Full Text of HB3397 102nd General Assembly
HB3397 102ND GENERAL ASSEMBLY |
| | 102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022 HB3397 Introduced 2/22/2021, by Rep. Deanne M. Mazzochi SYNOPSIS AS INTRODUCED: |
| 215 ILCS 5/356z.25 | | 410 ILCS 50/3.5 new | |
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Amends the Illinois Insurance Code to prohibit an individual or group policy of accident and health insurance or managed care plan from imposing a deductible, coinsurance, copayment, or any other cost-sharing requirement on coverage of diagnostic testing for a pediatric autoimmune neuropsychiatric disorder if such diagnostic testing is ordered by a physician. Provides that an individual or group policy of accident and health insurance or managed care plan is not required to cover diagnostic testing for a pediatric autoimmune neuropsychiatric disorder if a physician indicates that such diagnostic testing is requested by a guardian, authorized representative, or parent of a minor patient. Amends the Medical Patient Rights Act. Provides that a physician may not refuse a request of a guardian, authorized representative, or parent of a minor patient for minimally invasive diagnostic testing for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome.
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| | A BILL FOR |
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| | | HB3397 | | LRB102 14484 BMS 19837 b |
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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.25 as follows: | 6 | | (215 ILCS 5/356z.25) | 7 | | Sec. 356z.25. Coverage for treatment of pediatric | 8 | | autoimmune neuropsychiatric disorders associated with | 9 | | streptococcal infections and pediatric acute onset | 10 | | neuropsychiatric syndrome. A group or individual policy of | 11 | | accident and health insurance or managed care plan that is | 12 | | amended, delivered, issued, or renewed after July 18, 2017 | 13 | | (the effective date of Public Act 100-24) shall provide | 14 | | coverage for treatment of pediatric autoimmune | 15 | | neuropsychiatric disorders associated with streptococcal | 16 | | infections and pediatric acute-onset neuropsychiatric | 17 | | syndrome, including, but not limited to, the use of | 18 | | intravenous immunoglobulin therapy. | 19 | | For billing and diagnosis purposes, pediatric autoimmune | 20 | | neuropsychiatric disorders associated with streptococcal | 21 | | infections and pediatric acute onset neuropsychiatric syndrome | 22 | | shall be coded as autoimmune encephalitis until the American | 23 | | Medical Association and the Centers for Medicare and Medicaid |
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| 1 | | Services create and assign a specific code for pediatric | 2 | | autoimmune neuropsychiatric disorders associated with | 3 | | streptococcal infections and pediatric acute onset | 4 | | neuropsychiatric syndrome. Thereafter, pediatric autoimmune | 5 | | neuropsychiatric disorders associated with streptococcal | 6 | | infections and pediatric acute onset neuropsychiatric syndrome | 7 | | may be coded as autoimmune encephalitis, pediatric autoimmune | 8 | | neuropsychiatric disorders associated with streptococcal | 9 | | infections, or pediatric acute onset neuropsychiatric | 10 | | syndrome. | 11 | | If, at any time, the Secretary of the United States | 12 | | Department of Health and Human Services, or its successor | 13 | | agency, promulgates rules or regulations to be published in | 14 | | the Federal Register or publishes a comment in the Federal | 15 | | Register or issues an opinion, guidance, or other action that | 16 | | would require the State, pursuant to any provision of the | 17 | | Patient Protection and Affordable Care Act (Public Law | 18 | | 111-148), including, but not limited to, 42 U.S.C. | 19 | | 18031(d)(3)(B) or any successor provision, to defray the cost | 20 | | of any coverage for pediatric autoimmune neuropsychiatric | 21 | | disorders associated with streptococcal infections and | 22 | | pediatric acute onset neuropsychiatric syndrome outlined in | 23 | | this Section, then the requirement that an insurer cover | 24 | | pediatric autoimmune neuropsychiatric disorders associated | 25 | | with streptococcal infections and pediatric acute onset | 26 | | neuropsychiatric syndrome is inoperative other than any such |
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| 1 | | coverage authorized under Section 1902 of the Social Security | 2 | | Act, 42 U.S.C. 1396a, and the State shall not assume any | 3 | | obligation for the cost of coverage for pediatric autoimmune | 4 | | neuropsychiatric disorders associated with streptococcal | 5 | | infections and pediatric acute onset neuropsychiatric | 6 | | syndrome.
| 7 | | An individual or group policy of accident and health | 8 | | insurance or managed care plan may not impose a deductible, | 9 | | coinsurance, copayment, or any other cost-sharing requirement | 10 | | on coverage for diagnostic testing for pediatric autoimmune | 11 | | neuropsychiatric disorders if such diagnostic testing is | 12 | | ordered by a physician licensed to practice medicine in all | 13 | | its branches. | 14 | | An individual or group policy of accident and health | 15 | | insurance or managed care plan is not required to provide | 16 | | coverage for diagnostic testing for pediatric autoimmune | 17 | | neuropsychiatric disorders if a physician indicates that such | 18 | | diagnostic testing is requested by a guardian, authorized | 19 | | representative, or parent of a minor patient. | 20 | | (Source: P.A. 100-24, eff. 7-18-17; 100-863, eff. 8-14-18; | 21 | | 101-488, eff. 8-23-19.) | 22 | | Section 10. The Medical Patient Rights Act is amended by | 23 | | adding Section 3.5 as follows: | 24 | | (410 ILCS 50/3.5 new) |
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| 1 | | Sec. 3.5. Pediatric autoimmune neuropsychiatric disorder | 2 | | diagnostic testing for minors. A physician may not refuse a | 3 | | request of a guardian, authorized representative, or parent of | 4 | | a minor patient for minimally invasive diagnostic testing for | 5 | | pediatric autoimmune neuropsychiatric disorders associated | 6 | | with streptococcal infections and pediatric acute-onset | 7 | | neuropsychiatric syndrome.
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