|
|
|||||||
| |||||||
| |||||||
| 1 | AN ACT concerning regulation.
| ||||||
| 2 | Be it enacted by the People of the State of Illinois,
| ||||||
| 3 | represented in the General Assembly:
| ||||||
| 4 | Section 5. The Illinois Insurance Code is amended by | ||||||
| 5 | changing Sections 512-3, 512-4, and 512-5 as follows:
| ||||||
| 6 | (215 ILCS 5/512-3) (from Ch. 73, par. 1065.59-3)
| ||||||
| 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:
| ||||||
| 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 | ||||||
| 17 | whereby a consumer receives prescription drugs or other | ||||||
| 18 | pharmaceutical
services and those services are paid for by
an | ||||||
| 19 | agent of the employer or others.
| ||||||
| 20 | (b) "Third party program administrator" or "administrator" | ||||||
| 21 | means any person,
partnership or corporation who issues or | ||||||
| 22 | causes to be issued any payment
or reimbursement to a provider | ||||||
| 23 | for services rendered pursuant to a third
party prescription | ||||||
| |||||||
| |||||||
| 1 | program, but does not include the Director of Healthcare and | ||||||
| 2 | Family Services or any agent authorized by
the Director to | ||||||
| 3 | reimburse a provider of services rendered pursuant to a
program | ||||||
| 4 | of which the Department of Healthcare and Family Services is | ||||||
| 5 | the third party. | ||||||
| 6 | (c) "Director" means the Director of the Division of | ||||||
| 7 | Insurance of the Department of Financial and Professional | ||||||
| 8 | Regulation. | ||||||
| 9 | (d) "Division" means the Division of Insurance of the | ||||||
| 10 | Department of Financial and Professional Regulation.
| ||||||
| 11 | (Source: P.A. 95-331, eff. 8-21-07.)
| ||||||
| 12 | (215 ILCS 5/512-4) (from Ch. 73, par. 1065.59-4)
| ||||||
| 13 | Sec. 512-4. Registration. All third party prescription | ||||||
| 14 | programs and
administrators doing business in the State shall | ||||||
| 15 | register with the Director
of Insurance. The Director shall | ||||||
| 16 | promulgate regulations establishing criteria
for registration | ||||||
| 17 | in accordance with the terms of this Article. The Director
may | ||||||
| 18 | by rule establish an annual registration fee for each third | ||||||
| 19 | party administrator.
| ||||||
| 20 | (Source: P.A. 82-1005.)
| ||||||
| 21 | (215 ILCS 5/512-5) (from Ch. 73, par. 1065.59-5)
| ||||||
| 22 | Sec. 512-5. Fiduciary and Bonding Requirements. A third | ||||||
| 23 | party prescription program administrator shall (1) establish | ||||||
| 24 | and
maintain a fiduciary account, separate and apart from any | ||||||
| |||||||
| |||||||
| 1 | and all other
accounts, for the receipt and disbursement of | ||||||
| 2 | funds for reimbursement of
providers of services under the | ||||||
| 3 | program, or (2) post,
or cause to be posted, a bond of | ||||||
| 4 | indemnity in an amount equal to not less
than 10% of the total | ||||||
| 5 | estimated annual reimbursements under the program.
| ||||||
| 6 | The establishment of such fiduciary accounts and bonds | ||||||
| 7 | shall be consistent
with applicable State law.
If a bond of | ||||||
| 8 | indemnity is posted, it shall be held by the Director of | ||||||
| 9 | Insurance
for the benefit and indemnification of the providers | ||||||
| 10 | of services under the
third party prescription program.
| ||||||
| 11 | An administrator who operates more than one third party | ||||||
| 12 | prescription program
may establish and maintain a separate | ||||||
| 13 | fiduciary account or bond of indemnity
for each such program, | ||||||
| 14 | or may operate and maintain a consolidated fiduciary
account or | ||||||
| 15 | bond of indemnity for all such programs.
| ||||||
| 16 | The requirements of this Section do not apply to any third | ||||||
| 17 | party prescription
program administered by or on behalf of any | ||||||
| 18 | insurance company, Health Care
Service Plan Corporation or | ||||||
| 19 | Pharmaceutical Service Plan Corporation authorized
to do | ||||||
| 20 | business in the State of Illinois.
| ||||||
| 21 | (Source: P.A. 82-1005.)
| ||||||