6, | ||||||
18 | 356z.8, 356z.9,
356z.10
356z.9 , 364.01, 367.2, 368a, 401, | ||||||
19 | 401.1,
402,
403, 403A, 408,
408.2, and 412, and paragraphs (7) | ||||||
20 | and (15) of Section 367 of the Illinois
Insurance Code.
| ||||||
21 | Notwithstanding any other rulemaking authority that may | ||||||
22 | exist, neither the Governor nor any agency or agency head under | ||||||
23 | the jurisdiction of the Governor has any authority to make or | ||||||
24 | promulgate rules to implement or enforce the provisions of this |
| |||||||
| |||||||
1 | amendatory Act of the 95th General Assembly. If, however, the | ||||||
2 | Governor believes that rules are necessary to implement or | ||||||
3 | enforce the provisions of this amendatory Act of the 95th | ||||||
4 | General Assembly, the Governor may suggest rules to the General | ||||||
5 | Assembly by filing them with the Clerk of the House and the | ||||||
6 | Secretary of the Senate and by requesting that the General | ||||||
7 | Assembly authorize such rulemaking by law, enact those | ||||||
8 | suggested rules into law, or take any other appropriate action | ||||||
9 | in the General Assembly's discretion. Nothing contained in this | ||||||
10 | amendatory Act of the 95th General Assembly shall be | ||||||
11 | interpreted to grant rulemaking authority under any other | ||||||
12 | Illinois statute where such authority is not otherwise | ||||||
13 | explicitly given. For the purposes of this amendatory Act of | ||||||
14 | the 95th General Assembly, "rules" is given the meaning | ||||||
15 | contained in Section 1-70 of the Illinois Administrative | ||||||
16 | Procedure Act, and "agency" and "agency head" are given the | ||||||
17 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
18 | Administrative Procedure Act to the extent that such | ||||||
19 | definitions apply to agencies or agency heads under the | ||||||
20 | jurisdiction of the Governor. | ||||||
21 | (Source: P.A. 94-1076, eff. 12-29-06; 95-189, eff. 8-16-07; | ||||||
22 | 95-331, eff. 8-21-07; 95-422, eff. 8-24-07; 95-520, eff. | ||||||
23 | 8-28-07; revised 12-5-07.)
| ||||||
24 | Section 99. Effective date. This Act takes effect upon | ||||||
25 | becoming law.
|