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Legislative Update (January to June 2004) |
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REVISED ILLINOIS STATUTES Defrauding Drug and Alcohol Screening Tests Effective July 9, 2004, the criminal code is amended to make it unlawful for a person to take certain actions with the intent to foil or defeat or defraud a drug or alcohol screening test, such as by using synthetic or human substances or other products. A violation of this section of the criminal code is a Class 4 felony, with a minimum fine of $1,000. See Public Act 093-0691. The Illinois Spousal Continuation Law The Illinois Spousal Continuation Law protects a covered spouse and dependent children who lose group health insurance coverage due to death or retirement of the employee or divorce from the employee. Employers offering fully insured group and accident health plans are required to comply, regardless of the group's size. Effective January 1, 2004, the law was amended to include HMO plans. This law does not apply to (1) self-insured employers; (2) health and welfare benefit plans, (ie., union plans); or (3) insurance policies or trusts written in other states. See 215 ILCS 5/367.2 The Illinois Continuation Law Effective January 1, 2004, the Illinois Continuation Law was amended to require employers to offer continuation coverage to an employee whose insurance is terminated due to a reduction in hours worked. Employers must provide continuation of coverage to employees and eligible dependents who were continuously covered under group coverage for three months prior to termination of employment. The law applies to all employers who provide employees with fully insured group and accident health plans or HMO coverage, regardless of the group's size. See 215 ILCS 5/367e. Dependent Child Continuation Law Effective July 1, 2004, the Illinois Dependent Child Continuation Law protects dependent children who lose their group health insurance coverage with an employer group of any size due to: 1) attainment of the limiting age under a policy; or 2) the death of an insured parent (and coverage is not available under the Spousal Continuation Law.) The law applies to employer groups of any size, provided the employer offers fully insured group and accident health plans and fully insured HMO coverage. Continuation coverage must be provided for a maximum of two years after the date a dependant child’s insurance stops due to a qualifying event. See 215 ILCS 5/367.2 5 Drug or Alcohol Impaired Minor Responsibility Act The Act allows individuals to file a lawsuit against any person at least 18 years of age who willfully supplies alcoholic liquor or illegal drugs to a child under 18 which results in injury or death to the child. Individuals may be awarded economic damages, pain and suffering, punitive damages, attorney’s fees and court costs. The law became effective January 1, 2004 but applies only to causes of action that accrue after October 1, 2004. The statute of limitations is two years for these cases. See Public Act 93-588. Mental Health Commitment Training The Mental Health and Developmental Disabilities Administrative Act was amended to require the Department of Human Services to hold an annual training event for judges, attorneys, law enforcement, hospital and community agency personnel and health care personnel. Court Ordered Treatment for Driving Under the Influence Illinois House Bill 1358 amends the Illinois Vehicle Code to require that, as a part of the final sentencing process, individuals convicted of driving under the influence (DUI) or placed on supervision for DUI undergo imposition of evaluation recommendations for drug or alcohol abuse problems in accordance with rules adopted by the Department of Human Services (rather than undergo the imposition of treatment as appropriate). The Bill requires that the defendant must pay the cost for the evaluation and treatment program. See HB 1358 DHS Olmstead Initiative If passed into law, the MI Olmstead Initiative of 2004 would establish a 5-year program to provide individuals with mental illness or a co-occurring disorder of mental illness and substance abuse with appropriate residential and community-based support services. This Bill was drafted in response to the U.S. Supreme Court’s decision in Olmstead v. L.C. ex. Rel. Zimring in order to: 1) enable 1,000 qualifying persons who currently reside in nursing facilities to move within the next 5 years to the most integrated community residential settings as possible; and 2) to provide cost effective community residential environments and supportive services. The Bill requires the Department of Human Services to identify potential participants for the program and requires that implementation of the program begin by July 1, 2005. See HB 3915 Proposed Amendments to DHS/MHDD RFP Process If passed, DHS will be authorized to initiate a $64,000,000, 2-year pilot project aimed at improving the delivery of community-based services. The project will increase the number of service contracts open to a competitive selection process, increase the use of fee-for-service contracts and utilize performance-based contracts. See HB 5000 The training will cover the following issues: mental illness, the standards for civil commitment and involuntary treatment, completing documentation, and changes in the Mental Health and Developmental Disabilities Code and Mental Health and Developmental Disabilities Confidentiality Act. See Public Act 93-0376 English-Only Policies The Illinois Human Rights Act was amended to prohibit employers from having “English Only” policies in the workplace. Effective January 1, 2004, Illinois employers are prohibited from imposing restrictions on or preventing a language from being spoken in the workplace by an employee in communications that are unrelated to the employee’s duties. See Public Act 93-0217 PROPOSED LEGISLATION Parity Coverage for Substance Abuse Treatment Drafted by the Firm at the request of IADDA, this proposed Bill requires health insurers to provide substance abuse treatment parity in insurance policies. If passed into law, Senate Bill 2943 will amend the Illinois Insurance Code to require certain health insurers that provide coverage under group policies (i.e., employer policies) to cover the treatment of substance abuse under the same terms and conditions as coverage for other illnesses and diseases. This bill is currently pending before the Illinois State Senate. See SB 2943 Opioid Antagonist Liability Act If passed, the Act would allow a person, other than a licensed health care professional permitted to dispense an opioid antagonist, to administer the drug if he or she: (1) in good faith believes the person is experiencing a drug overdose; and (2) acts with reasonable care. The Act also provides immunity from civil liability or criminal prosecution to the person administering the drug. See HB 6916 NEW REGULATIONS Children’s Mental Health Screening, Assessment and Support Program (SASS) Effective July 1, 2004, any "publicly funded" children under 21 years of age who present in a hospital for psychiatric admission must be screened through the new Children’s Mental Health Screening, Assessment and Support (SASS) program. Pursuant to the Children’s Mental Health Act of 2003 (405 ILCS 49) SASS is being implemented by the Illinois Department of Public Aid in conjunction with DHS and DCFS. The new regulations establish criteria for payment to providers for SASS services. The SASS program covers mental health inpatient, outpatient, and screening services for children who are current Medicaid recipients, are Medicaid-eligible or have no insurance for a mental condition. The goal of the program is to expand access to services for underserved and uninsured children by providing alternative services to inpatient hospitalization. The program is expected to target resources more efficiently and effectively by preventing unnecessary psychiatric hospitalizations of children and adolescents. It is estimated that SASS will leverage an additional $1.1 million in federal Medicaid funding. See 59 Illinois Administrative Code 131, Illinois Register Volume 28, Issue 29 Hospital Charity Care Reporting Requirements This adopted rule revises the reporting requirements regarding uninsured care in hospitals which are eligible to receive Medicaid disproportionate share hospital (DSH) adjustment payments. Most notably, the rules expand the definition of “hospital charity care charges" and "hospital bad debt" to include inpatient, outpatient and hospital clinic services provided to individuals without health insurance or other sources of third party coverage, including TANF. Charity care charges and bad debt cannot include unpaid co-pays or third party obligations of insured patients, contractual allowances or the hospital's charges or reduced charges attributable to services provided under obligation of the Hill-Burton Act. See 89 Illinois Administrative Code 150, Illinois Register, Volume 28, Issue 28 PROPOSED REGULATIONS HMO Copayments and Deductible Limits The Rule proposes to adjust the maximum yearly out-of-pocket limits for HMO enrollees and specify how those maximums may be calculated. Copayments and deductibles will be required to be a specific dollar amount or a specific percentage of the cost of the care. No combination of deductibles and copayments for basic health care services may exceed 50% of the HMO’s usual and customary fee and must be waived when, in a contract calendar year, deductibles and copayments paid for the receipt of basic health care services exceed $3000 per enrollee or $6000 per family. Illinois Register, Volume 28, Issue 25 SASS Presumptive Eligibility The proposed rule would establish presumptive eligibility for children under 19 that will allow them to have immediate health care coverage while their applications for medical benefits are being reviewed. During fiscal year 2005, medical services provided under presumptive eligibility provisions are expected to result in an increase in cost to the State of approximately $18 million. See Illinois Register, Volume 28, Issue 20 Health Care Worker Background Check Code If passed, the rule will contain a list of additional disqualifying offenses, requirements concerning fingerprint and non-fingerprint background checks, and procedures for criminal history record checks after January 1, 2004, and requirements for notification to applicants and employees. The amendment will also include the following two new provisions: 1) health care employers will be required to establish a policy concerning employment of individuals whose criminal history record checks indicate convictions for offenses that are not disqualifying; and 2) employers will be required to develop a policy concerning employment of individuals who have been granted waivers. See Illinois Register Volume 28, Issue 8 Asset Determination for TANF (Temporary Assistance for Needy Families) This rule change proposes to exempt pension plans, including accounts solely owned by an individual such as an Individual Retirement Account (IRA), 401 K and Keogh Plan, from consideration as an asset for TANF eligibility. Implementing this change is expected to simplify the way these assets are considered for the TANF Program. See Illinois Register, Volume 28, Issue 31 EXECUTIVE ORDER Family Day By Executive Order issued on July 8, 2004, Governor Blagojevich proclaimed that September 27, 2004 is Family Day – A Day To Eat Dinner With Your Children. The purpose is to “encourage all families to take this easy step toward ensuring that their children lead safe, substance-free lives.” The Order is in response to research by The National Center on Addiction and Substance Abuse (CASA) at Columbia University which found that teens from families that almost never eat together are 72% more likely to smoke, drink, or use illegal drugs than the average teen. See Illinois Register, Volume 28, Issue 30. |