Illinois General Assembly - Illinois Compiled Statutes

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20 ILCS 3935/4

(20 ILCS 3935/4) (from Ch. 111 1/2, par. 6604)

Sec. 4.

Determination of an individual transplant candidate's eligibility.

(a) The Board shall have until June 30, 1985 to organize, establish all
of the necessary criteria and operating procedures, and adopt such rules
and regulations as it deems necessary to screen and act on such applications
as it may receive under this Act.

(b) The Board shall begin screening applications
nominating Illinois residents who are potential or actual organ transplant
recipients after July 1, 1985, and who due to limitations, exclusions
or gaps in their accident and health insurance or in federal, state, and
local government medical assistance programs, might be eligible to receive
benefits from funds appropriated to the Department of Public Health to
cover part or all of the expenses involved in undergoing an experimental
organ transplantation procedure. All such applications must be in such form
and contain such information as the Board shall require, and must come
directly from a teaching hospital or affiliated medical center with an
established and proven experimental organ transplantation program which
exists for the purpose of treatment of human subjects and which is formally
affiliated with or part of a school whose graduates are eligible for
examination for licensing pursuant to the statutes, rules and regulations
administered by the Department of Professional Regulation and whose
graduates, if licensed, are eligible for admission to the medical staff of
an accredited hospital. In the application the teaching hospital or
affiliated medical center must certify that the nominee is a viable
candidate for an organ transplant procedure,
and has been medically approved by their medical specialists in this field
for this procedure.  All tests and applicable work-ups necessary to support
such conclusions shall have been completed at the time of the application
at no cost to the State of Illinois, and the results of such tests and all
other applicable medical records concerning the nominee shall be forwarded
to the Board for the confidential use of its members and staff only.  Such
medical records shall not be public records, and shall be maintained as a
separate part of each nominee's application file.  Such records and
deliberations of the Board shall be privileged and confidential in
accordance with Sections 8-2101, 8-2102, 8-2103, 8-2104 and 8-2105 of the
Code of Civil Procedure, as amended, and such applications, records and
deliberations of the Board are exempt from the provisions of The Freedom of
Information Act. The application and supporting records must document that
the nominee was a legally domiciled resident of this State at the time the
pathophysiological state necessitating the organ transplantation procedure
was originally identified, and that the nominee continues to be legally
domiciled in the State of Illinois.

(c) Screening of applications may be performed as often as necessary and
may be performed by any 3 members of the Board.

(d) Those applications deemed eligible by the screening team shall be
referred to the full Board for final determination as to eligibility for
state benefits and for recommendation to the Director of Public Health as
to the level of benefits the nominee shall receive.
However, in emergency situations, a screening team may make a final
determination as to eligibility for state benefits.

All benefits shall cover all or part of the actual costs of, rather than
the billed charges for, the procedure, with no more than 10 percent of the
award being allocated to professional fees.

(e) Any benefits which the Board recommends to be paid on behalf of an
eligible nominee shall be supplemental to any health insurance benefits
that individual is otherwise entitled to, and no state benefits shall be
paid to a hospital or other provider until all other health insurance benefits
for that individual have been exhausted.

(f) Whenever the Board recommends, and the Director of Public Health
approves, payment of such benefits as are authorized by this Act or the
rules and regulations promulgated hereunder shall be made from such
appropriations as the General Assembly may provide for this purpose to the
Department of Public Health. No one individual shall be eligible to receive
more than a total of $200,000 under this Act.

The maximum level of payment recommended by the Board for live donor
acquisition charges shall be $10,000.  No payments shall be made for
complications or follow-up hospitalization for a donor of an organ
transplanted under this program.

(g) Meetings of the Board or any screening team for the purpose of
reviewing or discussing applications are exempt from the Open Meetings Act;
provided that those portions of meetings at which final determinations
are made shall be public meetings.

(h) A transplantation institution located outside of the State of
Illinois shall not be approved for participation under this program unless
such institution is closer to the residence of the patient than is any
approved Illinois institution, or unless the required procedure is offered
at the out-of-state institution and the procedure is not approved at any
institution located within the State.

(Source: P.A. 85-1209.)