HB4634ham001 95TH GENERAL ASSEMBLY

Health Care Availability and Access Committee

Filed: 3/11/2008

09500HB4634ham001 LRB095 14693 DRJ 47843 a

AMENDMENT TO HOUSE BILL 4634

AMENDMENT NO. ______. Amend House Bill 4634 by replacing everything after the enacting clause with the following:

"Section 5. The Department of Public Aid Law of the Civil Administrative Code of Illinois is amended by adding Section 2205-15 as follows:

(20 ILCS 2205/2205-15 new)

Sec. 2205-15. Prostate and testicular cancer diagnostic evaluation and treatment program.

(a) Subject to appropriation, the Department of Healthcare and Family Services shall establish a prostate and testicular cancer diagnostic evaluation and treatment program. A person is eligible for diagnostic evaluation and, if that evaluation is positive for the respective cancer, treatment services under the program if he meets all of the following conditions:

(1) He has been screened for prostate or testicular cancer in a manner approved by the Department, including, but not limited to, by means of participation in the screening program established under Section 2310-397 of the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois.

(2) He continues to need that treatment. A person shall be considered to need treatment if, in the opinion of his treating physician licensed to practice medicine in all its branches, he requires therapy directed toward cure or palliation of prostate or testicular cancer, including recurrent metastatic cancer that is a known or presumed complication of prostate or testicular cancer and complications resulting from the treatment modalities themselves. Covered diagnostic evaluation shall include, but is not limited to, initial and follow-up ultrasound biopsies, pelvic CT Scans, bone scans, follow-up PSA (Prostate Specific Antigen) testing, and DRE (Digital Rectal Examination) as recommended by the treating physician.

(3) He is uninsured for prostate or testicular cancer diagnostic evaluation and treatment, that is, he does not have creditable coverage, as defined under the Health Insurance Portability and Accountability Act, for that treatment.

(4) He meets the citizenship requirements set forth in 89 Ill. Adm. Code 120.310 and the residence requirements set forth in 89 Ill. Adm. Code 120.311.

(5) He furnishes a Social Security number as described in 89 Ill. Adm. Code 120.327.

(6) He cooperates in establishing his eligibility to participate in the program as described in 89 Ill. Adm. Code 120.308.

A person's assets are exempt from consideration in determining his eligibility for diagnostic evaluation and treatment services under this Section.

(b) Notwithstanding any other provision of law, the Department of Healthcare and Family Services (i) does not have a claim against the estate of a deceased recipient of diagnostic evaluation or treatment services under this Section or against the estate of a recipient's deceased spouse and (ii) does not have a lien against any homestead property or other legal or equitable real property interest owned by a recipient of diagnostic evaluation or treatment services under this Section.

(c) A person who enters a nursing facility for the purpose of receiving services that qualify as treatment under this Section must provide the Department with income information sufficient to enable the Department to calculate a group care credit as established in 89 Ill. Adm. Code 120.40 and 120.60.

(d) A person applying for or receiving diagnostic evaluation and treatment services under this Section has the appeal rights described in 89 Ill. Adm. Code 102.80 through 102.83 in the case of applicants for or recipients of assistance under the Illinois Public Aid Code.

(e) Notwithstanding any other rulemaking authority that may exist, neither the Governor nor any agency or agency head under the jurisdiction of the Governor has any authority to make or promulgate rules to implement or enforce the provisions of this amendatory Act of the 95th General Assembly. If, however, the Governor believes that rules are necessary to implement or enforce the provisions of this amendatory Act of the 95th General Assembly, the Governor may suggest rules to the General Assembly by filing them with the Clerk of the House and Secretary of the Senate and by requesting that the General Assembly authorize such rulemaking by law, enact those suggested rules into law, or take any other appropriate action in the General Assembly's discretion. Nothing contained in this amendatory Act of the 95th General Assembly shall be interpreted to grant rulemaking authority under any other Illinois statute where such authority is not otherwise explicitly given. For the purposes of this amendatory Act of the 95th General Assembly, "rules" is given the meaning contained in Section 1-70 of the Illinois Administrative Procedure Act, and "agency" and "agency head" are given the meanings contained in Sections 1-20 and 1-25 of the Illinois Administrative Procedure Act to the extent that such definitions apply to agencies or agency heads under the jurisdiction of the Governor.

Section 10. The Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois is amended by changing Section 2310-397 as follows:

(20 ILCS 2310/2310-397) (was 20 ILCS 2310/55.90)

Sec. 2310-397. Prostate and testicular cancer program.

(a) The Department, subject to appropriation or other available funding, shall conduct a program to promote awareness and early detection of prostate and testicular cancer. The program may include, but need not be limited to:

(1) Dissemination of information regarding the incidence of prostate and testicular cancer, the risk factors associated with prostate and testicular cancer, and the benefits of early detection and treatment.

(2) Promotion of information and counseling about treatment options, including: identification of the methods for the treatment of prostate and testicular cancer that meet current clinical standards; information concerning the advantages, disadvantages, and risks associated with those treatment methods; and information concerning the availability of public and private sources of payment for diagnostic evaluation and the treatment of prostate and testicular cancer.

(3) Establishment and promotion of referral services (including referrals for diagnostic evaluation and treatment services) and screening programs.

Beginning July 1, 2004, the program must include the development and dissemination, through print and broadcast media, of public service announcements that publicize the importance of prostate and testicular cancer screening for men over age 40.

(b) Subject to appropriation or other available funding, a Prostate and Testicular Cancer Screening Program shall be established in the Department of Public Health.

(1) The Program shall apply to the following persons and entities:

(A) uninsured and underinsured men over the age of 40 who are at risk for prostate cancer, or younger men upon the advice of a physician or upon the request of the patient 50 years of age and older;

(B) (blank); uninsured and underinsured men between 40 and 50 years of age who are at high risk for prostate cancer, upon the advice of a physician or upon the request of the patient; and

(B-5) uninsured and underinsured men 14 years of age and older who are at risk for testicular cancer, or younger men upon the advice of a physician or upon the request of the patient; and

(C) non-profit organizations providing assistance to persons described in subparagraphs (A) and (B).

(2) Any entity funded by the Program shall coordinate with other local providers of prostate and testicular cancer screening, diagnostic, follow-up, education, and advocacy services to avoid duplication of effort. Any entity funded by the Program shall comply with any applicable State and federal standards regarding prostate and testicular cancer screening.

(3) Administrative costs of the Department shall not exceed 10% of the funds allocated to the Program. Indirect costs of the entities funded by this Program shall not exceed 12%. The Department shall define "indirect costs" in accordance with applicable State and federal law.

(4) Any entity funded by the Program shall collect data and maintain records that are determined by the Department to be necessary to facilitate the Department's ability to monitor and evaluate the effectiveness of the entities and the Program. Commencing with the Program's second year of operation, the Department shall submit an Annual Report to the General Assembly and the Governor. The report shall describe the activities and effectiveness of the Program and shall include, but not be limited to, the following types of information regarding those served by the Program:

(A) the number;

(B) the ethnic, geographic, and age breakdown;

(C) the stages of presentation; and

(D) the diagnostic and treatment status.

(5) The Department or any entity funded by the Program shall collect personal and medical information necessary to administer the Program from any individual applying for services under the Program. The information shall be confidential and shall not be disclosed other than for purposes directly connected with the administration of the Program or except as otherwise provided by law or pursuant to prior written consent of the subject of the information.

(6) The Department or any entity funded by the program may disclose the confidential information to medical personnel and fiscal intermediaries of the State to the extent necessary to administer the Program, and to other State public health agencies or medical researchers if the confidential information is necessary to carry out the duties of those agencies or researchers in the investigation, control, or surveillance of prostate and testicular cancer.

(c) The Department shall adopt rules to implement the Prostate and Testicular Cancer Screening Program in accordance with the Illinois Administrative Procedure Act.

(d) Implementation of the changes made by this amendatory Act of the 95th General Assembly is subject to appropriation.

(e) Notwithstanding any other rulemaking authority that may exist, neither the Governor nor any agency or agency head under the jurisdiction of the Governor has any authority to make or promulgate rules to implement or enforce the provisions of this amendatory Act of the 95th General Assembly. If, however, the Governor believes that rules are necessary to implement or enforce the provisions of this amendatory Act of the 95th General Assembly, the Governor may suggest rules to the General Assembly by filing them with the Clerk of the House and Secretary of the Senate and by requesting that the General Assembly authorize such rulemaking by law, enact those suggested rules into law, or take any other appropriate action in the General Assembly's discretion. Nothing contained in this amendatory Act of the 95th General Assembly shall be interpreted to grant rulemaking authority under any other Illinois statute where such authority is not otherwise explicitly given. For the purposes of this amendatory Act of the 95th General Assembly, "rules" is given the meaning contained in Section 1-70 of the Illinois Administrative Procedure Act, and "agency" and "agency head" are given the meanings contained in Sections 1-20 and 1-25 of the Illinois Administrative Procedure Act to the extent that such definitions apply to agencies or agency heads under the jurisdiction of the Governor.

(Source: P.A. 92-16, eff. 6-28-01; 93-122, 1-1-04.)".