Illinois 2023-2024 Regular Session

Illinois House Bill HB3960 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB3960 Introduced , by Rep. Lindsey LaPointe SYNOPSIS AS INTRODUCED: 215 ILCS 5/352 from Ch. 73, par. 964 305 ILCS 5/5-16.8 Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the medical assistance program shall be subject to provisions of the Illinois Insurance Code concerning telehealth services. Makes a conforming change in the Illinois Insurance Code. LRB103 31065 BMS 57688 b A BILL FOR 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB3960 Introduced , by Rep. Lindsey LaPointe SYNOPSIS AS INTRODUCED: 215 ILCS 5/352 from Ch. 73, par. 964 305 ILCS 5/5-16.8 215 ILCS 5/352 from Ch. 73, par. 964 305 ILCS 5/5-16.8 Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the medical assistance program shall be subject to provisions of the Illinois Insurance Code concerning telehealth services. Makes a conforming change in the Illinois Insurance Code. LRB103 31065 BMS 57688 b LRB103 31065 BMS 57688 b A BILL FOR
2	2	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB3960 Introduced , by Rep. Lindsey LaPointe SYNOPSIS AS INTRODUCED:
3	3	215 ILCS 5/352 from Ch. 73, par. 964 305 ILCS 5/5-16.8 215 ILCS 5/352 from Ch. 73, par. 964 305 ILCS 5/5-16.8
4	4	215 ILCS 5/352 from Ch. 73, par. 964
5	5	305 ILCS 5/5-16.8
6	6	Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the medical assistance program shall be subject to provisions of the Illinois Insurance Code concerning telehealth services. Makes a conforming change in the Illinois Insurance Code.
7	7	LRB103 31065 BMS 57688 b LRB103 31065 BMS 57688 b
8	8	LRB103 31065 BMS 57688 b
9	9	A BILL FOR
10	10	HB3960LRB103 31065 BMS 57688 b HB3960 LRB103 31065 BMS 57688 b
11	11	HB3960 LRB103 31065 BMS 57688 b
12	12	1 AN ACT concerning regulation.
13	13	2 Be it enacted by the People of the State of Illinois,
14	14	3 represented in the General Assembly:
15	15	4 Section 5. The Illinois Insurance Code is amended by
16	16	5 changing Section 352 as follows:
17	17	6 (215 ILCS 5/352) (from Ch. 73, par. 964)
18	18	7 Sec. 352. Scope of Article.
19	19	8 (a) Except as provided in subsections (b), (c), (d), and
20	20	9 (e), this Article shall apply to all companies transacting in
21	21	10 this State the kinds of business enumerated in clause (b) of
22	22	11 Class 1 and clause (a) of Class 2 of Section 4. Nothing in this
23	23	12 Article shall apply to, or in any way affect policies or
24	24	13 contracts described in clause (a) of Class 1 of Section 4;
25	25	14 however, this Article shall apply to policies and contracts
26	26	15 which contain benefits providing reimbursement for the
27	27	16 expenses of long term health care which are certified or
28	28	17 ordered by a physician including but not limited to
29	29	18 professional nursing care, custodial nursing care, and
30	30	19 non-nursing custodial care provided in a nursing home or at a
31	31	20 residence of the insured.
32	32	21 (b) (Blank).
33	33	22 (c) A policy issued and delivered in this State that
34	34	23 provides coverage under that policy for certificate holders
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38	38	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB3960 Introduced , by Rep. Lindsey LaPointe SYNOPSIS AS INTRODUCED:
39	39	215 ILCS 5/352 from Ch. 73, par. 964 305 ILCS 5/5-16.8 215 ILCS 5/352 from Ch. 73, par. 964 305 ILCS 5/5-16.8
40	40	215 ILCS 5/352 from Ch. 73, par. 964
41	41	305 ILCS 5/5-16.8
42	42	Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the medical assistance program shall be subject to provisions of the Illinois Insurance Code concerning telehealth services. Makes a conforming change in the Illinois Insurance Code.
43	43	LRB103 31065 BMS 57688 b LRB103 31065 BMS 57688 b
44	44	LRB103 31065 BMS 57688 b
45	45	A BILL FOR
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51	51	215 ILCS 5/352 from Ch. 73, par. 964
52	52	305 ILCS 5/5-16.8
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71	71	1 who are neither residents of nor employed in this State does
72	72	2 not need to provide to those nonresident certificate holders
73	73	3 who are not employed in this State the coverages or services
74	74	4 mandated by this Article.
75	75	5 (d) Stop-loss insurance is exempt from all Sections of
76	76	6 this Article, except this Section and Sections 353a, 354,
77	77	7 357.30, and 370. For purposes of this exemption, stop-loss
78	78	8 insurance is further defined as follows:
79	79	9 (1) The policy must be issued to and insure an
80	80	10 employer, trustee, or other sponsor of the plan, or the
81	81	11 plan itself, but not employees, members, or participants.
82	82	12 (2) Payments by the insurer must be made to the
83	83	13 employer, trustee, or other sponsors of the plan, or the
84	84	14 plan itself, but not to the employees, members,
85	85	15 participants, or health care providers.
86	86	16 (e) A policy issued or delivered in this State to the
87	87	17 Department of Healthcare and Family Services (formerly
88	88	18 Illinois Department of Public Aid) and providing coverage,
89	89	19 under clause (b) of Class 1 or clause (a) of Class 2 as
90	90	20 described in Section 4, to persons who are enrolled under
91	91	21 Article V of the Illinois Public Aid Code or under the
92	92	22 Children's Health Insurance Program Act is exempt from all
93	93	23 restrictions, limitations, standards, rules, or regulations
94	94	24 respecting benefits imposed by or under authority of this
95	95	25 Code, except those specified by subsection (1) of Section 143,
96	96	26 Section 356z.22, Section 370c, and Section 370c.1. Nothing in
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107	107	1 this subsection, however, affects the total medical services
108	108	2 available to persons eligible for medical assistance under the
109	109	3 Illinois Public Aid Code.
110	110	4 (f) An in-office membership care agreement provided under
111	111	5 the In-Office Membership Care Act is not insurance for the
112	112	6 purposes of this Code.
113	113	7 (Source: P.A. 101-190, eff. 8-2-19.)
114	114	8 Section 10. The Illinois Public Aid Code is amended by
115	115	9 changing Section 5-16.8 as follows:
116	116	10 (305 ILCS 5/5-16.8)
117	117	11 Sec. 5-16.8. Required health benefits. The medical
118	118	12 assistance program shall (i) provide the post-mastectomy care
119	119	13 benefits required to be covered by a policy of accident and
120	120	14 health insurance under Section 356t and the coverage required
121	121	15 under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6,
122	122	16 356z.26, 356z.29, 356z.32, 356z.33, 356z.34, 356z.35, 356z.46,
123	123	17 356z.47, 356z.51, 356z.53, 356z.56, 356z.59, and 356z.60 of
124	124	18 the Illinois Insurance Code, (ii) be subject to the provisions
125	125	19 of Sections 356z.19, 356z.22, 356z.44, 356z.49, 364.01, 370c,
126	126	20 and 370c.1 of the Illinois Insurance Code, and (iii) be
127	127	21 subject to the provisions of subsection (d-5) of Section 10 of
128	128	22 the Network Adequacy and Transparency Act.
129	129	23 The Department, by rule, shall adopt a model similar to
130	130	24 the requirements of Section 356z.39 of the Illinois Insurance
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141	141	1 Code.
142	142	2 On and after July 1, 2012, the Department shall reduce any
143	143	3 rate of reimbursement for services or other payments or alter
144	144	4 any methodologies authorized by this Code to reduce any rate
145	145	5 of reimbursement for services or other payments in accordance
146	146	6 with Section 5-5e.
147	147	7 To ensure full access to the benefits set forth in this
148	148	8 Section, on and after January 1, 2016, the Department shall
149	149	9 ensure that provider and hospital reimbursement for
150	150	10 post-mastectomy care benefits required under this Section are
151	151	11 no lower than the Medicare reimbursement rate.
152	152	12 (Source: P.A. 101-81, eff. 7-12-19; 101-218, eff. 1-1-20;
153	153	13 101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-574, eff.
154	154	14 1-1-20; 101-649, eff. 7-7-20; 102-30, eff. 1-1-22; 102-144,
155	155	15 eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
156	156	16 102-530, eff. 1-1-22; 102-642, eff. 1-1-22; 102-804, eff.
157	157	17 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-1093,
158	158	18 eff. 1-1-23; 102-1117, eff. 1-13-23.)
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