Illinois State Legislation Update – Recently Enacted Laws During its recently concluded legislative session, the Illinois General Assembly passed a va

Public Act 97-0091 (House Bill 1191) – Routine Care in Clinical Cancer Trials
Signed into law on July 11, this new law prevents a group accident and health insurance policy from excluding routine patient care administered to an insured participating in a qualified cancer trial if the policy covers that same routine patient care for an insured not participating in a qualified cancer trial. It further requires no difference in out-of-pocket liability between an insured in a trial versus one not in a trial. This law is effective Jan. 1, 2012.

Public Act 97-0142 (Senate Bill 1555) – Illinois Health Benefits Exchange Law / State Employees HSA Law
Also effective as of July 14, this law requires Illinois to establish a Health Insurance Exchange program that consists of a marketplace where individuals and businesses can purchase subsidized health care plans. The law includes the creation of a Legislative Study Committee to study and report on the implementation needs to establish the exchange. To ensure balance, six of the 12 appointed members will come from the Illinois House of Representatives and six members from the Illinois Senate. The committee is required to report on the governance of the program by Sept. 30.

This law does not create the actual health insurance exchange; it simply provides guidelines as to how the exchange will be set-up at the legislative level.

In addition, PA 97-0142 includes the creation of a health savings account (HSA) for employees of Illinois state agencies and departments. Beginning in taxable year 2011, each employer shall make available to each eligible individual a HSA program and deposit $2,750 annually into each individual’s account. The law provides that funds can only be used for:

1. the purpose of paying qualified medical expenses of the eligible individual or his or her dependents,
   
2. to purchase a health coverage policy, certificate, or contract, or
   
3. to pay for health insurance other than a Medicare supplemental policy for those who are Medicare eligible.

This law also repeals the Health Care Justice Act.

Public Act 97-0198 (House Bill 1825) – Oral Cancer Drug Parity
Signed by Governor Quinn on July 27, this law requires that health insurance plans that provide coverage for cancer medications cannot have more restrictive treatment limitations or more restrictive financial requirements for oral cancer medications than intravenous and injected cancer medications. However, the law does not mandate coverage for cancer medications.

Public Act 97-0281 (House Bill 2249) – A1C Diabetes Self-Management Training and Education
Signed on Aug. 9, this law requires a group policy of accident and health insurance that is amended, delivered, issued or renewed after the law’s Jan. 1, 2012, effective date to provide coverage for outpatient self-management training and education, equipment and supplies. Further, the law defines “diabetes self-management training” as instruction in an outpatient setting which enables a diabetic patient to understand the diabetic management process and daily management of diabetic therapy as a means of avoiding frequent hospitalization and complications. This is specifically designed to help diabetics maintain their A1C levels within the normal range.

Public Act 97-0282 (House Bill 3039) – Heart Disease Prevention Notification
This law requires insurers to provide annual information regarding the importance and value of early detection and proactive management for cardiovascular disease. It was effective immediately upon the governor’s signature on Aug. 9. However, doctors have up to 60 days to update their information.