Clark Kaericher | Executive Director, Healthcare Council & Sr. VP of Government Affairs | 618-806-1501
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April 28, 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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So far, the session has gone about as well as can be expected. You know when watch a scary movie, it’s daytime and the characters are all happy and having fun? That’s how I feel. I hope it continues to feel like that from now until adjournment May 19th. But you just know that somewhere out there, someone is ready to jump out from behind a corner with a terrible bill idea…
Committee Recap
In good news, HB 3338 (Mah) which creates the “Safe Patient Limits Act” was sent to subcommittee in House Labor and Commerce. The bill sets up nurse staffing ratios. The Illinois Chamber of Commerce opposes this bill as a legislative overreach best left up to hospital administrators and their staffs. This subcommittee has posted a hearing for this bill on Wednesday at 2 pm along with the regular committee.
HB 2719 amends the Fair Patient Billing Act. It mandates that a hospital shall screen each uninsured patient for eligibility in State and federal health insurance programs, financial assistance offered by the hospital, and other public programs that may assist with health care costs and provide information about those programs. This bill passed the House on a largely party line vote and this week passed the Senate Human Services Committee 9-5.
HB 3631, PBM passed out of Senate Insurance 8-0-0 yesterday. This bill amends the Pharmacy Benefit Managers Article of the Illinois Insurance Code. Provides that a pharmacy benefit manager may not retaliate against a pharmacist or pharmacy for disclosing information in a court, in an administrative hearing, before a legislative commission or committee, in any other proceeding, or to a government or law enforcement agency, if the pharmacist or pharmacy has reasonable cause to believe that the disclosed information is evidence of a violation of a State or federal law, rule, or regulation. Provides that a pharmacist or pharmacy shall make commercially reasonable efforts to limit the disclosure of confidential and proprietary information. Provides that retaliatory actions against a pharmacy or pharmacist include specified actions. Provides that the provisions apply to contracts entered into or renewed on or after July 1, 2022 (rather than July 1, 2023).
HB 3955, Hospitals passed out of Senate Insurance 8-0-0 yesterday. This bill provides that, notwithstanding any provision of law to the contrary, hospitals organized or licensed under the Acts, in accordance with specified federal law, shall not delay provisions of a required appropriate medical screening examination or further medical examination and treatment for a patient in a hospital's emergency room in order to inquire about the individual's method of payment or insurance status.
SB 1282, INS Coverage passed out of House Insurance 12-0-0. This bill Provides that 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, 2025 shall provide coverage for preventative liver disease screenings for individuals 35 years of age or older and under the age of 65 at high risk for liver disease, including liver ultrasounds and alpha-fetoprotein blood tests every 6 months, without imposing a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage provided.
SB 1559, Insulin passed out of House Health Care Availability & Accessibility 8-0-0. This bill creates the Access to Affordable Insulin Act. 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 1568, Insurance Plans passed out of House Insurance 15-0-0. This bill provides that the Department of Insurance shall collect specified information concerning disability insurance plans and limitations on mental health and substance use disorder benefits. Provides that the Department shall present its findings regarding information collected under the provisions to the General Assembly no later than April 30, 2024.
New Postings
House Insurance Committee meets on Tuesday at 2 pm to have a subject matter hearing on three controversial bills. Two of the three are auto insurance concerns but SB 1289 House Amendment 1 reinserts dental loss ratio. The Illinois Chamber of Commerce opposes dental loss ratios.
House Health Care Licenses Committee meets at 10 am on Wednesday. It will consider SB 761 (Lightford-Collins) which creates an “EMT Training, Recruitment and Retention Task Force”.
HB 3338 is posted in both House Labor and the relevant subcommittee at 2 pm on Wednesday (more above).
Floor Votes of Note
HB 559, Temporary Permit passed out of the House on concurrence by a vote of 112-0-0. This bill provides that any person who was issued a temporary out-of-state permit or temporary reinstatement permit by the Department of Financial and Professional Regulation in response to the COVID-19 pandemic may continue to practice under his or her temporary out-of-state permit if he or she submits an application for licensure by endorsement to the Department on or before May 11, 2023
Exciting Member News: Bristol Myers Squibb Strengthens Cell Therapy Capabilities by Adding New Illinois Manufacturing Facility for Viral Vector Production
This week Bristol Myers Squibb announced expansion of its global cell therapy manufacturing network to enable in-house viral vector production through a U.S.-based manufacturing facility and its operations in Libertyville, Illinois, following the company’s execution of an agreement with Novartis. The facility and its operations have capabilities to produce viral vector for both of Bristol Myers Squibb’s CAR T cell therapies. This development advances the company’s long-term ambitions in cell therapy.
“The addition of an in-house facility for viral vector production that complements our external partnerships affords us the ability to manufacture current and next-generation vector technology, and increase future capacity,” said Karin Shanahan, executive vice president, Global Product Development & Supply, Bristol Myers Squibb. “Bringing the Libertyville site operations and employees onboard to join our expanding global cell therapy manufacturing network enhances the depth and breadth of our existing capabilities.”
Manufacturing cell therapies is both operationally and technically complex because they are created uniquely for each individual patient, using a patient’s own T cells as the starting material. Viral vectors are a key component of engineering T cells for infusion back to the patient. Because cell therapies are rapidly transforming the way we treat different types of cancers, the demand for viral vector is increasing significantly. A dual-sourcing vector strategy supports reliable delivery of Bristol Myers Squibb CAR T cell therapies to keep pace with growing demand and ensure that more eligible patients can access these treatments. Read more here.
Rulemaking
Hospitals: The DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES adopted an amendment to Hospital Services (89 IAC 148; 46 Ill Reg 16331) effective 4/5/23 that implements PA 102-43, authorizing payment for long-acting injectable medications administered to treat mental health or substance use disorders in the hospital inpatient setting. These payments will be authorized for medications prescribed by a board-certified or board-eligible psychiatrist and administered in a psychiatric setting, with documentation of follow-up appointments and prior approval for subsequent injection doses. Since 1st Notice, HFS added board-eligible psychiatrists with less than 7 years’ experience since completing a psychiatric residency to those who may prescribe long- acting injectable medications. Questions/requests for copies: Steffanie Garrett, HFS, 201 S. Grand Ave. East, 3rd Floor, Springfield IL 62763-0002, HFS.Rules@illinois.gov
Medicare Supplements: The DEPARTMENT OF INSURANCE adopted amendments to the Part titled Minimum Standards for Individual and Group Medicare Supplement Insurance (50 IAC 2008; 46 Ill Reg 17541) effective 4/4/23 implementing new “Medigap birthday rule” requirements of the Illinois Insurance Code effective 1/ 1/22. The rulemaking requires that notice of an annual open enrollment period of 45 days after the insured’s birthday for Medicare supplement policy holders in Illinois ages 65-75 (during which they may select a different plan from the same carrier, provided it does not exceed the benefits of their current plan) be included in or attached to all applications for Medicare supplement insurance. If this notice is not part of the application, it must be electronically submitted to DOI for approval before it is sent to applicants. Insurers that offer Medicare supplement policies are affected. Questions/requests for copies: Ryan Gillespie, DOI, 320 W. Washington St., 5th Fl., Springfield IL 62767, 217/558-2746
Articles of Interest
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