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Session Adjourns for the Year
Session went into the evening hours last night, in large part due to a last-ditch effort to provide the City of Chicago with additional considerations regarding a potential city-based casino. However, that effort did not result in an agreement and both chambers adjourned without final action.
Taking stock of healthcare-related issues, there were a few developments.
The ethylene oxide phase-out (HB3888) failed to advance out of the Senate Executive Committee, receiving only 7 votes (10 were required to advance the bill). Illinois Chamber President and CEO Todd Maisch testified in committee on behalf of hospitals across the state that would be impacted by further sterilization facility closures. Senators highlighted their frustration that an amendment was adopted that would carve out most manufacturers outside of Cook, Lake and DuPage counties, and asked that the Senate sponsor come back next year and attempt to work out a negotiated resolution. As a result, we anticipate this issue won't be going away anytime soon.
The insulin copay cap bill (SB667) passed through the House with an amendment that ties the $100 copay limitation to CPI and replaced language authorizing an Attorney General price investigation with a reporting requirement for the Department of Insurance. The Senate concurred with the House amendment, and Gov. Pritzker has indicated that he will sign the bill. The Chamber went neutral with the adoption of the amendment as it was the best deal industry could expect given the political reality of the situation.
SB1756 passed both chambers - it
amends the Illinois Insurance Code to require certain insurance companies to comply with prohibitions under the Managed Care Reform and Patient Rights Act. It also changes the term "managed care organization" to "health maintenance organization" in a provision concerning the recently passed assessment imposed under the Illinois Public Aid Code.
SB1909 - This legislation was originally the vehicle for post-partum and pregnancy insurance coverage changes, but was gutted with a new amendment which passed both chambers. The amendment concerns
the Alzheimer's Disease Research Act, and subject to funding availability, moneys in the Alzheimer's Disease Research, Care, and Support Fund shall be used by the Department of Public Health to cover costs associated with executing appropriate modules of the Behavioral Risk Factor Surveillance System and otherwise administering relevant data collection and implementing recommendations outlined in the Alzheimer's Disease State Plan.
Federal CMS Announces Pricing Rules
The U.S. Department of Health and Human Services announced several rule updates and proposals this morning that will impact employer-provided health plans and hospitals.
The "Transparency in Coverage"
rule
"would require most employer-based group health plans and health insurance issuers offering group and individual coverage to disclose price and cost-sharing information to participants, beneficiaries, and enrollees up front." Per the release, health plans would be required to:
- Give consumers real-time, personalized access to cost-sharing information, including an estimate of their cost-sharing liability for all covered healthcare items and services, through an online tool that most group health plans and health insurance issuers would be required to make available to all of their members, and in paper form, at the consumer's request.
- Disclose on a public website their negotiated rates for in-network providers and allowed amounts paid for out-of-network providers. Making this information available to the public is intended to drive innovation, support informed, price-conscious decision-making, and promote competition in the healthcare industry.
HHS also announced a finalized rule with a variety of requirements for hospitals, including:
- Comprehensive Machine-Readable File: Hospitals will be required to make public all hospital standard charges (including the gross charges, payer-specific negotiated charges, the amount the hospital is willing to accept in cash from a patient, and the minimum and maximum negotiated charges) for all items and services on the Internet in a single data file that can be read by other computer systems. The file must include additional information such as common billing or accounting codes used by the hospital (such as Healthcare Common Procedure Coding System (HCPCS) codes) and a description of the item or service to provide common elements for consumers to compare standard charges from hospital to hospital.
- Display of Shoppable Services in a Consumer-Friendly Manner: Hospitals will be required to make public payer-specific negotiated charges, the amount the hospital is willing to accept in cash from a patient for an item or service, and the minimum and maximum negotiated charges for 300 common shoppable services in a manner that is consumer-friendly and update the information at least annually.
A fact sheet on the Transparency rule is here and the fact sheet on the hospital rule is here.
New Healthcare Legislation
Two new healthcare-related bills were introduced this week but were not acted upon.
SB2309 - Van Pelt - Creates the Unidentified Patient Act. Provides that the Act may be referred to as the Elisha Brittman Law. Provides that upon the arrival of an unidentified patient into a hospital's emergency department the hospital shall take specified efforts towards identifying the patient. Requires a hospital to contact the local law enforcement agency and request that a missing person report be completed for an unidentified patient if the specified efforts are not possible or are unsuccessful. Provides that local law enforcement should be requested to enter an unidentified patient into the Federal Bureau of Investigation's National Crime Information Center database. Requires hospital staff to contact local law enforcement to perform fingerprinting services in an effort to identify an unidentified patient. Provides that hospital staff shall make a referral to the hospital's public information officer to obtain specified identifying materials and submit them to local media outlets if the fingerprinting services are not possible or are unsuccessful. Provides that if a hospital receives a claim from an individual of being an unidentified patient's next of kin, a DNA sample may be collected from the unidentified patient and the individual and verified either on-site or at an associated laboratory, but must be provided on a voluntary basis and shall be used solely to help identify the unidentified patient and any familial relations. Provides that if law enforcement requests an unidentified patient's information to help identify a suspect, fugitive, material witness, or missing person, the hospital and hospital personnel must disclose only the information allowed under the federal Health Insurance Portability and Accountability Act of 1996. Defines terms.
HB3965 - Welch -
Amends the Illinois Insurance Code. Requires every insurance company authorized to do business in this State or accredited by this State with assets of at least $50,000,000 to submit an annual report on its voluntary supplier diversity program to the Department of Insurance. Sets forth provisions on what the report must include and how and when the report must be submitted. Provides that, for each report, the Department shall publish the results on its Internet website for 5 years after submission. Requires the Department to hold an annual insurance company supplier diversity workshop in February of 2021 and every February thereafter to discuss the reports with representatives of the insurance companies and vendors. Provides that the Department shall prepare a template for voluntary supplier diversity reports. Effective immediately.
JCAR Update
DFPR proposed amendments to the Part titled Wholesale Drug Distribution Licensing Act (68 IAC 1510; 43 Ill Reg 13160) implementing Public Act 101-420. The Act and this rulemaking extend the licensing, storage, handling and recordkeeping requirements that currently apply to wholesale drug distributors to third-party logistics providers (entities that contract with drug manufacturers to provide or coordinate warehousing, distribution, and other services, without claiming any ownership of the drugs or responsibility for their disposition). Applicants for licensure as third-party logistics providers will be subject to the same liability insurance, bond requirements, license application and annual renewal fees (both $200), and fees for changes of ownership ($200) or changes of name or address ($100) as wholesale distributors. Wholesale drug distributors and third-party logistics providers are affected by this rulemaking.
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