Bill Text: IL HB3509 | 2019-2020 | 101st General Assembly | Engrossed

NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Amends the State Employees Group Insurance Act of 1971, Illinois Insurance Code, and the Illinois Public Aid Code. Provides that pasteurized donated human breast milk shall be covered under health insurance and the medical assistance program under the Illinois Public Aid Code. Describes the requirements that must be met to have pasteurized human breast milk covered under health insurance and the medical assistance program. Effective January 1, 2020.

Spectrum: Partisan Bill (Democrat 14-0)

Status: (Passed) 2019-08-23 - Public Act . . . . . . . . . 101-0511 [HB3509 Detail]

Download: Illinois-2019-HB3509-Engrossed.html



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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 adding Section 6.16 as follows:
6 (5 ILCS 375/6.16 new)
7 Sec. 6.16. Human breast milk coverage. Notwithstanding any
8other provision of this Act, pasteurized donated human breast
9milk, which may include human milk fortifiers if indicated by a
10prescribing licensed medical practitioner, shall be covered
11under a health plan for persons who are otherwise eligible for
12coverage under this Act, if the covered person is an infant
13under the age of 6 months, a physician prescribes the milk for
14the covered person, and:
15 (1) the milk is obtained from a human milk bank that is
16 licensed by the Department of Public Health;
17 (2) a licensed medical practitioner has issued an order
18 for an infant who is medically or physically unable to
19 receive maternal breast milk or participate in breast
20 feeding or whose mother is medically or physically unable
21 to produce maternal breast milk in sufficient quantities or
22 participate in breast feeding despite optimal lactation
23 support; or

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1 (3) a licensed medical practitioner has issued an order
2 for an infant who meets any of the following conditions:
3 (A) a body weight below healthy levels determined
4 by the licensed medical practitioner;
5 (B) a congenital or acquired condition that places
6 the infant at a high risk for development of
7 necrotizing enterocolitis; or
8 (C) a congenital or acquired condition that may
9 benefit from the use of donor breast milk as determined
10 by the Department of Public Health.
11 Section 10. The Illinois Insurance Code is amended by
12adding Section 356z.33 as follows:
13 (215 ILCS 5/356z.33 new)
14 Sec. 356z.33. Human breast milk coverage. Notwithstanding
15any other provision of this Act, pasteurized donated human
16breast milk, which may include human milk fortifiers if
17indicated by a prescribing licensed medical practitioner,
18shall be covered under an individual or group health insurance
19for persons who are otherwise eligible for coverage under this
20Act, if the covered person is an infant under the age of 6
21months, a physician prescribes the milk for the covered person,
22and:
23 (1) the milk is obtained from a human milk bank that is
24 licensed by the Department of Public Health;

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1 (2) a licensed medical practitioner has issued an order
2 for an infant who is medically or physically unable to
3 receive maternal breast milk or participate in breast
4 feeding or whose mother is medically or physically unable
5 to produce maternal breast milk in sufficient quantities or
6 participate in breast feeding despite optimal lactation
7 support; or
8 (3) a licensed medical practitioner has issued an order
9 for an infant who meets any of the following conditions:
10 (A) a body weight below healthy levels determined
11 by the licensed medical practitioner;
12 (B) a congenital or acquired condition that places
13 the infant at a high risk for development of
14 necrotizing enterocolitis; or
15 (C) a congenital or acquired condition that may
16 benefit from the use of donor breast milk as determined
17 by the Department of Public Health.
18 Section 15. The Illinois Public Aid Code is amended by
19adding Section 5-40 as follows:
20 (305 ILCS 5/5-40 new)
21 Sec. 5-40. Human breast milk coverage. Notwithstanding any
22other provision of this Act, pasteurized donated human breast
23milk, which may include human milk fortifiers if indicated by a
24prescribing licensed medical practitioner, shall be covered

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1under a health plan for persons who are otherwise eligible for
2coverage under this Act, if the covered person is an infant
3under the age of 6 months, a physician prescribes the milk for
4the covered person, and:
5 (1) the milk is obtained from a human milk bank that is
6 licensed by the Department of Public Health;
7 (2) a licensed medical practitioner has issued an order
8 for an infant who is medically or physically unable to
9 receive maternal breast milk or participate in breast
10 feeding or whose mother is medically or physically unable
11 to produce maternal breast milk in sufficient quantities or
12 participate in breast feeding despite optimal lactation
13 support; or
14 (3) a licensed medical practitioner has issued an order
15 for an infant who meets any of the following conditions:
16 (A) a body weight below healthy levels determined
17 by the licensed medical practitioner;
18 (B) a congenital or acquired condition that places
19 the infant at a high risk for development of
20 necrotizing enterocolitis; or
21 (C) a congenital or acquired condition that may
22 benefit from the use of donor breast milk as determined
23 by the Department of Public Health.
24 Section 99. Effective date. This Act takes effect January
251, 2020.
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