Lori Cowdrey Benso | Executive Director, Healthcare Council | 217-725-6522
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The purpose of the Healthcare Council is to develop and take actions to achieve affordable, accessible, efficient, high-quality healthcare options for the employers and residents of our state. We advocate for market-based solutions that encourage innovation in healthcare delivery – and work against costly mandates and burdensome regulations. Through quarterly meetings, the Council brings together the diverse voices of the healthcare community and provides a forum to interact with government and private sector leaders at the highest levels. |
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April 11, 2022
Friday was the last day of scheduled session.
Session Update:
The House and Senate had a very busy last week of session with floor action and committees. The Senate and House adjourned late Saturday am.
The Chamber will send the end of session report on Tuesday. Here are a few highlights from the last week of session:
Key Bills that passed in the last week of session:
HB 0836 Creates the Health Insurance Coverage Premium Misalignment Study Act. Sets forth provisions concerning the purpose of the Act and findings. Provides that the Department of Insurance shall oversee a study to explore rate setting approaches that may yield a misalignment of premiums across different tiers of coverage in Illinois' individual health insurance market. Provides that the study shall produce cost estimates for Illinois residents addressing metal-level premium misalignment policy along with the impact of the policy on health insurance affordability and access and the uninsured rates for low-income and middle-income residents, with break-out data by geography, race, ethnicity, and income level. Provides that the study shall evaluate how premium realignment if implemented would affect costs and outcomes for Illinoisans. Provides that the Department shall develop and submit, no later than January 1, 2024, a report to the General Assembly and the Governor concerning the design, costs, benefits, and implementation of premium realignment to increase affordability and access to health care coverage that leverages existing State infrastructure.
HB 1950, Hospital Assessment passed out of the Senate 56-0-0 and the House on concurrence by a vote of 113-0-0. In a provision concerning safety-net hospitals, provides that beginning July 1, 2020 and ending on December 31, 2026, a hospital that would have qualified for the rate year beginning October 1, 2020 and was designated a federal rural referral center on October 1, 2020 shall be a Safety-Net Hospital. In provisions concerning hospital provider funding, provides that certain annual assessments on inpatient services and outpatient services shall be imposed on each hospital provider for calendar years 2021 through 2026 (rather than for calendar years 2021 and 2022). Makes changes to the definition of "Assessment Adjustment". Extends the period during which certain transfers shall be made from the Hospital Provider Fund. Contains provisions concerning: (i) the applicable reimbursement factor from July 1, 2020 through December 31, 2022 and January 1, 2023 through December 31, 2026; and (ii) fee for-service supplemental payments beginning January 1, 2023. In a provision concerning the classification of Illinois hospitals for the purpose of allocating the funds included in capitation payments to managed care organizations, defines "critical access hospital" and "public hospital". Provides that, beginning January 1, 2023 and each calendar year thereafter, assignment to the safety-net class shall be based on the annual safety-net rate year beginning 15 months before the beginning of the first Payout Quarter of the calendar year. Makes changes to provisions concerning high Medicaid hospitals and defines "regional high volume hospital". Provides that, from January 1, 2023 through December 31, 2023, the Department of Healthcare and Family Services shall establish the amounts that shall be allocated to the hospital class directed payment fixed pools identified under a specified provision of the Code for the quarterly development of a uniform per unit add-on. Requires the Department to ensure that hospitals assigned to the fixed pools are paid no less than 95% of the annual initial rate for each 6-month period of each annual payout period. Contains provisions concerning directed payment amounts established by the Department for the Payout Quarter beginning January 1, 2023; pass-through payments for calendar year 2023; the sum of the total estimated annual payments to each hospital class for calendar year 2023; and other matters. Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that a general acute care hospital is authorized to file a notice with the Department of Public Health and the Health Facilities and Services Review Board to establish an acute mental illness category of service in accordance with the Illinois Health Facilities Planning Act and add authorized acute mental illness beds if the following conditions are met: (i) the general acute care hospital qualifies as a safety-net hospital as determined by the Department of Healthcare and Family Services at the time of filing the notice or for the year immediately prior to the date of filing the notice; (ii) the notice seeks to establish no more than 24 authorized acute mental illness beds; and (iii) the notice seeks to reduce the number of authorized beds in another category of service to offset the number of authorized acute mental illness beds. In provisions requiring the Department of Healthcare and Family Services to pay certain amounts to the human poison control center designated under the Poison Control System Act, provides that not less than $3,750,000 shall be paid for State fiscal years 2021 through 2026 (rather than for State fiscal year 2021 and 2022) and not less than $1,875,000 shall be paid for the period July 1, 2026 through December 31, 2026 (rather than for the period July 1, 2022 through December 31, 2022). Amends the Department of Public Health Powers and Duties Law. Provides that, by February 1, 2023, the Department of Public Health and the Department of Healthcare and Family Services shall provide a joint report to the General Assembly on options and recommendations for the establishment of a permanent Safety-Net Hospital Health Equity and Access Leadership (HEAL) Grant Program. Provides that the Departments of Public Health and Healthcare and Family Services may consult with the statewide association representing a majority of hospitals and safety-net hospitals on the report. Sets forth information that may be included in the report, including, but not limited to: (1) criteria for a safety-net hospital to be eligible for the program; (2) potential projects eligible for grant funds, which may include projects to reduce health disparities, advance health equity, or improve access to or the quality of healthcare services; and (3) potential strategies to generate federal Medicaid matching funds for expenditures under the program. Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions requiring the Department of Healthcare and Family Services to make adjustment payments for inpatient services to hospitals that meet certain requirements, provides that such adjustment payments shall be made to a hospital that reopens a previously closed hospital facility within 4 (rather than 3) calendar years of the hospital facility's closure. Amends the Illinois Income Tax Act. Extends the income tax credit for certain hospitals through taxable years ending on or before December 31, 2027 (currently, December 31, 2022). Amends the Use Tax Act, the Service Use Tax Act, the Service Occupation Tax Act, and the Retailers' Occupation Tax Act. Provides that certain hospital exemptions apply on a continuous basis. Effective immediately.
SB 3910 (Sen Fine D-Glenview, Rep Jones D-Calumet City, Rep Morgan D-Highwood) Amends the Uniform Prescription Drug Information Card Act. Provides that a uniform prescription drug information card issued by a health benefit plan shall display on the card the regulatory entity that holds authority over the plan, whether the plan is fully insured or self-insured, the issuer's National Association of Insurance Commissioners company code, any deductible applicable to the plan, any out-of-pocket maximum limitation applicable to the plan, and a toll-free telephone number and Internet website address through which the cardholder may seek consumer assistance information. Provides that a discounted health care services plan administrator shall issue to its beneficiaries a card that contains information about the regulatory entity that holds authority over the plan and whether the plan is fully insured or self-insured. Amends the Uniform Health Care Service Benefits Information Card Act. Provides that a health care benefit information card or other technology containing uniform health care benefit information issued by a health benefit plan or a dental plan shall specifically identify and display on the card the regulatory entity that holds authority over the plan, whether the plan is fully insured or self-insured, the issuer's National Association of Insurance Commissioners company code, any deductible applicable to the plan, any out-of-pocket maximum limitation applicable to the plan, and a toll-free telephone number and Internet website address through which the cardholder may seek consumer assistance information. Makes other changes. Effective January 1, 2023.
Bills that failed to pass:
HB 1462 (Rep. Yang Rohr D-Naperville, Rep. Stava-Murray D-Downers Grove, Rep. Hirschauer D-West Chicago). Creates the Prescription Drug Affordability Act. Defines terms. Establishes the Prescription Drug Affordability Board and provides that the Board's purpose is to protect State residents, State and local governments, commercial health plans, health care providers, pharmacies licensed in the State, and other stakeholders within the health care system from the high costs of prescription drug products. Contains other provisions about the Board, including: members of the Board; conflicts of interest; terms of members; the hiring of an executive director, general counsel, and staff for the Board; staff salary; meetings of the Board; and powers and duties of the Board. Creates the Prescription Drug Affordability Stakeholder Council with the purpose to provide stakeholder input to assist the Prescription Drug Affordability Board in making decisions as required under the Act. Contains other provisions about the Council, including: members of the Council; terms of members; and reimbursement of member travel expenses. Provides that the Board shall identify specified prescription drug products and determine whether each prescription drug product should be subject to a cost review. Provides that if the Board finds that spending on a prescription drug product has led or will lead to an affordability challenge, the Board shall establish an upper payment limit after considering: (i) the cost of administering the drug; (ii) the cost of delivering the drug to consumers; and (iii) other relevant administrative costs related to the drug. Includes provisions regarding remedies and an appeal process. Creates the Prescription Drug Affordability Fund to be used only to provide funding for the Board and for the purposes authorized under the Act. Provides that the Board shall submit a report to the General Assembly including specified information. Provides that the Board shall conduct a study of the operation of the generic drug market that includes specified information on or before June 1, 2023. Includes a provision on term expiration for Board and Council members. Makes conforming changes in the State Finance Act. Effective January 1, 2023. This bill stalled in the House.
HB 1463, (Rep Scherer D-Decatur, Rep Flowers D-Chicago, Rep Ramirez D-Chicago) Network Adequacy Changes. This bill amends the Illinois Insurance Code. Adds provisions concerning market analysis and market conduct actions. Makes changes to provisions concerning market conduct and non-financial examinations, examination reports, insurance compliance self-evaluative privilege, confidentiality, fees and charges, examination, and fiduciary and bonding requirements. Amends the Network Adequacy and Transparency Act. Adds definitions. Establishes minimum ratios of providers to beneficiaries for network plans issued, delivered, amended, or renewed during 2023. Makes changes to provisions concerning network adequacy, notice of nonrenewal or termination, transition of services, network transparency, administration and enforcement, and provider requirements. Amends the Managed Care Reform and Patient Rights Act. Makes changes to provisions concerning notice of nonrenewal or termination and transition of services. Amends the Illinois Administrative Procedure Act to authorize the Department of Insurance to adopt emergency rules implementing federal standards for provider ratios, time and distance, or appointment wait times when such standards apply to health insurance coverage regulated by the Department of Insurance and are more stringent than the State standards extant at the time the final federal standards are published. Effective immediately. This bill failed in the House by a vote of 40-21-7.
HB1466 (Rep. Guzzardi D-Chicago, Rep. Collins D-Chicago, Rep. Willis D-Northlake) Creates the Access to Affordable Insulin Act. Sets forth provisions concerning an insulin urgent-need program. Provides that by July 1, 2022, each manufacturer shall establish procedures to make insulin available to eligible individuals who are in urgent need of insulin or who are in need of access to an affordable insulin supply. Sets forth provisions concerning insulin urgent-need program exceptions, eligibility, forms, applications, claims and reimbursement, copayments, information sheets, navigators, and penalties. Defines terms. Amends the Illinois Insurance Code. In provisions concerning cost sharing in prescription insulin drugs, provides that an insurer that provides coverage for prescription insulin drugs under the terms of a health coverage plan the insurer offers shall limit the total amount that an insured is required to pay for a 30-day supply of covered prescription insulin drugs at an amount not to exceed $35 (rather than $100). Effective immediately. This bill passed the House and was referred to Senate Assignments.
HB 4175 INS-HEALTH BENEFIT EXCHANGE, deadline was extended to March 31, 2022. Amends the Illinois Health Benefits Exchange Law. Provides that the Department of Insurance has the authority to operate the Illinois Health Benefits Exchange. Provides that the Director of Insurance may require plans in the individual market to be made available for comparison on the exchange, but may not require all plans be purchased exclusively on the exchange. Provides that the Director may require that plans offered on the exchange conform with standardized plan designs. Provides that the Director may apply a monthly assessment to each health benefits plan sold in the Illinois Health Benefits Exchange according to specified rates. Provides that the Director shall establish an advisory committee to provide advice to the Director concerning the operation of the exchange and that the advisory committee shall include specified members. Provides that the Department shall also have the authority to coordinate the operations of the exchange with the operations of the State Medicaid program and the FamilyCare Program to determine eligibility for those programs as soon as practicable. Provides that the Department shall adopt rules. Removes provisions concerning small employer health insurance coverage and markets. Makes other changes. Effective January 1, 2023. This bill was assigned to Appropriations-Human Services Committee but did not make it out of Committee.
SB 3926 (Sen Fine D-Glenview, Sen Gillespie D-Arlington Heights, Sen Simmons D-Chicago) Provides that any failure to make a disclosure or obtain a signed confirmation required under specified provisions of the Short-Term, Limited-Duration Health Insurance Coverage Act is an unfair method of competition and an unfair and deceptive act or practice in the business of insurance. Provides that the Director of Insurance shall have the power to examine and investigate into the affairs of every person subject to specified provisions of the Short-Term, Limited-Duration Health Insurance Coverage Act. Provides that the Director may place on probation, suspend, revoke, or refuse to issue or renew an insurance producer's license or may levy a civil penalty or take any combination of actions for any failure to make a disclosure or obtain a signed confirmation required or any unlawful practice described under specified provisions of the Short-Term, Limited-Duration Health Insurance Coverage Act. Amends the Short-Term, Limited-Duration Health Insurance Coverage Act. Sets forth provisions concerning the purpose and scope of the Act. Provides that the Act applies to health insurance issuers that offer short-term, limited-duration health insurance coverage to groups and individuals (rather than only individuals) in the State. Sets forth provisions concerning duration of coverage; cancellation; and disclosure, filing, and coverage requirements of short term, limited-duration health insurance coverage. Sets forth provisions concerning unfair or deceptive practices relating to the sale of supplemental or short-term, limited-duration health insurance coverage. Provides that the Department of Insurance may adopt any rules necessary to carry out the provisions of the Act. Defines terms. Makes other changes. Effective January 1, 2023. This bill passed the Senate and was held on second reading in the House.
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