Bill Text: IL HB3177 | 2019-2020 | 101st General Assembly | Introduced


Bill Title: Amends the Illinois Insurance Code. In provisions requiring insurance coverage for prostate-specific antigen tests and for colorectal cancer examination and screening, removes provisions requiring the testing be recommended or prescribed by a physician. Amends the Illinois Insurance Code, the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code to require insurance policies to provide coverage for testing to establish the presence or absence of sexually transmitted diseases or infections. Effective immediately.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2019-03-29 - Rule 19(a) / Re-referred to Rules Committee [HB3177 Detail]

Download: Illinois-2019-HB3177-Introduced.html


101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB3177

Introduced , by Rep. Deanne M. Mazzochi

SYNOPSIS AS INTRODUCED:
5 ILCS 375/6.11
55 ILCS 5/5-1069.3
65 ILCS 5/10-4-2.3
105 ILCS 5/10-22.3f
215 ILCS 5/356u
215 ILCS 5/356x
215 ILCS 5/356z.33 new
215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2
215 ILCS 130/4003 from Ch. 73, par. 1504-3
215 ILCS 165/10 from Ch. 32, par. 604
305 ILCS 5/5-16.8

Amends the Illinois Insurance Code. In provisions requiring insurance coverage for prostate-specific antigen tests and for colorectal cancer examination and screening, removes provisions requiring the testing be recommended or prescribed by a physician. Amends the Illinois Insurance Code, the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code to require insurance policies to provide coverage for testing to establish the presence or absence of sexually transmitted diseases or infections. Effective immediately.
LRB101 08463 RAB 53539 b
FISCAL NOTE ACT MAY APPLY
STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT

A BILL FOR

HB3177LRB101 08463 RAB 53539 b
1 AN ACT concerning regulation.
2 Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4 Section 5. The State Employees Group Insurance Act of 1971
5is amended by changing Section 6.11 as follows:
6 (5 ILCS 375/6.11)
7 (Text of Section before amendment by P.A. 100-1170)
8 Sec. 6.11. Required health benefits; Illinois Insurance
9Code requirements. The program of health benefits shall provide
10the post-mastectomy care benefits required to be covered by a
11policy of accident and health insurance under Section 356t of
12the Illinois Insurance Code. The program of health benefits
13shall provide the coverage required under Sections 356g,
14356g.5, 356g.5-1, 356m, 356u, 356w, 356x, 356z.2, 356z.4,
15356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
16356z.14, 356z.15, 356z.17, 356z.22, 356z.25, and 356z.26, and
17356z.29, 356z.32, and 356z.33 of the Illinois Insurance Code.
18The program of health benefits must comply with Sections
19155.22a, 155.37, 355b, 356z.19, 370c, and 370c.1 of the
20Illinois Insurance Code. The Department of Insurance shall
21enforce the requirements of this Section.
22 Rulemaking authority to implement Public Act 95-1045, if
23any, is conditioned on the rules being adopted in accordance

HB3177- 2 -LRB101 08463 RAB 53539 b
1with all provisions of the Illinois Administrative Procedure
2Act and all rules and procedures of the Joint Committee on
3Administrative Rules; any purported rule not so adopted, for
4whatever reason, is unauthorized.
5(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17;
6100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1024, eff.
71-1-19; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; revised
81-8-19.)
9 (Text of Section after amendment by P.A. 100-1170)
10 Sec. 6.11. Required health benefits; Illinois Insurance
11Code requirements. The program of health benefits shall provide
12the post-mastectomy care benefits required to be covered by a
13policy of accident and health insurance under Section 356t of
14the Illinois Insurance Code. The program of health benefits
15shall provide the coverage required under Sections 356g,
16356g.5, 356g.5-1, 356m, 356u, 356w, 356x, 356z.2, 356z.4,
17356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
18356z.14, 356z.15, 356z.17, 356z.22, 356z.25, 356z.26, 356z.29,
19and 356z.32, and 356z.33 of the Illinois Insurance Code. The
20program of health benefits must comply with Sections 155.22a,
21155.37, 355b, 356z.19, 370c, and 370c.1 of the Illinois
22Insurance Code. The Department of Insurance shall enforce the
23requirements of this Section with respect to Sections 370c and
24370c.1 of the Illinois Insurance Code; all other requirements
25of this Section shall be enforced by the Department of Central

HB3177- 3 -LRB101 08463 RAB 53539 b
1Management Services.
2 Rulemaking authority to implement Public Act 95-1045, if
3any, is conditioned on the rules being adopted in accordance
4with all provisions of the Illinois Administrative Procedure
5Act and all rules and procedures of the Joint Committee on
6Administrative Rules; any purported rule not so adopted, for
7whatever reason, is unauthorized.
8(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17;
9100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1024, eff.
101-1-19; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19;
11100-1170, eff. 6-1-19.)
12 Section 10. The Counties Code is amended by changing
13Section 5-1069.3 as follows:
14 (55 ILCS 5/5-1069.3)
15 Sec. 5-1069.3. Required health benefits. If a county,
16including a home rule county, is a self-insurer for purposes of
17providing health insurance coverage for its employees, the
18coverage shall include coverage for the post-mastectomy care
19benefits required to be covered by a policy of accident and
20health insurance under Section 356t and the coverage required
21under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x,
22356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
23356z.14, 356z.15, 356z.22, 356z.25, and 356z.26, and 356z.29,
24356z.32, and 356z.33 of the Illinois Insurance Code. The

HB3177- 4 -LRB101 08463 RAB 53539 b
1coverage shall comply with Sections 155.22a, 355b, 356z.19, and
2370c of the Illinois Insurance Code. The Department of
3Insurance shall enforce the requirements of this Section. The
4requirement that health benefits be covered as provided in this
5Section is an exclusive power and function of the State and is
6a denial and limitation under Article VII, Section 6,
7subsection (h) of the Illinois Constitution. A home rule county
8to which this Section applies must comply with every provision
9of this Section.
10 Rulemaking authority to implement Public Act 95-1045, if
11any, is conditioned on the rules being adopted in accordance
12with all provisions of the Illinois Administrative Procedure
13Act and all rules and procedures of the Joint Committee on
14Administrative Rules; any purported rule not so adopted, for
15whatever reason, is unauthorized.
16(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17;
17100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1024, eff.
181-1-19; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; revised
1910-3-18.)
20 Section 15. The Illinois Municipal Code is amended by
21changing Section 10-4-2.3 as follows:
22 (65 ILCS 5/10-4-2.3)
23 Sec. 10-4-2.3. Required health benefits. If a
24municipality, including a home rule municipality, is a

HB3177- 5 -LRB101 08463 RAB 53539 b
1self-insurer for purposes of providing health insurance
2coverage for its employees, the coverage shall include coverage
3for the post-mastectomy care benefits required to be covered by
4a policy of accident and health insurance under Section 356t
5and the coverage required under Sections 356g, 356g.5,
6356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.10,
7356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25,
8and 356z.26, and 356z.29, 356z.32, and 356z.33 of the Illinois
9Insurance Code. The coverage shall comply with Sections
10155.22a, 355b, 356z.19, and 370c of the Illinois Insurance
11Code. The Department of Insurance shall enforce the
12requirements of this Section. The requirement that health
13benefits be covered as provided in this is an exclusive power
14and function of the State and is a denial and limitation under
15Article VII, Section 6, subsection (h) of the Illinois
16Constitution. A home rule municipality to which this Section
17applies must comply with every provision of this Section.
18 Rulemaking authority to implement Public Act 95-1045, if
19any, is conditioned on the rules being adopted in accordance
20with all provisions of the Illinois Administrative Procedure
21Act and all rules and procedures of the Joint Committee on
22Administrative Rules; any purported rule not so adopted, for
23whatever reason, is unauthorized.
24(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17;
25100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1024, eff.
261-1-19; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; revised

HB3177- 6 -LRB101 08463 RAB 53539 b
110-4-18.)
2 Section 20. The School Code is amended by changing Section
310-22.3f as follows:
4 (105 ILCS 5/10-22.3f)
5 Sec. 10-22.3f. Required health benefits. Insurance
6protection and benefits for employees shall provide the
7post-mastectomy care benefits required to be covered by a
8policy of accident and health insurance under Section 356t and
9the coverage required under Sections 356g, 356g.5, 356g.5-1,
10356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.11, 356z.12,
11356z.13, 356z.14, 356z.15, 356z.22, 356z.25, and 356z.26, and
12356z.29, 356z.32, and 356z.33 of the Illinois Insurance Code.
13Insurance policies shall comply with Section 356z.19 of the
14Illinois Insurance Code. The coverage shall comply with
15Sections 155.22a, 355b, and 370c of the Illinois Insurance
16Code. The Department of Insurance shall enforce the
17requirements of this Section.
18 Rulemaking authority to implement Public Act 95-1045, if
19any, is conditioned on the rules being adopted in accordance
20with all provisions of the Illinois Administrative Procedure
21Act and all rules and procedures of the Joint Committee on
22Administrative Rules; any purported rule not so adopted, for
23whatever reason, is unauthorized.
24(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;

HB3177- 7 -LRB101 08463 RAB 53539 b
1100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
21-1-19; 100-1102, eff. 1-1-19; revised 10-4-18.)
3 Section 25. The Illinois Insurance Code is amended by
4changing Sections 356u and 356x and by adding Section 356z.33
5as follows:
6 (215 ILCS 5/356u)
7 Sec. 356u. Pap tests and prostate-specific antigen tests.
8 (a) A group policy of accident and health insurance that
9provides coverage for hospital or medical treatment or services
10for illness on an expense-incurred basis and is amended,
11delivered, issued, or renewed after the effective date of this
12amendatory Act of 1997 shall provide coverage for all of the
13following:
14 (1) An annual cervical smear or Pap smear test for
15 female insureds.
16 (2) An annual digital rectal examination and a
17 prostate-specific antigen test, for male insureds upon the
18 recommendation of a physician licensed to practice
19 medicine in all its branches for:
20 (A) asymptomatic men age 50 and over;
21 (B) African-American men age 40 and over; and
22 (C) men age 40 and over with a family history of
23 prostate cancer.
24 (3) Surveillance tests for ovarian cancer for female

HB3177- 8 -LRB101 08463 RAB 53539 b
1 insureds who are at risk for ovarian cancer.
2 (b) This Section shall not apply to agreements, contracts,
3or policies that provide coverage for a specified disease or
4other limited benefit coverage.
5 (c) For the purposes of this Section:
6 "At risk for ovarian cancer" means:
7 (1) having a family history (i) with one or more
8 first-degree relatives with ovarian cancer, (ii) of
9 clusters of women relatives with breast cancer, or (iii) of
10 nonpolyposis colorectal cancer; or
11 (2) testing positive for BRCA1 or BRCA2 mutations.
12 "Surveillance tests for ovarian cancer" means annual
13screening using (i) CA-125 serum tumor marker testing, (ii)
14transvaginal ultrasound, (iii) pelvic examination.
15(Source: P.A. 94-122, eff. 1-1-06.)
16 (215 ILCS 5/356x)
17 Sec. 356x. Coverage for colorectal cancer examination and
18screening.
19 (a) An individual or group policy of accident and health
20insurance or a managed care plan that is amended, delivered,
21issued, or renewed on or after the effective date of this
22amendatory Act of the 93rd General Assembly that provides
23coverage to a resident of this State must provide benefits or
24coverage for all colorectal cancer examinations and laboratory
25tests for colorectal cancer as prescribed by a physician, in

HB3177- 9 -LRB101 08463 RAB 53539 b
1accordance with the published American Cancer Society
2guidelines on colorectal cancer screening or other existing
3colorectal cancer screening guidelines issued by nationally
4recognized professional medical societies or federal
5government agencies, including the National Cancer Institute,
6the Centers for Disease Control and Prevention, and the
7American College of Gastroenterology.
8 (b) Coverage required under this Section may not impose any
9deductible, coinsurance, waiting period, or other cost-sharing
10limitation that is greater than that required for other
11coverage under the policy.
12(Source: P.A. 93-568, eff. 1-1-04.)
13 (215 ILCS 5/356z.33 new)
14 Sec. 356z.33. Coverage for sexually transmitted disease
15testing. A group or individual policy of accident and health
16insurance amended, delivered, issued, or renewed after the
17effective date of this amendatory Act of the 101st General
18Assembly shall provide coverage for testing to establish the
19presence or absence of sexually transmitted diseases or
20infections.
21 Section 30. The Health Maintenance Organization Act is
22amended by changing Section 5-3 as follows:
23 (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)

HB3177- 10 -LRB101 08463 RAB 53539 b
1 Sec. 5-3. Insurance Code provisions.
2 (a) Health Maintenance Organizations shall be subject to
3the provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
4141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154,
5154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 355.2, 355.3,
6355b, 356g.5-1, 356m, 356v, 356w, 356x, 356y, 356z.2, 356z.4,
7356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12,
8356z.13, 356z.14, 356z.15, 356z.17, 356z.18, 356z.19, 356z.21,
9356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 356z.33,
10364, 364.01, 367.2, 367.2-5, 367i, 368a, 368b, 368c, 368d,
11368e, 370c, 370c.1, 401, 401.1, 402, 403, 403A, 408, 408.2,
12409, 412, 444, and 444.1, paragraph (c) of subsection (2) of
13Section 367, and Articles IIA, VIII 1/2, XII, XII 1/2, XIII,
14XIII 1/2, XXV, and XXVI of the Illinois Insurance Code.
15 (b) For purposes of the Illinois Insurance Code, except for
16Sections 444 and 444.1 and Articles XIII and XIII 1/2, Health
17Maintenance Organizations in the following categories are
18deemed to be "domestic companies":
19 (1) a corporation authorized under the Dental Service
20 Plan Act or the Voluntary Health Services Plans Act;
21 (2) a corporation organized under the laws of this
22 State; or
23 (3) a corporation organized under the laws of another
24 state, 30% or more of the enrollees of which are residents
25 of this State, except a corporation subject to
26 substantially the same requirements in its state of

HB3177- 11 -LRB101 08463 RAB 53539 b
1 organization as is a "domestic company" under Article VIII
2 1/2 of the Illinois Insurance Code.
3 (c) In considering the merger, consolidation, or other
4acquisition of control of a Health Maintenance Organization
5pursuant to Article VIII 1/2 of the Illinois Insurance Code,
6 (1) the Director shall give primary consideration to
7 the continuation of benefits to enrollees and the financial
8 conditions of the acquired Health Maintenance Organization
9 after the merger, consolidation, or other acquisition of
10 control takes effect;
11 (2)(i) the criteria specified in subsection (1)(b) of
12 Section 131.8 of the Illinois Insurance Code shall not
13 apply and (ii) the Director, in making his determination
14 with respect to the merger, consolidation, or other
15 acquisition of control, need not take into account the
16 effect on competition of the merger, consolidation, or
17 other acquisition of control;
18 (3) the Director shall have the power to require the
19 following information:
20 (A) certification by an independent actuary of the
21 adequacy of the reserves of the Health Maintenance
22 Organization sought to be acquired;
23 (B) pro forma financial statements reflecting the
24 combined balance sheets of the acquiring company and
25 the Health Maintenance Organization sought to be
26 acquired as of the end of the preceding year and as of

HB3177- 12 -LRB101 08463 RAB 53539 b
1 a date 90 days prior to the acquisition, as well as pro
2 forma financial statements reflecting projected
3 combined operation for a period of 2 years;
4 (C) a pro forma business plan detailing an
5 acquiring party's plans with respect to the operation
6 of the Health Maintenance Organization sought to be
7 acquired for a period of not less than 3 years; and
8 (D) such other information as the Director shall
9 require.
10 (d) The provisions of Article VIII 1/2 of the Illinois
11Insurance Code and this Section 5-3 shall apply to the sale by
12any health maintenance organization of greater than 10% of its
13enrollee population (including without limitation the health
14maintenance organization's right, title, and interest in and to
15its health care certificates).
16 (e) In considering any management contract or service
17agreement subject to Section 141.1 of the Illinois Insurance
18Code, the Director (i) shall, in addition to the criteria
19specified in Section 141.2 of the Illinois Insurance Code, take
20into account the effect of the management contract or service
21agreement on the continuation of benefits to enrollees and the
22financial condition of the health maintenance organization to
23be managed or serviced, and (ii) need not take into account the
24effect of the management contract or service agreement on
25competition.
26 (f) Except for small employer groups as defined in the

HB3177- 13 -LRB101 08463 RAB 53539 b
1Small Employer Rating, Renewability and Portability Health
2Insurance Act and except for medicare supplement policies as
3defined in Section 363 of the Illinois Insurance Code, a Health
4Maintenance Organization may by contract agree with a group or
5other enrollment unit to effect refunds or charge additional
6premiums under the following terms and conditions:
7 (i) the amount of, and other terms and conditions with
8 respect to, the refund or additional premium are set forth
9 in the group or enrollment unit contract agreed in advance
10 of the period for which a refund is to be paid or
11 additional premium is to be charged (which period shall not
12 be less than one year); and
13 (ii) the amount of the refund or additional premium
14 shall not exceed 20% of the Health Maintenance
15 Organization's profitable or unprofitable experience with
16 respect to the group or other enrollment unit for the
17 period (and, for purposes of a refund or additional
18 premium, the profitable or unprofitable experience shall
19 be calculated taking into account a pro rata share of the
20 Health Maintenance Organization's administrative and
21 marketing expenses, but shall not include any refund to be
22 made or additional premium to be paid pursuant to this
23 subsection (f)). The Health Maintenance Organization and
24 the group or enrollment unit may agree that the profitable
25 or unprofitable experience may be calculated taking into
26 account the refund period and the immediately preceding 2

HB3177- 14 -LRB101 08463 RAB 53539 b
1 plan years.
2 The Health Maintenance Organization shall include a
3statement in the evidence of coverage issued to each enrollee
4describing the possibility of a refund or additional premium,
5and upon request of any group or enrollment unit, provide to
6the group or enrollment unit a description of the method used
7to calculate (1) the Health Maintenance Organization's
8profitable experience with respect to the group or enrollment
9unit and the resulting refund to the group or enrollment unit
10or (2) the Health Maintenance Organization's unprofitable
11experience with respect to the group or enrollment unit and the
12resulting additional premium to be paid by the group or
13enrollment unit.
14 In no event shall the Illinois Health Maintenance
15Organization Guaranty Association be liable to pay any
16contractual obligation of an insolvent organization to pay any
17refund authorized under this Section.
18 (g) Rulemaking authority to implement Public Act 95-1045,
19if any, is conditioned on the rules being adopted in accordance
20with all provisions of the Illinois Administrative Procedure
21Act and all rules and procedures of the Joint Committee on
22Administrative Rules; any purported rule not so adopted, for
23whatever reason, is unauthorized.
24(Source: P.A. 99-761, eff. 1-1-18; 100-24, eff. 7-18-17;
25100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1026, eff.
268-22-18; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; revised

HB3177- 15 -LRB101 08463 RAB 53539 b
110-4-18.)
2 Section 35. The Limited Health Service Organization Act is
3amended by changing Section 4003 as follows:
4 (215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
5 Sec. 4003. Illinois Insurance Code provisions. Limited
6health service organizations shall be subject to the provisions
7of Sections 133, 134, 136, 137, 139, 140, 141.1, 141.2, 141.3,
8143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5, 154.6,
9154.7, 154.8, 155.04, 155.37, 355.2, 355.3, 355b, 356v,
10356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.32,
11356z.33, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, 409,
12412, 444, and 444.1 and Articles IIA, VIII 1/2, XII, XII 1/2,
13XIII, XIII 1/2, XXV, and XXVI of the Illinois Insurance Code.
14For purposes of the Illinois Insurance Code, except for
15Sections 444 and 444.1 and Articles XIII and XIII 1/2, limited
16health service organizations in the following categories are
17deemed to be domestic companies:
18 (1) a corporation under the laws of this State; or
19 (2) a corporation organized under the laws of another
20 state, 30% or more of the enrollees of which are residents
21 of this State, except a corporation subject to
22 substantially the same requirements in its state of
23 organization as is a domestic company under Article VIII
24 1/2 of the Illinois Insurance Code.

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1(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
2100-201, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1057, eff.
31-1-19; 100-1102, eff. 1-1-19; revised 10-4-18.)
4 Section 40. The Voluntary Health Services Plans Act is
5amended by changing Section 10 as follows:
6 (215 ILCS 165/10) (from Ch. 32, par. 604)
7 Sec. 10. Application of Insurance Code provisions. Health
8services plan corporations and all persons interested therein
9or dealing therewith shall be subject to the provisions of
10Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,
11143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b, 356g,
12356g.5, 356g.5-1, 356r, 356t, 356u, 356v, 356w, 356x, 356y,
13356z.1, 356z.2, 356z.4, 356z.5, 356z.6, 356z.8, 356z.9,
14356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.18,
15356z.19, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30,
16356z.32, 356z.33, 364.01, 367.2, 368a, 401, 401.1, 402, 403,
17403A, 408, 408.2, and 412, and paragraphs (7) and (15) of
18Section 367 of the Illinois Insurance Code.
19 Rulemaking authority to implement Public Act 95-1045, if
20any, is conditioned on the rules being adopted in accordance
21with all provisions of the Illinois Administrative Procedure
22Act and all rules and procedures of the Joint Committee on
23Administrative Rules; any purported rule not so adopted, for
24whatever reason, is unauthorized.

HB3177- 17 -LRB101 08463 RAB 53539 b
1(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
2100-863, eff. 8-14-18; 100-1026, eff. 8-22-18; 100-1057, eff.
31-1-19; 100-1102, eff. 1-1-19; revised 10-4-18.)
4 Section 45. The Illinois Public Aid Code is amended by
5changing Section 5-16.8 as follows:
6 (305 ILCS 5/5-16.8)
7 Sec. 5-16.8. Required health benefits. The medical
8assistance program shall (i) provide the post-mastectomy care
9benefits required to be covered by a policy of accident and
10health insurance under Section 356t and the coverage required
11under Sections 356g.5, 356u, 356w, 356x, 356z.6, 356z.26, and
12356z.29, 356z.32, and 356z.33 of the Illinois Insurance Code
13and (ii) be subject to the provisions of Sections 356z.19,
14364.01, 370c, and 370c.1 of the Illinois Insurance Code.
15 On and after July 1, 2012, the Department shall reduce any
16rate of reimbursement for services or other payments or alter
17any methodologies authorized by this Code to reduce any rate of
18reimbursement for services or other payments in accordance with
19Section 5-5e.
20 To ensure full access to the benefits set forth in this
21Section, on and after January 1, 2016, the Department shall
22ensure that provider and hospital reimbursement for
23post-mastectomy care benefits required under this Section are
24no lower than the Medicare reimbursement rate.

HB3177- 18 -LRB101 08463 RAB 53539 b
1(Source: P.A. 99-433, eff. 8-21-15; 99-480, eff. 9-9-15;
299-642, eff. 7-28-16; 100-138, eff. 8-18-17; 100-863, eff.
38-14-18; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; revised
410-4-18.)
5 Section 95. No acceleration or delay. Where this Act makes
6changes in a statute that is represented in this Act by text
7that is not yet or no longer in effect (for example, a Section
8represented by multiple versions), the use of that text does
9not accelerate or delay the taking effect of (i) the changes
10made by this Act or (ii) provisions derived from any other
11Public Act.
12 Section 99. Effective date. This Act takes effect upon
13becoming law.
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