State Government Administration Committee
Filed: 3/5/2008
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1 | AMENDMENT TO HOUSE BILL 5614
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2 | AMENDMENT NO. ______. Amend House Bill 5614 by replacing | ||||||
3 | everything after the enacting clause with the following:
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4 | "Section 5. The Illinois Insurance Code is amended by | ||||||
5 | changing Sections 512-3, 512-4, and 512-5 as follows:
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6 | (215 ILCS 5/512-3) (from Ch. 73, par. 1065.59-3)
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7 | Sec. 512-3. Definitions. For the purposes of this Article, | ||||||
8 | unless the
context otherwise requires, the terms defined in | ||||||
9 | this Article have the meanings
ascribed
to them herein:
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10 | (a) "Third party prescription program" or "program" means | ||||||
11 | any system of
providing for the reimbursement of pharmaceutical | ||||||
12 | services and prescription
drug products offered or operated in | ||||||
13 | this State under a contractual arrangement
or agreement between | ||||||
14 | a provider of such services and another party who is
not the | ||||||
15 | consumer of those services and products. Such programs may | ||||||
16 | include, but need not be limited to, employee benefit
plans |
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1 | whereby a consumer receives prescription drugs or other | ||||||
2 | pharmaceutical
services and those services are paid for by
an | ||||||
3 | agent of the employer or others.
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4 | (b) "Third party program administrator" or "administrator" | ||||||
5 | means any person,
partnership or corporation who issues or | ||||||
6 | causes to be issued any payment
or reimbursement to a provider | ||||||
7 | for services rendered pursuant to a third
party prescription | ||||||
8 | program, but does not include the Director of Healthcare and | ||||||
9 | Family Services or any agent authorized by
the Director to | ||||||
10 | reimburse a provider of services rendered pursuant to a
program | ||||||
11 | of which the Department of Healthcare and Family Services is | ||||||
12 | the third party. | ||||||
13 | (c) "Director" means the Director of the Division of | ||||||
14 | Insurance of the Department of Financial and Professional | ||||||
15 | Regulation. | ||||||
16 | (d) "Division" means the Division of Insurance of the | ||||||
17 | Department of Financial and Professional Regulation.
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18 | (Source: P.A. 95-331, eff. 8-21-07.)
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19 | (215 ILCS 5/512-4) (from Ch. 73, par. 1065.59-4)
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20 | Sec. 512-4. Registration. All third party prescription | ||||||
21 | programs and
administrators doing business in the State shall | ||||||
22 | register with the Director
of Insurance . The Director shall | ||||||
23 | promulgate regulations establishing criteria
for registration | ||||||
24 | in accordance with the terms of this Article. The Director
may | ||||||
25 | by rule establish an annual registration fee for each third |
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1 | party administrator.
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2 | (Source: P.A. 82-1005.)
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3 | (215 ILCS 5/512-5) (from Ch. 73, par. 1065.59-5)
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4 | Sec. 512-5. Fiduciary and Bonding Requirements. A third | ||||||
5 | party prescription program administrator shall (1) establish | ||||||
6 | and
maintain a fiduciary account, separate and apart from any | ||||||
7 | and all other
accounts, for the receipt and disbursement of | ||||||
8 | funds for reimbursement of
providers of services under the | ||||||
9 | program, or (2) post,
or cause to be posted, a bond of | ||||||
10 | indemnity in an amount equal to not less
than 10% of the total | ||||||
11 | estimated annual reimbursements under the program.
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12 | The establishment of such fiduciary accounts and bonds | ||||||
13 | shall be consistent
with applicable State law.
If a bond of | ||||||
14 | indemnity is posted, it shall be held by the Director of | ||||||
15 | Insurance
for the benefit and indemnification of the providers | ||||||
16 | of services under the
third party prescription program.
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17 | An administrator who operates more than one third party | ||||||
18 | prescription program
may establish and maintain a separate | ||||||
19 | fiduciary account or bond of indemnity
for each such program, | ||||||
20 | or may operate and maintain a consolidated fiduciary
account or | ||||||
21 | bond of indemnity for all such programs.
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22 | The requirements of this Section do not apply to any third | ||||||
23 | party prescription
program administered by or on behalf of any | ||||||
24 | insurance company, Health Care
Service Plan Corporation or | ||||||
25 | Pharmaceutical Service Plan Corporation authorized
to do |
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1 | business in the State of Illinois.
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2 | (Source: P.A. 82-1005.)".
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