Sen. Rachelle Crowe
Filed: 4/24/2019
 
 


 




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1
AMENDMENT TO HOUSE BILL 3509 




2 AMENDMENT NO. ______. Amend House Bill 3509 by replacing 
3everything after the enacting clause with the following:


4 "Section 5. The State Employees Group Insurance Act of 1971 
5is amended by adding Section 6.16 as follows:

6 (5 ILCS 375/6.16 new)
7 Sec. 6.16. Human breast milk coverage. Notwithstanding any 
8other provision of this Act, pasteurized donated human breast 
9milk, which may include human milk fortifiers if indicated by a 
10prescribing licensed medical practitioner, shall be covered 
11under a health plan for persons who are otherwise eligible for 
12coverage under this Act, if the covered person is an infant 
13under the age of 6 months, a physician prescribes the milk for 
14the covered person, and all of the following conditions are 
15met:
16  (1) the milk is obtained from a human milk bank that is 
 
 
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1 licensed by the Department of Public Health;
2  (2) the infant is critically ill and the infant's 
3 mother is medically or physically unable to produce 
4 maternal breast milk or produce maternal breast milk in 
5 sufficient quantities to meet the infant's needs or the 
6 maternal breast milk is contraindicated;
7  (3) the milk has been determined to be medically 
8 necessary for the infant; and
9  (4) one or more of the following applies:
10   (A) the infant's birth weight is below 1,500 grams;
11   (B) the infant has a congenital or acquired 
12 condition that places the infant at a high risk for 
13 development of necrotizing enterocolitis;
14   (C) the infant has infant hypoglycemia;
15   (D) the infant has congenital heart disease;
16   (E) the infant has had or will have an organ 
17 transplant;
18   (F) the infant has sepsis; or
19   (G) the infant has any other serious congenital or 
20 acquired condition for which the use of donated human 
21 breast milk is medically necessary and supports the 
22 treatment and recovery of the infant.

23 Section 10. The Illinois Insurance Code is amended by 
24adding Section 356z.33 as follows:

 
 
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1 (215 ILCS 5/356z.33 new)
2 Sec. 356z.33. Human breast milk coverage. Notwithstanding 
3any other provision of this Act, pasteurized donated human 
4breast milk, which may include human milk fortifiers if 
5indicated by a prescribing licensed medical practitioner, 
6shall be covered under an individual or group health insurance 
7for persons who are otherwise eligible for coverage under this 
8Act, if the covered person is an infant under the age of 6 
9months, a physician prescribes the milk for the covered person, 
10and all of the following conditions are met:
11  (1) the milk is obtained from a human milk bank that is 
12 licensed by the Department of Public Health;
13  (2) the infant is critically ill and the infant's 
14 mother is medically or physically unable to produce 
15 maternal breast milk or produce maternal breast milk in 
16 sufficient quantities to meet the infant's needs or the 
17 maternal breast milk is contraindicated;
18  (3) the milk has been determined to be medically 
19 necessary for the infant; and
20  (4) one or more of the following applies:
21   (A) the infant's birth weight is below 1,500 grams;
22   (B) the infant has a congenital or acquired 
23 condition that places the infant at a high risk for 
24 development of necrotizing enterocolitis;
25   (C) the infant has infant hypoglycemia;
26   (D) the infant has congenital heart disease;
 
 
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1   (E) the infant has had or will have an organ 
2 transplant;
3   (F) the infant has sepsis; or
4   (G) the infant has any other serious congenital or 
5 acquired condition for which the use of donated human 
6 breast milk is medically necessary and supports the 
7 treatment and recovery of the infant.

8 Section 15. The Illinois Public Aid Code is amended by 
9adding Section 5-40 as follows:

10 (305 ILCS 5/5-40 new)
11 Sec. 5-40. Human breast milk coverage. Notwithstanding any 
12other provision of this Act, pasteurized donated human breast 
13milk, which may include human milk fortifiers if indicated by a 
14prescribing licensed medical practitioner, shall be covered 
15under a health plan for persons who are otherwise eligible for 
16coverage under this Act, if the covered person is an infant 
17under the age of 6 months, a physician prescribes the milk for 
18the covered person, and all of the following conditions are 
19met:
20  (1) the milk is obtained from a human milk bank that is 
21 licensed by the Department of Public Health;
22  (2) the infant is critically ill and the infant's 
23 mother is medically or physically unable to produce 
24 maternal breast milk or produce maternal breast milk in 
 
 
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1 sufficient quantities to meet the infant's needs or the 
2 maternal breast milk is contraindicated;
3  (3) the milk has been determined to be medically 
4 necessary for the infant; and
5  (4) one or more of the following applies:
6   (A) the infant's birth weight is below 1,500 grams;
7   (B) the infant has a congenital or acquired 
8 condition that places the infant at a high risk for 
9 development of necrotizing enterocolitis;
10   (C) the infant has infant hypoglycemia;
11   (D) the infant has congenital heart disease;
12   (E) the infant has had or will have an organ 
13 transplant;
14   (F) the infant has sepsis; or
15   (G) the infant has any other serious congenital or 
16 acquired condition for which the use of donated human 
17 breast milk is medically necessary and supports the 
18 treatment and recovery of the infant.


19 Section 99. Effective date. This Act takes effect January 
201, 2020.".