Aaron Winters | Executive Director, Healthcare Council | 847-334-6411
Good morning Healthcare Council. The House is in session tomorrow, and the Senate is off this week. The budget address has been issued, and appropriations hearings have already begun. On to the update!
Health Insurance Tax Included In Pritzker's Budget
Last Wednesday Gov. JB Pritzker
his first budget, which included a variety of proposed tax increases to balance the more than $3 billion budget hole. Of particular note was what the administration is billing as a "Managed Care Organization Assessment" that would generate nearly $400 million in new revenue. Details were spotty last week regarding how the tax would be structured, other than it would be set up as a per-member per-month assessment similar to what other states have implemented. The budget book did highlight Majority Leader Greg Harris' HB272 as an alternative which would implement a 1 percent health insurance claims assessment as an alternative approach, although states have moved away from claims assessments in favor of PMPM taxes, like what has occurred in Michigan. This tax was among a variety of taxes proposed (although this was one of the biggest revenue raisers). Other taxes include the revenues from legalizing marijuana, taxing e-cigarettes, a plastic bag tax and a variety of other taxes and reductions to corporate tax structures.
Other new budget healthcare items:
- $6 million for new lead screening cases
- $20.6 million for a new 200-bed Chicago Veterans' Home
- $3.2 million for behavioral health to implement the Section 1115 Behavioral Health Waiver
- $2 million in grants to assist with Department of Aging dementia and Alzheimer's efforts
Committees Posted for the Week
Only the House is in session this week. As always, if you are supporting or opposing any legislation, please let us know.
House Insurance Committee
Feb 26, 2019
Room 118 Capitol Building
- Morgan - Creates the Freedom from Aggressive Insurance Increases Review Act. Creates the independent, quasi-judicial Health Insurance Rate Review Board that has discretion to determine if rates are "excessive." The Chamber is opposed - competition is the best way to keep health care costs low.
- Swanson - Amends the Illinois Insurance Code. Requires an individual or group policy of accident and health insurance or managed care plan to provide coverage for long-term antibiotic therapy for a person with a tick-borne disease. The Chamber is opposed - long-term antibiotic use is considered experimental.
- DeLuca - Amends the Illinois Insurance Code in an Article concerning accident and health insurance. Excludes certain supplemental lines of business from general health insurance mandate requirements. Chamber supports.
- Wehrli - Amends the Short-Term, Limited-Duration Health Insurance Coverage Act. Provides that a short-term, limited-duration health insurance coverage policy must have an expiration date that is less than 366 days (rather than 181 days) and may be renewed or extended (rather than prohibiting a policy to be renewable or extendable within a period of 365 days after the individual's coverage under the policy ends). The intent of the legislation is to realign Illinois short-term policy regulation with federal rules.
- Conroy - Amends the Illinois Insurance Code. Requires the Department of Insurance to develop a uniform electronic prior authorization form to be used by an insurer that provides prescription drug benefits when requiring prior authorization.
- Hoffman - Amends the Illinois Insurance Code. Provides that neither a group health plan nor an accident and health insurer offering group or individual health insurance coverage shall discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider's license or certification under applicable State law. This is an initiative of the Illinois Chiropractors. The Chamber is opposed.
- Hoffman - Amends the Illinois Insurance Guaranty Fund Article of the Illinois Insurance Code. Provides that a "covered claim" does not include a claim for fines and penalties paid to government authorities. Provides that the board of directors of the Illinois Insurance Guaranty Fund has the authority to assess to pay off a loan necessary to pay covered claims.
- Manley - Amends the Genetic Information Privacy Act. Provides that long-term care and life insurance policies are among those for which an insurer may not seek information derived from genetic testing. Removes language specifying that a provision prohibiting an insurer from using or disclosing protected health information that is genetic information for underwriting purposes does not apply to insurers issuing long-term care policies. The Chamber is opposed.
Consumer Protection Committee
Feb 26, 2019
Room 122B Capitol Building
- Gong-Gershowitz - Creates the Drug and Sharps Waste Stewardship Act. Directs the Environmental Protection Agency to administer a drug and sharps waste stewardship program. Provides that the State Board of Pharmacy is to guide and advise the Agency in its administration of the program. Requires covered entities to provide lists of covered and not covered products to the State Board and to implement stewardship plans. Requires stewardship plans to be submitted to the Agency for review and acceptance. Requires that all counties have at least one collection site for unused drugs and sharps per 50,000 people, and no fewer than 5 such collection sites. Requires counties that do not have the necessary number of collection sites to establish a mail-back program, or alternative collection program for covered products, or both. Imposes an administrative fee on covered entities. Provides penalties for covered entities that fail to comply with the provisions of the Act. Creates the Drug and Sharps Stewardship Fund and the Drug and Sharps Stewardship Penalty Account within the Fund. Directs the Agency to post lists of compliant covered entities on its website. Exempts stewardship programs already in existence under local ordinances at the time the Act takes effect from the Act's provisions, but provides that those entities with programs that are not within the Act's purview are not to receive any monetary support from the Drug and Sharps Stewardship Fund or the Drug and Sharps Stewardship Penalty Account. Exempts confidential proprietary information from public disclosure by the Agency.
Human Services Committee
Feb 27, 2019
Room C-1 Stratton Building
- Flowers - Amends the Illinois Public Aid Code. Provides that a redetermination of eligibility for medical assistance benefits shall be conducted once every 12 months. Effective January 1, 2020.
- Amends the Community-Integrated Living Arrangements Licensure and Certification Act. Provides that licenses for community mental health or developmental services agencies are valid for one year (rather than 3 years). Provides that an agency licensed under the Act or a community-integrated living arrangement certified by an agency must maintain for public inspection copies of investigative reports and surveys conducted by the Department of Human Services. Provides that the Department must prepare a quarterly report detailing violations of the Act by an agency licensed under the Act or a community-integrated living arrangement certified by an agency and must publish the report on its website.
- Bailey - Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Requires the Department of Public Health to create and maintain a list of each immunizing agent derived from aborted fetal tissue and any alternative immunizing agents. Provides that the Department shall ensure that, before administering an immunizing agent derived from aborted fetal tissue to an individual, a health care provider shall provide to the individual or, if the individual is a child, to the parent, guardian, or person in loco parentis of the child: (1) notification that the immunizing agent was derived from aborted fetal tissue; (2) if an immunizing agent that is not an immunizing agent derived from aborted fetal tissue is available as an alternative to an immunizing agent derived from aborted fetal tissue, an offer of the alternative; and (3) notification of the option to decline the receipt of the immunizing agent. Effective immediately.
- Bennett - Creates the Authorized Electronic Monitoring in Community-Integrated Living Arrangements and Developmental Disability Facilities Act. Provides that under certain conditions, a resident of a living arrangement certified under the Community-Integrated Living Arrangements Licensure and Certification Act and a resident of a developmental disability facility shall be permitted to use an audio and video surveillance system in his or her room at his or her own expense.
- Jones - Amends the Illinois Health Facilities Planning Act. Creates the South Suburban Trauma Center Fund as a special fund in the State treasury. Provides for the deposit and use of moneys in the fund. Provides for duties of the Health Facilities and Services Review Board regarding a south suburban trauma center. Amends the Toll Highway Act. Provides for the use of specified toll revenue. Amends the State Finance Act to provide for the South Suburban Trauma Center Fund. Effective immediately.
- McSweeney - Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires managed care organizations (MCOs) to publish, at least quarterly for the preceding quarter, on their websites: (1) the total number of claims received by the MCO; (2) the number and monetary amount of claims payments made to a service provider; (3) the dates of services rendered for the claims payments made under item (2); (4) the dates the claims were received by the MCO for the claims payments made under item (2); and (5) the dates on which claims payments under item (2) were released. Effective July 1, 2019.
- Hurley - Amends the Emergency Medical Services (EMS) Systems Act. Provides that covered vehicle service provider personnel who treat and either release or transport to a health care facility an individual experiencing a suspected or an actual opioid overdose shall document in the patient's care report the date and time of the overdose, the location in latitude and longitude where the overdose victim was initially encountered, whether one or more doses of an opioid overdose reversal drug was administered, and whether the overdose was fatal or nonfatal when the overdose victim was initially encountered and during the transportation of the victim to a health care facility.
- Lilly - Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services shall not require any person committed to the custody of the Department of Corrections who is eligible for medical assistance to pay a fee as a co-payment for services.
- Evans - NCI DESIGNATION-SUPPORT
- Evans - URGE CREATION OF CANCER CAUCUS
Judiciary - Civil Committee
Feb 27, 2019
Room D-1 Stratton Building
Flowers - Creates the Medical Device Safety Act. Provides that (i) all medical devices to be used by, surgically applied to, or surgically implanted within a patient be under warranty, regardless of the severity of the patient's medical condition necessitating the device, (ii) all persons and entities that produce, sell, offer for sale, or provide medical devices to be used by, surgically applied to, or surgically implanted within a patient are liable for all costs to the patient for the replacement of each medical device if the medical device malfunctions due to no fault of the patient, and (iii) all hospitals and ambulatory surgical treatment centers shall waive the costs charged to patients for follow-up surgeries that result from defective medical devices, regardless of whether or not those defective medical devices are capable of being implanted. Amends the University of Illinois Hospital Act, the Ambulatory Surgical Treatment Center Act, and the Hospital Licensing Act. Requires that the University of Illinois Hospital, all ambulatory surgical treatment centers, and all hospitals licensed under the Hospital Licensing Act waive the costs charged to patients for follow-up surgeries that result from previous surgical errors. Effective immediately.
Health Care Licenses Committee
Feb 27, 2019
Room 122B Capitol Building
Sponsor ABR - Short Description Last Action
- Flowers - Amends the Pharmacy Practice Act. Requires that at least one registered pharmacy technician be on duty whenever the practice of pharmacy is conducted. Requires that pharmacies fill no more than 10 prescriptions per hour. Requires 10 pharmacy technician hours per 100 prescriptions filled. Prohibits pharmacies from requiring pharmacists to participate in advertising or soliciting activities that may jeopardize patient health, safety, or welfare and any activities or external factors that interfere with the pharmacist's ability to provide appropriate professional services. Provides that a pharmacist shall receive specified break periods.
- Flowers - Amends the Illinois Insurance Code, the Pharmacy Practice Act, and the Wholesale Drug Distribution Licensing Act. Prohibits the licensure, transference, use, or sale of any records relative to prescription information containing patient-identifiable or prescriber-identifiable data by any licensee or registrant of the Acts for commercial purposes.
- Amends the Pharmacy Practice Act. Requires that at least one registered pharmacy technician be on duty whenever the practice of pharmacy is conducted. Requires that pharmacies fill no more than 10 prescriptions per hour. Requires 10 pharmacy technician hours per 100 prescriptions filled. Prohibits pharmacies from requiring pharmacists to participate in advertising or soliciting activities that may jeopardize patient health, safety, or welfare and any activities or external factors that interfere with the pharmacist's ability to provide appropriate professional services. Provides that a pharmacist shall receive specified break periods.
- Flowers - Amends the Medical Practice Act of 1987. Removes provisions prohibiting the Department of Financial and Professional Regulation from disciplining a physician for experimental treatments for Lyme disease or other tick-borne diseases.
- Willis - Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Requires the Department of Public Health to ensure that those who draw blood from children and adults with intellectual and developmental disabilities are trained, at least once every 3 years, in the most current method of drawing blood from children and adults with developmental and intellectual disabilities.
- Mussman - Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Provides that the Director of Public Health, if a physician licensed to practice medicine in all its branches in Illinois, shall establish a standing order complete with the issuance of a prescription for a hormonal contraceptive in accordance with the requirements of the provisions. Provides that if the Director is not a physician licensed to practice medicine in all its branches in Illinois, the Medical Director of the Department of Public Health shall establish the standing order. Amends the Illinois Insurance Code. Requires a group or individual policy of accident and health insurance or managed care plan to provide coverage for patient care services provided by a pharmacist. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, and the School Code. Amends the Pharmacy Practice Act. Provides that the definition of "practice of pharmacy" includes the dispensing of hormonal contraceptives pursuant to the standing order under provisions of the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Amends the Illinois Public Aid Code. Requires the medical assistance program to cover patient care services provided by a pharmacist for hormonal contraceptives assessment and consultation. Effective January 1, 2020.
- Greenwood - Amends the Departments of State Government Law. Provides that expedited temporary occupational or professional licenses issued to service members and the spouses of service members meeting specified requirements shall be valid for 3 years (currently, valid 6 months) after the date of issuance or until a license is granted or a notice to deny a license is issued in accordance with rules adopted by the department issuing the license, whichever occurs first. Provides that the required fee paid in the application process for an expedited temporary occupational or professional license issued to service members and the spouses of service members shall be refundable (currently, not refundable).
Prescription Drug Affordability & Accessibility Committee
Feb 27, 2019
Room 114 Capitol Building
SUBJECT MATTER: Public Opinion and Policy Overview.
- Flowers - Amends the Illinois Food, Drug and Cosmetic Act. Requires manufacturers of brand name or generic prescription drugs to notify State purchasers, health insurers, health care service plan providers, pharmacy benefit managers, and the General Assembly of specified increases in drug prices at least 60 days before such increase and the cost of specified new prescription drugs within 3 days after approval by the U.S. Food and Drug Administration. Provides that within 30 days after such notifications, prescription drug manufacturers shall report specified information to State purchasers, health insurers, health care service plan providers, pharmacy benefit managers, and the General Assembly. Provides that failure to report such information shall result in a specified civil penalty. Requires the General Assembly to conduct an annual public hearing on aggregate trends in prescription drug pricing. Provides that if the manufacturer of a prescription drug or its agent meets or otherwise communicates with a prescriber for the purpose of marketing a drug, then the manufacturer or its agent shall disclose to the prescriber if any ingredient in the drug it is marketing is known to pose a risk of dependency in humans. The Chamber is opposed.
- Creates the Prescription Drug Pricing Transparency Act. Requires health insurers to disclose certain rate and spending information concerning prescription drugs and certain prescription drug pricing information to the Department of Public Health. Requires the Department and health insurers to create annual lists of prescription drugs on which the State spends significant health care dollars and for which costs have increased at a certain rate over time. Requires the Department and health insurers to provide their lists to the Attorney General. Requires prescription drug manufacturers to notify the Attorney General if they are introducing a new prescription drug at a wholesale acquisition cost that exceeds the threshold set for a specialty drug under the Medicare Part D program. Amends the Illinois Insurance Code. Requires a group or individual policy of accident and health insurance that provides coverage for prescription drugs to apply the same cost-sharing requirements to interchangeable biological products as apply to generic drugs under the policy. Amends the Pharmacy Practice Act. Provides that when a pharmacist receives a prescription for a biological product, the pharmacist shall select the lowest priced interchangeable biological product (rather than allowing a pharmacist to substitute an interchangeable biological product only if certain requirements are met). Requires that when a pharmacist receives a prescription from a Medicaid recipient, the pharmacist shall select the preferred drug or biological product from the State's preferred drug list. Makes other changes. The Chamber is opposed.
- Sosnowski - Amends the Illinois Insurance Code. Creates the Pharmacy Benefits Managers Article. Provides that a pharmacy or pharmacist shall have the right to provide an insured information regarding the amount of the insured's cost share for a prescription drug and that neither a pharmacy nor a pharmacist shall be penalized by a pharmacy benefits manager for discussing certain information or for selling a lower-priced drug to the insured if one is available. Provides that a pharmacy benefits manager shall not, through contract, prohibit a pharmacy from offering and providing direct and limited delivery services to an insured as an ancillary service of the pharmacy, as delineated in the contract between the pharmacy benefits manager and the pharmacy. Provides that a pharmacy benefits manager shall not charge, or attempt to collect from, an insured a copayment that exceeds the total charges submitted by the network pharmacy.
- Moeller - Creates the Wholesale Importation of Prescription Drugs Act. Requires the Department of Public Health to design an importation program where the State is the licensed wholesaler of imported drugs from licensed, regulated Canadian suppliers. Requires the program to address specified issues, including billing issues, cost savings issues, and safety and regulatory issues. Contains auditing and reporting requirements. Provides that the Department shall enlist the assistance of the Attorney General to identify the potential for anti-competitive behavior in industries that would be affected by an importation program. Requires the Department to submit a formal request to the Secretary of the United States Department of Health and Human Services for certification of the importation program. Requires the Department to have the program operational within 6 months after receiving the certification. Contains provisions concerning implementation requirements. The Chamber is opposed.
- Willis - Amends the Managed Care Reform and Patient Rights Act. Provides that every health insurance carrier that provides coverage for prescription drugs shall ensure that no fewer than 25% of certain individual and group plans offered shall apply a pre-deductible, flat-dollar copayment structure to the entire drug benefit. Provides that the flat-dollar copayment structure for prescription drugs must be reasonably graduated and proportionately related in all tier levels such that the copayment structure as a whole does not discriminate against or discourage the enrollment of individuals with significant health care needs. Requires the health insurance carriers to clearly and appropriately name the plans to aid in consumer or plan-sponsor plan selection. Requires the health insurance carriers to market the plans in the same manner as their other plans. Provides that if a health insurance carrier offers fewer than 4 plans, the health insurance carrier shall ensure that one plan shall use the drug benefit structure, including cost-sharing requirements. Requires the Department of Insurance to adopt rules necessary to implement and enforce the provisions. Effective January 1, 2020. The Chamber is opposed.
- Stuart - DPH-PAINKILLER GUIDELINES
Elementary & Secondary Education: School Curriculum & Policies Committee
Feb 27, 2019
Room 413 Stratton Building
Ford -Mandates metal detectors at hospital entrances, among other public buildings. Chamber is opposed.
Mental Health Committee
Feb 28, 2019 11:00AM
Room 114 Capitol Building
- Creates the Children's Mental Health Local Integrated Fund Act. Creates local children's mental health collaboratives.
- Connor - Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Directs the Department to create and maintain an online database and resource page on its website. Provides that the page shall contain mental health resources specifically geared towards school counselors, parents, and teachers with the goal of connecting those people with mental health resources related to bullying and school shootings and encouraging information sharing among educational administrators, school security personnel, and school resource officers.
- Carroll - Creates the Higher Education Mental Health Act. Provides for legislative findings and purposes. Requires the Board of Higher Education to establish the Advisory Commission on Serving and Supporting Students with Mental Health Disabilities in Institutions of Higher Education.
- Welch - Creates the Mental Health Early Action on Campus Act. Provides for intent, legislative findings, purposes of the Act, and definitions. Provides that to raise mental health awareness on college campuses, each public college or university in this State must complete specified tasks.
- Lilly - Amends the Developmental Disability and Mental Disability Services Act. Provides that the Department of Human Services shall establish family centers throughout the State to provide counseling and mental health services to families who are indigent based on any behavior or mental health condition as determined by Department rule.
Joint Insurance and Prescription Drug Affordability and Accessibility Hearing
Mar 01, 2019
C-600, 6th Floor Michael A. Bilandic Building
SUBJECT MATTER: Insurance and Drug Cost Impact on Consumers.
There have been no healthcare-related rules proposed since our last update.
Second Annual Women in Business Conference
The Illinois Chamber of Commerce is hosting its second Women in Business conference on March 15
, 2019 at Pinstripes in Oak Brook, IL. The event will bring together business leaders from across the State to encourage women to invest in themselves, become courageous leaders, and be a force in their careers.
Our panel topics this year focus on practices to better diversify corporations and understanding why diversity brings more business success; individual communication tactics to send a message of confidence; and learning from proven influencers on the skills that can help you get to where you want to be professionally. These panels will be capped with keynote addresses by inspiring speakers to embolden attendees to blaze their own path. The event will end with a networking and social event.
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