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91_HB4176sam002
LRB9109951JSpcam07
1 AMENDMENT TO HOUSE BILL 4176
2 AMENDMENT NO. . Amend House Bill 4176 by inserting
3 immediately below line 5 the following:
4 "Section 5. Legislative intent. It is the intent of the
5 legislature to lessen patients' waiting times, decrease
6 administrative burdens for pharmacies, and improve care to
7 patients by minimizing confusion, eliminating unnecessary
8 paperwork, and streamlining the dispensing of prescription
9 products paid for by third-party payors. This Act shall be
10 broadly applied and interpreted to effectuate this purpose.
11 Section 10. Definitions. As used in this Act, the
12 following terms have the meanings given in this Section.
13 "Department" means the Department of Insurance.
14 "Director" means the Director of Insurance.
15 "Health benefit plan" means an accident and health
16 insurance policy or certificate subject to the Illinois
17 Insurance Code, a voluntary health services plan subject to
18 the Voluntary Health Services Plans Act, a health maintenance
19 organization subscriber contract subject to the Health
20 Maintenance Organization Act, a plan provided by a multiple
21 employer welfare arrangement, or a plan provided by another
22 benefit arrangement. Without limitation, "health benefit
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1 plan" does not mean any of the following types of insurance:
2 (1) accident;
3 (2) credit;
4 (3) disability income;
5 (4) long-term or nursing home care;
6 (5) specified disease;
7 (6) dental or vision;
8 (7) coverage issued as a supplement to liability
9 insurance;
10 (8) medical payments under automobile or
11 homeowners;
12 (9) insurance under which benefits are payable with
13 or without regard to fault as statutorily required to be
14 contained in any liability policy or equivalent
15 self-insurance;
16 (10) hospital income or indemnity;
17 (11) self-insured health benefit plans under the
18 federal Employee Retirement Income Security Act of 1974.
19 Section 15. Uniform prescription drug information cards
20 required.
21 (a) A health benefit plan that issues a card or other
22 technology and provides coverage for prescription drugs or
23 devices and an administrator of such a plan including, but
24 not limited to, third-party administrators for self-insured
25 plans and state-administered plans shall issue to its
26 insureds a card or other technology containing uniform
27 prescription drug information. The uniform prescription drug
28 information card or other technology shall specifically
29 identify and display the following mandatory data elements on
30 the front of the card:
31 (1) BIN number;
32 (2) Processor control number if required for claims
33 adjudication;
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1 (3) Group number;
2 (4) Card issuer identifier;
3 (5) Cardholder ID number; and
4 (6) Cardholder name.
5 The uniform prescription drug information card or other
6 technology shall specifically identify and display the
7 following mandatory data elements on the back of the card:
8 (1) Claims submission names and addresses; and
9 (2) Help desk telephone numbers and names.
10 (b) A new uniform prescription drug information card or
11 other technology shall be issued by a health benefit plan
12 upon enrollment and reissued upon any change in the insured's
13 coverage that affects mandatory data elements contained on
14 the card.
15 Section 20. Applicability and enforcement.
16 (a) This Act applies to health benefit plans that are
17 amended, delivered, issued, or renewed on and after the
18 effective date of this amendatory Act of the 91st General
19 Assembly.
20 (b) The Director may adopt rules necessary to implement
21 the Department's responsibilities under this Act. To enforce
22 the provisions of this Act, the Director may issue a cease
23 and desist order or require a health benefit plan to submit a
24 plan of correction for violations of this Act, or both.
25 Subject to the provisions of the Illinois Administrative
26 Procedure Act, the Director may, pursuant to Section 403A of
27 the Illinois Insurance Code, impose upon a health benefit
28 plan an administrative fine not to exceed $250,000 for
29 failure to submit a requested plan of correction, failure to
30 comply with its plan or correction, or repeated violations of
31 this Act.
32 Section 99. Effective date. This Act takes effect on
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1 January 1, 2001.".