Full Text of HB5352 96th General Assembly
HB5352 96TH GENERAL ASSEMBLY
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96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010 HB5352
Introduced 2/5/2010, by Rep. Angelo Saviano - Michael J. Zalewski SYNOPSIS AS INTRODUCED: |
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Amends the Uniform Prescription Drug Information Card Act. Provides that a discounted health care services plan administrator shall issue
to its beneficiaries and insureds a card or other technology containing uniform prescription drug
information. Provides that the card or other technology issued by a discounted health care services plan administrator shall display the same mandatory data elements as is required on cards and other technologies issued by health benefit plans. Sets forth a definition for "discounted health care services plan administrator".
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A BILL FOR
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HB5352 |
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LRB096 16811 RPM 32118 b |
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| AN ACT concerning insurance.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Section 5. The Uniform Prescription Drug Information Card | 5 |
| Act is amended by changing Section 15 as follows:
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| (215 ILCS 138/15)
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| Sec. 15. Uniform prescription drug information cards | 8 |
| required.
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| (a) A health benefit plan that issues a card or other | 10 |
| technology and
provides coverage for prescription drugs or
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| devices
and an administrator of such a plan including, but not | 12 |
| limited to, third-party
administrators for self-insured plans | 13 |
| and state-administered plans shall issue
to its
insureds a card | 14 |
| or other technology containing uniform prescription drug
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| information. A discounted health care services plan | 16 |
| administrator shall issue
to its beneficiaries and insureds a | 17 |
| card or other technology containing uniform prescription drug
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| information. The uniform prescription drug information card or | 19 |
| other
technology issued by a health benefit plan or discounted | 20 |
| health care services plan administrator shall
specifically | 21 |
| identify and display the following
mandatory data elements on | 22 |
| the front of the card:
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| (1) BIN number;
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HB5352 |
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LRB096 16811 RPM 32118 b |
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| (2) Processor control number if required for claims | 2 |
| adjudication;
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| (3) Group number;
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| (4) Card issuer identifier;
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| (5) Cardholder ID number; and
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| (6) Cardholder name.
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| The uniform prescription drug information card or other | 8 |
| technology shall
specifically identify and display the | 9 |
| following mandatory data elements on the
back of the card:
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| (1) Claims submission names and addresses; and
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| (2) Help desk telephone numbers and names.
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| (b) A new uniform prescription drug information card or | 13 |
| other technology
shall be
issued by a health benefit plan upon | 14 |
| enrollment and reissued upon any change in
the insured's | 15 |
| coverage that affects mandatory data elements contained on the
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| card. | 17 |
| (c) As used in this Section, "discounted health care | 18 |
| services plan administrator" means any person, partnership, or | 19 |
| corporation, other than an insurer, health service | 20 |
| corporation, limited health service organization holding a | 21 |
| certificate of authority under the Limited Health Service | 22 |
| Organization Act, or health maintenance organization holding a | 23 |
| certificate of authority under the Health Maintenance | 24 |
| Organization Act, that arranges, contracts with, or | 25 |
| administers contracts with a provider whereby insureds or | 26 |
| beneficiaries are provided an incentive to use health care |
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HB5352 |
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LRB096 16811 RPM 32118 b |
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| services provided by health care service providers under a | 2 |
| discounted health care service plan in which there are no other | 3 |
| incentives, such as copayment, coinsurance, or any other | 4 |
| reimbursement differential, for beneficiaries to utilize the | 5 |
| provider. "Discounted health care services plan administrator" | 6 |
| also includes any person, partnership, or corporation, other | 7 |
| than an insurer, health service corporation, limited health | 8 |
| service organization holding a certificate of authority under | 9 |
| the Limited Health Service Organization Act, or health | 10 |
| maintenance organization holding a certificate of authority | 11 |
| under the Health Maintenance Organization Act, that enters into | 12 |
| a contract with another administrator to enroll beneficiaries | 13 |
| or insureds in a preferred provider program marketed as an | 14 |
| independently identifiable program based on marketing | 15 |
| materials or member benefit identification cards.
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| (Source: P.A. 91-777, eff. 1-1-01.)
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