102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
Introduced 1/5/2022, by Rep. Kelly M. Cassidy
SYNOPSIS AS INTRODUCED:
215 ILCS 5/356z.53 new
305 ILCS 5/5-16.8
Amends the Illinois Insurance Code. Provides that an individual or
group policy of accident and health insurance or managed care plan that is
amended, delivered, issued, or renewed on or after the effective date of
the amendatory Act shall provide coverage for aesthetic services and
restorative care provided for the treatment of physical injuries to
victims of domestic violence when medically necessary as determined by a
physician licensed to practice medicine in all its branches. Defines
"domestic violence". Makes a conforming change in the Medical Assistance
Article of the Illinois Public Aid Code.
|FISCAL NOTE ACT MAY APPLY|
A BILL FOR
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AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
The Illinois Insurance Code is amended by
adding Section 356z.53 as follows:
(215 ILCS 5/356z.53 new)
Coverage for treatment for survivors of
(a) As used in this Section, "domestic violence" has the
meaning ascribed to that term in Section 103 of the Illinois
Domestic Violence Act of 1986.
(b) An individual or group policy of accident and health
insurance or managed care plan that is amended, delivered,
issued, or renewed on or after the effective date of this
amendatory Act of the 102nd General Assembly shall provide
coverage for aesthetic services and restorative care provided
for the treatment of physical injuries to victims of domestic
violence when medically necessary as determined by a physician
licensed to practice medicine in all its branches.
The Illinois Public Aid Code is amended by
changing Section 5-16.8 as follows:
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(305 ILCS 5/5-16.8)
Required health benefits.
(i) provide the post-mastectomy care
benefits required to be covered by a policy of
health insurance under Section 356t and the coverage required
under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6,
356z.26, 356z.29, 356z.32, 356z.33, 356z.34, 356z.35,
356z.46, 356z.47, 356z.51, and 356z.53
Insurance Code, (ii) be subject to the provisions of
364.01, 370c, and
370c.1 of the Illinois
Insurance Code, and (iii) be subject to
the provisions of subsection (d-5) of Section 10 of the
Network Adequacy and Transparency Act.
The Department, by rule, shall adopt a model similar to
the requirements of Section 356z.39 of the Illinois Insurance
On and after July 1, 2012, the Department shall reduce any
rate of reimbursement for services or other payments or alter
any methodologies authorized by this Code to reduce any rate
of reimbursement for services or other payments in accordance
with Section 5-5e.
To ensure full access to the benefits set forth in this
Section, on and after January 1, 2016, the Department shall
ensure that provider and hospital reimbursement for
post-mastectomy care benefits required under this Section are
no lower than the Medicare reimbursement rate.
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(Source: P.A. 101-81, eff. 7-12-19; 101-218, eff. 1-1-20;
101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-574, eff.
1-1-20; 101-649, eff. 7-7-20; 102-30, eff. 1-1-22; 102-144,
eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
102-530, eff. 1-1-22; 102-642, eff. 1-1-22; revised 10-27-21.)