96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010
HB5527

 

Introduced 2/9/2010, by Rep. Angelo Saviano - Michael J. Zalewski

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 138/15

    Amends the Uniform Prescription Drug Information Card Act. Provides that a discounted health care services plan administrator shall issue to its beneficiaries and insureds a card or other technology containing uniform prescription drug information. Sets forth the mandatory data elements that the card or other technology issued by a discounted health care services plan administrator shall display. Sets forth a definition for "discounted health care services plan administrator".


LRB096 20211 RPM 35782 b

 

 

A BILL FOR

 

HB5527 LRB096 20211 RPM 35782 b

1     AN ACT concerning insurance.
 
2     Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
 
4     Section 5. The Uniform Prescription Drug Information Card
5 Act is amended by changing Section 15 as follows:
 
6     (215 ILCS 138/15)
7     Sec. 15. Uniform prescription drug information cards
8 required.
9     (a) A health benefit plan that issues a card or other
10 technology and provides coverage for prescription drugs or
11 devices and an administrator of such a plan including, but not
12 limited to, third-party administrators for self-insured plans
13 and state-administered plans shall issue to its insureds a card
14 or other technology containing uniform prescription drug
15 information. The uniform prescription drug information card or
16 other technology shall specifically identify and display the
17 following mandatory data elements on the front of the card:
18         (1) BIN number;
19         (2) Processor control number if required for claims
20     adjudication;
21         (3) Group number;
22         (4) Card issuer identifier;
23         (5) Cardholder ID number; and

 

 

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1         (6) Cardholder name.
2     The uniform prescription drug information card or other
3 technology shall specifically identify and display the
4 following mandatory data elements on the back of the card:
5         (1) Claims submission names and addresses; and
6         (2) Help desk telephone numbers and names.
7     (b) A discounted health care services plan administrator
8 shall issue to its beneficiaries and insureds a card or other
9 technology containing uniform prescription drug information.
10 The uniform prescription drug information card or other
11 technology issued by a discounted health care services plan
12 administrator shall specifically identify and display the
13 following mandatory data elements:
14         (1) BIN number;
15         (2) processor control number, if required for claims
16     adjudication;
17         (3) group number;
18         (4) card issuer identifier;
19         (5) cardholder ID number;
20         (6) cardholder name;
21         (7) claims submission names and addresses; and
22         (8) help desk telephone numbers and names.
23     (c) (b) A new uniform prescription drug information card or
24 other technology shall be issued by a health benefit plan upon
25 enrollment and reissued upon any change in the insured's
26 coverage that affects mandatory data elements contained on the

 

 

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1 card.
2     (d) As used in this Section, "discounted health care
3 services plan administrator" means any person, partnership, or
4 corporation, other than an insurer, health service
5 corporation, limited health service organization holding a
6 certificate of authority under the Limited Health Service
7 Organization Act, or health maintenance organization holding a
8 certificate of authority under the Health Maintenance
9 Organization Act, that arranges, contracts with, or
10 administers contracts with a provider whereby insureds or
11 beneficiaries are provided an incentive to use health care
12 services provided by health care service providers under a
13 discounted health care service plan in which there are no other
14 incentives, such as copayment, coinsurance, or any other
15 reimbursement differential, for beneficiaries to utilize the
16 provider. "Discounted health care services plan administrator"
17 also includes any person, partnership, or corporation, other
18 than an insurer, health service corporation, limited health
19 service organization holding a certificate of authority under
20 the Limited Health Service Organization Act, or health
21 maintenance organization holding a certificate of authority
22 under the Health Maintenance Organization Act, that enters into
23 a contract with another administrator to enroll beneficiaries
24 or insureds in a preferred provider program marketed as an
25 independently identifiable program based on marketing
26 materials or member benefit identification cards.

 

 

HB5527 - 4 - LRB096 20211 RPM 35782 b

1 (Source: P.A. 91-777, eff. 1-1-01.)