Full Text of HB3403 102nd General Assembly
HB3403 102ND GENERAL ASSEMBLY |
| | 102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022 HB3403 Introduced 2/22/2021, by Rep. Suzanne Ness SYNOPSIS AS INTRODUCED: |
| 215 ILCS 5/356z.41 | | 305 ILCS 5/5-16.8 | |
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Amends the Illinois Insurance Code to provide that an insurer that provides coverage for prescription insulin drugs pursuant to the terms of a health coverage plan the insurer offers shall limit the total amount that an insured is required to pay for a 30-day supply of covered prescription insulin drugs at an amount not to exceed $30 (rather than $100). Makes a conforming change in the Illinois Public Aid Code. Effective immediately.
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| | | FISCAL NOTE ACT MAY APPLY | |
| | A BILL FOR |
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| 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 Section 356z.41 as follows: | 6 | | (215 ILCS 5/356z.41) | 7 | | Sec. 356z.41. Cost sharing in prescription insulin drugs; | 8 | | limits; confidentiality of rebate information. | 9 | | (a) As used in this Section, "prescription insulin drug" | 10 | | means a prescription drug that contains insulin and is used to | 11 | | control blood glucose levels to treat diabetes but does not | 12 | | include an insulin drug that is
administered to a patient | 13 | | intravenously. | 14 | | (b) This Section applies to a group or individual policy | 15 | | of accident and health insurance amended, delivered, issued, | 16 | | or renewed on or after the effective date of this amendatory | 17 | | Act of the 102nd General Assembly this amendatory Act of the | 18 | | 101st General Assembly . | 19 | | (c) An insurer that provides coverage for prescription | 20 | | insulin drugs pursuant to the terms of a health coverage plan | 21 | | the insurer offers shall limit the total amount that an | 22 | | insured is required to pay for a 30-day supply of covered | 23 | | prescription insulin drugs at an amount not to exceed $30 |
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| 1 | | $100 , regardless of the quantity or type of covered | 2 | | prescription insulin drug used to fill the insured's | 3 | | prescription. | 4 | | (d) Nothing in this Section prevents an insurer from | 5 | | reducing an insured's cost sharing by an amount greater than | 6 | | the amount specified in subsection (c). | 7 | | (e) The Director may use any of the Director's enforcement | 8 | | powers to obtain an insurer's compliance with this Section. | 9 | | (f) The Department may adopt rules as necessary to | 10 | | implement and administer this Section and to align it with | 11 | | federal requirements. | 12 | | (g) On January 1 of each year, the limit on the amount that | 13 | | an insured is required to pay for a 30-day supply of a covered | 14 | | prescription insulin drug shall increase by a percentage equal | 15 | | to the percentage change from the preceding year in the | 16 | | medical care component of the Consumer Price Index of the | 17 | | Bureau of Labor Statistics of the United States Department of | 18 | | Labor.
| 19 | | (Source: P.A. 101-625, eff. 1-1-21 .) | 20 | | Section 10. The Illinois Public Aid Code is amended by | 21 | | changing Section 5-16.8 as follows:
| 22 | | (305 ILCS 5/5-16.8)
| 23 | | Sec. 5-16.8. Required health benefits. The medical | 24 | | assistance program
shall
(i) provide the post-mastectomy care |
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| 1 | | benefits required to be covered by a policy of
accident and | 2 | | health insurance under Section 356t and the coverage required
| 3 | | under Sections 356g.5, 356u, 356w, 356x, 356z.6, 356z.26, | 4 | | 356z.29, 356z.32, 356z.33, 356z.34, and 356z.35 of the | 5 | | Illinois
Insurance Code and (ii) be subject to the provisions | 6 | | of Sections 356z.19, 356z.41, 364.01, 370c, and 370c.1 of the | 7 | | Illinois
Insurance Code.
| 8 | | The Department, by rule, shall adopt a model similar to | 9 | | the requirements of Section 356z.39 of the Illinois Insurance | 10 | | Code. | 11 | | On and after July 1, 2012, the Department shall reduce any | 12 | | rate of reimbursement for services or other payments or alter | 13 | | any methodologies authorized by this Code to reduce any rate | 14 | | of reimbursement for services or other payments in accordance | 15 | | with Section 5-5e. | 16 | | To ensure full access to the benefits set forth in this | 17 | | Section, on and after January 1, 2016, the Department shall | 18 | | ensure that provider and hospital reimbursement for | 19 | | post-mastectomy care benefits required under this Section are | 20 | | no lower than the Medicare reimbursement rate. | 21 | | (Source: P.A. 100-138, eff. 8-18-17; 100-863, eff. 8-14-18; | 22 | | 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. | 23 | | 7-12-19; 101-218, eff. 1-1-20; 101-281, eff. 1-1-20; 101-371, | 24 | | eff. 1-1-20; 101-574, eff. 1-1-20; 101-649, eff. 7-7-20.)
| 25 | | Section 99. Effective date. This Act takes effect upon | 26 | | becoming law.
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