Promoting Health Insurance Fairness

A measure designed to promote health insurance fairness became law this year in Illinois. House Bill 3923, sponsored by Senator Heather Steans and Representative Greg Harris, established an independent review process for carriers who have denied claims and made it easier for small businesses to apply for health insurance. It also set up a committee that will be responsible for creating a standard heath insurance application for individual and small employer policies.

House Bill 3923 provides positive results for all sources involved. Business organizations will have a more competitive edge. Insurance companies will have a more concise process to delineate claims. Advocates will be able to consult outside of the insurance companies and receive quicker responses to dire requests when time is critical for a patient's treatment.

An initiative passed this year that is aimed at sustaining Illinois’ small and rural hospitals by reimbursing Critical Access Hospitals (CAHs) for medicaid costs. House Bill 5765, sponsored by Senator Gary Forby, allows the Department of Healthcare and Family Services to reimburse CAHs for outpatient services at a rate no less than the cost of care.

The Illinois Hospital Association claims that CAHs make up about 25 percent of the hospitals statewide and are typically the largest employer for regions in which they are located. With some rural areas seeing higher unemployment already, a CAH closing could mean unemployment may reach 20 percent in that community. This protects both jobs and health resources for those regions.

The measure was supported by key constituent organizations including AARP Illinois, The Community Renewal Society, Illinois Citizens for Better Care, the Jane Addams Senior Caucus, SEIU and AFSCME.

Streamlined Services Legislation Passes Both Houses

Legislation aimed at streamlining services and reducing the State’s financial deficit passed both houses this year. House Bill 5124 (Bond) creates a streamlined auditing and accreditation system for all human services state agencies. Agencies included under this legislation are the Department of Human Services, the Department of Children and Family Services, and the Department of Healthcare and Family Services.  The new system is intended to address potential inefficiencies or redundancies in the oversight of service providers, auditing procedures, licensing and training requirements.

Children Able to Remain Enrolled in the ALL KIDS Program

Children enrolled in the ALL KIDS program will be able to remain enrolled, even if their premiums for coverage are late, under legislation passed this year. House Bill 5927 (Delgado) removes a provision in the law that makes children ineligible for the ALL KIDS program for three months if their premium payments are late.  ALL KIDS provides com prehensive coverage including doctors’ visits, hospital stays, prescription drugs, vision care, dental care and medical devices like eyeglasses and asthma inhalers.

Toxoplasmosis Testing for Pregnant Women

Senate Bill 3667(Delgado) creates the Prenatal and Neonatal Congenital Toxoplasmosis Prevention and Treatment Act, which will require every health care professional who provides health care services to a pregnant woman to provide them with Toxoplasmosis screening and counseling, unless the services are refused.  The offer of testing and counseling must be noted on the woman’s medical records. 

Medicaid Reimbursement to Critical Access Hospitals

The problem of Medicaid reimbursement to Critical Access Hospitals was addressed this year in the General Assembly. Senate Bill 3264 (Forby) would require Critical Access Hospitals be reimbursed for outpatient Medicaid services based on cost and seeks to obtain matching federal funds for the reimbursement payments. The proposal will have a significant impact on the smaller rural hospitals located throughout Southern Illinois where many Critical Access Hospitals are several miles from the nearest medical facility and serve large sections of the state.

National Health Care Reform Recognized in Illinois

An effort was made this year to prepare Illinois for national health care reform. Senate Bill 3047 (Koehler) creates the Health Care Justice Implementation Task Force.  This task force will study the new federal health care laws to identify any changes that may be needed in state law or administrative policies.

Efficiency in Nursing Homes

Senate Bill 321 (Link) became law this year that declares that the Director of the Department of Public Health is permitted to require that a nursing home use the amount of a penalty assessed under this Act for the intent of implementing a designated plan of correction instead of paying the amount of the penalty to the Department, if the Director of the Department concludes that it would be in the best interest of the patients of a nursing to take the action. This measure was signed by the Governor and is now law. (PA 96-0883)

Medicaid Revenue Maximization Fund

Senate Bill 3762 (Schoenberg) creates the Medicaid Revenue Maximization Fund. The intention of this legislation is to identify ways by which the current state and local government administration of Medicaid matchable services can be modified to maximize federal revenues.  By encouraging state agencies to work together on this initiative, it is possible for the State of Illinois to realize over $100 million in additional federal matching funds and other third party revenues as a result of this legislation.

Students with Diabetes

Legislation was introduced this year aimed at benefitting students attending schools who have diabetes. SB 3822 (Steans), creates the Care of Students with Diabetes Act to address the management of children with diabetes in a school setting. This measure contains several guidelines for schools in reference to handling students with diabetes, and is meant to ensure that students attending schools get proper care while at school.