Good afternoon, Healthcare Council. It's been a busy two weeks of session - third reading deadlines in both the House and the Senate have passed, and the House is off this week. The Senate will be in session this week starting tomorrow. On to the update!
Healthcare Bills Still Alive
With the third reading deadline passed in the House and Senate, the number of contentious healthcare-related bills continues to dwindle. Here's a brief summary of the major bills we are tracking:
SB 0458 (SFA 0001) popped up last week - filed by Sen. Manar, it would require insurance coverage for telehealth services on the same level as in-person providers. The amendment has been assigned to Senate Human Services. As drafted, SB458 would take away one of the strongest benefits to telehealth, which is cost.
HB5464 - While currently in Rules, we expect this legislation to surface later. Rep. Feigenholtz's legislation (and initiative of the Illinois Behavioral Health Association) requires insurance plans to provide unlimited benefits for the treatment of mental health, emotional and substance abuse condition and disorders, and takes away the ability to contest medical necessity as well as other employer cost-containment tools. The Chamber is working on alternatives that would mitigate the cost to health insurance.
HB68 - Rep. Lang's legislation that would create a private right of action for basically anyone to sue a health insurance plan to enforce state mental health parity laws also has negotiations ongoing. As with HB5464, the Chamber is working on more cost-effective alternatives.
HB4146 passed out of the House on a vote of 71-27 after an amendment failed in the House Insurance: Health & Life Committee. The legislation would prevent any change to a health plan's drug formulary list during a plan year. The Chamber is opposed - we should not tie the hands of insurance plans as new pharmaceuticals come into the marketplace that provide consumers with more cost-effective options.
HB4900 is Rep. Guzzardi's legislation that would regulate "price gouging" in the generic pharmaceutical space. He announced on the House Floor that an amendment would be forthcoming in the Senate. It passed the House on a vote of 65-38. Chamber remains opposed as the free market should dictate the pricing of pharmaceutical drugs. The bill has not yet been assigned a committee in the Senate.
There are a few other bills that we are tracking that are mentioned in the Committee update, and as always, please let me know if anything is top of mind in your space.
Committees Scheduled This Week
It's a light committee week in the Senate. Below is a list of healthcare-related bills currently posted.
Senate Public Health Committee
Date: May 1, 2018 - 3 pm
Location: 400 Capitol - Springfield, IL
Bills Posted:
SR1595 - Aquino - Declares the first week of December of 2018 as "Cancer Screen Week".
HB4440 - Mulroe - 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.
HB4909 - Biss - Amends the Vital Records Act. Provides that specified fees for birth record searches or certified copies of birth records shall be waived for all requests made by a youth in care, as defined in the Children and Family Services Act, or a person under the age of 27 who was a youth in care, as defined in the Children and Family Services Act, on or after his or her 18th birthday. Sets forth provisions concerning verification of a person's youth in care status. Provides that a person whose fees are waived must not be charged for verification. Provides that a person who knowingly or purposefully falsifies the verification is subject to a penalty of $100. Requires the State Registrar of Vital Records to establish standards and procedures for waiver of the applicable fees. Limits a person to no more than 4 birth records annually under these provisions.
HB5070 - Althoff - Amends the Telehealth Act. Includes clinicians licensed to provide medical services under Illinois law in the definition of "health care professional".
Senate Human Services
Date: May 1, 2018 - 4:30 pm
Location: 409 Capitol - Springfield, IL
Bills Posted:
SR1587 - Althoff - Declares August of 2018 as "Free and Charitable Clinic Month"
SJR57 - Morrison - Recognizes May 16, 2018 as the third "Annual Illinois Foster Youth and Alumni Legislative Shadow Day".
HB4383 - Steans - 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
HB4847 - Martinez - Amends the Adult Protective Services Act. Expands the definition of "eligible adult" to include an adult who resides in any of the facilities that are excluded from the definition of "domestic living situation" if either: (i) the alleged abuse or neglect occurs outside of the facility and not under facility supervision and the alleged abuser is a family member, caregiver, or another person with a continuing relationship with the adult; or (ii) the alleged financial exploitation is perpetrated by a family member, caregiver, or another person with a continuing relationship with the adult, but who is not an employee of the facility where the adult resides.
Senate Licenses Activities and Pensions Committee
Date: May 2, 2018 - 3 pm
Location: 400 Capitol - Springfield, IL
Bills Posted:
SJR67 - Martinez - Creates the Home Birth Maternity Care Crisis Study Committee to provide the General Assembly a consumer-focused, evidence-based solution to the Illinois Home Birth Maternity Care Crisis.
Senate Insurance Committee
Date: May 2, 2018 - 4:45 pm
Location: 400 Capitol - Springfield, IL
Subject Matter Only: SB 2807 - SFA 1, SB 3213
Note: SB2807 SA1 is Sen. Oberweis' "Right to Shop" legislation. It's an initiative of the Foundation for Government Accountability and modeled after legislation passed in Maine. The legislation would require insurance plans to allow beneficiaries to utilize out-of-network providers if their price for services is cheaper than in-network providers. Any cost savings would be split by the beneficiary and the health insurance plan. The Chamber has concerns with this legislation as there is no measurement of quality - just looking at a snapshot of the cost of services without regard to outcomes could set up a situation where beneficiaries receive lower quality care, resulting in more long-term costs for employers.
SB3213 is an initiative of Thresholds and would require private insurance plans to cover community-based treatments that are currently covered by Medicaid. The Chamber and interested parties have met with the sponsor and expressed concerns with importing Medicaid treatment models into the private insurance sphere.
JCAR Update
There have been two new additions of the Illinois Register since our last update.
HFS proposed amendments to Medical Payment (89 IAC 140; 42 Ill Reg 7285) and Children's Health Insurance Program (89 IAC 125; 42 Ill Reg 7280) reflecting Public Act 100-538, which removes all restrictions on coverage of abortion by the Medical Assistance Program (Part 140) and the All Kids Health Insurance program (Part 125, for persons age 19 and under). Additionally, the Part 140 amendments reflect PA 100-395 by expanding coverage of mammography services to include magnetic resonance imaging of the entire breast when directed by a physician as a followup to an abnormal mammogram.
The Division of Specialized Care for Children at the University of Illinois proposed the repeal of the Part titled Program Content and Guidelines for Division of Specialized Care for Children (89 IAC 1200; 42 Ill Reg 7185) and proposed a new Part with the same name (89 IAC 1200; 42 Ill Reg 7238). The new Part reflects current eligibility standards and procedures for the program, which coordinates diagnostic services, specialized medical care and medical financial assistance for children with physical disabilities or conditions that may lead to physical disabilities.
DHS proposed the repeal of the Part titled Medicaid Community Mental Health Services Program (59 IAC 132; 42 Ill Reg 7322) and proposed a replacement Part with the same title (59 IAC 132; 42 Ill Reg 7408). The current Part includes the certification process and requirements for Medicaid community mental health centers, along with definitions of the types of covered services they provide. The new Part includes the certification process and requirements to be met by community mental health centers. The definitions of covered services will be included in Department of Healthcare and Family Services rules concerning Medical Payment (89 IAC 140) in a future rulemaking.
DPH proposed amendments to Community-Based Residential Rehabilitation Center Demonstration Program Code (77 IAC 220; 42 Ill Reg 7655) updating various procedures for community-based residential rehabilitation centers serving persons who have suffered acquired brain injuries. The rulemaking defines and clarifies qualifications for life skills trainers, updates statutory references, clarifies that intravenous parenteral medication may only be administered by a registered nurse or physician, and clarifies information to be recorded when medications are administered. Supplies of staple and perishable foods kept on the premises of each residence must be adequate to prepare a minimum of three days' meals; each licensee must have a designated food distribution location from which life skills trainers will pick up food supplies every 3 or 4 days. Participants and employees of residential rehab centers are affected.
