Clark Kaericher | Executive Director, Healthcare Council & Sr. VP of Government Affairs | 618-806-1501
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February 3, 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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Short session week this week. Only the Senate was in and they met for a combined time of less than one hour.
Both Chambers will convene next week, and we will have our first committees (more on that below).
Committees Have Been Posted
The Senate has a few committees posted for next week. As always, your position/thoughts on these bills are invaluable.
Senate Public Health will meet on Tuesday at 1:30. There are only two bills posted:
SB 69 (Fine) - Requires every hospital to adopt an influenza and pneumococcal immunization policy that includes procedures for identifying patients age 50 or older for influenza immunization and 65 or older for pneumococcal immunization (rather than just for identifying patients age 65 or older).
SB 152 (Anderson) will allow the sale of unpasteurized milk. The Chads on Instagram say that will help me pack on the muscle.
Senate Insurance will be at 3:30 in room 400. There are four bills posted:
SB 54 (Fine) - Provides that coverage for self-management training and education, equipment, and supplies for diabetes treatment shall include insulin pumps and medical supplies required for the use of an insulin pump when medically necessary and prescribed by a physician licensed to practice medicine in all its branches.
SB 56 (Fine) - In provisions concerning Medicare supplement policy minimum standards, provides that if an individual is at least 65 years of age but no more than 75 years of age and has an existing Medicare supplement policy, then the individual is entitled to an annual open enrollment period lasting 45 days, commencing with the individual's birthday, and the individual may purchase any Medicare supplement policy with the same issuer or any affiliate authorized to transact business in the State (instead of only the same issuer) that offers benefits equal to or lesser than those provided by the previous coverage.
SB 89 (Harris) - Amends the Illinois Insurance Code. Provides that if the entry of an Order of Liquidation occurs on or after January 1, 2023, then the obligations shall not exceed $500,000 or exceed without any deduction $50,000 for any unearned premium claim or refund under any one policy.
SB 101 (Fine)- Insurance Mandate. Amends the Illinois Insurance Code. Provides that no group or individual policy of accident and health insurance or managed care plan shall deny or delay coverage for medically necessary treatment because the insured, enrollee, or beneficiary previously received any treatment, including the same or similar treatment, for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections or pediatric acute onset neuropsychiatric syndrome, or because the insured, enrollee, or beneficiary has been diagnosed with or receives treatment for an otherwise diagnosed condition. Provides that coverage of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome shall adhere to the treatment recommendations developed by a medical professional consortium convened for the purposes of researching, identifying, and publishing best practice standards for diagnosis and treatment of such disorders or syndrome that are accessible for medical professionals and are based on evidence of positive patient outcomes. Provides that coverage for any form of medically necessary treatment shall not be limited over a lifetime of an insured, enrollee, or beneficiary, unless the patient is no longer benefiting from the treatment, or by policy period. Provides that nothing in the provisions prevents insurers from requesting treatment notes and anticipated duration of treatment and outcomes. Effective immediately.
Other Legislative Updates
Full committee lists have been posted for both legislative chambers this week. The full lists for the Senate is on ilga.gov and the House should be up soon. Here are the highlights from our prospective:
House Insurance will be led again by Rep. Jones. He and I had a great meeting this week and I look forward to working with him.
There will be 10 Democrats and 5 Republicans on this committee. Representative Keicher will serve as the minority spokesman.
House Judiciary Civil will be a 10-5 split. It’s chaired by Rep. Gong-Gershowitz. Representative Ann Williams will be the Vice Chair. New to the committee will be freshman Rep. Jenn Ladisch Douglass. The Republican spokesman will be Rep. Ugaste.
House Executive Committee will have an 8-4 split. It’s chaired by Rep. Rita and House GOP Deputy Leader Ryan Spain is the ranking Republican.
Senate Insurance, despite some earlier statehouse whispers, will remain with Senator Napoleon Harris- this is good news as he has done a fantastic job dealing with these complicated issues. Senator Syverson will be the ranking Republican. The committee has a 7-4 split.
Senate Judiciary will have a new chair in Sen. Martwick. Senator Tracy is the minority spokesman. That committee will have a 6-3 split.
Senate Executive will be 9-4, chaired by Senator Castro and Sen. Anderson will represent the GOP.
Supremely Disappointing Decision on BIPA
The Illinois Supreme Court held today that the 5-year catch-all statute of limitations applies to all BIPA claims.
The Tims v. Black Horse Carriers opinion (attached) relies heavily on the “Legislative Findings/Intent” provisions in Section 5 of BIPA, citing the 2008 Legislature’s statements about the “unknown” ramifications of “the harms associated with biometric technology” and the “biologically unique” nature of biometric data. (see pp. 11-12). The Court concluded: “We find that a longer limitations period [5 years] would comport with the public welfare and safety aims of the General Assembly by allowing an aggrieved party sufficient time to discover the violation and take action.” (p. 13).
The full decision can be read HERE.
New Bills of Interest
EMS System:
HB 1595 (Kelly) - Amends the Emergency Medical Services (EMS) Systems Act. Provides that specified Advisory Committees shall include one representative from the labor organization recognized as the exclusive representative of specified entities' employees. Provides that an EMS Medical Director may only suspend any EMS personnel, EMS Lead Instructor, individual, individual provider, or other participant considered not to be meeting the requirements of the Program Plan if the EMS Medical Director obtains agreement from the Department of Public Health. Allows arbitration meeting specified requirements as alternative dispute resolution procedures for EMS System licensing and makes conforming changes throughout the Act. Provides that a member of a fire department's or fire protection district's collective bargaining unit shall be eligible to work under a silver spanner program for another fire department EMS System that is not the full time employer of that member, for a period not to exceed 12 months, without being required to test into the EMS System of the fire department or fire protection district.
Health Data/Records:
SB 186 (Villa) - 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.
SB 188 (McClure) - Amends the Consent by Minors to Health Care Services Act. Allows a parent who consents to the performance upon his or her child of a health care service to request to inspect and copy the child's records or any part thereof so long as it is related to the health care service the parent consented to. Amends the Mental Health and Developmental Disabilities Confidentiality Act. Allows the personal representative under HIPAA of a recipient to request to inspect and copy a recipient's record or any part thereof, regardless of the age of the recipient.
Insurance:
HB 1565 (Stuart) – 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 January 1, 2024 and that provides coverage for prescription drugs shall provide coverage for vaginal estrogen, and that coverage for vaginal estrogen shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement.
SB 241 (Ellman) - Amends the Network Adequacy and Transparency Act. Provides that an insurer providing a network plan shall file a description with the Director of Insurance of written policies and procedures on how the network plan will provide 24-hour, 7-day per week access to reproductive health care. Further, the Department of Insurance shall consider establishing ratios for reproductive health care physicians or other providers.
SB 288 (Rezin) - Amends the State Employees Group Insurance Act of 1971. Prohibits the State from applying for any federal waiver that would reduce or eliminate any protection or coverage required under the Patient Protection and Affordable Care Act (Affordable Care Act) that was in effect on January 1, 2017, including, but not limited to, any protection for persons with preexisting conditions and coverage for services identified as essential health benefits under the Affordable Care Act. Provides that the State or an agency of the executive branch may apply for such a waiver only if granted authorization by the General Assembly through joint resolution. Amends the Illinois Insurance Code. Prohibits the State from applying for any federal waiver that would permit an individual or group health insurance plan to reduce or eliminate any protection or coverage required under the Affordable Care Act that was in effect on January 1, 2017, including, but not limited to, any protection for persons with preexisting conditions and coverage for services identified as essential health benefits under the Affordable Care Act.
Licensing:
HB 1538 (Huynh) - Amends the Home Health, Home Services, and Home Nursing Agency Licensing Act. Provides that a 3-year (rather than an annual) license shall be issued for conducting or maintaining a home health agency. Provides that the fee for each single home health agency license or any renewal shall be $100 (rather than $25). Effective immediately.
HB 1572 (Hauter)- Gives the Secretary of Financial and Professional Regulation has the power to issue licenses, including temporary licenses, to health care professionals on an expedited basis in accordance with the rules adopted by the Department of Financial and Professional Regulation for expedited licensure.
SB 199 (Feignholtz) - Amends the Nurse Practice Act. Removes a provision providing that the scope of practice of an advanced practice registered nurse with full practice authority includes prescribing benzodiazepines or Schedule II narcotic drugs.
SB 218 (Gillespie) - Provides that a physician assistant shall be deemed by law to possess the ability to prescribe, dispense, order, administer, and procure drugs and medical devices without delegation of such authority by a physician. Provides that such ability shall include the prescribing of Schedule II, III, IV, and V controlled substances. Provides that to prescribe Schedule II, III, IV, or V controlled substances under the Act, a physician assistant shall obtain a mid-level practitioner controlled substances license. Provides that when a written collaboration agreement is required under the Act, delegation of prescriptive authority by a physician is not required.
SB 303 (Morrison) - Amends the Pharmacy Practice Act. 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. Effective immediately.
Medicaid:
HB 1536 (Huynh) - Provides the no appropriation may be expended to a managed care organization under contract with the Department of Healthcare and Family Services unless the managed care organization, and its pharmacy benefits manager, allows prescription drug benefits to be provided by specialty pharmacies that are certified in the Business Enterprise Program and accredited by at least 2 different accreditation entities for specialty pharmacy services on the same terms and conditions by any willing provider that is qualified for network participation and authorized to dispense prescription drugs.
HB 1558 (Hirschauer) - Removes language requiring the Department of Public Health to establish, by rule, and charge a fee to any facility or program applying to be certified to participate in the Medicare program or in the Medicaid program to cover the costs associated with the application, inspection, and survey of the facility or program and processing of the application.
HB 1570 (Hernandez, L.) - Amends the Administration Article of the Illinois Public Aid Code. Provides that the amendatory Act may be referred to as the Healthy Illinois for All Law. Provides that by July 1, 2023, the Department of Healthcare and Family Services may provide medical services to noncitizens 19 years of age through 41 years of age who (i) are not eligible for medical assistance due to their not meeting the otherwise applicable provisions under the Code concerning citizenship requirements and (ii) have income at or below 133% of the federal poverty level plus 5% for the applicable family size as determined under applicable federal law and regulations. Provide that persons eligible for medical services under the amendatory Act shall receive benefits identical to the benefits provided under the Health Benefits Service Package as that term is defined in the Code.
SB 200 (Morrison) – On and after July 1, 2023, medically necessary orthodontic services may be covered under the medical assistance program.
New Rulemaking
Hospitals: The DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES proposed an amendment to Hospital Services (89 IAC 148; 47 Ill Reg 1145) implementing PA 102-4, which established a $50 million annual funding pool for Safety Net Obstetrical Payments. These payments will be disbursed among Safety Net Hospitals that maintain designation by the Department of Public Health as perinatal centers with facilities for labor and delivery.
Hospital Assistance: The OFFICE OF THE ATTORNEY GENERAL adopted amendments to Hospital Financial Assistance under the Fair Patient Billing Act (77 IAC 4500; 46 Ill Reg 14822) effective 1/11/23 that define the Federal Poverty Income Guidelines upon which the income criteria for assistance under this Part are based, refer to the federal Department of Health and Human Services website address where current and updated guidelines are posted, and repeal an appendix that lists the current calendar year’s poverty income levels.
6% Increase in ACA Marketplace Open Enrollment
The final numbers of open enrollment were released this week and Illinois saw a decent jump in the number of enrollees. In Illinois, 342, 995 plans were selected. This represents a 6% increase from the prior year.
In total, 11 carriers offered a record 309 plans. The state spent $3.2 million to inform residents about their potential to qualify.
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