Clark Kaericher | Executive Director, Healthcare Council & Sr. VP of Government Affairs | 618-806-1501
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February 10, 2023
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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It’s Super Bowl Weekend. Sadly, for Illinois, the Bears won’t be playing but they’ll settle for a state-of-the-art stadium deal…
I’ve got the Eagles prevailing over the Chiefs.
Committees for Next Week
House Insurance Tuesday 2 pm
HB 1384 (Cassidy and many others)- A group or individual policy of accident and health insurance that is amended, delivered, issued, or renewed on or after January 1, 2025 may not deny coverage for medically necessary reconstructive services that are intended to restore physical appearance. Amends the Medical Assistance Article of the Illinois Public Aid Code to make the same requirement.
HB 1601 (Hoffman) - A group health plan or an accident and health insurer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider's license or certification under applicable State law. Nothing in the provisions shall be construed as preventing a group health plan, an accident and health insurer, or the Director of Insurance from establishing varying reimbursement rates based on quality or performance measures
House Health Care Availability & Accessibility Tuesday 3 pm
HB 1186 (Croke) - Amends the Health Maintenance Organization Act. Provides that the powers of a health maintenance organization include the voluntary use of a referral system for enrollees to access providers under contract with or employed by the health maintenance organization. Provides that the provisions shall not be construed as requiring the use of a referral system to obtain a certificate of authority.
Unless someone objects, I plan to file a witness slip in support of this measure for the Chamber based on support for prior measures.
House Judiciary Committee- Civil: Wednesday 9 am
HB 1230 (Jones, T.) – Healthcare exemption to BIPA.
While this isn’t the Chamber bill (see below for more) we are in support of anything that would improve the state’s broken BIPA law. I’ve spoken with the sponsor, and he intends to work this bill but, with anything BIPA, its going to be an uphill battle.
Senate Insurance Recap
Senate Insurance met for the first time last week. Only one bill the Healthcare Council is tracking passed out of committee. That bill was Senator Fine’s SB 101. This bill was the PANDAS Mandate that first surfaced during Veto Session. Considering it had the amended language from this fall, we were neutral on the bill. The only (non-citizen) witness slip on the matter was a “no position on the merits” filed by our friends at the Illinois Life and Health Insurance Council.
New Bills to Watch
Today at noon is the Senate bill filing deadline. That explains the numerous Senate Bills highlighted here. Next week is the House filing deadline, so it’ll be worse. After that though, things will lighten considerably. As always, I tried to divide by topic of interest.
Health Data
HB 2039 (Moeller-Manly) Creates the Access to Public Health Data Act. Provides that the Department of Public Health, the Department of Human Services, and the Department of Children and Family Services shall, at the request of a local health department in Illinois, make any and all public health data related to residents of that local health department's jurisdiction available to that local health department for the purposes of preventing or controlling disease, injury, or disability. Provides that the Department of Public Health, the Department of Human Services, and the Department of Healthcare and Family Services may adopt any rules necessary to implement the Act.
SB 1618 (Morrison) - No later than July 1, 2024, each health plan and pharmacy benefit manager operating in this State shall, upon request of a covered individual, his or her health care provider, or an authorized third party on his or her behalf, furnish specified cost, benefit, and coverage data to the covered individual, his or her health care provider, or the third party of his or her choosing and shall ensure that the data is: (1) current no later than one business day after any change is made; (2) provided in real time; and (3) in a format that is easily accessible to the covered individual or, in the case of his or her health care provider, through an electronic health records system. Provides that the format of the request shall use specified industry content and transport standards.
Insurance
HB 2071 (Gong-Gershowitz) - Provides that no insurer, dental service plan corporation, professional service corporation, insurance network leasing company, or any company that amends, delivers, issues, or renews an individual or group policy of accident and health insurance on or after the effective date of the amendatory Act shall require a dental care provider to incur a fee to access and obtain payment or reimbursement for services provided. Provides that a dental plan carrier shall provide a dental care provider with 100% of the contracted amount of the payment or reimbursement.
HB 2088 (Jones) - Every company authorized to do business in the State or accredited by the State with assets of at least $50,000,000 shall submit a report on its voluntary supplier diversity program, or the company's procurement program if there is no supplier diversity program, to the Department of Insurance. Provides that the voluntary supplier diversity report shall set forth specified information. Provides that each company is required to submit a report to the Department on or before April 1, 2024, and on or before April 1 every year thereafter. Provides that the Department shall publish the results of supplier diversity reports on its Internet website for 5 years after submission.
SB 324 (Fine) - Amends the Illinois Insurance Code and the Health Maintenance Organization Act. Provides that all individual and small group accident and health policies written subject to certain federal standards must file rates with the Department of Insurance for approval. Provides that unreasonable rate increases or inadequate rates shall be disapproved. Provides that when an insurer files a schedule or table of premium rates for individual or small employer health benefit plans, the Department of Insurance shall post notice of the premium rate filings, rate filing summaries, and other information about the rate increase or decrease online on the Department's website. Provides that the Department shall open a 30-day public comment period on the date that a rate filing is posted on the website. Provides that after the close of the public comment period, the Department shall issue a decision to approve, disapprove, or modify a rate filing, and post the decision on the Department's website.
The Chamber will oppose this bill- as we oppose all government price controls. This would upend the entire insurance marketplace.
SB 1282 (Simmons) - A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after the effective date of the amendatory Act shall provide coverage for preventative screenings for individuals 18 years of age or older and under the age of 65 at high risk for liver disease every 6 months without imposing a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage provided.
SB 1422 (Joyce) - If the policies, agreements, or arrangements of an insurer operate unreasonably in restricting an insured individual's ability to obtain home medical equipment, then an insurer is required to reasonably reimburse its insured for expenses incurred due to the unreasonable restriction.
SB 1557 (Murphy) - No individual or group policy of accident and health insurance or managed care organization shall change an insured's eligibility or coverage during a contract period. Provides that during a contract period, insureds shall have the protection and continuity of their providers, medication, covered benefits, and formulary during the contract period.
Medicaid
HB 2050 (Avelar) Provides that on and after July 1, 2023, medically necessary orthodontic services may be covered under the medical assistance program.
SB 1408 (Murphy)- Drugs prescribed to residents of the following facilities are not subject to prior approval as a result of the 4-prescription limit: (i) long-term care facilities as defined in the Nursing Home Care Act; (ii) community-integrated living arrangements as defined in the Community-Integrated Living Arrangements Licensure and Certification Act; (iii) supportive living facilities as defined in the Code; (iv) intermediate care facilities for persons with developmental disabilities as defined in the ID/DD Community Care Act; and (v) medically complex for the developmentally disabled facilities as defined in the MC/DD Act.
Pharmaceuticals
HB 2189 (Guzzardi)/ SB 1559 (Murphy)- Creates the Access to Affordable Insulin Act. 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 assistance to access 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).
SB 1413 (Rezin) - Creates the Sale of Pharmaceuticals on Social Media Act. Provides that, notwithstanding any other provision of law, no individual shall sell or advertise the sale of a pharmaceutical on social media unless the individual has completed a verification process with specified requirements.
SB 1414 (Holmes) - Amends the Illinois Controlled Substances Act. Provides that, notwithstanding any other provision of law, a prescriber shall not be required to issue prescriptions electronically if he or she certifies to the Department of Financial and Professional Regulation that he or she will not issue more than 100 (rather than 25) prescriptions during a 12-month period. Provides that prescriptions in both oral and written form for controlled substances shall be included in determining whether the prescriber will reach the limit of 100 (rather than 25) prescriptions.
Workforce/Licensing
HB 1615 (Hirschauer) - Amends the Nurse Practice Act. Declares a primary goal of the Illinois Nursing Workforce Center is to develop a strategic plan for nursing workforce in the State by selecting priorities to be addressed, including: (1) for license renewals beginning in 2024 and each renewal thereafter, to develop and require the completion of a supply survey of all licensed nurses at initial licensure and each license renewal thereafter; and (2) no later than 2026, to develop a nurse demand and employer survey to be collected biennially.
HB 1622 (Spain) – Nurse licensure compact.
HB 1630 (Fritts-Spain)- Allows the Board of Trustees of Community College District No. 506 to establish and offer at Sauk Valley Community College a baccalaureate-level nursing education pilot program that confers a bachelor of science degree in nursing upon the meeting of specified conditions. Requires the Illinois Community College Board to conduct a statewide evaluation of the nursing program and report on the results of the evaluation by July 1, 2028
HB 2126 (Morgan) - Includes programs recognized by the Pharmacy Technician Certification Board as a standard nationally accredited education and training program under which a new pharmacy technician may be educated and trained.
SB 1315 (Feignholtz) - Creates the Nurse Educator Scholarship Fund as a special fund in the State treasury to be used by the Department of Public Health to provide scholarships to nurse educators. Provides that each fiscal year, beginning July 1, 2023, the Comptroller shall transfer $1,500,000 from the General Revenue Fund to the Nurse Educator Scholarship Fund to implement these provisions. Provides that $6,000,000 (instead of $4,000,000) of the moneys deposited in the Nursing Dedicated and Professional Fund each year shall be set aside and appropriated to the Illinois Student Assistance Commission for nursing scholarships awarded pursuant to the Nursing Education Scholarship Law.
We Have Our BIPA Bills
I don’t have to tell you that BIPA reform has been a major priority for the Chamber. While we’d love to see wholesale reform of the Act, unfortunately that is extremely unlikely to happen given this General Assembly.
However, there might be an opportunity for a few steps forward. Sen. President Pro Tempore Cunningham has filed the Chamber’s security exception language in SB 1511.
SB 1511 (Cunningham-Holmes) - Defines "security purpose" as the purpose of preventing retail theft, fraud, or any other misappropriation or theft of a thing of value, including protecting property from trespass, controlling access to property, protecting any person from harm, including stalking, violence, or harassment, and assisting a law enforcement investigation. Allows a private entity to collect, capture, or otherwise obtain a person's or customer's biometric identifier or biometric information without satisfying other specified requirements if: (1) the private entity collects, captures, or otherwise obtains a person's or customer's biometric identifier or biometric information for a security purpose; (2) the private entity uses the biometric identifier or biometric information only for a security purpose; (3) the private entity retains the biometric identifier or biometric information no longer than is reasonably necessary to satisfy a security purpose; and (4) the private entity documents a process and time frame to delete any biometric identifier or biometric information.
Representative Ugaste, Minority Spokesman of the House Judiciary Committee, has filed the identical language in the House with HB 2259.
The broader BIPA bills are SB 1506 (Cunningham) and HB 2252 (Ugaste). These bills are coalition language from last year with the IMA, Chicagoland and the IL Chamber. It’s the broader reform but is very unlikely to be enacted.
Changes the definitions of "biometric identifier" and "written release". Defines "biometric lock", "biometric time clock", "electronic signature", "in writing", and "security purpose". Provides that if the biometric identifier or biometric information is collected or captured for the same repeated process, the private entity is only required to inform the subject or receive consent during the initial collection. Waives certain requirements for collecting, capturing, or otherwise obtaining a person's or a customer's biometric identifier or biometric information under certain circumstances relating to security purposes. Provides that nothing in the Act shall be construed to apply to information captured by a biometric time clock or biometric lock that converts a person's biometric identifier or biometric information to a mathematical representation. Requires the Department of Labor to provide information for employers regarding the requirements of the Act on its website. Amends the Workers' Compensation Act. Provides that nothing in the Act limits, prevents, or preempts a recovery by an employee under the Biometric Information Privacy Act. Effective immediately.
Finally, On a Lighter Note…
There was a lot this week, so I thought we needed to close with a palate cleanser.
My dog turned 11 this week. To her dismay, I told my daughters and the 3 year old thought the occasion merited a tea party complete with princess costumes. The dog wasn’t amused but she was at least a good sport.
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