Bill Text: IL HB5527 | 2009-2010 | 96th General Assembly | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Amends the Uniform Prescription Drug Information Card Act. Provides that a discounted health care services plan administrator shall issue to its beneficiaries and insureds a card or other technology containing uniform prescription drug information. Sets forth the mandatory data elements that the card or other technology issued by a discounted health care services plan administrator shall display. Sets forth a definition for "discounted health care services plan administrator".

Sponsorship: Slight Partisan Bill (Democrat 3-1)

Status: (Passed) 2010-07-27 - Public Act . . . . . . . . . 96-1326 [HB5527 Detail]

Download: Illinois-2009-HB5527-Introduced.html

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96TH GENERAL ASSEMBLY State of Illinois 2009 and 2010 HB5527 Introduced 2/9/2010, by Rep. Angelo Saviano - Michael J. Zalewski SYNOPSIS AS INTRODUCED:
215 ILCS 138/15
Amends the Uniform Prescription Drug Information Card Act. Provides that a discounted health care services plan administrator shall issue to its beneficiaries and insureds a card or other technology containing uniform prescription drug information. Sets forth the mandatory data elements that the card or other technology issued by a discounted health care services plan administrator shall display. Sets forth a definition for "discounted health care services plan administrator".
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A BILL FOR
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AN ACT concerning insurance.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Uniform Prescription Drug Information Card
Act is amended by changing Section 15 as follows:
(215 ILCS 138/15)
Sec. 15. Uniform prescription drug information cards
required.
(a) A health benefit plan that issues a card or other
technology and provides coverage for prescription drugs or
devices and an administrator of such a plan including, but not
limited to, third-party administrators for self-insured plans
and state-administered plans shall issue to its insureds a card
or other technology containing uniform prescription drug
information. The uniform prescription drug information card or
other technology shall specifically identify and display the
following mandatory data elements on the front of the card:
(1) BIN number;
(2) Processor control number if required for claims
adjudication;
(3) Group number;
(4) Card issuer identifier;
(5) Cardholder ID number; and

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(6) Cardholder name.
The uniform prescription drug information card or other
technology shall specifically identify and display the
following mandatory data elements on the back of the card:
(1) Claims submission names and addresses; and
(2) Help desk telephone numbers and names.
(b) A discounted health care services plan administrator
shall issue to its beneficiaries and insureds a card or other
technology containing uniform prescription drug information.
The uniform prescription drug information card or other
technology issued by a discounted health care services plan
administrator shall specifically identify and display the
following mandatory data elements:
(1) BIN number;
(2) processor control number, if required for claims
adjudication;
(3) group number;
(4) card issuer identifier;
(5) cardholder ID number;
(6) cardholder name;
(7) claims submission names and addresses; and
(8) help desk telephone numbers and names.
(c) (b) A new uniform prescription drug information card or
other technology shall be issued by a health benefit plan upon
enrollment and reissued upon any change in the insured's
coverage that affects mandatory data elements contained on the

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card.
(d) As used in this Section, "discounted health care
services plan administrator" means any person, partnership, or
corporation, other than an insurer, health service
corporation, limited health service organization holding a
certificate of authority under the Limited Health Service
Organization Act, or health maintenance organization holding a
certificate of authority under the Health Maintenance
Organization Act, that arranges, contracts with, or
administers contracts with a provider whereby insureds or
beneficiaries are provided an incentive to use health care
services provided by health care service providers under a
discounted health care service plan in which there are no other
incentives, such as copayment, coinsurance, or any other
reimbursement differential, for beneficiaries to utilize the
provider. "Discounted health care services plan administrator"
also includes any person, partnership, or corporation, other
than an insurer, health service corporation, limited health
service organization holding a certificate of authority under
the Limited Health Service Organization Act, or health
maintenance organization holding a certificate of authority
under the Health Maintenance Organization Act, that enters into
a contract with another administrator to enroll beneficiaries
or insureds in a preferred provider program marketed as an
independently identifiable program based on marketing
materials or member benefit identification cards.

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(Source: P.A. 91-777, eff. 1-1-01.)