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90_HB0776ham001
LRB9000964WHmgam03
1 AMENDMENT TO HOUSE BILL 776
2 AMENDMENT NO. . Amend House Bill 776 on page 1,
3 lines 2 and 6 by inserting after "5-16.3" each time it
4 appears the following:
5 "and adding Section 5-16.10"; and
6 on page 5, line 11 by inserting after the period the
7 following:
8 "The Illinois Department shall adopt rules defining
9 "marketing activities" prohibited by this subsection (c-5).";
10 and
11 on page 5, line 25 by inserting after the period the
12 following:
13 "A managed health care entity may provide health care related
14 items that are of nominal value and pre-approved by the
15 Illinois Department to prospective enrollees. A managed
16 health care entity may also provide to enrollees health care
17 related items that have been pre-approved by the Illinois
18 Department as an incentive to manage their health care
19 appropriately."; and
20 on page 27, line 11 by inserting after the period the
21 following:
-2- LRB9000964WHmgam03
1 "The Illinois Department shall adopt rules defining
2 "marketing activities" prohibited by this subsection (c-5).";
3 and
4 on page 27, line 25 by inserting after the period the
5 following:
6 "A managed health care entity may provide health care related
7 items that are of nominal value and pre-approved by the
8 Illinois Department to prospective enrollees. A managed
9 health care entity may also provide to enrollees health care
10 related items that have been pre-approved by the Illinois
11 Department as an incentive to manage their health care
12 appropriately."; and
13 on page 45, by inserting after line 6 the following:
14 "(305 ILCS 5/5-16.10 new)
15 Sec. 5-16.10. Managed care entities; marketing. A
16 managed health care entity providing services under this
17 Article V may not engage in door-to-door marketing activities
18 or marketing activities at an office of the Illinois
19 Department or a county department in order to enroll
20 recipients in the entity's health care delivery system. The
21 Department shall adopt rules defining "marketing activities"
22 prohibited by this Section.
23 Before a managed health care entity providing services
24 under this Article V may market its health care delivery
25 system to recipients, the Illinois Department must approve a
26 marketing plan submitted by the entity to the Illinois
27 Department. The Illinois Department shall adopt guidelines
28 for approving marketing plans submitted by managed health
29 care entities under this Section. Besides prohibiting
30 door-to-door marketing activities and marketing activities at
31 public aid offices, the guidelines shall include at least the
32 following:
-3- LRB9000964WHmgam03
1 (1) A managed health care entity may not offer or
2 provide any gift, favor, or other inducement in marketing
3 its health care delivery system to integrated health care
4 program enrollees. A managed health care entity may
5 provide health care related items that are of nominal
6 value and pre-approved by the Department to prospective
7 enrollees. A managed health care entity may also
8 provide to enrollees health care related items that have
9 been pre-approved by the Department as an incentive to
10 manage their health care appropriately.
11 (2) All persons employed or otherwise engaged by a
12 managed health care entity to market the entity's health
13 care delivery system to recipients or to supervise that
14 marketing shall register with the Illinois Department.
15 The Inspector General appointed under Section 12-13.1 may
16 conduct investigations to determine whether the marketing
17 practices of managed health care entities providing services
18 under this Article V comply with the guidelines.".