Good morning, Healthcare Council, and Happy New Year! 2018 promises to be active in the healthcare space both federally and at the state level. The Illinois General Assembly kicks into gear starting Jan. 23 when the Illinois House reconvenes. The Senate won't return until Jan. 30. On to the update!
RSVP Today for the Next Healthcare Council Quarterly Meeting
The next quarterly meeting of the Healthcare Council will take place in Springfield on Jan. 29. We are excited that Illinois Department of Insurance Director Jennifer Hammer will preview her agency's 2018 legislative agenda, as well as walk through the department's market conduct exam process. Healthcare Council member
Hospital Sisters Health System has agreed to host at the HSHS St. John's Children's Hospital. Details and RSVP form are here.
Healthcare Council Quarterly Meeting
2 pm
Monday, January 29
HSHS St. John's Children Hospital
Carol Jo Vecchie Women & Children's Center
Tea Room
415 N 9th Street, Springfield
Hospital Assessment Talks Continue
After months of negotiations with the Illinois Department of Healthcare and Family Services, the Illinois Health and Hospital Association distributed its latest assessment model to member hospitals last Friday. A major negotiating point between hospitals and the department remains what the upper payment limit will be in the new assessment regime - and in turn, how much Medicaid funds are returned to individual hospitals. The current assessment authorization expires this summer. General Assembly action will be necessary to implement any new legislation, as well as federal approval. A House hearing is scheduled for this week to discuss the redesign of the hospital assessment, but we haven't reached the finish line yet.
Committee Hearings Scheduled for this Week
House and Senate Veterans' Affairs Committees
Tuesday, Jan. 9
10 am
Location:
C-600, 6th Floor - Michael A. Bilandic Building - - Chicago, IL
Subject Matter: Quincy Veterans' Home Legionella Outbreak and Response.
House
Appropriations-Human Services Committee
Thursday, Jan. 11
2 pm
Location:
C-600, 6th Floor - Michael A. Bilandic Building - - Chicago, IL
Subject Matter: HFS and IHA presentation on the redesign of the hospital assessment program.
House Mental Health Committee
Friday, Jan. 12
11 am
Location:
C-600, 6th Floor - Michael A. Bilandic Building - - Chicago, IL
Subject Matter: Addiction Parity
JCAR Update
There have been several new healthcare-related administrative rules proposed since our last update.
HFS proposed an rule that
exempts new eyeglasses or lenses required as a result of eye surgery from the normal Medical Assistance limit of one pair of eyeglasses or set of lenses every 24 months for recipients age 21 and older. The rule is in response to PA 100-135.
Insurance proposed an amendment to the Part titled Internal Security Standard and Fidelity Bonds (50 IAC 904; 42 Ill Reg 53) aligning its provisions with guidance issued by the National Association of Insurance Commissioners and removing time specifications for surety bonds.
DFPR proposed amendments to the Part titled Optometric Practice Act of 1987 (68 IAC 1302; 41 Ill Reg 15448) implementing recommendations of the State's Collaborative Optometric/ Opthamalological Task Force regarding minimum education requirements for advanced optometric procedures (e.g., subcutaneous injections, removal of skin tags, removal of benign lesions, biopsies).
Insurance proposed
amendments to Insurance Data Reporting Requirements (50 IAC 4203; 41 Ill Reg 15485) updating data collection procedures for reports that are now submitted to DOI electronically instead of by mail. The definitions of certain data elements have also been revised to promote consistency among different insurers. DOI also proposed repeal of the Parts titled Life and Accident and Health Policy Forms; Dividends (50 IAC 914; 41 Ill Reg 15472), Family Group Life Insurance Policy Forms (50 IAC 1403; 41 Ill Reg 15476), and Producer Felony Review (50 IAC 2403; 41 Ill Reg 15480). The Part 914 and Part 1403 rulemakings repeal rules for obsolete types of policies and dividends. The Part 2403 rulemaking repeals rules for determining that a person with a felony conviction can be granted an insurance producer license; these rules have been superseded by Public Act 100- 286, effective 1/1/18.
DFPR proposed amendments to the Part titled Pharmacy Practice Act (68 IAC 1330; 41 Ill Reg 15130) replacing State-specific standards for sterile and nonsterile compounding with the United States Pharmacopeia National Formulary (USP-NF) now in use in more than 35 states. Pharmacies that compound drugs must keep compounding materials in a separate storage area, set aside an area exclusively for sterile compounding if it compounds sterile products, and have access to a current USP Compounding Compendium. Other provisions allow pharmacies to sell limited quantities of non-sterile compounded products to doctors and other practitioners for office use under specified conditions (e.g., the drug may only be administered in the office, not dispensed for later use, and sales cannot exceed 5% of the pharmacy's annual prescription purchases); permit sterile compounding of veterinary products for office use and limited veterinary dispensing from office stock; and allow pharmacists in charge of an automated dispensing system located in another facility to designate a licensed nurse or physician assistant to stock or restock automated dispensing and storage systems. Pharmacists, medical practitioners and veterinarians are affected by this rulemaking.
Finally, Insurance proposed amendments to Infertility Coverage (50 IAC 2015; 41 Ill Reg 15176) and Registration of Worker's Compensation Utilization Review Organizations (50 IAC 2905; 41 Ill Reg 15182) and proposed repeal of the Parts titled Required Benefits for Mental, Emotional or Nervous Disorders (50 IAC 2006; 41 Ill Reg 15172) and Privacy of Personal Information (50 IAC 4001; 41 Ill Reg 15189). The Part 2015 amendments implement Public Act 99-421 by expanding the definition of infertility (currently, inability to conceive after one year of unprotected sexual intercourse or to sustain a successful pregnancy) to include inability to conceive after being diagnosed with a condition affecting fertility, or after one year of attempts to produce conception. Coverage of treatment that involves oocyte retrieval (e.g., in vitro fertilization) must be provided for individuals who have been unable to either attain or maintain a viable pregnancy. These rules apply to insurers offering accident and health insurance to groups of more than 25 employees. Amendments to Part 2905 implement PA 99-111 by recognizing the Accreditation Association for Ambulatory Health Care as an organization that may accredit utilization review organizations, thereby qualifying them for reduced registration and renewal fees. The repeal of Part 2006 removes an obsolete definition of registered clinical psychologist (now, licensed clinical psychologist) and the Part 4001 repealer eliminates rules that duplicate provisions in Part 4002 (Personal Information Privacy Protection).
