Illinois General Assembly - Full Text of HB4051
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Full Text of HB4051  99th General Assembly

HB4051 99TH GENERAL ASSEMBLY

  
  

 


 
99TH GENERAL ASSEMBLY
State of Illinois
2015 and 2016
HB4051

 

Introduced , by Rep. Dan Brady

 

SYNOPSIS AS INTRODUCED:
 
105 ILCS 145/10
215 ILCS 125/1-2  from Ch. 111 1/2, par. 1402
215 ILCS 130/1002  from Ch. 73, par. 1501-2
215 ILCS 134/10
215 ILCS 165/2  from Ch. 32, par. 596
215 ILCS 165/7  from Ch. 32, par. 601
770 ILCS 23/5

    Amends the Care of Students with Diabetes Act, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Managed Care Reform and Patient Rights Act, the Voluntary Health Services Plans Act, and the Health Care Services Lien Act to add pharmacy or pharmacist-provided services to the types of health services under the Acts and to add pharmacists as health care providers or health care professionals under the Acts. Effective January 1, 2016.


LRB099 10326 AMC 30553 b

 

 

A BILL FOR

 

HB4051LRB099 10326 AMC 30553 b

1    AN ACT concerning pharmacists.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Care of Students with Diabetes Act is
5amended by changing Section 10 as follows:
 
6    (105 ILCS 145/10)
7    Sec. 10. Definitions. As used in this Act:
8    "Delegated care aide" means a school employee who has
9agreed to receive training in diabetes care and to assist
10students in implementing their diabetes care plan and has
11entered into an agreement with a parent or guardian and the
12school district or private school.
13    "Diabetes care plan" means a document that specifies the
14diabetes-related services needed by a student at school and at
15school-sponsored activities and identifies the appropriate
16staff to provide and supervise these services.
17    "Health care provider" means a physician licensed to
18practice medicine in all of its branches, advanced practice
19nurse who has a written agreement with a collaborating
20physician who authorizes the provision of diabetes care, or a
21physician assistant who has a written supervision agreement
22with a supervising physician who authorizes the provision of
23diabetes care, or a pharmacist licensed to practice pharmacy.

 

 

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1    "Principal" means the principal of the school.
2    "School" means any primary or secondary public, charter, or
3private school located in this State.
4    "School employee" means a person who is employed by a
5public school district or private school, a person who is
6employed by a local health department and assigned to a school,
7or a person who contracts with a school or school district to
8perform services in connection with a student's diabetes care
9plan. This definition must not be interpreted as requiring a
10school district or private school to hire additional personnel
11for the sole purpose of serving as a designated care aide.
12(Source: P.A. 96-1485, eff. 12-1-10.)
 
13    Section 10. The Health Maintenance Organization Act is
14amended by changing Section 1-2 as follows:
 
15    (215 ILCS 125/1-2)  (from Ch. 111 1/2, par. 1402)
16    Sec. 1-2. Definitions. As used in this Act, unless the
17context otherwise requires, the following terms shall have the
18meanings ascribed to them:
19    (1) "Advertisement" means any printed or published
20material, audiovisual material and descriptive literature of
21the health care plan used in direct mail, newspapers,
22magazines, radio scripts, television scripts, billboards and
23similar displays; and any descriptive literature or sales aids
24of all kinds disseminated by a representative of the health

 

 

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1care plan for presentation to the public including, but not
2limited to, circulars, leaflets, booklets, depictions,
3illustrations, form letters and prepared sales presentations.
4    (2) "Director" means the Director of Insurance.
5    (3) "Basic health care services" means emergency care, and
6inpatient hospital and physician care, outpatient medical
7services, mental health services and care for alcohol and drug
8abuse, including any reasonable deductibles and co-payments,
9all of which are subject to the limitations described in
10Section 4-20 of this Act and as determined by the Director
11pursuant to rule.
12    (4) "Enrollee" means an individual who has been enrolled in
13a health care plan.
14    (5) "Evidence of coverage" means any certificate,
15agreement, or contract issued to an enrollee setting out the
16coverage to which he is entitled in exchange for a per capita
17prepaid sum.
18    (6) "Group contract" means a contract for health care
19services which by its terms limits eligibility to members of a
20specified group.
21    (7) "Health care plan" means any arrangement whereby any
22organization undertakes to provide or arrange for and pay for
23or reimburse the cost of basic health care services, excluding
24any reasonable deductibles and copayments, from providers
25selected by the Health Maintenance Organization and such
26arrangement consists of arranging for or the provision of such

 

 

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1health care services, as distinguished from mere
2indemnification against the cost of such services, except as
3otherwise authorized by Section 2-3 of this Act, on a per
4capita prepaid basis, through insurance or otherwise. A "health
5care plan" also includes any arrangement whereby an
6organization undertakes to provide or arrange for or pay for or
7reimburse the cost of any health care service for persons who
8are enrolled under Article V of the Illinois Public Aid Code or
9under the Children's Health Insurance Program Act through
10providers selected by the organization and the arrangement
11consists of making provision for the delivery of health care
12services, as distinguished from mere indemnification. A
13"health care plan" also includes any arrangement pursuant to
14Section 4-17. Nothing in this definition, however, affects the
15total medical services available to persons eligible for
16medical assistance under the Illinois Public Aid Code.
17    (8) "Health care services" means any services included in
18the furnishing to any individual of medical, or dental, or
19pharmacy care, or the hospitalization or incident to the
20furnishing of such care or hospitalization as well as the
21furnishing to any person of any and all other services for the
22purpose of preventing, alleviating, curing or healing human
23illness or injury.
24    (9) "Health Maintenance Organization" means any
25organization formed under the laws of this or another state to
26provide or arrange for one or more health care plans under a

 

 

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1system which causes any part of the risk of health care
2delivery to be borne by the organization or its providers.
3    (10) "Net worth" means admitted assets, as defined in
4Section 1-3 of this Act, minus liabilities.
5    (11) "Organization" means any insurance company, a
6nonprofit corporation authorized under the Dental Service Plan
7Act or the Voluntary Health Services Plans Act, or a
8corporation organized under the laws of this or another state
9for the purpose of operating one or more health care plans and
10doing no business other than that of a Health Maintenance
11Organization or an insurance company. "Organization" shall
12also mean the University of Illinois Hospital as defined in the
13University of Illinois Hospital Act or a unit of local
14government health system operating within a county with a
15population of 3,000,000 or more.
16    (12) "Provider" means any physician, hospital facility,
17facility licensed under the Nursing Home Care Act, pharmacist,
18or facility or long-term care facility as those terms are
19defined in the Nursing Home Care Act or other person which is
20licensed or otherwise authorized to furnish health care
21services and also includes any other entity that arranges for
22the delivery or furnishing of health care service.
23    (13) "Producer" means a person directly or indirectly
24associated with a health care plan who engages in solicitation
25or enrollment.
26    (14) "Per capita prepaid" means a basis of prepayment by

 

 

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1which a fixed amount of money is prepaid per individual or any
2other enrollment unit to the Health Maintenance Organization or
3for health care services which are provided during a definite
4time period regardless of the frequency or extent of the
5services rendered by the Health Maintenance Organization,
6except for copayments and deductibles and except as provided in
7subsection (f) of Section 5-3 of this Act.
8    (15) "Subscriber" means a person who has entered into a
9contractual relationship with the Health Maintenance
10Organization for the provision of or arrangement of at least
11basic health care services to the beneficiaries of such
12contract.
13(Source: P.A. 97-1148, eff. 1-24-13; 98-651, eff. 6-16-14;
1498-841, eff. 8-1-14; revised 10-24-14.)
 
15    Section 15. The Limited Health Service Organization Act is
16amended by changing Section 1002 as follows:
 
17    (215 ILCS 130/1002)  (from Ch. 73, par. 1501-2)
18    Sec. 1002. Definitions. As used in this Act, unless the
19context otherwise requires, the following terms shall have the
20meanings ascribed to them:
21    "Advertisement" means any printed or published material,
22audiovisual material and descriptive literature of the limited
23health care plan used in direct mail, newspapers, magazines,
24radio scripts, television scripts, billboards and similar

 

 

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1displays; and any descriptive literature or sales aids of all
2kinds disseminated by a representative of the limited health
3care plan for presentation to the public including, but not
4limited to, circulars, leaflets, booklets, depictions,
5illustrations, form letters and prepared sales presentations.
6    "Copayment" means the amount that an enrollee must pay in
7order to receive a specific service that is not fully prepaid.
8    "Director" means the Director of Insurance.
9    "Enrollee" means an individual who has been enrolled in a
10limited health care plan.
11    "Evidence of coverage" means any certificate, agreement or
12contract issued to an enrollee setting out the coverage to
13which that enrollee is entitled in exchange for a per capita
14prepaid sum.
15    "Group contract" means a contract for limited health
16services which by its terms limits eligibility to members of a
17specified group.
18    "In-plan covered services" means covered limited health
19services obtained from providers who are employed by, under
20contract with, referred by, or otherwise affiliated with the
21LHSO and emergency services.
22    "Limited health care plan" means any arrangement whereby an
23organization undertakes to provide or arrange for and, pay for
24or reimburse the cost of any limited health services from
25providers selected by the limited health service organization
26and such arrangement consists of arranging for or the provision

 

 

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1of such limited health services on a per capita prepaid basis,
2as distinguished from mere indemnification against the cost of
3such limited services on a per capita prepaid basis through
4insurance except as otherwise provided under Section 3009.
5    "Limited health service" means ambulance care services,
6dental care services, vision care services, pharmaceutical
7services, pharmacist-provided services, clinical laboratory
8services, and podiatric care services. Limited health service
9shall not include hospital, medical, surgical or emergency
10services except when those services are essential to the
11delivery of the limited health service. Essential hospital,
12medical, surgical, or emergency services shall be covered
13unless specifically excluded.
14    "Limited health service organization" (LHSO) means any
15organization formed under the laws of this or another state to
16provide or arrange for one or more limited health care plans
17under a system which causes any part of the risk of limited
18health care delivery to be borne by the organization or its
19providers.
20    "Net worth" means admitted assets, as defined in Section
211003 of this Act, minus liabilities.
22    "Organization" means any insurance company or other
23corporation organized under the laws of this or another state
24for the purpose of operating one or more limited health care
25plans and doing no business other than that of a health
26maintenance organization or a limited health service

 

 

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1organization or an insurance company. Organization does not
2include (1) any entity otherwise authorized on the effective
3date of this Act pursuant to the laws of this State either to
4provide any limited health service on a prepayment basis or to
5indemnity for any limited health service; nor does it include
6(2) any provider or other entity when providing or arranging
7for the provision of limited health services pursuant to a
8contract with a limited health service organization or with any
9entity described in (1) of this definition.
10    "Out-of-plan covered services" means non-emergency,
11self-referred covered limited health services obtained from
12providers who are not otherwise employed by, under contract
13with, or otherwise affiliated with the LHSO or services
14obtained without a referral from providers who have contracted
15to provide limited health services to the enrollee on behalf of
16the limited health care plan.
17    "Point-of-service product" (POS) means a group contract
18that includes both in-plan covered services and out-of-plan
19covered services as well as a POS contract in which the risk
20for out-of-plan covered services is borne through reinsurance.
21This term does not apply to indemnity benefits offered through
22an LHSO that are underwritten in whole by a licensed insurance
23carrier and offered in conjunction with the LHSO benefit
24package.
25    "Provider" means any physician, dentist, pharmacist,
26health facility, or other person or institution which is duly

 

 

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1licensed or otherwise authorized to deliver or furnish limited
2health services and also includes any other entity that
3arranges for the delivery or furnishing of limited health
4service.
5    "Per capita prepaid" means a basis of payment by which a
6fixed amount of money is prepaid per individual or any other
7enrollment unit to the limited health service organization or
8for limited health services which are provided during a
9definite time period regardless of the frequency or extent of
10the services rendered, except for copayments of a fixed amount
11by the limited health service organization.
12    "Subscriber" means the person whose employment or other
13status, except for family dependency, is the basis for
14entitlement to limited health services pursuant to a contract
15with an organization authorized to provide or arrange for such
16services under this Act.
17    "Uncovered expense" means the cost of limited health
18services that are the obligation of a limited health service
19organization for which an enrollee may be liable in the event
20of the insolvency of the organization. Costs incurred by a
21provider who has agreed in writing not to bill enrollees,
22except for permissible supplemental charges, shall be
23considered covered expenses.
24(Source: P.A. 87-1079; 88-568, eff. 8-5-94; 88-667, eff.
259-16-94.)
 

 

 

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1    Section 20. The Managed Care Reform and Patient Rights Act
2is amended by changing Section 10 as follows:
 
3    (215 ILCS 134/10)
4    Sec. 10. Definitions. :
5    "Adverse determination" means a determination by a health
6care plan under Section 45 or by a utilization review program
7under Section 85 that a health care service is not medically
8necessary.
9    "Clinical peer" means a health care professional who is in
10the same profession and the same or similar specialty as the
11health care provider who typically manages the medical
12condition, procedures, or treatment under review.
13    "Department" means the Department of Insurance.
14    "Emergency medical condition" means a medical condition
15manifesting itself by acute symptoms of sufficient severity
16(including, but not limited to, severe pain) such that a
17prudent layperson, who possesses an average knowledge of health
18and medicine, could reasonably expect the absence of immediate
19medical attention to result in:
20        (1) placing the health of the individual (or, with
21    respect to a pregnant woman, the health of the woman or her
22    unborn child) in serious jeopardy;
23        (2) serious impairment to bodily functions; or
24        (3) serious dysfunction of any bodily organ or part.
25    "Emergency medical screening examination" means a medical

 

 

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1screening examination and evaluation by a physician licensed to
2practice medicine in all its branches, or to the extent
3permitted by applicable laws, by other appropriately licensed
4personnel under the supervision of or in collaboration with a
5physician licensed to practice medicine in all its branches to
6determine whether the need for emergency services exists.
7    "Emergency services" means, with respect to an enrollee of
8a health care plan, transportation services, including but not
9limited to ambulance services, and covered inpatient and
10outpatient hospital services furnished by a provider qualified
11to furnish those services that are needed to evaluate or
12stabilize an emergency medical condition. "Emergency services"
13does not refer to post-stabilization medical services.
14    "Enrollee" means any person and his or her dependents
15enrolled in or covered by a health care plan.
16    "Health care plan" means a plan, including, but not limited
17to, a health maintenance organization, a managed care community
18network as defined in the Illinois Public Aid Code, or an
19accountable care entity as defined in the Illinois Public Aid
20Code that receives capitated payments to cover medical services
21from the Department of Healthcare and Family Services, that
22establishes, operates, or maintains a network of health care
23providers that has entered into an agreement with the plan to
24provide health care services to enrollees to whom the plan has
25the ultimate obligation to arrange for the provision of or
26payment for services through organizational arrangements for

 

 

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1ongoing quality assurance, utilization review programs, or
2dispute resolution. Nothing in this definition shall be
3construed to mean that an independent practice association or a
4physician hospital organization that subcontracts with a
5health care plan is, for purposes of that subcontract, a health
6care plan.
7    For purposes of this definition, "health care plan" shall
8not include the following:
9        (1) indemnity health insurance policies including
10    those using a contracted provider network;
11        (2) health care plans that offer only dental or only
12    vision coverage;
13        (3) preferred provider administrators, as defined in
14    Section 370g(g) of the Illinois Insurance Code;
15        (4) employee or employer self-insured health benefit
16    plans under the federal Employee Retirement Income
17    Security Act of 1974;
18        (5) health care provided pursuant to the Workers'
19    Compensation Act or the Workers' Occupational Diseases
20    Act; and
21        (6) not-for-profit voluntary health services plans
22    with health maintenance organization authority in
23    existence as of January 1, 1999 that are affiliated with a
24    union and that only extend coverage to union members and
25    their dependents.
26    "Health care professional" means a physician, a registered

 

 

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1professional nurse, a pharmacist, or other individual
2appropriately licensed or registered to provide health care
3services.
4    "Health care provider" means any physician, pharmacist,
5hospital facility, facility licensed under the Nursing Home
6Care Act, long-term care facility as defined in Section 1-113
7of the Nursing Home Care Act, or other person that is licensed
8or otherwise authorized to deliver health care services.
9Nothing in this Act shall be construed to define Independent
10Practice Associations or Physician-Hospital Organizations as
11health care providers.
12    "Health care services" means any services included in the
13furnishing to any individual of medical or pharmacist care, or
14the hospitalization incident to the furnishing of such care, as
15well as the furnishing to any person of any and all other
16services for the purpose of preventing, alleviating, curing, or
17healing human illness or injury including home health and
18pharmaceutical services and products.
19    "Medical director" means a physician licensed in any state
20to practice medicine in all its branches appointed by a health
21care plan.
22    "Person" means a corporation, association, partnership,
23limited liability company, sole proprietorship, or any other
24legal entity.
25    "Pharmacist" has the same meaning as set forth in the
26Pharmacy Practice Act.

 

 

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1    "Physician" means a person licensed under the Medical
2Practice Act of 1987.
3    "Post-stabilization medical services" means health care
4services provided to an enrollee that are furnished in a
5licensed hospital by a provider that is qualified to furnish
6such services, and determined to be medically necessary and
7directly related to the emergency medical condition following
8stabilization.
9    "Stabilization" means, with respect to an emergency
10medical condition, to provide such medical treatment of the
11condition as may be necessary to assure, within reasonable
12medical probability, that no material deterioration of the
13condition is likely to result.
14    "Utilization review" means the evaluation of the medical
15necessity, appropriateness, and efficiency of the use of health
16care services, procedures, and facilities.
17    "Utilization review program" means a program established
18by a person to perform utilization review.
19(Source: P.A. 98-651, eff. 6-16-14; 98-841, eff. 8-1-14;
20revised 10-24-14.)
 
21    Section 25. The Voluntary Health Services Plans Act is
22amended by changing Sections 2 and 7 as follows:
 
23    (215 ILCS 165/2)  (from Ch. 32, par. 596)
24    Sec. 2. For the purposes of this Act, the following terms

 

 

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1have the respective meanings set forth in this section, unless
2different meanings are plainly indicated by the context:
3    (a) "Health Services Plan Corporation" means a corporation
4organized under the terms of this Act for the purpose of
5establishing and operating a voluntary health services plan and
6providing other medically related services.
7    (b) "Voluntary health services plan" means either a plan or
8system under which medical, hospital, nursing and relating
9health services may be rendered to a subscriber or beneficiary
10at the expense of a health services plan corporation, or any
11contractual arrangement to provide, either directly or through
12arrangements with others, dental care services to subscribers
13and beneficiaries.
14    (c) "Subscriber" means a natural person to whom a
15subscription certificate has been issued by a health services
16plan corporation. Persons eligible under Section 5-2 of the
17Illinois Public Aid Code may be subscribers if a written
18agreement exists, as specified in Section 25 of this Act,
19between the Health Services Plan Corporation and the Department
20of Healthcare and Family Services. A subscription certificate
21may be issued to such persons at no cost.
22    (d) "Beneficiary" means a person designated in a
23subscription certificate as one entitled to receive health
24services.
25    (e) "Health services" means those services ordinarily
26rendered by physicians licensed in Illinois to practice

 

 

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1medicine in all of its branches, by podiatric physicians
2licensed in Illinois to practice podiatric medicine, by
3dentists and dental surgeons licensed to practice in Illinois,
4by nurses registered in Illinois, by dental hygienists licensed
5to practice in Illinois, by pharmacists licensed in Illinois to
6practice pharmacy, and by assistants and technicians acting
7under professional supervision; it likewise means hospital
8services as usually and customarily rendered in Illinois, and
9the compounding and dispensing of drugs and medicines by
10pharmacists and assistant pharmacists registered in Illinois.
11    (f) "Subscription certificate" means a certificate issued
12to a subscriber by a health services plan corporation, setting
13forth the terms and conditions upon which health services shall
14be rendered to a subscriber or a beneficiary.
15    (g) "Physician rendering service for a plan" means a
16physician licensed in Illinois to practice medicine in all of
17its branches who has undertaken or agreed, upon terms and
18conditions acceptable both to himself and to the health
19services plan corporation involved, to furnish medical service
20to the plan's subscribers and beneficiaries.
21    (h) "Dentist or dental surgeon rendering service for a
22plan" means a dentist or dental surgeon licensed in Illinois to
23practice dentistry or dental surgery who has undertaken or
24agreed, upon terms and conditions acceptable both to himself
25and to the health services plan corporation involved, to
26furnish dental or dental surgical services to the plan's

 

 

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1subscribers and beneficiaries.
2    (i) "Director" means the Director of Insurance of the State
3of Illinois.
4    (j) "Person" means any of the following: a natural person,
5corporation, partnership or unincorporated association.
6    (k) "Podiatric physician or podiatric surgeon rendering
7service for a plan" means any podiatric physician or podiatric
8surgeon licensed in Illinois to practice podiatry, who has
9undertaken or agreed, upon terms and conditions acceptable both
10to himself and to the health services plan corporation
11involved, to furnish podiatric or podiatric surgical services
12to the plan's subscribers and beneficiaries.
13    (l) "Pharmacist rendering service for a plan" means a
14pharmacist licensed in Illinois to practice pharmacy who has
15undertaken or agreed, upon terms and conditions acceptable both
16to the pharmacist and to the health services plan corporation
17involved, to furnish pharmacy and pharmacist-provided service
18to the plan's subscribers and beneficiaries.
19(Source: P.A. 98-214, eff. 8-9-13.)
 
20    (215 ILCS 165/7)  (from Ch. 32, par. 601)
21    Sec. 7. Every physician licensed in Illinois to practice
22medicine in all of its branches, every podiatric physician
23licensed to practice podiatric medicine in Illinois, every
24pharmacist licensed to practice pharmacy in Illinois, and every
25dentist and dental surgeon licensed to practice in Illinois may

 

 

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1be eligible to render medical, podiatric, pharmacy, or dental
2services respectively, upon such terms and conditions as may be
3mutually acceptable to such physician, podiatric physician,
4pharmacist, dentist or dental surgeon and to the health
5services plan corporation involved. Such a corporation shall
6impose no restrictions on the physicians, podiatric
7physicians, pharmacist, dentists, or dental surgeons who treat
8its subscribers as to methods of diagnosis or treatment. The
9private physician-patient relationship shall be maintained,
10and subscribers shall at all times have free choice of any
11physician, podiatric physician, dentist, pharmacist, or dental
12surgeon who is rendering service on behalf of the corporation.
13All of the records, charts, files and other data of a health
14services plan corporation pertaining to the condition of health
15of its subscribers and beneficiaries shall be and remain
16confidential, and no disclosure of the contents thereof shall
17be made by the corporation to any person, except upon the prior
18written authorization of the particular subscriber or
19beneficiary concerned.
20(Source: P.A. 98-214, eff. 8-9-13.)
 
21    Section 30. The Health Care Services Lien Act is amended by
22changing Section 5 as follows:
 
23    (770 ILCS 23/5)
24    Sec. 5. Definitions. In this Act:

 

 

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1    "Health care professional" means any individual in any of
2the following license categories: licensed physician, licensed
3dentist, licensed optometrist, licensed naprapath, licensed
4clinical psychologist, or licensed physical therapist, or
5licensed pharmacist.
6    "Health care provider" means any entity in any of the
7following license categories: licensed hospital, licensed home
8health agency, licensed ambulatory surgical treatment center,
9licensed long-term care facilities, or licensed emergency
10medical services personnel, or licensed pharmacy.
11    This amendatory Act of the 94th General Assembly applies to
12causes of action accruing on or after its effective date.
13(Source: P.A. 93-51, eff. 7-1-03; 94-403, eff. 1-1-06.)
 
14    Section 99. Effective date. This Act takes effect January
151, 2016.