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90_HB0008ham003 LRB9000863JSgcam07 1 AMENDMENT TO HOUSE BILL 8 2 AMENDMENT NO. . Amend House Bill 8, AS AMENDED, by 3 replacing everything after the enacting clause with the 4 following: 5 "Section 1. Short title. This Act may be cited as the 6 Genetic Information Privacy Act. 7 Section 5. Legislative findings; intent. The General 8 Assembly finds that: 9 (1) The use of genetic testing can be valuable to 10 an individual. 11 (2) Despite existing laws, regulations, and 12 professional standards which require or promote voluntary 13 and confidential use of genetic testing information, many 14 members of the public are deterred from seeking genetic 15 testing because of fear that test results will be 16 disclosed without consent or be used in a discriminatory 17 manner. 18 (3) The public health will be served by 19 facilitating voluntary and confidential nondiscriminatory 20 use of genetic testing information. 21 Section 10. Definitions. As used in this Act: -2- LRB9000863JSgcam07 1 "Genetic testing" means a test of a person's genes, gene 2 products, or chromosomes for abnormalities or deficiencies, 3 including carrier status, that (i) are linked to physical or 4 mental disorders or impairments, (ii) indicate a 5 susceptibility to illness, disease, impairment, or other 6 disorders, whether physical or mental, or (iii) demonstrate 7 genetic or chromosomal damage due to environmental factors. 8 Genetic testing does not include routine physical 9 measurements; chemical, blood and urine analyses that are 10 widely accepted and in use in clinical practice; tests for 11 use of drugs; and tests for the presence of the human 12 immunodeficiency virus. 13 "Insurer" means (i) an entity that transacts an insurance 14 business and (ii) a managed care plan. 15 "Managed care plan" means a plan that establishes, 16 operates, or maintains a network of health care providers 17 that have entered into agreements with the plan to provide 18 health care services to enrollees where the plan has the 19 ultimate and direct contractual obligation to the enrollee to 20 arrange for the provision of or pay for services through: 21 (1) organizational arrangements for ongoing quality 22 assurance, utilization review programs, or dispute 23 resolution; or 24 (2) financial incentives for persons enrolled in 25 the plan to use the participating providers and 26 procedures covered by the plan. 27 A managed care plan may be established or operated by any 28 entity including a licensed insurance company, hospital or 29 medical service plan, health maintenance organization, 30 limited health service organization, preferred provider 31 organization, third party administrator, or an employer or 32 employee organization. 33 Section 15. Confidentiality of genetic information. -3- LRB9000863JSgcam07 1 (a) Except as otherwise provided in this Act, genetic 2 testing and information derived from genetic testing is 3 confidential and privileged and may be released only to the 4 individual tested and to persons specifically authorized, in 5 writing in accordance with Section 30, by that individual to 6 receive the information. Except as otherwise provided in 7 subsection (b) and in Section 30, this information shall not 8 be admissible as evidence, nor discoverable in any action of 9 any kind in any court, or before any tribunal, board, agency, 10 or person pursuant to Part 21 of Article VIII of the Code of 11 Civil Procedure. No liability shall attach to any hospital, 12 physician, or other health care provider for compliance with 13 the provisions of this Act including a specific written 14 release by the individual in accordance with this Act. 15 (b) When a biological sample is legally obtained by a 16 peace officer for use in a criminal investigation or 17 prosecution, information derived from genetic testing of that 18 sample may be disclosed for identification purposes to 19 appropriate law enforcement authorities conducting the 20 investigation or prosecution and may be used in accordance 21 with Section 5-4-3 of the Unified Code of Corrections. The 22 information may be used for identification purposes during 23 the course of the investigation or prosecution with respect 24 to the individual tested without the consent of the 25 individual and shall be admissible as evidence in court. 26 The information shall be confidential and may be 27 disclosed only for purposes of criminal investigation or 28 prosecution. 29 (c) If the subject of the information requested by law 30 enforcement is found innocent of the offense or otherwise not 31 criminally penalized, then the court records shall be 32 expunged by the court within 30 days after the final legal 33 proceeding. The court shall notify the subject of the 34 information of the expungement of the records in writing. -4- LRB9000863JSgcam07 1 (d) Results of genetic testing that indicate that the 2 individual tested is at the time of the test afflicted with a 3 disease, whether or not currently symptomatic, are not 4 subject to the confidentiality requirements of this Act. 5 Section 20. Use of genetic testing information for 6 insurance purposes. 7 (a) An insurer may not seek information derived from 8 genetic testing for use in connection with a policy of 9 accident and health insurance. Except as provided in 10 subsection (b), an insurer that receives information derived 11 from genetic testing may not use the information for a 12 nontherapeutic purpose as it relates to a policy of accident 13 and health insurance. 14 (b) An insurer may consider the results of genetic 15 testing in connection with a policy of accident and health 16 insurance if the individual voluntarily submits the results 17 and the results are favorable to the individual. 18 (c) An insurer that possesses information derived from 19 genetic testing may not release the information to a third 20 party, except as specified in Section 30. 21 Section 22. Tests to determine inherited characteristics 22 in paternity proceedings. Nothing in this Act shall be 23 construed to affect or restrict in any way the ordering of or 24 use of results from deoxyribonucleic acid (DNA) testing or 25 other tests to determine inherited characteristics by the 26 court in a judicial proceeding under the Illinois Parentage 27 Act of 1984 or by the Illinois Department of Public Aid in an 28 administrative paternity proceeding under Article X of the 29 Illinois Public Aid Code and rules promulgated under that 30 Article. 31 Section 25. Use of genetic testing information by -5- LRB9000863JSgcam07 1 employers. 2 (a) An employer shall treat genetic testing information 3 in such a manner that is consistent with the requirements of 4 federal law, including but not limited to the Americans with 5 Disabilities Act. 6 (b) An employer may release genetic testing information 7 only in accordance with Section 30. 8 Section 30. Disclosure of person tested and test 9 results. 10 (a) No person may disclose or be compelled to disclose 11 the identity of any person upon whom a genetic test is 12 performed or the results of a genetic test in a manner that 13 permits identification of the subject of the test, except to 14 the following persons: 15 (1) The subject of the test or the subject's 16 legally authorized representative. This paragraph does 17 not create a duty or obligation under which a health care 18 provider must notify the subject's spouse or legal 19 guardian of the test results, and no such duty or 20 obligation shall be implied. No civil liability or 21 criminal sanction under this Act shall be imposed for any 22 disclosure or nondisclosure of a test result to a spouse 23 by a physician acting in good faith under this paragraph. 24 For the purpose of any proceedings, civil or criminal, 25 the good faith of any physician acting under this 26 paragraph shall be presumed. 27 (2) Any person designated in a specific written 28 legally effective release of the test results executed by 29 the subject of the test or the subject's legally 30 authorized representative. 31 (3) An authorized agent or employee of a health 32 facility or health care provider if the health facility 33 or health care provider itself is authorized to obtain -6- LRB9000863JSgcam07 1 the test results, the agent or employee provides patient 2 care, and the agent or employee has a need to know the 3 information in order to conduct the tests or provide care 4 or treatment. 5 (4) A health facility or health care provider that 6 procures, processes, distributes, or uses: 7 (A) a human body part from a deceased person 8 with respect to medical information regarding that 9 person; or 10 (B) semen provided prior to the effective date 11 of this Act for the purpose of artificial 12 insemination. 13 (5) Health facility staff committees for the 14 purposes of conducting program monitoring, program 15 evaluation, or service reviews. 16 (6) In the case of a minor under 18 years of age, 17 the health care provider who ordered the test shall make 18 a reasonable effort to notify the minor's parent or legal 19 guardian if, in the professional judgment of the health 20 care provider, notification would be in the best interest 21 of the minor and the health care provider has first 22 sought unsuccessfully to persuade the minor to notify the 23 parent or legal guardian or after a reasonable time after 24 the minor has agreed to notify the parent or legal 25 guardian, the health care provider has reason to believe 26 that the minor has not made the notification. This 27 paragraph shall not create a duty or obligation under 28 which a health care provider must notify the minor's 29 parent or legal guardian of the test results, nor shall a 30 duty or obligation be implied. No civil liability or 31 criminal sanction under this Act shall be imposed for any 32 notification or non-notification of a minor's test result 33 by a health care provider acting in good faith under this 34 paragraph. For the purpose of any proceeding, civil or -7- LRB9000863JSgcam07 1 criminal, the good faith of any health care provider 2 acting under this paragraph shall be presumed. 3 (7) All information and records held by a State 4 agency or local health authority pertaining to genetic 5 information shall be strictly confidential and exempt 6 from copying and inspection under the Freedom of 7 Information Act. The information and records shall not 8 be released or made public by the State agency or local 9 health authority and shall not be admissible as evidence 10 nor discoverable in any action of any kind in any court 11 or before any tribunal, board, agency, or person and 12 shall be treated in the same manner as the information 13 and those records subject to the provisions of Part 21 of 14 Article VIII of the Code of Civil Procedure except under 15 the following circumstances: 16 (A) when made with the written consent of all 17 persons to whom the information pertains; 18 (B) when authorized by Section 5-4-3 of the 19 Unified Code of Corrections; 20 (C) when made for the sole purpose of 21 implementing the Phenylketonuria Testing Act and 22 rules; or 23 (D) when made under the authorization of the 24 Illinois Parentage Act of 1984. 25 Disclosure shall be limited to those who have a need to 26 know the information, and no additional disclosures may be 27 made. 28 (b) Disclosure by an insurer in accordance with the 29 requirements of the Article XL of the Illinois Insurance Code 30 shall be deemed compliance with this Section. 31 Section 35. Disclosure by person to whom results have 32 been disclosed. No person to whom the results of a test have 33 been disclosed may disclose the test results to another -8- LRB9000863JSgcam07 1 person except as authorized by Section 30. 2 Section 40. Right of action. 3 (a) Any person aggrieved by a violation of this Act 4 shall have a right of action in the circuit court and may 5 recover for each violation: 6 (1) Against any person who negligently violates a 7 provision of this Act, liquidated damages of $1,000 or 8 actual damages, whichever is greater. 9 (2) Against any person who intentionally or 10 recklessly violates a provision of this Act, liquidated 11 damages of $5,000 or actual damages, whichever is 12 greater. 13 (3) Reasonable attorney fees. 14 (4) Such other relief, including an injunction, as 15 the court may deem appropriate. 16 (b) Article XL of the Illinois Insurance Code shall 17 provide the exclusive remedy for violations of Section 30 by 18 insurers. 19 Section 45. Damages or other relief. Nothing in this 20 Act limits the right of the subject of a test to recover 21 damages or other relief under any other applicable law. 22 Section 91. The Illinois Insurance Code is amended by 23 adding Section 356t as follows: 24 (215 ILCS 5/356t new) 25 Sec. 356t. Use of information derived from genetic 26 testing. After the effective date of this amendatory Act of 27 1997, an insurer must comply with the provisions of the 28 Genetic Information Privacy Act in connection with the 29 amendment, delivery, issuance, or renewal of, or claims for 30 or denial of coverage under, an individual or group policy of -9- LRB9000863JSgcam07 1 accident and health insurance. 2 Section 93. The Health Maintenance Organization Act is 3 amended by changing Section 5-3 as follows: 4 (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2) 5 Sec. 5-3. Insurance Code provisions. 6 (a) Health Maintenance Organizations shall be subject to 7 the provisions of Sections 133, 134, 137, 140, 141.1, 141.2, 8 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5, 9 154.6, 154.7, 154.8, 155.04, 355.2, 356m, 356t, 367i, 401, 10 401.1, 402, 403, 403A, 408, 408.2, and 412, paragraph (c) of 11 subsection (2) of Section 367, and Articles VIII 1/2, XII, 12 XII 1/2, XIII, XIII 1/2, and XXVI of the Illinois Insurance 13 Code. 14 (b) For purposes of the Illinois Insurance Code, except 15 for Articles XIII and XIII 1/2, Health Maintenance 16 Organizations in the following categories are deemed to be 17 "domestic companies": 18 (1) a corporation authorized under the Medical 19 Service Plan Act, the Dental Service Plan Act, the Vision 20 Service Plan Act, the Pharmaceutical Service Plan Act, 21 the Voluntary Health Services Plan Act, or the Nonprofit 22 Health Care Service Plan Act; 23 (2) a corporation organized under the laws of this 24 State; or 25 (3) a corporation organized under the laws of 26 another state, 30% or more of the enrollees of which are 27 residents of this State, except a corporation subject to 28 substantially the same requirements in its state of 29 organization as is a "domestic company" under Article 30 VIII 1/2 of the Illinois Insurance Code. 31 (c) In considering the merger, consolidation, or other 32 acquisition of control of a Health Maintenance Organization -10- LRB9000863JSgcam07 1 pursuant to Article VIII 1/2 of the Illinois Insurance Code, 2 (1) the Director shall give primary consideration 3 to the continuation of benefits to enrollees and the 4 financial conditions of the acquired Health Maintenance 5 Organization after the merger, consolidation, or other 6 acquisition of control takes effect; 7 (2)(i) the criteria specified in subsection (1)(b) 8 of Section 131.8 of the Illinois Insurance Code shall not 9 apply and (ii) the Director, in making his determination 10 with respect to the merger, consolidation, or other 11 acquisition of control, need not take into account the 12 effect on competition of the merger, consolidation, or 13 other acquisition of control; 14 (3) the Director shall have the power to require 15 the following information: 16 (A) certification by an independent actuary of 17 the adequacy of the reserves of the Health 18 Maintenance Organization sought to be acquired; 19 (B) pro forma financial statements reflecting 20 the combined balance sheets of the acquiring company 21 and the Health Maintenance Organization sought to be 22 acquired as of the end of the preceding year and as 23 of a date 90 days prior to the acquisition, as well 24 as pro forma financial statements reflecting 25 projected combined operation for a period of 2 26 years; 27 (C) a pro forma business plan detailing an 28 acquiring party's plans with respect to the 29 operation of the Health Maintenance Organization 30 sought to be acquired for a period of not less than 31 3 years; and 32 (D) such other information as the Director 33 shall require. 34 (d) The provisions of Article VIII 1/2 of the Illinois -11- LRB9000863JSgcam07 1 Insurance Code and this Section 5-3 shall apply to the sale 2 by any health maintenance organization of greater than 10% of 3 its enrollee population (including without limitation the 4 health maintenance organization's right, title, and interest 5 in and to its health care certificates). 6 (e) In considering any management contract or service 7 agreement subject to Section 141.1 of the Illinois Insurance 8 Code, the Director (i) shall, in addition to the criteria 9 specified in Section 141.2 of the Illinois Insurance Code, 10 take into account the effect of the management contract or 11 service agreement on the continuation of benefits to 12 enrollees and the financial condition of the health 13 maintenance organization to be managed or serviced, and (ii) 14 need not take into account the effect of the management 15 contract or service agreement on competition. 16 (f) Except for small employer groups as defined in the 17 Small Employer Rating, Renewability and Portability Health 18 Insurance Act and except for medicare supplement policies as 19 defined in Section 363 of the Illinois Insurance Code, a 20 Health Maintenance Organization may by contract agree with a 21 group or other enrollment unit to effect refunds or charge 22 additional premiums under the following terms and conditions: 23 (i) the amount of, and other terms and conditions 24 with respect to, the refund or additional premium are set 25 forth in the group or enrollment unit contract agreed in 26 advance of the period for which a refund is to be paid or 27 additional premium is to be charged (which period shall 28 not be less than one year); and 29 (ii) the amount of the refund or additional premium 30 shall not exceed 20% of the Health Maintenance 31 Organization's profitable or unprofitable experience with 32 respect to the group or other enrollment unit for the 33 period (and, for purposes of a refund or additional 34 premium, the profitable or unprofitable experience shall -12- LRB9000863JSgcam07 1 be calculated taking into account a pro rata share of the 2 Health Maintenance Organization's administrative and 3 marketing expenses, but shall not include any refund to 4 be made or additional premium to be paid pursuant to this 5 subsection (f)). The Health Maintenance Organization and 6 the group or enrollment unit may agree that the 7 profitable or unprofitable experience may be calculated 8 taking into account the refund period and the immediately 9 preceding 2 plan years. 10 The Health Maintenance Organization shall include a 11 statement in the evidence of coverage issued to each enrollee 12 describing the possibility of a refund or additional premium, 13 and upon request of any group or enrollment unit, provide to 14 the group or enrollment unit a description of the method used 15 to calculate (1) the Health Maintenance Organization's 16 profitable experience with respect to the group or enrollment 17 unit and the resulting refund to the group or enrollment unit 18 or (2) the Health Maintenance Organization's unprofitable 19 experience with respect to the group or enrollment unit and 20 the resulting additional premium to be paid by the group or 21 enrollment unit. 22 In no event shall the Illinois Health Maintenance 23 Organization Guaranty Association be liable to pay any 24 contractual obligation of an insolvent organization to pay 25 any refund authorized under this Section. 26 (Source: P.A. 88-313; 89-90, eff. 6-30-95.) 27 Section 95. The Limited Health Service Organization Act 28 is amended by changing Section 4003 as follows: 29 (215 ILCS 130/4003) (from Ch. 73, par. 1504-3) 30 Sec. 4003. Illinois Insurance Code provisions. Limited 31 health service organizations shall be subject to the 32 provisions of Sections 133, 134, 137, 140, 141.1, 141.2, -13- LRB9000863JSgcam07 1 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5, 2 154.6, 154.7, 154.8, 155.04, 355.2, 356t, 401, 401.1, 402, 3 403, 403A, 408, 408.2, and 412, and Articles VIII 1/2, XII, 4 XII 1/2, XIII, XIII 1/2, and XXVI of the Illinois Insurance 5 Code. For purposes of the Illinois Insurance Code, except 6 for Articles XIII and XIII 1/2, limited health service 7 organizations in the following categories are deemed to be 8 domestic companies: 9 (1) a corporation under the laws of this State; or 10 (2) a corporation organized under the laws of 11 another state, 30% of more of the enrollees of which are 12 residents of this State, except a corporation subject to 13 substantially the same requirements in its state of 14 organization as is a domestic company under Article VIII 15 1/2 of the Illinois Insurance Code. 16 (Source: P.A. 86-600; 87-587; 87-1090.) 17 Section 97. The Voluntary Health Services Plans Act is 18 amended by changing Section 10 as follows: 19 (215 ILCS 165/10) (from Ch. 32, par. 604) 20 Sec. 10. Application of Insurance Code provisions. 21 Health services plan corporations and all persons interested 22 therein or dealing therewith shall be subject to the 23 provisions of Article XII 1/2 and Sections 3.1, 133, 140, 24 143, 143c, 149, 354, 355.2, 356r, 356t, 367.2, 401, 401.1, 25 402, 403, 403A, 408, 408.2, and 412, and paragraphs (7) and 26 (15) of Section 367 of the Illinois Insurance Code. 27 (Source: P.A. 89-514, eff. 7-17-96.)".