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| 1 | | (Text of Section before amendment by P.A. 102-768) |
| 2 | | Sec. 6.11. Required health benefits; Illinois Insurance |
| 3 | | Code
requirements. The program of health
benefits shall |
| 4 | | provide the post-mastectomy care benefits required to be |
| 5 | | covered
by a policy of accident and health insurance under |
| 6 | | Section 356t of the Illinois
Insurance Code. The program of |
| 7 | | health benefits shall provide the coverage
required under |
| 8 | | Sections 356g, 356g.5, 356g.5-1, 356m, 356q,
356u, 356w, 356x, |
| 9 | | 356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, |
| 10 | | 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22, |
| 11 | | 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, |
| 12 | | 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51, |
| 13 | | 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and |
| 14 | | 356z.62 of the
Illinois Insurance Code.
The program of health |
| 15 | | benefits must comply with Sections 155.22a, 155.37, 355b, |
| 16 | | 356z.19, 370c, and 370c.1 and Article XXXIIB of the
Illinois |
| 17 | | Insurance Code. The Department of Insurance shall enforce the |
| 18 | | requirements of this Section with respect to Sections 370c and |
| 19 | | 370c.1 of the Illinois Insurance Code; all other requirements |
| 20 | | of this Section shall be enforced by the Department of Central |
| 21 | | Management Services.
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| 22 | | Rulemaking authority to implement Public Act 95-1045, if |
| 23 | | any, is conditioned on the rules being adopted in accordance |
| 24 | | with all provisions of the Illinois Administrative Procedure |
| 25 | | Act and all rules and procedures of the Joint Committee on |
| 26 | | Administrative Rules; any purported rule not so adopted, for |
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| 1 | | whatever reason, is unauthorized. |
| 2 | | (Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20; |
| 3 | | 101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff. |
| 4 | | 1-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103, |
| 5 | | eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; |
| 6 | | 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. |
| 7 | | 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, |
| 8 | | eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; |
| 9 | | revised 12-13-22.)
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| 10 | | (Text of Section after amendment by P.A. 102-768) |
| 11 | | Sec. 6.11. Required health benefits; Illinois Insurance |
| 12 | | Code
requirements. The program of health
benefits shall |
| 13 | | provide the post-mastectomy care benefits required to be |
| 14 | | covered
by a policy of accident and health insurance under |
| 15 | | Section 356t of the Illinois
Insurance Code. The program of |
| 16 | | health benefits shall provide the coverage
required under |
| 17 | | Sections 356g, 356g.5, 356g.5-1, 356m, 356q,
356u, 356w, 356x, |
| 18 | | 356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, |
| 19 | | 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22, |
| 20 | | 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, |
| 21 | | 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51, |
| 22 | | 356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59, and |
| 23 | | 356z.60, and 356z.62 of the
Illinois Insurance Code.
The |
| 24 | | program of health benefits must comply with Sections 155.22a, |
| 25 | | 155.37, 355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of |
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| 1 | | the
Illinois Insurance Code. The Department of Insurance shall |
| 2 | | enforce the requirements of this Section with respect to |
| 3 | | Sections 370c and 370c.1 of the Illinois Insurance Code; all |
| 4 | | other requirements of this Section shall be enforced by the |
| 5 | | Department of Central Management Services.
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| 6 | | Rulemaking authority to implement Public Act 95-1045, if |
| 7 | | any, is conditioned on the rules being adopted in accordance |
| 8 | | with all provisions of the Illinois Administrative Procedure |
| 9 | | Act and all rules and procedures of the Joint Committee on |
| 10 | | Administrative Rules; any purported rule not so adopted, for |
| 11 | | whatever reason, is unauthorized. |
| 12 | | (Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20; |
| 13 | | 101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff. |
| 14 | | 1-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103, |
| 15 | | eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; |
| 16 | | 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. |
| 17 | | 1-1-23; 102-768, eff. 1-1-24; 102-804, eff. 1-1-23; 102-813, |
| 18 | | eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff. 1-1-23; |
| 19 | | 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
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| 20 | | Section 15. The Criminal Identification Act is amended by |
| 21 | | changing Section 3.2 as follows:
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| 22 | | (20 ILCS 2630/3.2) (from Ch. 38, par. 206-3.2)
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| 23 | | Sec. 3.2.
(a) It is the duty of any person conducting or |
| 24 | | operating a medical facility,
or any physician or nurse as |
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| 1 | | soon as treatment permits to notify the local
law enforcement |
| 2 | | agency of that jurisdiction upon the application for
treatment |
| 3 | | of a person who is not accompanied by a law enforcement |
| 4 | | officer,
when it reasonably appears that the person requesting |
| 5 | | treatment has
received:
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| 6 | | (1) any injury resulting from the discharge of a |
| 7 | | firearm; or
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| 8 | | (2) any injury sustained in the commission of or as a |
| 9 | | victim of a
criminal offense.
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| 10 | | Any hospital, physician or nurse shall be forever held |
| 11 | | harmless from
any civil liability for their reasonable |
| 12 | | compliance with the provisions of
this Section. |
| 13 | | (b) Notwithstanding subsection (a), nothing in this
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| 14 | | Section shall be construed to require the reporting of lawful
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| 15 | | health care activity, whether such activity may constitute a
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| 16 | | violation of another state's law. |
| 17 | | (c) As used in this Section: |
| 18 | | "Lawful health care" means: |
| 19 | | (1) reproductive health care that is not unlawful |
| 20 | | under the laws of this State or was not unlawful under the |
| 21 | | laws of this State as of January 13, 2023 (the effective |
| 22 | | date of Public Act 102-1117), including on any theory of |
| 23 | | vicarious, joint, several, or conspiracy liability; or |
| 24 | | (2) the treatment of gender dysphoria or the |
| 25 | | affirmation of an individual's gender identity or gender |
| 26 | | expression, including but not limited to, all supplies, |
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| 1 | | care, and services of a medical, behavioral health, mental |
| 2 | | health, surgical, psychiatric, therapeutic, diagnostic, |
| 3 | | preventative, rehabilitative, or supportive nature that is |
| 4 | | not unlawful under the laws of this State or was not |
| 5 | | unlawful under the laws of this State as of January 13, |
| 6 | | 2023 (the effective date of Public Act 102-1117), |
| 7 | | including on any theory of vicarious, joint, several, or |
| 8 | | conspiracy liability.
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| 9 | | "Lawful health care activity" means seeking, providing,
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| 10 | | receiving, assisting in seeking, providing, or receiving,
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| 11 | | providing material support for, or traveling to obtain lawful
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| 12 | | health care. |
| 13 | | (Source: P.A. 102-1117, eff. 1-13-23.)
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| 14 | | Section 20. The Counties Code is amended by changing |
| 15 | | Section 5-1069.3 as follows:
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| 16 | | (55 ILCS 5/5-1069.3)
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| 17 | | Sec. 5-1069.3. Required health benefits. If a county, |
| 18 | | including a home
rule
county, is a self-insurer for purposes |
| 19 | | of providing health insurance coverage
for its employees, the |
| 20 | | coverage shall include coverage for the post-mastectomy
care |
| 21 | | benefits required to be covered by a policy of accident and |
| 22 | | health
insurance under Section 356t and the coverage required |
| 23 | | under Sections 356g, 356g.5, 356g.5-1, 356q, 356u,
356w, 356x, |
| 24 | | 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, |
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| 1 | | 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, |
| 2 | | 356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, |
| 3 | | 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, |
| 4 | | 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and 356z.62 |
| 5 | | of
the Illinois Insurance Code. The coverage shall comply with |
| 6 | | Sections 155.22a, 355b, 356z.19, and 370c of
the Illinois |
| 7 | | Insurance Code. The Department of Insurance shall enforce the |
| 8 | | requirements of this Section. The requirement that health |
| 9 | | benefits be covered
as provided in this Section is an
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| 10 | | exclusive power and function of the State and is a denial and |
| 11 | | limitation under
Article VII, Section 6, subsection (h) of the |
| 12 | | Illinois Constitution. A home
rule county to which this |
| 13 | | Section applies must comply with every provision of
this |
| 14 | | Section.
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| 15 | | Rulemaking authority to implement Public Act 95-1045, if |
| 16 | | any, is conditioned on the rules being adopted in accordance |
| 17 | | with all provisions of the Illinois Administrative Procedure |
| 18 | | Act and all rules and procedures of the Joint Committee on |
| 19 | | Administrative Rules; any purported rule not so adopted, for |
| 20 | | whatever reason, is unauthorized. |
| 21 | | (Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20; |
| 22 | | 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff. |
| 23 | | 1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203, |
| 24 | | eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22; |
| 25 | | 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. |
| 26 | | 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, |
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| 1 | | eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; |
| 2 | | 102-1117, eff. 1-13-23.)
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| 3 | | Section 25. The Illinois Municipal Code is amended by |
| 4 | | changing Section 10-4-2.3 as follows:
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| 5 | | (65 ILCS 5/10-4-2.3)
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| 6 | | Sec. 10-4-2.3. Required health benefits. If a |
| 7 | | municipality, including a
home rule municipality, is a |
| 8 | | self-insurer for purposes of providing health
insurance |
| 9 | | coverage for its employees, the coverage shall include |
| 10 | | coverage for
the post-mastectomy care benefits required to be |
| 11 | | covered by a policy of
accident and health insurance under |
| 12 | | Section 356t and the coverage required
under Sections 356g, |
| 13 | | 356g.5, 356g.5-1, 356q, 356u, 356w, 356x, 356z.4, 356z.4a, |
| 14 | | 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, |
| 15 | | 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, |
| 16 | | 356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41, |
| 17 | | 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54, |
| 18 | | 356z.56, 356z.57, 356z.59, and 356z.60, and 356z.62 of the |
| 19 | | Illinois
Insurance
Code. The coverage shall comply with |
| 20 | | Sections 155.22a, 355b, 356z.19, and 370c of
the Illinois |
| 21 | | Insurance Code. The Department of Insurance shall enforce the |
| 22 | | requirements of this Section. The requirement that health
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| 23 | | benefits be covered as provided in this is an exclusive power |
| 24 | | and function of
the State and is a denial and limitation under |
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| 1 | | Article VII, Section 6,
subsection (h) of the Illinois |
| 2 | | Constitution. A home rule municipality to which
this Section |
| 3 | | applies must comply with every provision of this Section.
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| 4 | | Rulemaking authority to implement Public Act 95-1045, if |
| 5 | | any, is conditioned on the rules being adopted in accordance |
| 6 | | with all provisions of the Illinois Administrative Procedure |
| 7 | | Act and all rules and procedures of the Joint Committee on |
| 8 | | Administrative Rules; any purported rule not so adopted, for |
| 9 | | whatever reason, is unauthorized. |
| 10 | | (Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20; |
| 11 | | 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff. |
| 12 | | 1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203, |
| 13 | | eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22; |
| 14 | | 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. |
| 15 | | 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, |
| 16 | | eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; |
| 17 | | 102-1117, eff. 1-13-23.)
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| 18 | | Section 30. The School Code is amended by changing Section |
| 19 | | 10-22.3f as follows:
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| 20 | | (105 ILCS 5/10-22.3f)
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| 21 | | Sec. 10-22.3f. Required health benefits. Insurance |
| 22 | | protection and
benefits
for employees shall provide the |
| 23 | | post-mastectomy care benefits required to be
covered by a |
| 24 | | policy of accident and health insurance under Section 356t and |
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| 1 | | the
coverage required under Sections 356g, 356g.5, 356g.5-1, |
| 2 | | 356q, 356u, 356w, 356x, 356z.4, 356z.4a,
356z.6, 356z.8, |
| 3 | | 356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, |
| 4 | | 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, |
| 5 | | 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51, |
| 6 | | 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and |
| 7 | | 356z.62 of
the
Illinois Insurance Code.
Insurance policies |
| 8 | | shall comply with Section 356z.19 of the Illinois Insurance |
| 9 | | Code. The coverage shall comply with Sections 155.22a, 355b, |
| 10 | | and 370c of
the Illinois Insurance Code. The Department of |
| 11 | | Insurance shall enforce the requirements of this Section.
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| 12 | | Rulemaking authority to implement Public Act 95-1045, if |
| 13 | | any, is conditioned on the rules being adopted in accordance |
| 14 | | with all provisions of the Illinois Administrative Procedure |
| 15 | | Act and all rules and procedures of the Joint Committee on |
| 16 | | Administrative Rules; any purported rule not so adopted, for |
| 17 | | whatever reason, is unauthorized. |
| 18 | | (Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20; |
| 19 | | 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff. |
| 20 | | 1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203, |
| 21 | | eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff. 1-1-22; |
| 22 | | 102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804, eff. |
| 23 | | 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, |
| 24 | | eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
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| 25 | | Section 35. The Illinois Insurance Code is amended by |
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| 1 | | changing Section 356z.4 and by adding Section 356z.62 as |
| 2 | | follows:
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| 3 | | (215 ILCS 5/356z.4)
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| 4 | | Sec. 356z.4. Coverage for contraceptives. |
| 5 | | (a)(1) The General Assembly hereby finds and declares all |
| 6 | | of the following: |
| 7 | | (A) Illinois has a long history of expanding timely |
| 8 | | access to birth control to prevent unintended pregnancy. |
| 9 | | (B) The federal Patient Protection and Affordable Care |
| 10 | | Act includes a contraceptive coverage guarantee as part of |
| 11 | | a broader requirement for health insurance to cover key |
| 12 | | preventive care services without out-of-pocket costs for |
| 13 | | patients. |
| 14 | | (C) The General Assembly intends to build on existing |
| 15 | | State and federal law to promote gender equity and women's |
| 16 | | health and to ensure greater contraceptive coverage equity |
| 17 | | and timely access to all federal Food and Drug |
| 18 | | Administration approved methods of birth control for all |
| 19 | | individuals covered by an individual or group health |
| 20 | | insurance policy in Illinois. |
| 21 | | (D) Medical management techniques such as denials, |
| 22 | | step therapy, or prior authorization in public and private |
| 23 | | health care coverage can impede access to the most |
| 24 | | effective contraceptive methods. |
| 25 | | (2) As used in this subsection (a): |
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| 1 | | "Contraceptive services" includes consultations, |
| 2 | | examinations, procedures, and medical services related to the |
| 3 | | use of contraceptive methods (including natural family |
| 4 | | planning) to prevent an unintended pregnancy. |
| 5 | | "Medical necessity", for the purposes of this subsection |
| 6 | | (a), includes, but is not limited to, considerations such as |
| 7 | | severity of side effects, differences in permanence and |
| 8 | | reversibility of contraceptive, and ability to adhere to the |
| 9 | | appropriate use of the item or service, as determined by the |
| 10 | | attending provider. |
| 11 | | "Therapeutic equivalent version" means drugs, devices, or |
| 12 | | products that can be expected to have the same clinical effect |
| 13 | | and safety profile when administered to patients under the |
| 14 | | conditions specified in the labeling and satisfy the following |
| 15 | | general criteria: |
| 16 | | (i) they are approved as safe and effective; |
| 17 | | (ii) they are pharmaceutical equivalents in that they |
| 18 | | (A) contain identical amounts of the same active drug |
| 19 | | ingredient in the same dosage form and route of |
| 20 | | administration and (B) meet compendial or other applicable |
| 21 | | standards of strength, quality, purity, and identity; |
| 22 | | (iii) they are bioequivalent in that (A) they do not |
| 23 | | present a known or potential bioequivalence problem and |
| 24 | | they meet an acceptable in vitro standard or (B) if they do |
| 25 | | present such a known or potential problem, they are shown |
| 26 | | to meet an appropriate bioequivalence standard; |
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| 1 | | (iv) they are adequately labeled; and |
| 2 | | (v) they are manufactured in compliance with Current |
| 3 | | Good Manufacturing Practice regulations. |
| 4 | | (3) An individual or group policy of accident and health |
| 5 | | insurance amended,
delivered, issued, or renewed in this State |
| 6 | | after the effective date of this amendatory Act of the 99th |
| 7 | | General Assembly shall provide coverage for all of the |
| 8 | | following services and contraceptive methods: |
| 9 | | (A) All contraceptive drugs, devices, and other |
| 10 | | products approved by the United States Food and Drug |
| 11 | | Administration. This includes all over-the-counter |
| 12 | | contraceptive drugs, devices, and products approved by the |
| 13 | | United States Food and Drug Administration, excluding male |
| 14 | | condoms, except as provided in the current comprehensive |
| 15 | | guidelines supported by the Health Resources and Services |
| 16 | | Administration. The following apply: |
| 17 | | (i) If the United States Food and Drug |
| 18 | | Administration has approved one or more therapeutic |
| 19 | | equivalent versions of a contraceptive drug, device, |
| 20 | | or product, a policy is not required to include all |
| 21 | | such therapeutic equivalent versions in its formulary, |
| 22 | | so long as at least one is included and covered without |
| 23 | | cost-sharing and in accordance with this Section. |
| 24 | | (ii) If an individual's attending provider |
| 25 | | recommends a particular service or item approved by |
| 26 | | the United States Food and Drug Administration based |
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| 1 | | on a determination of medical necessity with respect |
| 2 | | to that individual, the plan or issuer must cover that |
| 3 | | service or item without cost sharing. The plan or |
| 4 | | issuer must defer to the determination of the |
| 5 | | attending provider. |
| 6 | | (iii) If a drug, device, or product is not |
| 7 | | covered, plans and issuers must have an easily |
| 8 | | accessible, transparent, and sufficiently expedient |
| 9 | | process that is not unduly burdensome on the |
| 10 | | individual or a provider or other individual acting as |
| 11 | | a patient's authorized representative to ensure |
| 12 | | coverage without cost sharing. |
| 13 | | (iv) This coverage must provide for the dispensing |
| 14 | | of 12 months' worth of contraception at one time. |
| 15 | | (B) Voluntary sterilization procedures. |
| 16 | | (C) Contraceptive services, patient education, and |
| 17 | | counseling on contraception. |
| 18 | | (D) Follow-up services related to the drugs, devices, |
| 19 | | products, and procedures covered under this Section, |
| 20 | | including, but not limited to, management of side effects, |
| 21 | | counseling for continued adherence, and device insertion |
| 22 | | and removal. |
| 23 | | (4) Except as otherwise provided in this subsection (a), a |
| 24 | | policy subject to this subsection (a) shall not impose a |
| 25 | | deductible, coinsurance, copayment, or any other cost-sharing |
| 26 | | requirement on the coverage provided. The provisions of this |
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| 1 | | paragraph do not apply to coverage of voluntary male |
| 2 | | sterilization procedures to the extent such coverage would |
| 3 | | disqualify a high-deductible health plan from eligibility for |
| 4 | | a health savings account pursuant to the federal Internal |
| 5 | | Revenue Code, 26 U.S.C. 223. |
| 6 | | (5) Except as otherwise authorized under this subsection |
| 7 | | (a), a policy shall not impose any restrictions or delays on |
| 8 | | the coverage required under this subsection (a). |
| 9 | | (6) If, at any time, the Secretary of the United States |
| 10 | | Department of Health and Human Services, or its successor |
| 11 | | agency, promulgates rules or regulations to be published in |
| 12 | | the Federal Register or publishes a comment in the Federal |
| 13 | | Register or issues an opinion, guidance, or other action that |
| 14 | | would require the State, pursuant to any provision of the |
| 15 | | Patient Protection and Affordable Care Act (Public Law |
| 16 | | 111-148), including, but not limited to, 42 U.S.C. |
| 17 | | 18031(d)(3)(B) or any successor provision, to defray the cost |
| 18 | | of any coverage outlined in this subsection (a), then this |
| 19 | | subsection (a) is inoperative with respect to all coverage |
| 20 | | outlined in this subsection (a) other than that authorized |
| 21 | | under Section 1902 of the Social Security Act, 42 U.S.C. |
| 22 | | 1396a, and the State shall not assume any obligation for the |
| 23 | | cost of the coverage set forth in this subsection (a). |
| 24 | | (b) This subsection (b) shall become operative if and only |
| 25 | | if subsection (a) becomes inoperative. |
| 26 | | An individual or group policy of accident and health |
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| 1 | | insurance amended,
delivered, issued, or renewed in this State |
| 2 | | after the date this subsection (b) becomes operative that |
| 3 | | provides coverage for
outpatient services and outpatient |
| 4 | | prescription drugs or devices must provide
coverage for the |
| 5 | | insured and any
dependent of the
insured covered by the policy |
| 6 | | for all outpatient contraceptive services and
all outpatient |
| 7 | | contraceptive drugs and devices approved by the Food and
Drug |
| 8 | | Administration. Coverage required under this Section may not |
| 9 | | impose any
deductible, coinsurance, waiting period, or other |
| 10 | | cost-sharing or limitation
that is greater than that required |
| 11 | | for any outpatient service or outpatient
prescription drug or |
| 12 | | device otherwise covered by the policy.
|
| 13 | | Nothing in this subsection (b) shall be construed to |
| 14 | | require an insurance
company to cover services related to |
| 15 | | permanent sterilization that requires a
surgical procedure. |
| 16 | | As used in this subsection (b), "outpatient contraceptive |
| 17 | | service" means
consultations, examinations, procedures, and |
| 18 | | medical services, provided on an
outpatient basis and related |
| 19 | | to the use of contraceptive methods (including
natural family |
| 20 | | planning) to prevent an unintended pregnancy.
|
| 21 | | (c) (Blank).
|
| 22 | | (d) If a plan or issuer utilizes a network of providers, |
| 23 | | nothing in this Section shall be construed to require coverage |
| 24 | | or to prohibit the plan or issuer from imposing cost-sharing |
| 25 | | for items or services described in this Section that are |
| 26 | | provided or delivered by an out-of-network provider, unless |
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| 1 | | the plan or issuer does not have in its network a provider who |
| 2 | | is able to or is willing to provide the applicable items or |
| 3 | | services.
|
| 4 | | (Source: P.A. 100-1102, eff. 1-1-19; 101-13, eff. 6-12-19.)
|
| 5 | | (215 ILCS 5/356z.62 new) |
| 6 | | Sec. 356z.62. Coverage of preventive health services. |
| 7 | | (a) A policy of group health insurance coverage or |
| 8 | | individual health insurance coverage as defined in Section 5 |
| 9 | | of the Illinois Health Insurance Portability and |
| 10 | | Accountability Act shall, at a minimum, provide coverage for |
| 11 | | and shall not impose any cost-sharing requirements, including |
| 12 | | a copayment, coinsurance, or deductible, for: |
| 13 | | (1) evidence-based items or services that have in |
| 14 | | effect a rating of "A" or "B" in the current |
| 15 | | recommendations of the United States Preventive Services |
| 16 | | Task Force; |
| 17 | | (2) immunizations that have in effect a recommendation |
| 18 | | from the Advisory Committee on Immunization Practices of |
| 19 | | the Centers for Disease Control and Prevention with |
| 20 | | respect to the individual involved; |
| 21 | | (3) with respect to infants, children, and |
| 22 | | adolescents, evidence-informed preventive care and |
| 23 | | screenings provided for in the comprehensive guidelines |
| 24 | | supported by the Health Resources and Services |
| 25 | | Administration; and |
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| 1 | | (4) with respect to women, such additional preventive |
| 2 | | care and screenings not described in paragraph (1) of this |
| 3 | | subsection (a) as provided for in comprehensive guidelines |
| 4 | | supported by the Health Resources and Services |
| 5 | | Administration for purposes of this paragraph. |
| 6 | | (b) For purposes of this Section, and for purposes of any |
| 7 | | other provision of State law, recommendations of the United |
| 8 | | States Preventive Services Task Force regarding breast cancer |
| 9 | | screening, mammography, and prevention issued in or around |
| 10 | | November 2009 are not considered to be current. |
| 11 | | (c) For office visits: |
| 12 | | (1) if an item or service described in subsection (a) |
| 13 | | is billed separately or is tracked as individual encounter |
| 14 | | data separately from an office visit, then a policy may |
| 15 | | impose cost-sharing requirements with respect to the |
| 16 | | office visit; |
| 17 | | (2) if an item or service described in subsection (a) |
| 18 | | is not billed separately or is not tracked as individual |
| 19 | | encounter data separately from an office visit and the |
| 20 | | primary purpose of the office visit is the delivery of |
| 21 | | such an item or service, then a policy may not impose |
| 22 | | cost-sharing requirements with respect to the office |
| 23 | | visit; and |
| 24 | | (3) if an item or service described in subsection (a) |
| 25 | | is not billed separately or is not tracked as individual |
| 26 | | encounter data separately from an office visit and the |
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| 1 | | primary purpose of the office visit is not the delivery of |
| 2 | | such an item or service, then a policy may impose |
| 3 | | cost-sharing requirements with respect to the office |
| 4 | | visit. |
| 5 | | (d) A policy must provide coverage pursuant to subsection |
| 6 | | (a) for plan or policy years that begin on or after the date |
| 7 | | that is one year after the date the recommendation or |
| 8 | | guideline is issued. If a recommendation or guideline is in |
| 9 | | effect on the first day of the plan or policy year, the policy |
| 10 | | shall cover the items and services specified in the |
| 11 | | recommendation or guideline through the last day of the plan |
| 12 | | or policy year unless either: |
| 13 | | (1) a recommendation under paragraph (1) of subsection |
| 14 | | (a) is downgraded to a "D" rating; or |
| 15 | | (2) the item or service is subject to a safety recall |
| 16 | | or is otherwise determined to pose a significant safety |
| 17 | | concern by a federal agency authorized to regulate the |
| 18 | | item or service during the plan or policy year. |
| 19 | | (e) Network limitations. |
| 20 | | (1) Subject to paragraph (3) of this subsection, |
| 21 | | nothing in this Section requires coverage for items or |
| 22 | | services described in subsection (a) that are delivered by |
| 23 | | an out-of-network provider under a health maintenance |
| 24 | | organization health care plan, other than a |
| 25 | | point-of-service contract, or under a voluntary health |
| 26 | | services plan that generally excludes coverage for |
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| 1 | | out-of-network services except as otherwise required by |
| 2 | | law. |
| 3 | | (2) Subject to paragraph (3) of this subsection, |
| 4 | | nothing in this Section precludes a policy with a |
| 5 | | preferred provider program under Article XX-1/2 of this |
| 6 | | Code, a health maintenance organization point-of-service |
| 7 | | contract, or a similarly designed voluntary health |
| 8 | | services plan from imposing cost-sharing requirements for |
| 9 | | items or services described in subsection (a) that are |
| 10 | | delivered by an out-of-network provider. |
| 11 | | (3) If a policy does not have in its network a provider |
| 12 | | who can provide an item or service described in subsection |
| 13 | | (a), then the policy must cover the item or service when |
| 14 | | performed by an out-of-network provider and it may not |
| 15 | | impose cost-sharing with respect to the item or service. |
| 16 | | (f) Nothing in this Section prevents a company from using |
| 17 | | reasonable medical management techniques to determine the |
| 18 | | frequency, method, treatment, or setting for an item or |
| 19 | | service described in subsection (a) to the extent not |
| 20 | | specified in the recommendation or guideline. |
| 21 | | (g) Nothing in this Section shall be construed to prohibit |
| 22 | | a policy from providing coverage for items or services in |
| 23 | | addition to those required under subsection (a) or from |
| 24 | | denying coverage for items or services that are not required |
| 25 | | under subsection (a). Unless prohibited by other law, a policy |
| 26 | | may impose cost-sharing requirements for a treatment not |
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| 1 | | described in subsection (a) even if the treatment results from |
| 2 | | an item or service described in subsection (a). Nothing in |
| 3 | | this Section shall be construed to limit coverage requirements |
| 4 | | provided under other law. |
| 5 | | (h) The Director may develop guidelines to permit a |
| 6 | | company to utilize value-based insurance designs. In the |
| 7 | | absence of guidelines developed by the Director, any such |
| 8 | | guidelines developed by the Secretary of the U.S. Department |
| 9 | | of Health and Human Services that are in force under 42 U.S.C. |
| 10 | | 300gg-13 shall apply. |
| 11 | | (i) For student health insurance coverage as defined at 45 |
| 12 | | CFR 147.145, student administrative health fees are not |
| 13 | | considered cost-sharing requirements with respect to |
| 14 | | preventive services specified under subsection (a). As used in |
| 15 | | this subsection, "student administrative health fee" means a |
| 16 | | fee charged by an institution of higher education on a |
| 17 | | periodic basis to its students to offset the cost of providing |
| 18 | | health care through health clinics regardless of whether the |
| 19 | | students utilize the health clinics or enroll in student |
| 20 | | health insurance coverage. |
| 21 | | (j) For any recommendation or guideline specifically |
| 22 | | referring to women or men, a company shall not deny or limit |
| 23 | | the coverage required or a claim made under subsection (a) |
| 24 | | based solely on the individual's recorded sex or actual or |
| 25 | | perceived gender identity, or for the reason that the |
| 26 | | individual is gender nonconforming, intersex, transgender, or |
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| 1 | | has undergone, or is in the process of undergoing, gender |
| 2 | | transition, if, notwithstanding the sex or gender assigned at |
| 3 | | birth, the covered individual meets the conditions for the |
| 4 | | recommendation or guideline at the time the item or service is |
| 5 | | furnished. |
| 6 | | (k) This Section does not apply to grandfathered health |
| 7 | | plans, excepted benefits, or short-term, limited-duration |
| 8 | | health insurance coverage.
|
| 9 | | Section 40. The Health Maintenance Organization Act is |
| 10 | | amended by changing Section 5-3 as follows:
|
| 11 | | (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
|
| 12 | | Sec. 5-3. Insurance Code provisions.
|
| 13 | | (a) Health Maintenance Organizations
shall be subject to |
| 14 | | the provisions of Sections 133, 134, 136, 137, 139, 140, |
| 15 | | 141.1,
141.2, 141.3, 143, 143c, 147, 148, 149, 151,
152, 153, |
| 16 | | 154, 154.5, 154.6,
154.7, 154.8, 155.04, 155.22a, 355.2, |
| 17 | | 355.3, 355b, 355c, 356g.5-1, 356m, 356q, 356v, 356w, 356x, |
| 18 | | 356y,
356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, |
| 19 | | 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, |
| 20 | | 356z.15, 356z.17, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25, |
| 21 | | 356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33, |
| 22 | | 356z.35, 356z.36, 356z.40, 356z.41, 356z.46, 356z.47, 356z.48, |
| 23 | | 356z.50, 356z.51, 356z.53 256z.53, 356z.54, 356z.56, 356z.57, |
| 24 | | 356z.59, 356z.60, 356z.62, 364, 364.01, 364.3, 367.2, 367.2-5, |
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| 1 | | 367i, 368a, 368b, 368c, 368d, 368e, 370c,
370c.1, 401, 401.1, |
| 2 | | 402, 403, 403A,
408, 408.2, 409, 412, 444,
and
444.1,
|
| 3 | | paragraph (c) of subsection (2) of Section 367, and Articles |
| 4 | | IIA, VIII 1/2,
XII,
XII 1/2, XIII, XIII 1/2, XXV, XXVI, and |
| 5 | | XXXIIB of the Illinois Insurance Code.
|
| 6 | | (b) For purposes of the Illinois Insurance Code, except |
| 7 | | for Sections 444
and 444.1 and Articles XIII and XIII 1/2, |
| 8 | | Health Maintenance Organizations in
the following categories |
| 9 | | are deemed to be "domestic companies":
|
| 10 | | (1) a corporation authorized under the
Dental Service |
| 11 | | Plan Act or the Voluntary Health Services Plans Act;
|
| 12 | | (2) a corporation organized under the laws of this |
| 13 | | State; or
|
| 14 | | (3) a corporation organized under the laws of another |
| 15 | | state, 30% or more
of the enrollees of which are residents |
| 16 | | of this State, except a
corporation subject to |
| 17 | | substantially the same requirements in its state of
|
| 18 | | organization as is a "domestic company" under Article VIII |
| 19 | | 1/2 of the
Illinois Insurance Code.
|
| 20 | | (c) In considering the merger, consolidation, or other |
| 21 | | acquisition of
control of a Health Maintenance Organization |
| 22 | | pursuant to Article VIII 1/2
of the Illinois Insurance Code,
|
| 23 | | (1) the Director shall give primary consideration to |
| 24 | | the continuation of
benefits to enrollees and the |
| 25 | | financial conditions of the acquired Health
Maintenance |
| 26 | | Organization after the merger, consolidation, or other
|
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| 1 | | acquisition of control takes effect;
|
| 2 | | (2)(i) the criteria specified in subsection (1)(b) of |
| 3 | | Section 131.8 of
the Illinois Insurance Code shall not |
| 4 | | apply and (ii) the Director, in making
his determination |
| 5 | | with respect to the merger, consolidation, or other
|
| 6 | | acquisition of control, need not take into account the |
| 7 | | effect on
competition of the merger, consolidation, or |
| 8 | | other acquisition of control;
|
| 9 | | (3) the Director shall have the power to require the |
| 10 | | following
information:
|
| 11 | | (A) certification by an independent actuary of the |
| 12 | | adequacy
of the reserves of the Health Maintenance |
| 13 | | Organization sought to be acquired;
|
| 14 | | (B) pro forma financial statements reflecting the |
| 15 | | combined balance
sheets of the acquiring company and |
| 16 | | the Health Maintenance Organization sought
to be |
| 17 | | acquired as of the end of the preceding year and as of |
| 18 | | a date 90 days
prior to the acquisition, as well as pro |
| 19 | | forma financial statements
reflecting projected |
| 20 | | combined operation for a period of 2 years;
|
| 21 | | (C) a pro forma business plan detailing an |
| 22 | | acquiring party's plans with
respect to the operation |
| 23 | | of the Health Maintenance Organization sought to
be |
| 24 | | acquired for a period of not less than 3 years; and
|
| 25 | | (D) such other information as the Director shall |
| 26 | | require.
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| 1 | | (d) The provisions of Article VIII 1/2 of the Illinois |
| 2 | | Insurance Code
and this Section 5-3 shall apply to the sale by |
| 3 | | any health maintenance
organization of greater than 10% of its
|
| 4 | | enrollee population (including without limitation the health |
| 5 | | maintenance
organization's right, title, and interest in and |
| 6 | | to its health care
certificates).
|
| 7 | | (e) In considering any management contract or service |
| 8 | | agreement subject
to Section 141.1 of the Illinois Insurance |
| 9 | | Code, the Director (i) shall, in
addition to the criteria |
| 10 | | specified in Section 141.2 of the Illinois
Insurance Code, |
| 11 | | take into account the effect of the management contract or
|
| 12 | | service agreement on the continuation of benefits to enrollees |
| 13 | | and the
financial condition of the health maintenance |
| 14 | | organization to be managed or
serviced, and (ii) need not take |
| 15 | | into account the effect of the management
contract or service |
| 16 | | agreement on competition.
|
| 17 | | (f) Except for small employer groups as defined in the |
| 18 | | Small Employer
Rating, Renewability and Portability Health |
| 19 | | Insurance Act and except for
medicare supplement policies as |
| 20 | | defined in Section 363 of the Illinois
Insurance Code, a |
| 21 | | Health Maintenance Organization may by contract agree with a
|
| 22 | | group or other enrollment unit to effect refunds or charge |
| 23 | | additional premiums
under the following terms and conditions:
|
| 24 | | (i) the amount of, and other terms and conditions with |
| 25 | | respect to, the
refund or additional premium are set forth |
| 26 | | in the group or enrollment unit
contract agreed in advance |
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| 1 | | of the period for which a refund is to be paid or
|
| 2 | | additional premium is to be charged (which period shall |
| 3 | | not be less than one
year); and
|
| 4 | | (ii) the amount of the refund or additional premium |
| 5 | | shall not exceed 20%
of the Health Maintenance |
| 6 | | Organization's profitable or unprofitable experience
with |
| 7 | | respect to the group or other enrollment unit for the |
| 8 | | period (and, for
purposes of a refund or additional |
| 9 | | premium, the profitable or unprofitable
experience shall |
| 10 | | be calculated taking into account a pro rata share of the
|
| 11 | | Health Maintenance Organization's administrative and |
| 12 | | marketing expenses, but
shall not include any refund to be |
| 13 | | made or additional premium to be paid
pursuant to this |
| 14 | | subsection (f)). The Health Maintenance Organization and |
| 15 | | the
group or enrollment unit may agree that the profitable |
| 16 | | or unprofitable
experience may be calculated taking into |
| 17 | | account the refund period and the
immediately preceding 2 |
| 18 | | plan years.
|
| 19 | | The Health Maintenance Organization shall include a |
| 20 | | statement in the
evidence of coverage issued to each enrollee |
| 21 | | describing the possibility of a
refund or additional premium, |
| 22 | | and upon request of any group or enrollment unit,
provide to |
| 23 | | the group or enrollment unit a description of the method used |
| 24 | | to
calculate (1) the Health Maintenance Organization's |
| 25 | | profitable experience with
respect to the group or enrollment |
| 26 | | unit and the resulting refund to the group
or enrollment unit |
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| 1 | | or (2) the Health Maintenance Organization's unprofitable
|
| 2 | | experience with respect to the group or enrollment unit and |
| 3 | | the resulting
additional premium to be paid by the group or |
| 4 | | enrollment unit.
|
| 5 | | In no event shall the Illinois Health Maintenance |
| 6 | | Organization
Guaranty Association be liable to pay any |
| 7 | | contractual obligation of an
insolvent organization to pay any |
| 8 | | refund authorized under this Section.
|
| 9 | | (g) Rulemaking authority to implement Public Act 95-1045, |
| 10 | | if any, is conditioned on the rules being adopted in |
| 11 | | accordance with all provisions of the Illinois Administrative |
| 12 | | Procedure Act and all rules and procedures of the Joint |
| 13 | | Committee on Administrative Rules; any purported rule not so |
| 14 | | adopted, for whatever reason, is unauthorized. |
| 15 | | (Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19; |
| 16 | | 101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-393, eff. |
| 17 | | 1-1-20; 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, |
| 18 | | eff. 1-1-21; 102-30, eff. 1-1-22; 102-34, eff. 6-25-21; |
| 19 | | 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. |
| 20 | | 1-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, |
| 21 | | eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22; |
| 22 | | 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. |
| 23 | | 1-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, |
| 24 | | eff. 1-1-23; 102-1117, eff. 1-13-23; revised 1-22-23.)
|
| 25 | | Section 45. The Voluntary Health Services Plans Act is |
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| 1 | | amended by changing Section 10 as follows:
|
| 2 | | (215 ILCS 165/10) (from Ch. 32, par. 604)
|
| 3 | | Sec. 10. Application of Insurance Code provisions. Health |
| 4 | | services
plan corporations and all persons interested therein |
| 5 | | or dealing therewith
shall be subject to the provisions of |
| 6 | | Articles IIA and XII 1/2 and Sections
3.1, 133, 136, 139, 140, |
| 7 | | 143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b, |
| 8 | | 356g, 356g.5, 356g.5-1, 356q, 356r, 356t, 356u, 356v,
356w, |
| 9 | | 356x, 356y, 356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, |
| 10 | | 356z.6, 356z.8, 356z.9,
356z.10, 356z.11, 356z.12, 356z.13, |
| 11 | | 356z.14, 356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25, |
| 12 | | 356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33, |
| 13 | | 356z.40, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, |
| 14 | | 356z.56, 356z.57, 356z.59, 356z.60, 356z.62, 364.01, 364.3, |
| 15 | | 367.2, 368a, 401, 401.1,
402,
403, 403A, 408,
408.2, and 412, |
| 16 | | and paragraphs (7) and (15) of Section 367 of the Illinois
|
| 17 | | Insurance Code.
|
| 18 | | Rulemaking authority to implement Public Act 95-1045, if |
| 19 | | any, is conditioned on the rules being adopted in accordance |
| 20 | | with all provisions of the Illinois Administrative Procedure |
| 21 | | Act and all rules and procedures of the Joint Committee on |
| 22 | | Administrative Rules; any purported rule not so adopted, for |
| 23 | | whatever reason, is unauthorized. |
| 24 | | (Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19; |
| 25 | | 101-281, eff. 1-1-20; 101-393, eff. 1-1-20; 101-625, eff. |
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| 1 | | 1-1-21; 102-30, eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, |
| 2 | | eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; |
| 3 | | 102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 102-804, eff. |
| 4 | | 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, |
| 5 | | eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, eff. 1-1-23; |
| 6 | | 102-1117, eff. 1-13-23.)
|
| 7 | | Section 50. The Medical Practice Act of 1987 is amended by |
| 8 | | changing Section 18 as follows:
|
| 9 | | (225 ILCS 60/18) (from Ch. 111, par. 4400-18)
|
| 10 | | (Section scheduled to be repealed on January 1, 2027)
|
| 11 | | Sec. 18. Visiting professor, physician, or resident |
| 12 | | permits.
|
| 13 | | (A) Visiting professor permit.
|
| 14 | | (1) A visiting professor permit shall
entitle a person |
| 15 | | to practice medicine in all of its branches
or to practice |
| 16 | | the treatment of human ailments without the
use of drugs |
| 17 | | and without operative surgery provided:
|
| 18 | | (a) the person maintains an equivalent |
| 19 | | authorization
to practice medicine in all of its |
| 20 | | branches or to practice
the treatment of human |
| 21 | | ailments without the use of drugs
and without |
| 22 | | operative surgery in good standing in his or her
|
| 23 | | native licensing jurisdiction during the period of the
|
| 24 | | visiting professor permit;
|
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| 1 | | (b) the person has received a faculty appointment |
| 2 | | to
teach in a medical, osteopathic or chiropractic |
| 3 | | school in
Illinois; and
|
| 4 | | (c) the Department may prescribe the information |
| 5 | | necessary to
establish
an applicant's eligibility for |
| 6 | | a permit. This information shall include
without |
| 7 | | limitation (i) a statement from the dean of the |
| 8 | | medical school at which
the
applicant will be employed |
| 9 | | describing the applicant's qualifications and (ii)
a |
| 10 | | statement from the dean of the medical school listing |
| 11 | | every affiliated
institution in which the applicant |
| 12 | | will be providing instruction as part of the
medical |
| 13 | | school's education program and justifying any clinical |
| 14 | | activities at
each of the institutions listed by the |
| 15 | | dean.
|
| 16 | | (2) Application for visiting professor permits shall
|
| 17 | | be made to the Department, in writing, on forms prescribed
|
| 18 | | by the Department and shall be accompanied by the required
|
| 19 | | fee established by rule, which shall not be refundable. |
| 20 | | Any application
shall require the information as, in the |
| 21 | | judgment of the Department, will
enable the Department to |
| 22 | | pass on the qualifications of the applicant.
|
| 23 | | (3) A visiting professor permit shall be valid for no |
| 24 | | longer than 2
years from the date of issuance or until the |
| 25 | | time the
faculty appointment is terminated, whichever |
| 26 | | occurs first,
and may be renewed only in accordance with |
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| 1 | | subdivision (A)(6) of this
Section.
|
| 2 | | (4) The applicant may be required to appear before the |
| 3 | | Medical Board for an interview prior to, and as a
|
| 4 | | requirement for, the issuance of the original permit and |
| 5 | | the
renewal.
|
| 6 | | (5) Persons holding a permit under this Section shall
|
| 7 | | only practice medicine in all of its branches or practice
|
| 8 | | the treatment of human ailments without the use of drugs
|
| 9 | | and without operative surgery in the State of Illinois in
|
| 10 | | their official capacity under their contract
within the |
| 11 | | medical school itself and any affiliated institution in |
| 12 | | which the
permit holder is providing instruction as part |
| 13 | | of the medical school's
educational program and for which |
| 14 | | the medical school has assumed direct
responsibility.
|
| 15 | | (6) After the initial renewal of a visiting professor |
| 16 | | permit, a visiting professor permit shall be valid until |
| 17 | | the last day of the
next physician license renewal period, |
| 18 | | as set by rule, and may only be
renewed for applicants who |
| 19 | | meet the following requirements:
|
| 20 | | (i) have obtained the required continuing |
| 21 | | education hours as set by
rule; and
|
| 22 | | (ii) have paid the fee prescribed for a license |
| 23 | | under Section 21 of this
Act.
|
| 24 | | For initial renewal, the visiting professor must |
| 25 | | successfully pass a
general competency examination authorized |
| 26 | | by the Department by rule, unless he or she was issued an |
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| 1 | | initial visiting professor permit on or after January 1, 2007, |
| 2 | | but prior to July 1, 2007.
|
| 3 | | (B) Visiting physician permit.
|
| 4 | | (1) The Department may, in its discretion, issue a |
| 5 | | temporary visiting
physician permit, without examination, |
| 6 | | provided:
|
| 7 | | (a) (blank);
|
| 8 | | (b) that the person maintains an equivalent |
| 9 | | authorization to practice
medicine in all of its |
| 10 | | branches or to practice the treatment of human
|
| 11 | | ailments without the use of drugs and without |
| 12 | | operative surgery in good
standing in his or her |
| 13 | | native licensing jurisdiction during the period of the
|
| 14 | | temporary visiting physician permit;
|
| 15 | | (c) that the person has received an invitation or |
| 16 | | appointment to study,
demonstrate, or perform a
|
| 17 | | specific medical, osteopathic, chiropractic or |
| 18 | | clinical subject or
technique in a medical, |
| 19 | | osteopathic, or chiropractic school, a state or |
| 20 | | national medical, osteopathic, or chiropractic |
| 21 | | professional association or society conference or |
| 22 | | meeting, a hospital
licensed under the Hospital |
| 23 | | Licensing Act, a hospital organized
under the |
| 24 | | University of Illinois Hospital Act, or a facility |
| 25 | | operated
pursuant to the Ambulatory Surgical Treatment |
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| 1 | | Center Act; and
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| 2 | | (d) that the temporary visiting physician permit |
| 3 | | shall only permit the
holder to practice medicine in |
| 4 | | all of its branches or practice the
treatment of human |
| 5 | | ailments without the use of drugs and without |
| 6 | | operative
surgery within the scope of the medical, |
| 7 | | osteopathic, chiropractic, or
clinical studies, or in |
| 8 | | conjunction with the state or national medical, |
| 9 | | osteopathic, or chiropractic professional association |
| 10 | | or society conference or meeting, for which the holder |
| 11 | | was invited or appointed.
|
| 12 | | (2) The application for the temporary visiting |
| 13 | | physician permit shall be
made to the Department, in |
| 14 | | writing, on forms prescribed by the
Department, and shall |
| 15 | | be accompanied by the required fee established by
rule, |
| 16 | | which shall not be refundable. The application shall |
| 17 | | require
information that, in the judgment of the |
| 18 | | Department, will enable the
Department to pass on the |
| 19 | | qualification of the applicant, and the necessity
for the |
| 20 | | granting of a temporary visiting physician permit.
|
| 21 | | (3) A temporary visiting physician permit shall be |
| 22 | | valid for no longer than (i) 180
days
from the date of |
| 23 | | issuance or (ii) until the time the medical, osteopathic,
|
| 24 | | chiropractic, or clinical studies are completed, or the |
| 25 | | state or national medical, osteopathic, or chiropractic |
| 26 | | professional association or society conference or meeting |
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| 1 | | has concluded, whichever occurs first. The temporary |
| 2 | | visiting physician permit may be issued multiple times to |
| 3 | | a visiting physician under this paragraph (3) as long as |
| 4 | | the total number of days it is active do not exceed 180 |
| 5 | | days within a 365-day period.
|
| 6 | | (4) The applicant for a temporary visiting physician |
| 7 | | permit may be
required to appear before the Medical Board |
| 8 | | for an interview
prior to, and as a requirement for, the |
| 9 | | issuance of a temporary visiting
physician permit.
|
| 10 | | (5) A limited temporary visiting physician permit |
| 11 | | shall be issued to a
physician licensed in another state |
| 12 | | who has been requested to perform emergency
procedures in |
| 13 | | Illinois if he or she meets the requirements as |
| 14 | | established by
rule.
|
| 15 | | (C) Visiting resident permit.
|
| 16 | | (1) The Department may, in its discretion, issue a |
| 17 | | temporary visiting
resident permit, without examination, |
| 18 | | provided:
|
| 19 | | (a) (blank);
|
| 20 | | (b) that the person maintains an equivalent |
| 21 | | authorization to practice
medicine in all of its |
| 22 | | branches or to practice the treatment of human
|
| 23 | | ailments without the use of drugs and without |
| 24 | | operative surgery in good
standing in his or her |
| 25 | | native licensing jurisdiction during the period of
the |
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| 1 | | temporary visiting resident permit;
|
| 2 | | (c) that the applicant is enrolled in a |
| 3 | | postgraduate clinical training
program outside the |
| 4 | | State of Illinois that is approved by the Department;
|
| 5 | | (d) that the individual has been invited or |
| 6 | | appointed for a specific
period of time to perform a |
| 7 | | portion of that post graduate clinical training
|
| 8 | | program under the supervision of an Illinois licensed |
| 9 | | physician in an
Illinois patient care clinic or |
| 10 | | facility that is affiliated with the
out-of-State post |
| 11 | | graduate training program; and
|
| 12 | | (e) that the temporary visiting resident permit |
| 13 | | shall only permit the
holder to practice medicine in |
| 14 | | all of its branches or practice the
treatment of human |
| 15 | | ailments without the use of drugs and without |
| 16 | | operative
surgery within the scope of the medical, |
| 17 | | osteopathic, chiropractic or
clinical studies for |
| 18 | | which the holder was invited or appointed.
|
| 19 | | (2) The application for the temporary visiting |
| 20 | | resident permit shall be
made to the Department, in |
| 21 | | writing, on forms prescribed by the Department,
and shall |
| 22 | | be accompanied by the required fee established by rule. |
| 23 | | The
application shall require information that, in the |
| 24 | | judgment of the
Department, will enable the Department to |
| 25 | | pass on the qualifications of
the applicant.
|
| 26 | | (3) A temporary visiting resident permit shall be |
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| 1 | | valid for 180 days from
the date of issuance or until the |
| 2 | | time the medical, osteopathic,
chiropractic, or clinical |
| 3 | | studies are completed, whichever occurs first.
|
| 4 | | (4) The applicant for a temporary visiting resident |
| 5 | | permit may be
required to appear before the Medical Board |
| 6 | | for an interview
prior to, and as a requirement for, the |
| 7 | | issuance of a temporary visiting
resident permit.
|
| 8 | | (D) Postgraduate training exemption period; visiting |
| 9 | | rotations. A person may participate in visiting rotations in |
| 10 | | an approved postgraduate training program, not to exceed a |
| 11 | | total of 90 days for all rotations, if the following |
| 12 | | information is submitted in writing or electronically to the |
| 13 | | Department by the patient care clinics or facilities where the |
| 14 | | person will be performing the training or by an affiliated |
| 15 | | program: |
| 16 | | (1) The person who has been invited or appointed to |
| 17 | | perform a portion of their postgraduate clinical training |
| 18 | | program in Illinois. |
| 19 | | (2) The name and address of the primary patient care |
| 20 | | clinic or facility, the date the training is to begin, and |
| 21 | | the length of time of the invitation or appointment. |
| 22 | | (3) The name and license number of the Illinois |
| 23 | | physician who will be responsible for supervising the |
| 24 | | trainee and the medical director or division director of |
| 25 | | the department or facility. |
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| 1 | | (4) Certification from the postgraduate training |
| 2 | | program that the person is approved and enrolled in an |
| 3 | | graduate training program approved by the Department in |
| 4 | | their home state.
|
| 5 | | (Source: P.A. 102-20, eff. 1-1-22.)
|
| 6 | | Section 95. No acceleration or delay. Where this Act makes |
| 7 | | changes in a statute that is represented in this Act by text |
| 8 | | that is not yet or no longer in effect (for example, a Section |
| 9 | | represented by multiple versions), the use of that text does |
| 10 | | not accelerate or delay the taking effect of (i) the changes |
| 11 | | made by this Act or (ii) provisions derived from any other |
| 12 | | Public Act.
|
| 13 | | Section 99. Effective date. This Act takes effect upon |
| 14 | | becoming law.".
|