Bill Text: IL HB1479 | 2011-2012 | 97th General Assembly | Introduced

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Bill Title: Amends the Illinois Insurance Code to provide that accident and health insurance policies and managed care plans must provide coverage for intravenous feeding, prescription nutritional supplements, and hospital patient assessments. Makes corresponding changes in the State Employees Group Insurance Act of 1971, Counties Code, Illinois Municipal Code, School Code, Health Maintenance Organization Act, Voluntary Health Services Plans Act, and Illinois Public Aid Code. Amends the Emergency Medical Treatment Act to provide that every hospital licensed under the Hospital Licensing Act shall comply with the Hospital Emergency Service Act. Amends the Hospital Emergency Service Act to provide that every hospital required to be licensed by the Department of Public Health shall provide a hospital emergency service in accordance with rules and regulations adopted by the Department which shall be consistent with the federal Emergency Medical Treatment and Active Labor Act. Amends the Health Carrier External Review Act. Sets forth provisions concerning standard information for application forms; medical underwriting; the requirement to send to the applicant a copy of the health care service plan contract along with a notice; rescission and cancellation; postcontract investigation; and continuation. Makes changes in the provision concerning standard external review. Amends the Medical Patient Rights Act. Provides that each patient has a right to be informed of his or her inpatient or outpatient status. Provides that the statement of a hospital patient's rights shall include the right not to be discriminated against by the hospital and shall provide notice of how to initiate and lodge a grievance regarding improper discrimination. Sets forth provisions concerning discrimination grievance procedures and emergency room antidiscrimination notice. Amends the State Mandates Act to require implementation without reimbursement by the State. Effective immediately.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Failed) 2013-01-08 - Session Sine Die [HB1479 Detail]

Download: Illinois-2011-HB1479-Introduced.html

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97TH GENERAL ASSEMBLY State of Illinois 2011 and 2012 HB1479 Introduced , by Rep. Mary E. Flowers SYNOPSIS AS INTRODUCED:
See Index
Amends the Illinois Insurance Code to provide that accident and health insurance policies and managed care plans must provide coverage for intravenous feeding, prescription nutritional supplements, and hospital patient assessments. Makes corresponding changes in the State Employees Group Insurance Act of 1971, Counties Code, Illinois Municipal Code, School Code, Health Maintenance Organization Act, Voluntary Health Services Plans Act, and Illinois Public Aid Code. Amends the Emergency Medical Treatment Act to provide that every hospital licensed under the Hospital Licensing Act shall comply with the Hospital Emergency Service Act. Amends the Hospital Emergency Service Act to provide that every hospital required to be licensed by the Department of Public Health shall provide a hospital emergency service in accordance with rules and regulations adopted by the Department which shall be consistent with the federal Emergency Medical Treatment and Active Labor Act. Amends the Health Carrier External Review Act. Sets forth provisions concerning standard information for application forms; medical underwriting; the requirement to send to the applicant a copy of the health care service plan contract along with a notice; rescission and cancellation; postcontract investigation; and continuation. Makes changes in the provision concerning standard external review. Amends the Medical Patient Rights Act. Provides that each patient has a right to be informed of his or her inpatient or outpatient status. Provides that the statement of a hospital patient's rights shall include the right not to be discriminated against by the hospital and shall provide notice of how to initiate and lodge a grievance regarding improper discrimination. Sets forth provisions concerning discrimination grievance procedures and emergency room antidiscrimination notice. Amends the State Mandates Act to require implementation without reimbursement by the State. Effective immediately.
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A BILL FOR
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AN ACT concerning insurance.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The State Employees Group Insurance Act of 1971
is amended by changing Section 6.11 as follows:
(5 ILCS 375/6.11)
Sec. 6.11. Required health benefits; Illinois Insurance
Code requirements. The program of health benefits shall provide
the post-mastectomy care benefits required to be covered by a
policy of accident and health insurance under Section 356t of
the Illinois Insurance Code. The program of health benefits
shall provide the coverage required under Sections 356g,
356g.5, 356g.5-1, 356m, 356u, 356w, 356x, 356z.2, 356z.4,
356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
356z.14, 356z.15, and 356z.17, 356z.19, 356z.20, and 356z.21 of
the Illinois Insurance Code. The program of health benefits
must comply with Section 155.37 of the Illinois Insurance Code.
Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.

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(Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07;
95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-958, eff.
6-1-09; 95-978, eff. 1-1-09; 95-1005, eff. 12-12-08; 95-1044,
eff. 3-26-09; 95-1045, eff. 3-27-09; 95-1049, eff. 1-1-10;
96-139, eff. 1-1-10; 96-328, eff. 8-11-09; 96-639, eff. 1-1-10;
96-1000, eff. 7-2-10.)
Section 10. The Counties Code is amended by changing
Section 5-1069.3 as follows:
(55 ILCS 5/5-1069.3)
Sec. 5-1069.3. Required health benefits. If a county,
including a home rule county, is a self-insurer for purposes of
providing health insurance coverage for its employees, the
coverage shall include coverage for the post-mastectomy care
benefits required to be covered by a policy of accident and
health insurance under Section 356t and the coverage required
under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x,
356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
356z.14, and 356z.15, 356z.19, 356z.20, and 356z.21 of the
Illinois Insurance Code. The requirement that health benefits
be covered as provided in this Section is an exclusive power
and function of the State and is a denial and limitation under
Article VII, Section 6, subsection (h) of the Illinois
Constitution. A home rule county to which this Section applies
must comply with every provision of this Section.

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Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
(Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07;
95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-958, eff.
6-1-09; 95-978, eff. 1-1-09; 95-1005, eff. 12-12-08; 95-1045,
eff. 3-27-09; 95-1049, eff. 1-1-10; 96-139, eff. 1-1-10;
96-328, eff. 8-11-09; 96-1000, eff. 7-2-10.)
Section 15. The Illinois Municipal Code is amended by
changing Section 10-4-2.3 as follows:
(65 ILCS 5/10-4-2.3)
Sec. 10-4-2.3. Required health benefits. If a
municipality, including a home rule municipality, is a
self-insurer for purposes of providing health insurance
coverage for its employees, the coverage shall include coverage
for the post-mastectomy care benefits required to be covered by
a policy of accident and health insurance under Section 356t
and the coverage required under Sections 356g, 356g.5,
356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.10,
356z.11, 356z.12, 356z.13, 356z.14, and 356z.15 356z.19,
356z.20, and 356z.21 of the Illinois Insurance Code. The

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requirement that health benefits be covered as provided in this
is an exclusive power and function of the State and is a denial
and limitation under Article VII, Section 6, subsection (h) of
the Illinois Constitution. A home rule municipality to which
this Section applies must comply with every provision of this
Section.
Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
(Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07;
95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-958, eff.
6-1-09; 95-978, eff. 1-1-09; 95-1005, eff. 12-12-08; 95-1045,
eff. 3-27-09; 95-1049, eff. 1-1-10; 96-139, eff. 1-1-10;
96-328, eff. 8-11-09; 96-1000, eff. 7-2-10.)
Section 20. The School Code is amended by changing Section
10-22.3f as follows:
(105 ILCS 5/10-22.3f)
Sec. 10-22.3f. Required health benefits. Insurance
protection and benefits for employees shall provide the
post-mastectomy care benefits required to be covered by a
policy of accident and health insurance under Section 356t and

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the coverage required under Sections 356g, 356g.5, 356g.5-1,
356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.11, 356z.12,
356z.13, 356z.14, and 356z.15, 356z.19, and 356z.20 of the
Illinois Insurance Code.
Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
(Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07;
95-876, eff. 8-21-08; 95-958, eff. 6-1-09; 95-978, eff. 1-1-09;
95-1005, 12-12-08; 95-1045, eff. 3-27-09; 95-1049, eff.
1-1-10; 96-139, eff. 1-1-10; 96-328, eff. 8-11-09; 96-1000,
eff. 7-2-10.)
Section 25. The Emergency Medical Treatment Act is amended
by changing Section 1 as follows:
(210 ILCS 70/1) (from Ch. 111 1/2, par. 6151)
Sec. 1. No hospital, physician, dentist or other provider
of professional health care licensed under the laws of this
State may refuse to provide needed emergency treatment to any
person whose life would be threatened in the absence of such
treatment, because of that person's inability to pay therefor,
nor because of the source of any payment promised therefor.

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Every hospital licensed under the Hospital Licensing Act shall
comply with the Hospital Emergency Service Act.
(Source: P.A. 83-723.)
Section 30. The Hospital Emergency Service Act is amended
by changing Section 1 as follows:
(210 ILCS 80/1) (from Ch. 111 1/2, par. 86)
Sec. 1. Every hospital required to be licensed by the
Department of Public Health pursuant to the Hospital Licensing
Act which provides general medical and surgical hospital
services shall provide a hospital emergency service in
accordance with rules and regulations adopted by the Department
of Public Health which shall be consistent with the federal
Emergency Medical Treatment and Active Labor Act (42 U.S.C.
1395dd) and shall furnish such hospital emergency services to
any applicant who applies for the same in case of injury or
acute medical condition where the same is liable to cause death
or severe injury or serious illness. For purposes of this Act,
"applicant" includes any person who is brought to a hospital by
ambulance or specialized emergency medical services vehicle as
defined in the Emergency Medical Services (EMS) Systems Act.
(Source: P.A. 86-1461.)
Section 35. The Illinois Insurance Code is amended by
adding Sections 356z.19, 356z.20, and 356z.21 as follows:

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(215 ILCS 5/356z.19 new)
Sec. 356z.19. Intravenous feeding. A group or individual
policy of accident and health insurance or managed care plan
amended, delivered, issued, or renewed after the effective date
of this amendatory Act of the 97th General Assembly must
provide coverage for intravenous feeding. The benefits under
this Section shall be at least as favorable as for other
coverages under the policy and may be subject to the same
dollar amount limits, deductibles, and co-insurance
requirements applicable generally to other coverages under the
policy.
(215 ILCS 5/356z.20 new)
Sec. 356z.20. Prescription nutritional supplements. A
group or individual policy of accident and health insurance or
managed care plan amended, delivered, issued, or renewed after
the effective date of this amendatory Act of the 97th General
Assembly that provides coverage for prescription drugs must
provide coverage for reimbursement for medically appropriate
prescription nutritional supplements when ordered by a
physician licensed to practice medicine in all its branches and
the insured suffers from a condition that prevents him or her
from taking sufficient oral nourishment to sustain life.
(215 ILCS 5/356z.21 new)

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Sec. 356z.21. Hospital patient assessments. A group or
individual policy of accident and health insurance or managed
care plan amended, delivered, issued, or renewed after the
effective date of this amendatory Act of the 97th General
Assembly that provides coverage for hospital care shall include
in that coverage all services ordered by a physician and
provided in the hospital that are considered medically
necessary for the evaluation, assessment, and diagnosis of the
illness or condition that resulted in the hospital stay of the
enrollee or recipient. Such services are subject to reasonable
review and utilization standards required by the policy or plan
for all hospital services, as defined by the Department of
Insurance or its successor agency.
Section 40. The Health Maintenance Organization Act is
amended by changing Section 5-3 as follows:
(215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
Sec. 5-3. Insurance Code provisions.
(a) Health Maintenance Organizations shall be subject to
the provisions of Sections 133, 134, 137, 140, 141.1, 141.2,
141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5,
154.6, 154.7, 154.8, 155.04, 355.2, 356g.5-1, 356m, 356v, 356w,
356x, 356y, 356z.2, 356z.4, 356z.5, 356z.6, 356z.8, 356z.9,
356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17,
356z.18, 356z.19, 356z.20, 364.01, 367.2, 367.2-5, 367i, 368a,

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368b, 368c, 368d, 368e, 370c, 401, 401.1, 402, 403, 403A, 408,
408.2, 409, 412, 444, and 444.1, paragraph (c) of subsection
(2) of Section 367, and Articles IIA, VIII 1/2, XII, XII 1/2,
XIII, XIII 1/2, XXV, and XXVI of the Illinois Insurance Code.
(b) For purposes of the Illinois Insurance Code, except for
Sections 444 and 444.1 and Articles XIII and XIII 1/2, Health
Maintenance Organizations in the following categories are
deemed to be "domestic companies":
(1) a corporation authorized under the Dental Service
Plan Act or the Voluntary Health Services Plans Act;
(2) a corporation organized under the laws of this
State; or
(3) a corporation organized under the laws of another
state, 30% or more of the enrollees of which are residents
of this State, except a corporation subject to
substantially the same requirements in its state of
organization as is a "domestic company" under Article VIII
1/2 of the Illinois Insurance Code.
(c) In considering the merger, consolidation, or other
acquisition of control of a Health Maintenance Organization
pursuant to Article VIII 1/2 of the Illinois Insurance Code,
(1) the Director shall give primary consideration to
the continuation of benefits to enrollees and the financial
conditions of the acquired Health Maintenance Organization
after the merger, consolidation, or other acquisition of
control takes effect;

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(2)(i) the criteria specified in subsection (1)(b) of
Section 131.8 of the Illinois Insurance Code shall not
apply and (ii) the Director, in making his determination
with respect to the merger, consolidation, or other
acquisition of control, need not take into account the
effect on competition of the merger, consolidation, or
other acquisition of control;
(3) the Director shall have the power to require the
following information:
(A) certification by an independent actuary of the
adequacy of the reserves of the Health Maintenance
Organization sought to be acquired;
(B) pro forma financial statements reflecting the
combined balance sheets of the acquiring company and
the Health Maintenance Organization sought to be
acquired as of the end of the preceding year and as of
a date 90 days prior to the acquisition, as well as pro
forma financial statements reflecting projected
combined operation for a period of 2 years;
(C) a pro forma business plan detailing an
acquiring party's plans with respect to the operation
of the Health Maintenance Organization sought to be
acquired for a period of not less than 3 years; and
(D) such other information as the Director shall
require.
(d) The provisions of Article VIII 1/2 of the Illinois

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Insurance Code and this Section 5-3 shall apply to the sale by
any health maintenance organization of greater than 10% of its
enrollee population (including without limitation the health
maintenance organization's right, title, and interest in and to
its health care certificates).
(e) In considering any management contract or service
agreement subject to Section 141.1 of the Illinois Insurance
Code, the Director (i) shall, in addition to the criteria
specified in Section 141.2 of the Illinois Insurance Code, take
into account the effect of the management contract or service
agreement on the continuation of benefits to enrollees and the
financial condition of the health maintenance organization to
be managed or serviced, and (ii) need not take into account the
effect of the management contract or service agreement on
competition.
(f) Except for small employer groups as defined in the
Small Employer Rating, Renewability and Portability Health
Insurance Act and except for medicare supplement policies as
defined in Section 363 of the Illinois Insurance Code, a Health
Maintenance Organization may by contract agree with a group or
other enrollment unit to effect refunds or charge additional
premiums under the following terms and conditions:
(i) the amount of, and other terms and conditions with
respect to, the refund or additional premium are set forth
in the group or enrollment unit contract agreed in advance
of the period for which a refund is to be paid or

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additional premium is to be charged (which period shall not
be less than one year); and
(ii) the amount of the refund or additional premium
shall not exceed 20% of the Health Maintenance
Organization's profitable or unprofitable experience with
respect to the group or other enrollment unit for the
period (and, for purposes of a refund or additional
premium, the profitable or unprofitable experience shall
be calculated taking into account a pro rata share of the
Health Maintenance Organization's administrative and
marketing expenses, but shall not include any refund to be
made or additional premium to be paid pursuant to this
subsection (f)). The Health Maintenance Organization and
the group or enrollment unit may agree that the profitable
or unprofitable experience may be calculated taking into
account the refund period and the immediately preceding 2
plan years.
The Health Maintenance Organization shall include a
statement in the evidence of coverage issued to each enrollee
describing the possibility of a refund or additional premium,
and upon request of any group or enrollment unit, provide to
the group or enrollment unit a description of the method used
to calculate (1) the Health Maintenance Organization's
profitable experience with respect to the group or enrollment
unit and the resulting refund to the group or enrollment unit
or (2) the Health Maintenance Organization's unprofitable

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experience with respect to the group or enrollment unit and the
resulting additional premium to be paid by the group or
enrollment unit.
In no event shall the Illinois Health Maintenance
Organization Guaranty Association be liable to pay any
contractual obligation of an insolvent organization to pay any
refund authorized under this Section.
(g) Rulemaking authority to implement Public Act 95-1045,
if any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
(Source: P.A. 95-422, eff. 8-24-07; 95-520, eff. 8-28-07;
95-876, eff. 8-21-08; 95-958, eff. 6-1-09; 95-978, eff. 1-1-09;
95-1005, eff. 12-12-08; 95-1045, eff. 3-27-09; 95-1049, eff.
1-1-10; 96-328, eff. 8-11-09; 96-639, eff. 1-1-10; 96-833, eff.
6-1-10; 96-1000, eff. 7-2-10.)
Section 45. The Voluntary Health Services Plans Act is
amended by changing Section 10 as follows:
(215 ILCS 165/10) (from Ch. 32, par. 604)
Sec. 10. Application of Insurance Code provisions. Health
services plan corporations and all persons interested therein
or dealing therewith shall be subject to the provisions of

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Articles IIA and XII 1/2 and Sections 3.1, 133, 140, 143, 143c,
149, 155.37, 354, 355.2, 356g, 356g.5, 356g.5-1, 356r, 356t,
356u, 356v, 356w, 356x, 356y, 356z.1, 356z.2, 356z.4, 356z.5,
356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
356z.14, 356z.15, 356z.18, 356z.19, 356z.20, 364.01, 367.2,
368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412, and
paragraphs (7) and (15) of Section 367 of the Illinois
Insurance Code.
Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
(Source: P.A. 95-189, eff. 8-16-07; 95-331, eff. 8-21-07;
95-422, eff. 8-24-07; 95-520, eff. 8-28-07; 95-876, eff.
8-21-08; 95-958, eff. 6-1-09; 95-978, eff. 1-1-09; 95-1005,
eff. 12-12-08; 95-1045, eff. 3-27-09; 95-1049, eff. 1-1-10;
96-328, eff. 8-11-09; 96-833, eff. 6-1-10; 96-1000, eff.
7-2-10.)
Section 50. The Health Carrier External Review Act is
amended by changing Section 35 and by adding Sections 25.1,
25.2, 25.3, 25.4, 25.5, and 25.6 as follows:
(215 ILCS 180/25.1 new)

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Sec. 25.1. Standard information for application forms.
(a) The Director shall establish standard information and
health history questions that shall be used by all health care
service plans for their individual health care coverage
application forms for individual health plan contracts and
individual health insurance policies. The health care service
plan and health insurance application forms for individual
health plan contracts and health insurance policies may only
contain questions approved by the Director.
(b) The standard information and health history questions
developed by the Director shall contain clear and unambiguous
information and questions designed to ascertain the health
history of the applicant and shall be based on the medical
information that is reasonable and necessary for medical
underwriting purposes.
(c) The application form shall include a prominently
displayed notice that shall read: "Illinois law prohibits an
HIV test from being required or used by health care service
plans as a condition of obtaining coverage.".
(d) No later than 6 months after the adoption of the
regulation under subsection (a) of this Section, all individual
health care service plan application forms shall utilize only
the pool of approved questions and the standardized information
established pursuant to subsection (a).
(e) On and after January 1, 2011, all individual health
care service plan applications shall be reviewed and approved

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by the Director before they may be used by a health care
service plan.
(215 ILCS 180/25.2 new)
Sec. 25.2. Medical underwriting.
(a) "Medical underwriting" means the completion of a
reasonable investigation of the applicant's health history
information, which includes, but is not limited to, the
following:
(1) Ensuring that the information submitted on the
application form and the material submitted with the
application form are complete and accurate.
(2) Resolving all reasonable questions arising from
the application form or any materials submitted with the
application form or any information obtained by the health
care service plan as part of its verification of the
accuracy and completeness of the application form.
(b) A health care service plan shall complete medical
underwriting prior to issuing an enrollee or subscriber health
care service plan contract.
(c) A health care service plan shall adopt and implement
written medical underwriting policies and procedures to ensure
that the health care service plan does all of the following
with respect to an application for health care coverage:
(1) Reviews all of the following:
(A) Information on the application and any

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materials submitted with the application form for
accuracy and completeness.
(B) Claims information about the applicant that is
within the health care service plan's own claims
information.
(C) At least one commercially available
prescription drug database for information about the
applicant.
(2) Identifies and makes inquiries, including
contacting the applicant about any questions raised by
omissions, ambiguities, or inconsistencies based upon the
information collected pursuant to item (1) of this
subsection (c).
(d) The plan shall document all information collected
during the underwriting review process.
(e) On or before January 1, 2011, a health care service
plan shall file its medical underwriting policies and
procedures with the Department.
(215 ILCS 180/25.3 new)
Sec. 25.3. Copies of application and contract; notice.
(a) Within 10 business days after issuing a health care
service plan contract, the health care service plan shall send
a copy of the completed written application to the applicant
with a copy of the health care service plan contract issued by
the health care service plan, along with a notice that states

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all of the following:
(1) The applicant should review the completed
application carefully and notify the health care service
plan within 30 days of any inaccuracy in the application.
(2) Any intentional material misrepresentation or
intentional material omission in the information submitted
in the application may result in the cancellation or
rescission of the plan contract.
(3) The applicant should retain a copy of the completed
written application for the applicant's records.
(b) If new information is provided by the applicant within
the 30-day period permitted by subsection (a), then the
provisions concerning medical underwriting shall apply to the
new information.
(215 ILCS 180/25.4 new)
Sec. 25.4. Rescission; cancellation.
(a) Once a plan has issued an individual health care
service plan contract, the health care service plan shall not
rescind or cancel the health care service plan contract unless
all of the following apply:
(1) There was a material misrepresentation or material
omission in the information submitted by the applicant in
the written application to the health care service plan
prior to the issuance of the health care service plan
contract that would have prevented the contract from being

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entered into.
(2) The health care service plan completed medical
underwriting before issuing the plan contract.
(3) The health care service plan demonstrates that the
applicant intentionally misrepresented or intentionally
omitted material information on the application prior to
the issuance of the plan contract with the purpose of
misrepresenting his or her health history in order to
obtain health care coverage.
(4) The application form was approved by the
Department.
(5) The health care service plan sent a copy of the
completed written application to the applicant with a copy
of the health care service plan contract issued by the
health care service plan.
(b) Notwithstanding subsection (a) of this Section, an
enrollment or subscription may be canceled or not renewed for
failure to pay the fees for that coverage.
(215 ILCS 180/25.5 new)
Sec. 25.5. Postcontract investigation.
(a) If a health care service plan obtains information after
issuing an individual health care service plan contract that
the subscriber or enrollee may have intentionally omitted or
intentionally misrepresented material information during the
application for coverage process, then the health care service

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plan may investigate the potential omissions or
misrepresentations in order to determine whether the
subscriber's or enrollee's health care service plan contract
may be rescinded or canceled.
(b) The following provisions shall apply to a postcontract
issuance investigation:
(1) Upon initiating a postcontract issuance
investigation for potential rescission or cancellation of
health care coverage, the plan shall provide a written
notice to the enrollee or subscriber by regular and
certified mail that it has initiated an investigation of
intentional material misrepresentation or intentional
material omission on the part of the enrollee or subscriber
and that the investigation could lead to the rescission or
cancellation of the enrollee's or subscriber's health care
service plan contract. The notice shall be provided by the
health care service plan within 5 days of the initiation of
the investigation.
(2) The written notice required under item (1) of this
subsection (b) shall include full disclosure of the
allegedly intentional material omission or
misrepresentation and a clear and concise explanation of
why the information has resulted in the health care service
plan's initiation of an investigation to determine whether
rescission or cancellation is warranted. The notice shall
invite the enrollee or subscriber to provide any evidence

HB1479 - 21 - LRB097 06668 RPM 46754 b
or information within 45 business days to negate the plan's
reasons for initiating the postissuance investigation.
(3) The plan shall complete its investigation no later
than 90 days after the date that the notice is sent to the
enrollee or subscriber pursuant to item (1) of this
subsection (b).
(4) Upon completion of its postissuance investigation,
the plan shall provide written notice by regular and
certified mail to the subscriber or enrollee that it has
concluded its investigation and has made one of the
following determinations:
(A) The plan has determined that the enrollee or
subscriber did not intentionally misrepresent or
intentionally omit material information during the
application process and that the subscriber's or
enrollee's health care coverage will not be canceled or
rescinded.
(B) The plan intends to seek approval from the
Director to cancel or rescind the enrollee's or
subscriber's health care service plan contract for
intentional misrepresentation or intentional omission
of material information during the application for
coverage process.
(5) The written notice required under paragraph (B) of
item (4) of this subsection (b) shall do all of the
following:

HB1479 - 22 - LRB097 06668 RPM 46754 b
(A) Include full disclosure of the nature and
substance of any information that led to the plan's
determination that the enrollee or subscriber
intentionally misrepresented or intentionally omitted
material information on the application form.
(B) Provide the enrollee or subscriber with
information indicating that the health plan's
determination shall not become final until it is
reviewed and approved by the Department's independent
review process.
(C) Provide the enrollee or subscriber with
information regarding the Department's independent
review process and the right of the enrollee or
subscriber to opt out of that review process within 45
days of the date upon which an independent review
organization receives a request for independent
review.
(D) Provide a statement that the health care
service plan's proposed decision to cancel or rescind
the health care service plan contract shall not become
effective unless the Department's independent review
organization upholds the health care service plan' s
decision or unless the enrollee or subscriber has opted
out of the independent review.
(215 ILCS 180/25.6 new)

HB1479 - 23 - LRB097 06668 RPM 46754 b
Sec. 25.6. Continuation.
(a) A health care service plan shall continue to authorize
and provide all medically necessary health care services
required to be covered under an enrollee's or subscriber's
health care service plan contract until the effective date of
cancellation or rescission.
(b) The effective date of the health care service plan's
cancellation or the date upon which the plan may initiate a
rescission shall be no earlier than the date that the enrollee
or subscriber receives notification via regular and certified
mail that the independent review organization has made a
determination upholding the health care service plan's
decision to rescind or cancel.
(215 ILCS 180/35)
Sec. 35. Standard external review.
(a) Within 4 months after the date of receipt of a notice
of an adverse determination or final adverse determination, a
covered person or the covered person's authorized
representative may file a request for an external review with
the health carrier.
(b) Within 5 business days following the date of receipt of
the external review request, the health carrier shall complete
a preliminary review of the request to determine whether:
(1) the individual is or was a covered person in the
health benefit plan at the time the health care service was

HB1479 - 24 - LRB097 06668 RPM 46754 b
requested or at the time the health care service was
provided;
(2) the health care service that is the subject of the
adverse determination or the final adverse determination
is a covered service under the covered person's health
benefit plan, but the health carrier has determined that
the health care service is not covered because it does not
meet the health carrier's requirements for medical
necessity, appropriateness, health care setting, level of
care, or effectiveness;
(3) the covered person has exhausted the health
carrier's internal grievance process as set forth in this
Act;
(4) for appeals relating to a determination based on
treatment being experimental or investigational, the
requested health care service or treatment that is the
subject of the adverse determination or final adverse
determination is a covered benefit under the covered
person's health benefit plan except for the health
carrier's determination that the service or treatment is
experimental or investigational for a particular medical
condition and is not explicitly listed as an excluded
benefit under the covered person's health benefit plan with
the health carrier and that the covered person's health
care provider, who ordered or provided the services in
question and who is licensed under the Medical Practice Act

HB1479 - 25 - LRB097 06668 RPM 46754 b
of 1987, has certified that one of the following situations
is applicable:
(A) standard health care services or treatments
have not been effective in improving the condition of
the covered person;
(B) standard health care services or treatments
are not medically appropriate for the covered person;
(C) there is no available standard health care
service or treatment covered by the health carrier that
is more beneficial than the recommended or requested
health care service or treatment;
(D) the health care service or treatment is likely
to be more beneficial to the covered person, in the
health care provider's opinion, than any available
standard health care services or treatments; or
(E) that scientifically valid studies using
accepted protocols demonstrate that the health care
service or treatment requested is likely to be more
beneficial to the covered person than any available
standard health care services or treatments; and
(5) the covered person has provided all the information
and forms required to process an external review, as
specified in this Act.
(c) Within one business day after completion of the
preliminary review, the health carrier shall notify the covered
person and, if applicable, the covered person's authorized

HB1479 - 26 - LRB097 06668 RPM 46754 b
representative in writing whether the request is complete and
eligible for external review. If the request:
(1) is not complete, the health carrier shall inform
the covered person and, if applicable, the covered person's
authorized representative in writing and include in the
notice what information or materials are required by this
Act to make the request complete; or
(2) is not eligible for external review, the health
carrier shall inform the covered person and, if applicable,
the covered person's authorized representative in writing
and include in the notice the reasons for its
ineligibility.
The notice of initial determination of ineligibility shall
include a statement informing the covered person and, if
applicable, the covered person's authorized representative
that a health carrier's initial determination that the external
review request is ineligible for review may be appealed to the
Director by filing a complaint with the Director.
Notwithstanding a health carrier's initial determination
that the request is ineligible for external review, the
Director may determine that a request is eligible for external
review and require that it be referred for external review. In
making such determination, the Director's decision shall be in
accordance with the terms of the covered person's health
benefit plan and shall be subject to all applicable provisions
of this Act.

HB1479 - 27 - LRB097 06668 RPM 46754 b
(d) Whenever a request is eligible for external review the
health carrier shall, within 5 business days:
(1) assign an independent review organization from the
list of approved independent review organizations compiled
and maintained by the Director; and
(2) notify in writing the covered person and, if
applicable, the covered person's authorized representative
of the request's eligibility and acceptance for external
review and the name of the independent review organization.
The health carrier shall include in the notice provided to
the covered person and, if applicable, the covered person's
authorized representative a statement that the covered person
or the covered person's authorized representative may, within 5
business days following the date of receipt of the notice
provided pursuant to item (2) of this subsection (d), submit in
writing to the assigned independent review organization
additional information that the independent review
organization shall consider when conducting the external
review. The independent review organization is not required to,
but may, accept and consider additional information submitted
after 5 business days.
(e) The assignment of an approved independent review
organization to conduct an external review in accordance with
this Section shall be made from those approved independent
review organizations qualified to conduct external review as
required by Sections 50 and 55 of this Act.

HB1479 - 28 - LRB097 06668 RPM 46754 b
(f) Upon assignment of an independent review organization,
the health carrier or its designee utilization review
organization shall, within 5 business days, provide to the
assigned independent review organization the documents and any
information considered in making the adverse determination or
final adverse determination; in such cases, the following
provisions shall apply:
(1) Except as provided in item (2) of this subsection
(f), failure by the health carrier or its utilization
review organization to provide the documents and
information within the specified time frame shall not delay
the conduct of the external review.
(2) If the health carrier or its utilization review
organization fails to provide the documents and
information within the specified time frame, the assigned
independent review organization may terminate the external
review and make a decision to reverse the adverse
determination or final adverse determination.
(3) Within one business day after making the decision
to terminate the external review and make a decision to
reverse the adverse determination or final adverse
determination under item (2) of this subsection (f), the
independent review organization shall notify the health
carrier, the covered person and, if applicable, the covered
person's authorized representative, of its decision to
reverse the adverse determination.

HB1479 - 29 - LRB097 06668 RPM 46754 b
(g) Upon receipt of the information from the health carrier
or its utilization review organization, the assigned
independent review organization shall review all of the
information and documents and any other information submitted
in writing to the independent review organization by the
covered person and the covered person's authorized
representative.
(h) Upon receipt of any information submitted by the
covered person or the covered person's authorized
representative, the independent review organization shall
forward the information to the health carrier within 1 business
day.
(1) Upon receipt of the information, if any, the health
carrier may reconsider its adverse determination or final
adverse determination that is the subject of the external
review.
(2) Reconsideration by the health carrier of its
adverse determination or final adverse determination shall
not delay or terminate the external review.
(3) The external review may only be terminated if the
health carrier decides, upon completion of its
reconsideration, to reverse its adverse determination or
final adverse determination and provide coverage or
payment for the health care service that is the subject of
the adverse determination or final adverse determination.
In such cases, the following provisions shall apply:

HB1479 - 30 - LRB097 06668 RPM 46754 b
(A) Within one business day after making the
decision to reverse its adverse determination or final
adverse determination, the health carrier shall notify
the covered person and if applicable, the covered
person's authorized representative, and the assigned
independent review organization in writing of its
decision.
(B) Upon notice from the health carrier that the
health carrier has made a decision to reverse its
adverse determination or final adverse determination,
the assigned independent review organization shall
terminate the external review.
(i) In addition to the documents and information provided
by the health carrier or its utilization review organization
and the covered person and the covered person's authorized
representative, if any, the independent review organization,
to the extent the information or documents are available and
the independent review organization considers them
appropriate, shall consider the following in reaching a
decision:
(1) the covered person's pertinent medical records;
(2) the covered person's health care provider's
recommendation;
(3) consulting reports from appropriate health care
providers and other documents submitted by the health
carrier, the covered person, the covered person's

HB1479 - 31 - LRB097 06668 RPM 46754 b
authorized representative, or the covered person's
treating provider;
(4) the terms of coverage under the covered person's
health benefit plan with the health carrier to ensure that
the independent review organization's decision is not
contrary to the terms of coverage under the covered
person's health benefit plan with the health carrier;
(5) the most appropriate practice guidelines, which
shall include applicable evidence-based standards and may
include any other practice guidelines developed by the
federal government, national or professional medical
societies, boards, and associations;
(6) any applicable clinical review criteria developed
and used by the health carrier or its designee utilization
review organization; and
(7) the opinion of the independent review
organization's clinical reviewer or reviewers after
considering items (1) through (6) of this subsection (i) to
the extent the information or documents are available and
the clinical reviewer or reviewers considers the
information or documents appropriate; and
(8) for a denial of coverage based on a determination
that the health care service or treatment recommended or
requested is experimental or investigational, whether and
to what extent:
(A) the recommended or requested health care

HB1479 - 32 - LRB097 06668 RPM 46754 b
service or treatment has been approved by the federal
Food and Drug Administration, if applicable, for the
condition;
(B) medical or scientific evidence or
evidence-based standards demonstrate that the expected
benefits of the recommended or requested health care
service or treatment is more likely than not to be
beneficial to the covered person than any available
standard health care service or treatment and the
adverse risks of the recommended or requested health
care service or treatment would not be substantially
increased over those of available standard health care
services or treatments; or
(C) the terms of coverage under the covered
person's health benefit plan with the health carrier to
ensure that the health care service or treatment that
is the subject of the opinion is experimental or
investigational would otherwise be covered under the
terms of coverage of the covered person's health
benefit plan with the health carrier.
(j) Within 5 days after the date of receipt of all
necessary information, the assigned independent review
organization shall provide written notice of its decision to
uphold or reverse the adverse determination or the final
adverse determination to the health carrier, the covered person
and, if applicable, the covered person's authorized

HB1479 - 33 - LRB097 06668 RPM 46754 b
representative. In reaching a decision, the assigned
independent review organization is not bound by any claim
determinations reached prior to the submission of information
to the independent review organization. The assigned
independent review organization shall independently determine
if the health care services under review are the medically
necessary health care services that a physician, exercising
prudent clinical judgment, would provide to a patient for the
purpose of preventing, evaluating, diagnosing, or treating an
illness, injury, disease, or its symptoms and are: (i) in
accordance with generally accepted standards of medical
practice; (ii) clinically appropriate, in terms of type,
frequency, extent, site, and duration and considered effective
for the patient's illness, injury, or disease; and (iii) not
primarily for the convenience of the patient, physician, or
other health care provider. For the purposes of this subsection
(j), "generally accepted standards of medical practice" means
standards that are based on credible scientific evidence
published in peer-reviewed medical literature generally
recognized by the relevant medical community, physician
specialty society recommendations, and the views of physicians
practicing in relevant clinical areas and any other relevant
factors. In such cases, the following provisions shall apply:
(1) The independent review organization shall include
in the notice:
(A) a general description of the reason for the

HB1479 - 34 - LRB097 06668 RPM 46754 b
request for external review;
(B) the date the independent review organization
received the assignment from the health carrier to
conduct the external review;
(C) the time period during which the external
review was conducted;
(D) references to the evidence or documentation,
including the evidence-based standards, considered in
reaching its decision;
(E) the date of its decision; and
(F) the principal reason or reasons for its
decision, including what applicable, if any,
evidence-based standards that were a basis for its
decision.
(2) For reviews of experimental or investigational
treatments, the notice shall include the following
information:
(A) a description of the covered person's medical
condition;
(B) a description of the indicators relevant to
whether there is sufficient evidence to demonstrate
that the recommended or requested health care service
or treatment is more likely than not to be more
beneficial to the covered person than any available
standard health care services or treatments and the
adverse risks of the recommended or requested health

HB1479 - 35 - LRB097 06668 RPM 46754 b
care service or treatment would not be substantially
increased over those of available standard health care
services or treatments;
(C) a description and analysis of any medical or
scientific evidence considered in reaching the
opinion;
(D) a description and analysis of any
evidence-based standards;
(E) whether the recommended or requested health
care service or treatment has been approved by the
federal Food and Drug Administration, for the
condition;
(F) whether medical or scientific evidence or
evidence-based standards demonstrate that the expected
benefits of the recommended or requested health care
service or treatment is more likely than not to be more
beneficial to the covered person than any available
standard health care service or treatment and the
adverse risks of the recommended or requested health
care service or treatment would not be substantially
increased over those of available standard health care
services or treatments; and
(G) the written opinion of the clinical reviewer,
including the reviewer's recommendation as to whether
the recommended or requested health care service or
treatment should be covered and the rationale for the

HB1479 - 36 - LRB097 06668 RPM 46754 b
reviewer's recommendation.
(3) In reaching a decision, the assigned independent
review organization is not bound by any decisions or
conclusions reached during the health carrier's
utilization review process or the health carrier's
internal grievance or appeals process.
(4) Upon receipt of a notice of a decision reversing
the adverse determination or final adverse determination,
the health carrier immediately shall approve the coverage
that was the subject of the adverse determination or final
adverse determination.
(Source: P.A. 96-857, eff. 7-1-10; 96-967, eff. 1-1-11.)
Section 55. The Illinois Public Aid Code is amended by
changing Section 5-16.8 as follows:
(305 ILCS 5/5-16.8)
Sec. 5-16.8. Required health benefits. The medical
assistance program shall (i) provide the post-mastectomy care
benefits required to be covered by a policy of accident and
health insurance under Section 356t and the coverage required
under Sections 356g.5, 356u, 356w, 356x, and 356z.6, and
356z.21 of the Illinois Insurance Code and (ii) be subject to
the provisions of Section 364.01 of the Illinois Insurance
Code.
(Source: P.A. 95-189, eff. 8-16-07; 95-331, eff. 8-21-07.)

HB1479 - 37 - LRB097 06668 RPM 46754 b
Section 60. The Medical Patient Rights Act is amended by
changing Sections 2.04, 3, and 5 and adding Sections 2.06, 5.1,
and 5.2 as follows:
(410 ILCS 50/2.04) (from Ch. 111 1/2, par. 5402.04)
Sec. 2.04. "Insurance company" means (1) an insurance
company, fraternal benefit society, and any other insurer
subject to regulation under the Illinois Insurance Code; or (2)
a health maintenance organization, a limited health service
organization under the Limited Health Service Organization
Act, or a voluntary health services plan under the Voluntary
Health Services Plans Act.
(Source: P.A. 85-677; 85-679.)
(410 ILCS 50/2.06 new)
Sec. 2.06. Health insurance policy or health care plan.
"Health insurance policy or health care plan" means any policy
of health or accident insurance provided by a health insurance
company or under the Counties Code, the Municipal Code, the
State Employees Group Insurance Act or Medical Assistance
provided under the Public Aid Code.
(410 ILCS 50/3) (from Ch. 111 1/2, par. 5403)
Sec. 3. The following rights are hereby established:
(a) The right of each patient to care consistent with sound

HB1479 - 38 - LRB097 06668 RPM 46754 b
nursing and medical practices, to be informed of the name of
the physician responsible for coordinating his or her care, to
receive information concerning his or her condition and
proposed treatment, to refuse any treatment to the extent
permitted by law, and to privacy and confidentiality of records
except as otherwise provided by law. Each patient has a right
to be informed of his or her inpatient or outpatient status
while undergoing evaluation, assessment, diagnosis, treatment,
or observation in a hospital. The patient must be informed of
this status and put on notice that this admission status may
affect coverage by his or her health insurance policy or health
care plan or his or her personal responsibility for payment.
(b) The right of each patient, regardless of source of
payment, to examine and receive a reasonable explanation of his
total bill for services rendered by his physician or health
care provider, including the itemized charges for specific
services received. Each physician or health care provider shall
be responsible only for a reasonable explanation of those
specific services provided by such physician or health care
provider.
(c) In the event an insurance company or health services
corporation cancels or refuses to renew an individual policy or
plan, the insured patient shall be entitled to timely, prior
notice of the termination of such policy or plan.
An insurance company or health services corporation that
requires any insured patient or applicant for new or continued

HB1479 - 39 - LRB097 06668 RPM 46754 b
insurance or coverage to be tested for infection with human
immunodeficiency virus (HIV) or any other identified causative
agent of acquired immunodeficiency syndrome (AIDS) shall (1)
give the patient or applicant prior written notice of such
requirement, (2) proceed with such testing only upon the
written authorization of the applicant or patient, and (3) keep
the results of such testing confidential. Notice of an adverse
underwriting or coverage decision may be given to any
appropriately interested party, but the insurer may only
disclose the test result itself to a physician designated by
the applicant or patient, and any such disclosure shall be in a
manner that assures confidentiality.
The Department of Insurance shall enforce the provisions of
this subsection.
(d) The right of each patient to privacy and
confidentiality in health care. Each physician, health care
provider, health services corporation and insurance company
shall refrain from disclosing the nature or details of services
provided to patients, except that such information may be
disclosed to the patient, the party making treatment decisions
if the patient is incapable of making decisions regarding the
health services provided, those parties directly involved with
providing treatment to the patient or processing the payment
for that treatment, those parties responsible for peer review,
utilization review and quality assurance, and those parties
required to be notified under the Abused and Neglected Child

HB1479 - 40 - LRB097 06668 RPM 46754 b
Reporting Act, the Illinois Sexually Transmissible Disease
Control Act or where otherwise authorized or required by law.
This right may be waived in writing by the patient or the
patient's guardian, but a physician or other health care
provider may not condition the provision of services on the
patient's or guardian's agreement to sign such a waiver.
(Source: P.A. 86-895; 86-902; 86-1028; 87-334.)
(410 ILCS 50/5)
Sec. 5. Statement of hospital patient's rights.
(a) Each patient admitted to a hospital, and the guardian
or authorized representative or parent of a minor patient,
shall be given a written statement of all the rights enumerated
in this Act, or a similar statement of patients' rights
required of the hospital by the Joint Commission on
Accreditation of Healthcare Organizations or a similar
accrediting organization. The statement shall be given at the
time of admission or as soon thereafter as the condition of the
patient permits.
(b) If a patient is unable to read the written statement, a
hospital shall make a reasonable effort to provide it to the
guardian or authorized representative of the patient.
(c) The statement shall also include the right not to be
discriminated against by the hospital due to the patient's
race, color, or national origin where such characteristics are
not relevant to the patient's medical diagnosis and treatment.

HB1479 - 41 - LRB097 06668 RPM 46754 b
The statement shall further provide each admitted patient or
the patient's representative or guardian with notice of how to
initiate a grievance regarding improper discrimination with
the hospital and how the patient may lodge a grievance with the
Illinois Department of Public Health regardless of whether the
patient has first used the hospital's grievance process.
(Source: P.A. 88-56; 88-670, eff. 12-2-94.)
(410 ILCS 50/5.1 new)
Sec. 5.1. Discrimination grievance procedures. Upon
receipt of a grievance alleging unlawful discrimination on the
basis of race, color, or national origin, the hospital must
investigate the claim and work with the patient to address
valid or proven concerns in accordance with the hospital's
grievance process. At the conclusion of the hospital's
grievance process, the hospital shall inform the patient that
such grievances may be reported to the Illinois Department of
Public Health if not resolved to the patient's satisfaction at
the hospital level.
(410 ILCS 50/5.2 new)
Sec. 5.2. Emergency room antidiscrimination notice. Every
hospital shall post a sign next to or in close proximity of its
sign required by Section 489.20 (q)(1) of Title 42 of the Code
of Federal Regulations stating the following:
"You have the right not to be discriminated against by the

HB1479 - 42 - LRB097 06668 RPM 46754 b
hospital due to your race, color, or national origin if these
characteristics are unrelated to your diagnosis or treatment.
If you believe this right has been violated, please call
(insert number for hospital grievance officer).".
Section 90. The State Mandates Act is amended by adding
Section 8.35 as follows:
(30 ILCS 805/8.35 new)
Sec. 8.35. Exempt mandate. Notwithstanding Sections 6 and 8
of this Act, no reimbursement by the State is required for the
implementation of any mandate created by this amendatory Act of
the 97th General Assembly.
Section 99. Effective date. This Act takes effect upon
becoming law.
HB1479 - 43 - LRB097 06668 RPM 46754 b
INDEX
Statutes amended in order of appearance
5 ILCS 375/6.11
55 ILCS 5/5-1069.3
65 ILCS 5/10-4-2.3
105 ILCS 5/10-22.3f
210 ILCS 70/1 from Ch. 111 1/2, par. 6151
210 ILCS 80/1 from Ch. 111 1/2, par. 86
215 ILCS 5/356z.19 new
215 ILCS 5/356z.20 new
215 ILCS 5/356z.21 new
215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2
215 ILCS 165/10 from Ch. 32, par. 604
215 ILCS 180/25.1 new
215 ILCS 180/25.2 new
215 ILCS 180/25.3 new
215 ILCS 180/25.4 new
215 ILCS 180/25.5 new
215 ILCS 180/25.6 new
215 ILCS 180/35
305 ILCS 5/5-16.8
410 ILCS 50/2.04 from Ch. 111 1/2, par. 5402.04
410 ILCS 50/2.06 new
410 ILCS 50/3 from Ch. 111 1/2, par. 5403
410 ILCS 50/5
HB1479 - 44 - LRB097 06668 RPM 46754 b