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96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010
SB0682
Introduced 2/6/2009, by Sen. John J. Cullerton SYNOPSIS AS INTRODUCED:
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215 ILCS 125/4-5 |
from Ch. 111 1/2, par. 1408.5 |
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Amends the Health Maintenance Organization Act. Makes a technical change in
a
Section concerning organ transplants.
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A BILL FOR
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SB0682 |
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LRB096 06746 RPM 16830 b |
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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 Health Maintenance Organization Act is |
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| amended by changing Section 4-5 as follows:
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| (215 ILCS 125/4-5) (from Ch. 111 1/2, par. 1408.5)
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| Sec. 4-5. Organ Transplants. No contract or evidence
of |
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| coverage issued by a health maintenance organization which |
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| provides
coverage for health care services shall deny |
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| reimbursement for
an otherwise covered expense incurred for any |
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| organ transplantation
procedure solely on the
the basis that |
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| such procedure is deemed experimental or
investigational |
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| unless supported by the determination of the Office of
Health |
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| Care Technology Assessment within the Agency for Health Care |
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| Policy
and Research within the federal Department of Health and |
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| Human Services
that such procedure is either experimental or |
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| investigational or that there
is insufficient data or |
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| experience to determine whether an organ
transplantation |
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| procedure is clinically acceptable. If a health maintenance
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| organization has made written request, or had one made on its |
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| behalf by a
national organization, for determination by the |
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| Office of Health Care
Technology Assessment within the Agency |
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| for Health Care Policy and Research
within the federal |