102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB4337

 

Introduced 1/5/2022, by Rep. Kelly M. Cassidy

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 5/356z.53 new
305 ILCS 5/5-16.8

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


LRB102 21325 BMS 32066 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB4337LRB102 21325 BMS 32066 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Insurance Code is amended by
5adding Section 356z.53 as follows:
 
6    (215 ILCS 5/356z.53 new)
7    Sec. 356z.53. Coverage for treatment for survivors of
8domestic violence.
9    (a) As used in this Section, "domestic violence" has the
10meaning ascribed to that term in Section 103 of the Illinois
11Domestic Violence Act of 1986.
12    (b) An individual or group policy of accident and health
13insurance or managed care plan that is amended, delivered,
14issued, or renewed on or after the effective date of this
15amendatory Act of the 102nd General Assembly shall provide
16coverage for aesthetic services and restorative care provided
17for the treatment of physical injuries to victims of domestic
18violence when medically necessary as determined by a physician
19licensed to practice medicine in all its branches.
 
20    Section 10. The Illinois Public Aid Code is amended by
21changing Section 5-16.8 as follows:
 

 

 

HB4337- 2 -LRB102 21325 BMS 32066 b

1    (305 ILCS 5/5-16.8)
2    Sec. 5-16.8. Required health benefits. The medical
3assistance program shall (i) provide the post-mastectomy care
4benefits required to be covered by a policy of accident and
5health insurance under Section 356t and the coverage required
6under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6,
7356z.26, 356z.29, 356z.32, 356z.33, 356z.34, 356z.35, 356z.43,
8356z.46, 356z.47, 356z.51, and 356z.53 and 356z.43 of the
9Illinois Insurance Code, (ii) be subject to the provisions of
10Sections 356z.19, 356z.43, 356z.44, 356z.49, 364.01, 370c, and
11370c.1 of the Illinois Insurance Code, and (iii) be subject to
12the provisions of subsection (d-5) of Section 10 of the
13Network Adequacy and Transparency Act.
14    The Department, by rule, shall adopt a model similar to
15the requirements of Section 356z.39 of the Illinois Insurance
16Code.
17    On and after July 1, 2012, the Department shall reduce any
18rate of reimbursement for services or other payments or alter
19any methodologies authorized by this Code to reduce any rate
20of reimbursement for services or other payments in accordance
21with Section 5-5e.
22    To ensure full access to the benefits set forth in this
23Section, on and after January 1, 2016, the Department shall
24ensure that provider and hospital reimbursement for
25post-mastectomy care benefits required under this Section are
26no lower than the Medicare reimbursement rate.

 

 

HB4337- 3 -LRB102 21325 BMS 32066 b

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