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| Public Act 101-0488 | ||||
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AN ACT concerning regulation.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Illinois Insurance Code is amended by | ||||
changing Section 356z.25 as follows: | ||||
(215 ILCS 5/356z.25) | ||||
Sec. 356z.25. Coverage for treatment of pediatric | ||||
autoimmune neuropsychiatric disorders associated with | ||||
streptococcal infections and pediatric acute onset | ||||
neuropsychiatric syndrome. A group or individual policy of | ||||
accident and health insurance or managed care plan that is | ||||
amended, delivered, issued, or renewed after July 18, 2017 (the | ||||
effective date of Public Act 100-24) shall provide coverage for | ||||
treatment of pediatric autoimmune neuropsychiatric disorders | ||||
associated with streptococcal infections and pediatric | ||||
acute-onset neuropsychiatric syndrome, including, but not | ||||
limited to, the use of intravenous immunoglobulin therapy. | ||||
For billing and diagnosis purposes, pediatric autoimmune | ||||
neuropsychiatric disorders associated with streptococcal | ||||
infections and pediatric acute onset neuropsychiatric syndrome | ||||
shall be coded as autoimmune encephalitis until the American | ||||
Medical Association and the Centers for Medicare and Medicaid | ||||
Services create and assign a specific code for pediatric | ||||
autoimmune neuropsychiatric disorders associated with | ||
streptococcal infections and pediatric acute onset | ||
neuropsychiatric syndrome. Thereafter, pediatric autoimmune | ||
neuropsychiatric disorders associated with streptococcal | ||
infections and pediatric acute onset neuropsychiatric syndrome | ||
may be coded as autoimmune encephalitis, pediatric autoimmune | ||
neuropsychiatric disorders associated with streptococcal | ||
infections, or pediatric acute onset neuropsychiatric | ||
syndrome. | ||
If, at any time, the Secretary of the United States | ||
Department of Health and Human Services, or its successor | ||
agency, promulgates rules or regulations to be published in the | ||
Federal Register or publishes a comment in the Federal Register | ||
or issues an opinion, guidance, or other action that would | ||
require the State, pursuant to any provision of the Patient | ||
Protection and Affordable Care Act (Public Law 111-148), | ||
including, but not limited to, 42 U.S.C. 18031(d)(3)(B) or any | ||
successor provision, to defray the cost of any coverage for | ||
pediatric autoimmune neuropsychiatric disorders associated | ||
with streptococcal infections and pediatric acute onset | ||
neuropsychiatric syndrome outlined in this Section, then the | ||
requirement that an insurer cover pediatric autoimmune | ||
neuropsychiatric disorders associated with streptococcal | ||
infections and pediatric acute onset neuropsychiatric syndrome | ||
is inoperative other than any such coverage authorized under | ||
Section 1902 of the Social Security Act, 42 U.S.C. 1396a, and | ||
the State shall not assume any obligation for the cost of | ||
coverage for pediatric autoimmune neuropsychiatric disorders | ||
associated with streptococcal infections and pediatric acute | ||
onset neuropsychiatric syndrome.
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(Source: P.A. 100-24, eff. 7-18-17; 100-863, eff. 8-14-18.)
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Section 99. Effective date. This Act takes effect upon | ||
becoming law.
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