Bill Text: IL SB0682 | 2009-2010 | 96th General Assembly | Introduced
Bill Title: Amends the Health Maintenance Organization Act. Makes a technical change in a Section concerning organ transplants.
Sponsorship: Partisan Bill (Democrat 1)
Status: (Introduced - Dead) 2009-08-15 - Pursuant to Senate Rule 3-9(b) / Referred to Assignments [SB0682 Detail]
Download: Illinois-2009-SB0682-Introduced.html
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| 1 | AN ACT concerning regulation.
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| 2 | Be it enacted by the People of the State of Illinois, | |||||||||||||||||||
| 3 | represented in the General Assembly:
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| 4 | Section 5. The Health Maintenance Organization Act is | |||||||||||||||||||
| 5 | amended by changing Section 4-5 as follows:
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| 6 | (215 ILCS 125/4-5) (from Ch. 111 1/2, par. 1408.5)
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| 7 | Sec. 4-5. Organ Transplants. No contract or evidence
of | |||||||||||||||||||
| 8 | coverage issued by a health maintenance organization which | |||||||||||||||||||
| 9 | provides
coverage for health care services shall deny | |||||||||||||||||||
| 10 | reimbursement for
an otherwise covered expense incurred for any | |||||||||||||||||||
| 11 | organ transplantation
procedure solely on the
the basis that | |||||||||||||||||||
| 12 | such procedure is deemed experimental or
investigational | |||||||||||||||||||
| 13 | unless supported by the determination of the Office of
Health | |||||||||||||||||||
| 14 | Care Technology Assessment within the Agency for Health Care | |||||||||||||||||||
| 15 | Policy
and Research within the federal Department of Health and | |||||||||||||||||||
| 16 | Human Services
that such procedure is either experimental or | |||||||||||||||||||
| 17 | investigational or that there
is insufficient data or | |||||||||||||||||||
| 18 | experience to determine whether an organ
transplantation | |||||||||||||||||||
| 19 | procedure is clinically acceptable. If a health maintenance
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| 20 | organization has made written request, or had one made on its | |||||||||||||||||||
| 21 | behalf by a
national organization, for determination by the | |||||||||||||||||||
| 22 | Office of Health Care
Technology Assessment within the Agency | |||||||||||||||||||
| 23 | for Health Care Policy and Research
within the federal | |||||||||||||||||||
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| 1 | Department of Health and Human Services as to
whether a | ||||||
| 2 | specific organ transplantation procedure is clinically | ||||||
| 3 | acceptable
and said organization fails to respond to such a | ||||||
| 4 | request within a period of
90 days, the failure to act may be | ||||||
| 5 | deemed a determination that the
procedure is deemed to be | ||||||
| 6 | experimental or investigational. | ||||||
| 7 | (Source: P.A. 87-218.)
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