Good morning, Healthcare Council. We're in the last two weeks of regularly scheduled session. There is cautious bipartisan optimism that a budget will be passed by the General Assembly by May 31. Will it? Will it become law? We'll find out soon enough. On to the update!
Legislative Rundown
Contentious issues continue to be whittled down in the waning days of session. Here's a quick summary on some of the issues we are following.
The Chamber continues to seek compromises to Rep. Feigenholtz's HB5464 and Rep. Lang's HB68. HB5464 as introduced requires that all health insurance plans provide unlimited benefits for the treatment of mental health and substance abuse disorders, prevents an insurer from reviewing medical necessity for the first 28 days of treatment and significantly limits concurrent reviews after 28 days. These actions would remove important cost containment controls and would significantly increase the cost of healthcare for employers. The Chamber is in the process of advocating for an amendment that would remove prior authorization for certain inpatient and outpatient substance abuse treatments, but would preserve a health plan's ability to concurrently review medical necessity. On HB68, we continue to oppose the underlying bill that includes a private right of action to allow anyone to sue to enforce mental health parity laws, as well as onerous reporting requirements. The Chamber's position is to authorize targeted mental health market conduct exams and other Department of Insurance activities - we should leave enforcement to regulators and not to the courts. A meeting with proponents will occur Tuesday.
Similarly, the Chamber continues to advocate for a negotiated resolution to HB4146. The legislation as drafted would prevent a health plan from making any change to a prescription drug formulary mid-plan year. This would prevent an employer from achieving cost savings when more cost effective drugs enter the marketplace. Current negotiations center on an exceptions process that would allow mid-year switches, but if a prescribing provider certified that the drug was medically necessary, then a modification could not occur.
HB3479 has once again been posted to the Senate Human Services Committee this week. The legislation would mandate pharmacy reimbursement rates for Medicaid (and a filed amendment would extend that provision to private health plans). The Chamber believes that reimbursement rates should remain a contractual and market-based provision and not legislatively mandated.
HB5868 surfaced late in session and passed out of House Appropriations-Human Services last week. An initiative of Chamber member A Safe Haven, the legislation would authorize (but not mandate) insurance coverage of
residential extended care services and supports for substance abuse treatment. With Amendment 2, the Chamber supports.
Save The Date - Next Quarterly Meeting
The Healthcare Council is pleased to announce that Illinois Department of Healthcare and Family Services Director Felicia Norwood will be the keynote speaker for our next quarterly meeting on Monday, June 25 in Chicago. We'll be announcing a specific time and location soon. Director Norwood's remarks will be focused on the recently announced behavioral health 1155 waiver for Medicaid.
Healthcare-Related Legislation in Committees This Week
Below is a listing of healthcare bills and resolutions posted for committees.
Senate Veterans Affairs Committee
Date: May 21, 4:30 pm
Location: Room 409 Capitol
Bills Posted:
HB4310
- T. Cullerton - Amends the Department of Veterans' Affairs Act. Provides that a Veterans Home shall notify the residents of the Veterans Home, the families of residents at the Veterans Home, employees of the Veterans Home, and individuals working on contract at the Veterans Home within 24 hours of an outbreak of Legionnaires' disease at the Veterans Home.
HB5784 - T. Cullerton -
Amends the Department of Veterans' Affairs Act. Provides that the Department of Veterans' Affairs shall submit a quarterly report to the General Assembly by January 1, April 1, July 1, and October 1 of each year about the health and welfare of residents at Veterans Homes. Provides that each report shall include specified information, including, but not limited to, the number and nature of complaints made by residents and other specified parties and information on epidemics and cases of communicable disease at the Veterans Home. Effective July 2, 2018.
Senate Judiciary Committee
Date: May 22, 8 am
Location: Room 400 Capitol
Bills Posted:
HB4309 - Bush - Creates the Frail Elderly Individual Family Visitation Protection Act. Provides that the Act may be referred to as the Kasem/Baksys Visitation Law. Defines "family caregiver", "family member", "frail elderly individual", and "petitioner". Provides that if a family caregiver unreasonably prevents a family member from visiting the frail elderly individual, the court, upon a verified petition by the family member, may order the family caregiver to permit such visitation as the court deems reasonable and appropriate under the circumstances.
HB4595 - Biss - Creates the Illinois Employers Mutual Insurance Company Article in the Code and establishes the Company as a nonprofit, independent public corporation. Chamber opposes.
Senate Human Services
Date: May 22, 10 am
Location: Room 409 Capitol
Bills Posted:
HB3479 - Manar - Medicaid pharmacy reimbursement mandate. Chamber opposed.
HB5000 - McConchie - Amends the Department of Human Services Act. In a provision concerning investigative reports issued by the Office of the Inspector General upon completion of an abuse or neglect investigation, provides that the victim and the victim's guardian shall be provided with a redacted copy of the investigative report if the allegations of abuse or neglect are substantiated. Provides that unredacted investigative reports, as well as raw data, may be shared with a local law enforcement entity, a State's Attorney's office, or a county coroner's office upon written request. Effective immediately.
Senate Insurance Committee
Date: May 22, 5:15 pm
Location: Room 400 Capitol
Bills Posted:
HB2624 - Steans - Health Insurance Rate Review with gut-and-replace amendments filed for short-term medical insurance regulation
House Human Services Committee
Date: May 23, 9 am
Location: Room 413 Stratton Building
Subject Matter: Universal Long Term Care
Bills Posted:
ABR - Short Description Last Action
HR1046 - Durkin - Designates the month of May of 2018 as Cystic Fibrosis Awareness Month in the State of Illinois.
HR1071 - Welter - Recognizes Megan Bugg for her efforts to raise awareness of childhood cancer and fight for increased funding for research.
SB2447 - Yingling - Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to collect all regular reports required by contract or statute from managed care organizations through an electronic file transfer. Provides that ad hoc reports can be collected in alternative manners.
SB2808 - Demmer - Amends the Alzheimer's Disease and Related Dementias Services Act. Provides that an Alzheimer's disease and related dementias services curriculum compiled (rather than certified) by the Department of Public Health and published on the Department's website must include at a minimum specified topics.
SB2952 - McAuliffe - Makes changes to the Prescription Monitoring Program and its advisory committee.
House Labor and Commerce Committee
Date: May 23, 10 am
Location:
Room 114 Capitol Building
Bills Posted:
SB904 - Hoffman - Creates an advisory council within the Department of Insurance to review and make recommendations to the Department regarding rules to be adopted by the Department concerning continuing education courses, course materials, curriculum, and credentials of instructors.
House Healthcare Licenses Committee
Date: May 23, 10 am
Location:
Room 118 Capitol Building
Bills Posted:
HB4100 - Kifowit - Creates the Health Care Violence Prevention Act.
Senate Special Committee on the Oversight of Medicaid Managed Care
Date: May 23, 5 pm
Location: 400 Capitol
Bills Posted:
HB4146 - Steans - Frozen Formulary bill for health insurance plans.
House Human Services Committee
Date: May 24, 9:30 am
Location: Room D-1 Stratton
Bills Posted:
SB2662 - Mussman - Establishes the Task Force on State Contracting with Private Nonprofit Human Service Providers to study State contracting with private nonprofit human service providers and to develop recommendations on how to improve the contracting relationship and partnership between State departments and agencies and private nonprofit human service providers so that they work effectively and efficiently to improve the well-being of Illinoisans.
SB2952 - McAuliffe - Makes changes to the Prescription Monitoring Program and its advisory committee.
SB3062 - Mussman - Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Provides that the Department of Public Health shall develop and disseminate information regarding a bone marrow registry, including, but not limited to, specified information. Provides that the information may be disseminated orally, in print, electronically, or in any other manner determined by the Department.
SB3179 - Mussman - Amends the Department of Human Services Act. Provides that the Inspector General of the Department of Human Services shall further ensure (1) every person authorized to conduct investigations at community agencies receives ongoing training in investigations of alleged abuse or neglect in state-operated facilities and community agencies and (2) every person authorized to conduct investigations shall receive ongoing training in standards and licensure requirements for community-integrated living arrangements and minimum standards for certification of developmental training programs. Effective immediately.
House Executive Committee
Date: May 24, 11:30 am
Location: Room 118 Capitol
Bills Posted:
SB336 - Cassidy - Provides that notwithstanding provisions concerning the registration of qualifying patients and designated caregivers and the issuance of registry identification cards, a person who has received a physician certification for a medical condition that an opioid has been or could be prescribed for by a physician based on generally accepted standards of care is entitled to purchase medical cannabis from a dispensing organization.
SB2444 - DeLuca - Initiative of the Illinois Life Insurance Council. Excludes supplemental and disability insurance policies from general insurance mandates unless explicitly mentioned. Chamber supports.
JCAR Update
There is one new proposed healthcare-related rulemaking since our last update.
HFS proposed an amendment to Medical Payment (89 IAC 140; 42 Ill Reg 8119) adding treatment of impacted maxillary central incisors to the list of orthodontic procedures that may be covered by medical assistance for patients under age 21. Orthodontists that accept medical assistance patients will be affected.
