Full Text of HB0528 96th General Assembly
HB0528ham002 96TH GENERAL ASSEMBLY
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Health & Healthcare Disparities Committee
Filed: 3/12/2009
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| AMENDMENT TO HOUSE BILL 528
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| AMENDMENT NO. ______. Amend House Bill 528, AS AMENDED, by | 3 |
| replacing the introductory clause of Section 5 with the | 4 |
| following:
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| "Section 5. The State Employees Group Insurance Act of 1971 | 6 |
| is amended by changing Section 6.11 as follows:
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| (5 ILCS 375/6.11)
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| (Text of Section before amendment by P.A. 95-958 ) | 9 |
| Sec. 6.11. Required health benefits; Illinois Insurance | 10 |
| Code
requirements. The program of health
benefits shall provide | 11 |
| the post-mastectomy care benefits required to be covered
by a | 12 |
| policy of accident and health insurance under Section 356t of | 13 |
| the Illinois
Insurance Code. The program of health benefits | 14 |
| shall provide the coverage
required under Sections 356g.5,
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| 356u, 356w, 356x, 356z.2, 356z.4, 356z.6, 356z.9, 356z.10, | 16 |
| 356z.13
356z.11 , and 356z.14 , and 356z.15
of the
Illinois |
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| Insurance Code.
The program of health benefits must comply with | 2 |
| Section 155.37 of the
Illinois Insurance Code.
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| (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | 4 |
| 95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-978, eff. | 5 |
| 1-1-09; 95-1005, eff. 12-12-08; revised 12-15-08.)
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| (Text of Section after amendment by P.A. 95-958 )
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| Sec. 6.11. Required health benefits; Illinois Insurance | 8 |
| Code
requirements. The program of health
benefits shall provide | 9 |
| the post-mastectomy care benefits required to be covered
by a | 10 |
| policy of accident and health insurance under Section 356t of | 11 |
| the Illinois
Insurance Code. The program of health benefits | 12 |
| shall provide the coverage
required under Sections 356g.5,
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| 356u, 356w, 356x, 356z.2, 356z.4, 356z.6, 356z.9, 356z.10, | 14 |
| 356z.11, and 356z.12 , 356z.13
356z.11 , and 356z.14 , and 356z.15 | 15 |
| of the
Illinois Insurance Code.
The program of health benefits | 16 |
| must comply with Section 155.37 of the
Illinois Insurance Code.
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| (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | 18 |
| 95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-958, eff. | 19 |
| 6-1-09; 95-978, eff. 1-1-09; 95-1005, eff. 12-12-08; revised | 20 |
| 12-15-08.) | 21 |
| Section 10. The Counties Code is amended by changing | 22 |
| Section 5-1069.3 as follows: | 23 |
| (55 ILCS 5/5-1069.3)
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| (Text of Section before amendment by P.A. 95-958 )
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| Sec. 5-1069.3. Required health benefits. If a county, | 3 |
| including a home
rule
county, is a self-insurer for purposes of | 4 |
| providing health insurance coverage
for its employees, the | 5 |
| coverage shall include coverage for the post-mastectomy
care | 6 |
| benefits required to be covered by a policy of accident and | 7 |
| health
insurance under Section 356t and the coverage required | 8 |
| under Sections 356g.5, 356u,
356w, 356x, 356z.6, 356z.9, | 9 |
| 356z.10, 356z.13
356z.11 , and 356z.14 , and 356z.15 of
the | 10 |
| Illinois Insurance Code. The requirement that health benefits | 11 |
| be covered
as provided in this Section is an
exclusive power | 12 |
| and function of the State and is a denial and limitation under
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| Article VII, Section 6, subsection (h) of the Illinois | 14 |
| Constitution. A home
rule county to which this Section applies | 15 |
| must comply with every provision of
this Section.
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| (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | 17 |
| 95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-978, eff. | 18 |
| 1-1-09; 95-1005, eff. 12-12-08; revised 12-15-08.)
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| (Text of Section after amendment by P.A. 95-958 ) | 20 |
| Sec. 5-1069.3. Required health benefits. If a county, | 21 |
| including a home
rule
county, is a self-insurer for purposes of | 22 |
| providing health insurance coverage
for its employees, the | 23 |
| coverage shall include coverage for the post-mastectomy
care | 24 |
| benefits required to be covered by a policy of accident and | 25 |
| health
insurance under Section 356t and the coverage required |
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LRB096 06176 KTG 23421 a |
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| under Sections 356g.5, 356u,
356w, 356x, 356z.6, 356z.9, | 2 |
| 356z.10, 356z.11, and 356z.12 , 356z.13
356z.11 , and 356z.14 , | 3 |
| and 356z.15 of
the Illinois Insurance Code. The requirement | 4 |
| that health benefits be covered
as provided in this Section is | 5 |
| an
exclusive power and function of the State and is a denial | 6 |
| and limitation under
Article VII, Section 6, subsection (h) of | 7 |
| the Illinois Constitution. A home
rule county to which this | 8 |
| Section applies must comply with every provision of
this | 9 |
| Section.
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| (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | 11 |
| 95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-958, eff. | 12 |
| 6-1-09; 95-978, eff. 1-1-09; 95-1005, eff. 12-12-08; revised | 13 |
| 12-15-08.) | 14 |
| Section 15. The Illinois Municipal Code is amended by | 15 |
| changing Section 10-4-2.3 as follows: | 16 |
| (65 ILCS 5/10-4-2.3)
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| (Text of Section before amendment by P.A. 95-958 )
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| Sec. 10-4-2.3. Required health benefits. If a | 19 |
| municipality, including a
home rule municipality, is a | 20 |
| self-insurer for purposes of providing health
insurance | 21 |
| coverage for its employees, the coverage shall include coverage | 22 |
| for
the post-mastectomy care benefits required to be covered by | 23 |
| a policy of
accident and health insurance under Section 356t | 24 |
| and the coverage required
under Sections 356g.5, 356u, 356w, |
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LRB096 06176 KTG 23421 a |
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| 356x, 356z.6, 356z.9, 356z.10, 356z.13
356z.11 , and 356z.14 , | 2 |
| and 356z.15 of the Illinois
Insurance
Code. The requirement | 3 |
| that health
benefits be covered as provided in this is an | 4 |
| exclusive power and function of
the State and is a denial and | 5 |
| limitation under Article VII, Section 6,
subsection (h) of the | 6 |
| Illinois Constitution. A home rule municipality to which
this | 7 |
| Section applies must comply with every provision of this | 8 |
| Section.
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| (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | 10 |
| 95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-978, eff. | 11 |
| 1-1-09; 95-1005, eff. 12-12-08; revised 12-15-08.)
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| (Text of Section after amendment by P.A. 95-958 ) | 13 |
| Sec. 10-4-2.3. Required health benefits. If a | 14 |
| municipality, including a
home rule municipality, is a | 15 |
| self-insurer for purposes of providing health
insurance | 16 |
| coverage for its employees, the coverage shall include coverage | 17 |
| for
the post-mastectomy care benefits required to be covered by | 18 |
| a policy of
accident and health insurance under Section 356t | 19 |
| and the coverage required
under Sections 356g.5, 356u, 356w, | 20 |
| 356x, 356z.6, 356z.9, 356z.10, 356z.11, and 356z.12 , 356z.13
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| 356z.11 , and 356z.14 , and 356z.15 of the Illinois
Insurance
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| Code. The requirement that health
benefits be covered as | 23 |
| provided in this is an exclusive power and function of
the | 24 |
| State and is a denial and limitation under Article VII, Section | 25 |
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subsection (h) of the Illinois Constitution. A home rule |
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| municipality to which
this Section applies must comply with | 2 |
| every provision of this Section.
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| (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | 4 |
| 95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-958, eff. | 5 |
| 6-1-09; 95-978, eff. 1-1-09; 95-1005, eff. 12-12-08; revised | 6 |
| 12-15-08.) | 7 |
| Section 20. The Illinois Insurance Code is amended by | 8 |
| adding Section 356z.15 as follows: | 9 |
| (215 ILCS 5/356z.15 new) | 10 |
| Sec. 356z.15. Inpatient hospital care. A group or | 11 |
| individual policy of accident and health insurance or managed | 12 |
| care plan amended, delivered, issued, or renewed after the | 13 |
| effective date of this amendatory Act of the 96th General | 14 |
| Assembly that provides coverage for inpatient hospital care | 15 |
| shall not refuse coverage for services provided to an enrollee | 16 |
| or recipient that are ordered by a physician in a hospital that | 17 |
| may subject the patient to observation status while undergoing | 18 |
| evaluation and assessment for the illness or condition that | 19 |
| resulted in their hospital stay. | 20 |
| Section 25. The Illinois Public Aid Code is amended by | 21 |
| changing Section 5-16.8 as follows:
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| (305 ILCS 5/5-16.8)
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| Sec. 5-16.8. Required health benefits. The medical | 2 |
| assistance program
shall
(i) provide the post-mastectomy care | 3 |
| benefits required to be covered by a policy of
accident and | 4 |
| health insurance under Section 356t and the coverage required
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| under Sections 356g.5, 356u, 356w, 356x, and 356z.6 , and | 6 |
| 356z.15 of the Illinois
Insurance Code and (ii) be subject to | 7 |
| the provisions of Section 364.01 of the Illinois
Insurance | 8 |
| Code.
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| (Source: P.A. 95-189, eff. 8-16-07; 95-331, eff. 8-21-07.)
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| Section 30. The Medical Patient Rights Act is amended by | 11 |
| changing Sections 2.04, 3, and 5 and adding Sections 2.06, 5.1, | 12 |
| and 5.2 as follows:
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| (410 ILCS 50/2.04) (from Ch. 111 1/2, par. 5402.04)
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| Sec. 2.04.
"Insurance company" means (1) an insurance | 15 |
| company, fraternal
benefit society, and any other insurer | 16 |
| subject to regulation under the
Illinois Insurance Code; or (2) | 17 |
| a health maintenance organization , a limited health service | 18 |
| organization under the Limited Health Service Organization | 19 |
| Act, or a voluntary health services plan under the Voluntary | 20 |
| Health Services Plans Act .
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| (Source: P.A. 85-677; 85-679.)
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| (410 ILCS 50/2.06 new) | 23 |
| Sec. 2.06. "Health insurance policy or health care plan" |
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| means any policy of health or accident insurance provided by a | 2 |
| health insurance company or under the Counties Code, the | 3 |
| Municipal Code, the State Employees Group Insurance Act or | 4 |
| Medical Assistance provided under the Public Aid Code.
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| (410 ILCS 50/3) (from Ch. 111 1/2, par. 5403)
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| Sec. 3. The following rights are hereby established:
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| (a) The right of each patient to care consistent with sound | 8 |
| nursing and
medical practices, to be informed of the name of | 9 |
| the physician responsible
for coordinating his or her care, to | 10 |
| receive information concerning his or
her condition and | 11 |
| proposed treatment, to refuse any treatment to the extent
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| permitted by law, and to privacy and confidentiality of records | 13 |
| except as
otherwise provided by law. The patient has a right to | 14 |
| be informed at any time of his or her responsibility for | 15 |
| payment of services provided based on the inpatient, | 16 |
| outpatient, or observation status of the patient that may | 17 |
| affect coverage by his or her health insurance policy or health | 18 |
| care plan.
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| (b) The right of each patient, regardless of source of | 20 |
| payment, to examine
and receive a reasonable explanation of his | 21 |
| total bill for services rendered
by his physician or health | 22 |
| care provider, including the itemized charges
for specific | 23 |
| services received. Each physician or health care provider
shall | 24 |
| be responsible only for a reasonable explanation of those | 25 |
| specific
services provided by such physician or health care |
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| provider.
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| (c) In the event an insurance company or health services | 3 |
| corporation cancels
or refuses to renew an individual policy or | 4 |
| plan, the insured patient shall
be entitled to timely, prior | 5 |
| notice of the termination of such policy or plan.
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| An insurance company or health services corporation that | 7 |
| requires any
insured patient or applicant for new or continued | 8 |
| insurance or coverage to
be tested for infection with human | 9 |
| immunodeficiency virus (HIV) or any
other identified causative | 10 |
| agent of acquired immunodeficiency syndrome
(AIDS) shall (1) | 11 |
| give the patient or applicant prior written notice of such
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| requirement, (2) proceed with such testing only upon the | 13 |
| written
authorization of the applicant or patient, and (3) keep | 14 |
| the results of such
testing confidential. Notice of an adverse | 15 |
| underwriting or coverage
decision may be given to any | 16 |
| appropriately interested party, but the
insurer may only | 17 |
| disclose the test result itself to a physician designated
by | 18 |
| the applicant or patient, and any such disclosure shall be in a | 19 |
| manner
that assures confidentiality.
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| The Department of Insurance shall enforce the provisions of | 21 |
| this subsection.
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| (d) The right of each patient to privacy and | 23 |
| confidentiality in health
care. Each physician, health care | 24 |
| provider, health services corporation and
insurance company | 25 |
| shall refrain from disclosing the nature or details of
services | 26 |
| provided to patients, except that such information may be |
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| disclosed to the
patient, the party making treatment decisions | 2 |
| if the patient is incapable
of making decisions regarding the | 3 |
| health services provided, those parties
directly involved with | 4 |
| providing treatment to the patient or processing the
payment | 5 |
| for that treatment, those parties responsible for peer review,
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| utilization review and quality assurance, and those parties | 7 |
| required to
be notified under the Abused and Neglected Child | 8 |
| Reporting Act, the
Illinois Sexually Transmissible Disease | 9 |
| Control Act or where otherwise
authorized or required by law. | 10 |
| This right may be waived in writing by the
patient or the | 11 |
| patient's guardian, but a physician or other health care
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| provider may not condition the provision of services on the | 13 |
| patient's or
guardian's agreement to sign such a waiver.
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| (Source: P.A. 86-895; 86-902; 86-1028; 87-334.)"; and
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| by inserting immediately above Section 99 the following: | 16 |
| "Section 95. No acceleration or delay. Where this Act makes | 17 |
| changes in a statute that is represented in this Act by text | 18 |
| that is not yet or no longer in effect (for example, a Section | 19 |
| represented by multiple versions), the use of that text does | 20 |
| not accelerate or delay the taking effect of (i) the changes | 21 |
| made by this Act or (ii) provisions derived from any other | 22 |
| Public Act.".
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