Last Week in Review
Here is a brief synopsis of key updates from last week.
- SB1909 - Sen. Castro filed a new amendment to her post-partum care legislation last week that makes improvements to insurance code mandates but does not remove the Chamber's opposition.
Specifically, the mandate requires insurers to "unbundle" long-acting reversible contraceptives (LARC) from bundled delivery rates. The language comes from the
Illinois Perinatal Quality Collaborative. The goal of the language is to increase reimbursement for providers, thereby encouraging the use of LARCs. LARCs, and all FDA-approved contraceptives, are already coverage mandates in the insurance code.
The amendment also incorporates industry-supplied language that would prevent concurrent reviews of medical necessity for the first 48 hours of mental health/substance abuse treatment, but preserve concurrent review for all days after.
A larger concern is that the amendment incorporates a series of internal and external review requirements. As a reminder, consumers have the ability to challenge rulings of medical necessity through the procedures outlined in the Health Carrier External Review Act. The amendment layers on new processes outside of the direct requirements of the Act, as well as review requirements in last year's substance abuse legislation (SB682).
The bill sponsor informed the Chamber that she will be no longer amending the legislation in the Senate, and that all additional concerns should be directed to the House sponsor.
- HB457 - Rep. Yingling filed an amendment to a Speaker Madigan shell bill that expands on Leader Durkin's amendment regarding the regulation of ethylene oxide. It is our understanding that the changes incorporate feedback from the Illinois Environmental Council and specifically includes emissions poundage requirements.
- HB471 - Rep. Morgan found a new legislative vehicle for his rate review legislation last week and successfully passed the legislation out of the House Insurance Committee. A new amendment has been filed that would set additional requirements on what constitutes an "unreasonable" rate increase. The Chamber continues to oppose efforts to impede free market pricing of health insurance rates.
- HB466 - Rep. Scherer changed the bill sponsor of her Medicaid/commercial insurance substance abuse parity bill to Rep. Halpin. She committed to holding the legislation on second in committee pending an amendment.
- HB2604 - Rep. Crespo's nursing ratio legislation remains on second reading. The Chamber continues to oppose staffing requirements at hospitals.
Committees Scheduled for the Week
We're at the one-hour posting time of the year, so relatively little has been scheduled at this time with regard to healthcare-related committees. Senate Appropriations I is the only committee of note, with a meeting at 9 am on Tuesday for the Department of Human Service's budget hearing and 9 am on Wednesday for the budget hearings for the Department of Aging, Deaf and Hard of Hearing Commission, Coroner Training Board, and Department of Public Health.
Save the Date - Illinois Chamber Healthcare Council Quarterly Meeting
We are pleased to host Illinois Department of Healthcare and Family Services Acting Director Theresa Eagleson at our next quarterly meeting. Additional speakers will be announced in the coming weeks. Click here to register today.
Healthcare Council Quarterly Meeting
Monday, May 6
2 pm
The Memorial Center for Learning
228 W. Miller St.
MCLI 2A Curtis Theatre
Springfield, IL 62702
Association Health Plan Ruling
Following a federal judge ruling against the Trump Administration's Association Health Plan rule, the Chamber has had numerous conversations with federal and local stakeholders regarding our ongoing plans to explore an association health plan for Chamber members. While the final decision will be based on the fate of likely judicial appeals, the Chamber is committed to still advancing dialogue on the prospect of providing members greater pricing power in the insurance marketplace.
JCAR Update
Last Friday HFS withdrew proposed amendments to Medical Payment (89 IAC 140; 42 Ill Reg 18242) in response to a JCAR Objection. The amendments, which were published in the 10/12/18 Illinois Register, would have replaced the Primary Care Case Management program with the Integrated Health Homes program. HFS intends to file a new rule in the future.
