HEALTHCARE COUNCIL
Newsletter


AARON WINTERS

Executive Director
Healthcare Council



847-334-6411

Feb. 2, 2018
Good afternoon Healthcare Council.  Today is the deadline for legislative requests at the Illinois Legislative Reference Bureau, and bill introduction deadline is Feb. 16 in both chambers.  The Governor's Budget Address is Feb. 14. On to the update!
 
Governor's State of the State
On Wednesday, Governor Bruce Rauner gave his State of the State address to the Illinois General Assembly.  In a speech largely devoid of fireworks, he previewed executive orders and legislation regarding combating sexual harassment in state government, defended his administration's handling of the legionnaires' disease outbreak at the Quincy Veterans Home, reiterated the need for term limits for General Assembly members and highlighted accomplishments including criminal justice reform, the Future Energy Jobs Act and school choice.  As a preview to the budget address, the Governor maintained that his proposed budget would be balanced, with a small surplus to help start rolling back last year's tax hike.  Expect lots of proposed reforms with budget savings attached as part of the total package in the administration's budget proposal.
 
Healthcare Council Meeting
Last Monday the Healthcare Council had our first quarterly meeting of 2018.  Insurance Director Jennifer Hammer provided an overview of the Department's operations, as well as discussed the market conduct examination process.  She also highlighted the Department's response to the Opioid Crisis and mental health parity.  Next week we will circulate a copy of the PowerPoint she presented.  We also heard brief remarks from new U.S. HHS Region V Director Doug O'Brien.

Committee Hearings for Next Week
 
House Human Services & Special Needs Services and Senate Human Services Committees
Date:                          Feb. 6 - 2:30 PM
Location:                  Room D-1 - Stratton Building




Subject Matter       The Employment and Economic Opportunity for Persons with Disabilities Task Force Update.
 
House Veterans' Affairs Committee
Date:                          Feb. 7 - 9:00 AM
Location:                  Room 212 - Capitol Building 
Subject Matter       Quincy Veterans Home Legionella Outbreak and Response.
 
Human Services Committee
Date:                          Feb. 7 - 9:00 AM
Location:                  Room 122B - Capitol Building
Healthcare-Related Bills Posted:
 
HB2617 - Gabel - Amends the Illinois Insurance Code to provide that a policy of accident or health insurance shall provide coverage for medically necessary expenses for standard fertility preservation services when a necessary medical treatment may directly or indirectly cause iatrogenic infertility to an enrollee. Defines "iatrogenic infertility". Provides that in determining coverage for these expenses, an insurer shall not discriminate based on an individual's expected length of life, present or predicted disability, degree of medical dependency, quality of life, or other health conditions, nor based on personal characteristics, including age, sex, sexual orientation, or marital status. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code.
           
HB3813 - Willis - Amends the Community-Integrated Living Arrangements Licensure and Certification Act. Adds provisions concerning required disclosures and contract requirements for providers of community-integrated living arrangements. Provides that at the time of or prior to the execution of a contract to provide continuing care at a community-integrated living arrangement, or at the time of or prior to the transfer of any money or other property to a provider by or on behalf of a prospective resident, whichever shall first occur, a provider shall deliver a disclosure statement to the person with whom the contract is to be entered into that contains specified information.
 
Senate Public Health Committee
Date:                          Feb. 6 - 1:30 PM
Location:                  400 - Capitol 
Healthcare-Related Bills Posted:
 
SB2296 - Morrison- 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 establish a registry, to be known as the Advance Directives Registry, under which residents of the State may submit specified advance directive forms to the Department. Provides that information in the Registry shall be made available to hospitals licensed under the Hospital Licensing Act or organized under the University of Illinois Hospital Act. Provides that in the absence of gross negligence or willful misconduct, the Department and its employees are immune from any civil or criminal liability in connection with the creation and maintenance of the Registry. Provides that the Department shall adopt any rules necessary to implement these provisions and shall provide information regarding use of the Registry on its website. Provides that a person who knowingly submits a document to the Registry without authorization or assists in such submission shall be guilty of a Class A misdemeanor. Contains other provisions concerning the Registry.
 
SB2334 - Murphy - Amends the University of Illinois Hospital Act and Hospital Licensing Act. Provides that a hospital shall maintain a metal detector at each point of entry into the hospital. Provides that a hospital shall ensure that all members of the public, other than the employees of the hospital who display proper credentials, who enter the hospital at a point of entry are subjected to screening by a metal detector. Provides that individuals subject to screening shall include, but not be limited to, individuals in wheelchairs. Defines "point of entry". Effective July 1, 2018.
 
HB2984 - Cunningham -HEALTH-TECH        
 
Senate Insurance Committee
Date:                          Feb. 7 - 4:00 PM
Location:                  400 - Capitol - - Springfield, IL
Healthcare-Related Bills Posted:
 
SB2316 - Murphy - Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed after the effective date of the amendatory Act shall provide coverage for hippotherapy and other forms of therapeutic riding. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, and the Health Maintenance Organization Act.
 
HB1277 HA2 - Conroy/Cullerton - Replaces everything after the enacting clause. Amends the Illinois Insurance Code. Provides that a treatment that is administered or prescribed for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome after July 18, 2017 shall be covered. Provides that for billing and diagnosis purposes, pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome shall be coded as autoimmune encephalitis until a code is assigned. Provides that coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome may not be denied due to a diagnosis of autoimmune encephalopathy or autoimmune encephalitis. Effective immediately.
 
New Healthcare Bills Introduced This Week
 
As always, please let me know if you are taking a position on any current legislation.  Thanks!
 
Hospital/Provider Mandates and Issues
HB4392 - McAuliffe - 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 require every provider of mammography services to, if a patient's mammogram demonstrates dense breast tissue, provide notification to the patient in any summary of the mammography report sent to the patient pursuant to the federal Mammography Quality Standards Act that shall include, but not be limited to, certain information.
 
SB2442 - Mulroe - 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 require every provider of mammography services to, if a patient's mammogram demonstrates dense breast tissue, provide notification to the patient in any summary of the mammography report sent to the patient pursuant to the federal Mammography Quality Standards Act that shall include, but not be limited to, certain information.
 
HB4511 - Harper - Amends the University of Illinois Hospital Act and Hospital Licensing Act. Provides that each hospital shall post, in each facility that has an emergency room, a notice in a conspicuous location in the emergency room with information about how to enroll in health insurance through the Illinois health insurance marketplace.
 
HB4515 - Swanson - Amends the Medical Practice Act of 1987. Exempts physicians from disciplinary action by the Department of Financial and Professional Regulation based solely upon the licensee's recommendation or provision of a treatment method for Lyme disease or other tick-borne disease if specified criteria are met. Effective immediately.
 
Insurance Mandates and Issues
SB2440 - Morrison - Amends the Illinois Insurance Code. Provides than an insurer that amends, delivers, issues, or renews a group or individual policy of accident and health insurance or a qualified health plan that provides coverage for hospital or medical treatment and for treatment of a mental, emotional, nervous, or substance use disorder or condition shall submit an annual report to the Department of Insurance or, with respect to medical assistance, the Department of Healthcare and Family Services on or before March 1 containing specific information. Provides that the Director of Insurance cannot certify an insurer's policy if the insurer fails to submit all specific information required.
 
SB2437 - Weaver - Amends the Illinois Marriage and Dissolution of Marriage Act. Provides that as to any policy of life insurance insuring the life of either spouse, or any interest in such policy, that constitutes non-marital property, or constitutes marital property but was not specifically allocated between the parties as provided in the Act, a beneficiary designation made by or on behalf of the decedent prior to the entry of the judgment of dissolution or declaration of invalidity of marriage that provides for the payment or transfer at death of any of the proceeds of the policy to or for the benefit of the decedent's former spouse is void as of the time of the judgment of dissolution or declaration of invalidity of marriage and the policy proceeds shall pass as if the decedent's former spouse predeceased the decedent. Provides that a life insurance company that insures the life of either spouse or holds a policy in which either spouse has an interest will not be held liable for distributing the proceeds or transferring an interest in such a policy if it is disburses the proceeds or transfers the interest prior to the actual receipt of proof of the judgment of dissolution or declaration of invalidity of marriage.
 
SB2444 - Haine - This legislation is an initiative of the Illinois Life Insurance Council - the Chamber supports this bill.  Amends the Illinois Insurance Code in an Article concerning accident and health insurance. Provides that benefits mandated by the Article do not apply to certain types of insurance policies (rather than specified provisions of the Article do not apply to short-term travel, disability income, long-term care, accident only, or limited or specified disease policies).
 
Long-Term Care/Dept. of Aging/DD/Community Care
SB2457 - T. Cullerton - Amends the Developmental Disability and Mental Disability Services Act. Provides for the transition to community-based services of persons over 18 years of age with developmental disabilities in the State who qualify for Medicaid Waiver services, who reside in intermediate care facilities for persons with developmental disabilities with 9 or more residents, and who affirmatively request to receive community-based services or placement in a community-based setting and persons with developmental disabilities in the State who qualify for Medicaid Waiver services, who reside in a family home, who are in need of community-based services or placement in a community-based setting, and who affirmatively request community-based services or placement in a community-based setting. Establishes a schedule for the transition to community-based services. Provides that the Department of Human Services shall oversee the transition of persons to receive community-based services or placement in a community-based setting. Provides that nothing in these provisions forces persons who do not want community-based services or placement to move, nor does it force providers to close beds or enter into downsizing agreements with the State against their will. Effective immediately.
 
SB2469 - Castro - Amends the Respite Program Act. In a provision requiring the Director of the Department on Aging to submit an annual report to the Governor and the General Assembly detailing the progress of the respite care services provided under the Act, provides that the report shall also include an estimate of the demand for respite care services over the next 10 years.
 
HB4350 - Reick - Amends the Property Tax Extension Limitation Law in the Property Tax Code. Provides that a taxing district may, by ordinance, specify a period of time during which it will suspend its extension for nursing home purposes. Provides that, for the first levy year in which that taxing district resumes its full extension for nursing home purposes, the district's aggregate extension base shall be calculated as if the district had used its maximum extension for nursing home purposes for the levy years during which the extension was suspended. Provides that a taxing district may recapture the amount that the district could have levied for nursing home purposes during the suspension period by passing an ordinance increasing its aggregate extension base for that purpose. Effective immediately.
 
HB4359 - Andrade - Amends the Home Health, Home Services, and Home Nursing Agency Licensing Act. Provides that "home health agency" includes a public agency or private organization that provides the services of a physician licensed to practice medicine in all its branch and at least one other home health service.
 
HB4440 - Gabel - Amends the Nursing Home Care Act. Provides that the Department of Public Health shall provide facilities with educational information on all vaccines recommended by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices, including, but not limited to, the risks associated with shingles and how to protect oneself against the varicella-zoster virus. Requires a facility to distribute the information to each resident who requests the information and each newly admitted resident. Allows the facility to distribute the information to residents electronically. Effective January 1, 2019.
 
Medicaid/MCOs
SB2429 - Aquino - Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services shall provide dental services to an adult who is otherwise eligible for assistance under the medical assistance program. Provides that targeted dental services, as set forth in a specified exhibit in a federal consent decree, that are provided to adults under the medical assistance program shall be reimbursed at the rates set forth in a specified column in the exhibit for targeted dental services that are provided to persons under the age of 18 under the medical assistance program. Requires the Department to actively monitor the contractual relationship between Managed Care Organizations (MCOs) and a dental administrator contracted by an MCO to provide dental services. Contains provisions concerning the Department's adoption of appropriate data and measures; the inclusion of certain dental performance measures in the Department's Health Plan Comparison Tool and Illinois Medicaid Plan Report Card; and the collection of information about the types of contracted, broad-based care coordination occurring between a MCO and any dental administrator. Prohibits a health plan from attempting to limit the right of medical assistance recipients to obtain dental services from a qualified Medicaid provider. Prohibits the Department from adopting a rule or entering into a contract that prohibits a licensed dentist or dental hygienist from receiving reimbursement under the medical assistance program for a dental encounter. Effective immediately.
 
SB2446 - Morrison - Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to reimburse psychiatrists and federally qualified health centers for mental health services provided by advanced practice registered nurses certified in psychiatric and mental health nursing to medical assistance recipients via telepsychiatry. Effective immediately.
 
SB2447 - Murphy - Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that no later than January 1, 2019, the Auditor General shall initiate a performance audit of the Department of Healthcare and Family Services to determine the Department's compliance with certain requirements concerning Medicaid Managed Care Entities. Provides that the determinations shall include, but not be limited to: (i) whether the Department has developed and applied standardized quality performance measures to Medicaid Managed Care Entities; (ii) whether it has developed and implemented algorithms for automatic assignment of Medicaid enrollees into managed care entities; and (iii) whether the standardized quality performance measures and algorithms developed by the Department use measurable quality metrics, are developed and applied according to the statutory criteria, and are adequately documented. Effective immediately.
 
SB2491 - Syverson - Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that a licensed dental hygienist working under the supervision of a dentist and employed by a federally qualified health center shall be reimbursed for dental services provided to medical assistance recipients at the federally qualified health center's encounter rate. Effective immediately.
 
HB4383 - Feigenholtz
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that disenrollment of a Medicaid enrollee from a managed care organization under contract with the Department of Healthcare and Family Services shall be in accordance with specified federal requirements whenever a contract is terminated between a Medicaid managed care health plan and a primary care provider that results in a disruption to the Medicaid enrollee's provider-beneficiary relationship. Effective immediately.
 
HB4443 - Gabel - Amends the Illinois Insurance Code. Provides that all managed care plans shall ensure that all claims and indemnities concerning health care services shall be paid within 30 days after receipt of a claim that has provided specified information on a CMS-1500 Health Insurance Claim Form or a UB-04 (CMS-1450) form. Provides that certain health care providers shall be notified of any known failure of the claim and provide detailed information on how the claim may be satisfied to receive payment within 30 days after receipt. Provides that any undisputed portions of a claim must be reimbursed by the managed care plan within 30 days after receipt. Grants the Department of Insurance specific authority to issue a cease and desist order, fine, or otherwise penalize managed care plans that violate provisions concerning timely payment for health care services. Provides that a policy issued or delivered to the Department of Healthcare and Family Services that provides coverage to certain persons is subject to the provisions concerning timely payment for health care services. Makes conforming changes in the Illinois Public Aid Code.
 
Misc.
HB4407 - Lilly - Amends the School Code. With respect to age-appropriate developmental screening and age-appropriate social and emotional screening, provides that the Department of Public Health must, no later than January 1, 2019, develop rules and appropriate revisions to the Child Health Examination form in conjunction with various organizations. Effective immediately.
 
JCAR Update
There have been two new proposed rules since our last update.
 
DPH proposed amendments to Intermediate Care for the Developmentally Disabled Facilities Code (77 IAC 350; 42 Ill Reg 1992) removing a requirement that owners of ICF/ DD facilities, or other persons with significant financial interest in these facilities, include their social security numbers on license application or renewal forms.
 
DPH also proposed amendments to Hospital Licensing Requirements (77 IAC 250; 42 Ill Reg 2088) implementing various Public Acts. The rulemaking requires that patients be given written notice within 24 hours when they are placed under observation status rather than being admitted. The notice must advise the patient that observation status may affect private insurance, Medicare or Medicaid coverage for any services or medications they receive while in the hospital, as well as coverage of any subsequent discharge to a nursing home or to home- or community-based care. The notice also must advise the patient to contact his or her insurance provider to better understand the implications of being placed in observation status. DPH is also requiring hospitals to report emergency treatment of opioid overdoses within 48 hours of treatment; the report must indicate the age, sex, county of residence, race and ethnicity of the patient, the cause of the overdose (e.g., whether caused by heroin or by another opioid drug), and whether or not an opioid antagonist medication was administered.
 
 



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