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Illinois’ 2019 legislative session improved access to health care and more
June 3, 2019
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The Consolidated Omnibus Budget Reconciliation Act (COBRA) health benefit provisions amend the Employee Retirement Income Security Act, the Internal Revenue Code and the Public Health Service Act to require group health plans to provide a temporary continuation of group health coverage that otherwise might be terminated. Q2: What does COBRA do?
On Sunday, the Illinois General Assembly concluded its spring legislative session in Springfield. This Session, Illinois had a new governor and many new faces in the state legislature tackling some of the most complex and impactful issues in the state.
The Omnibus Budget Reconciliation Act refers to several different laws enacted under presidents Ronald Reagan, George H.W. Bush, and Bill Clinton. Here are the most well-known omnibus budget acts, listed in chronological order. Omnibus Budget Reconciliation Act of 1981. Omnibus accounts refer to accounts that hold more than one item (omni-meaning 'many' and -bus meaning 'business'). A minimum of two individuals are required to create an omnibus account. The American Rescue Plan Act (ARPA) requires that from April 1through September 30, COBRA health insurance continuation coverage be provided free of charge to employees and their beneficiaries who lose health care coverage because the employees have been fired or because their hours have been reduced. Insurers (including self-insured employers) will receive tax credits for. The right to COBRA continuation coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). COBRA continuation coverage can become available to you and other members of your family when group health coverage would otherwise end.
“AFC is proud to see Illinois take the necessary steps to invest in the services all Illinoisans need to be healthy and thrive,” said John Peller, President/CEO of the AIDS Foundation of Chicago. AFC advocated for the following bills that passed out of both chambers and are currently awaiting Gov. JB Pritzker’s signature:
HB 2259, the Medicaid Drug and Therapeutics Board Transparency Bill, seeks to increase transparency in the decision-making process and makeup of the Medicaid Drug and Therapeutics (D&T) Board, that with the Department of Healthcare and Family Services (HFS), determines the fee-for-service medication formulary in the Illinois Medicaid program. The bill was sponsored by Rep. Sara Feigenholtz (D-Chicago) in the House and Sen. Julie Morrison (D-Deerfield) in the Senate.
HB 2665, the Youth PrEP Bill, aligns Illinois law with federal guidance on a minor’s ability to access preventive health care services, like PrEP, without parental consent. The bill was sponsored by Rep. Lamont Robinson (D-Chicago) in the House and Sen. Robert Peters (D-Chicago) in the Senate.
Periodic table explorer free. The Periodic Table Explorer, also known as PTE offers you a new way of exploring the periodic table. In fact, it has the same functions as the original Periodic Table software but it adds some many more. Periodic Table Explorer is a software solution that allows users to explore the periodic table and get details about each chemical element. The program boasts a clean interface that offers quick. Periodictable Explorer Moving Away From An Accident By 24-Hour Locksmith Services April 11, 2021 by admin Have you experienced shutting your front doorway, just to find that you have gone out? The Periodic Table Explore has a completely new and innovative user interface that allows for an almost unlimited amount of control over the display. Each display can be opened any number of times. The Periodic Table Explorer is a simple to use resource that covers all of the elements of the periodic table, their compounds, properties, isotopes, reactions, English pronunciations and much more!
HB 465, the Copay Accumulator Bill, bans a newer barrier to health care access called copay accumulators and regulates pharmacy benefit managers. Copay accumulator policies are an unfriendly consumer practice where insurance companies don’t count the value of a copay card to an individual’s out-of-pocket costs. Copay assistance programs are critical for people living with HIV and other chronic diseases, as the cost of prescription drugs for these diseases tends to be even higher. The bill was sponsored by Rep. Greg Harris (D-Chicago) in the House and Sen. Andy Manar (D-Bunker Hill) in the Senate.
SB 1321, the Medicaid Omnibus Bill, contains some provisions from AFC’s legislative efforts as part of the Protect Our Care Illinois Coalition (POC) work to address Illinois’ Medicaid eligibility and redetermination backlogs. The omnibus Medicaid bill is a package of proposed fixes to Medicaid that was developed by the bi-partisan, bi-cameral Medicaid Legislative Working Group. The legislation makes some changes to streamline the process of initial Medicaid eligibility determinations and renewals. The bill is an important step towards addressing backlogs and the Coalition looks forward to continuing to work with the Administration, General Assembly, and stakeholders to keep Illinoisans healthy by ensuring continuity of coverage and care.
We also now have a state budget, which estimates $40.3 billion in revenue, roughly $1.4 billion more revenue than the governor’s introduced Fiscal Year 20 budget at $38.9 billion. The final budget contains level appropriations for the HIV lump sum at $25.5 million, HIV services to address the disproportionate impact of HIV/AIDS on African Americans and other communities of color at $1.2 million, and supportive housing at $15.6 million. These budget lines support primary care and HIV prevention, education, housing and treatment services throughout the entire state.
Phiewer for windows. Finally, the Fair Tax amendment will be on the November 2020 ballot, and voters will get a chance to decide whether the Illinois state constitution should be amended to include a Fair Tax.
The Fair Tax would allow low- to middle-income households to pay less in income taxes, while higher-income households would pay a fairer share. 97% of Illinoisans would see no increase in taxes, while only 3% would be required to pay more. The Fair Tax would generate much-needed revenue for critical health and human services across Illinois, including lifesaving services for people living with or vulnerable to HIV.
Categorized under Advocacy and Illinois.
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Consolidated Omnibus BudgetReconciliation Act of 1985
SEC. 9108.[42 U.S.C. 1395wwnote] CONTINUATION OF MEDICAREREIMBURSEMENT WAIVERS FOR CERTAIN HOSPITALS PARTICIPATING IN REGIONALHOSPITAL REIMBURSEMENT DEMONSTRATIONS.
(a) Continuation ofWaivers.--A hospital reimbursement control systemwhich, on January 1, 1985, was carrying out a demonstration under acontract which had been approved by the Secretary of Health and HumanServices pursuant to section 222(a) of the Social Security Amendments of1972, or under section 402 of the Social Security Amendments of 1967 (asamended by section 222(b) of the Social Security Amendments of 1972), shallbe deemed to meet the requirements of section 1886(c)(1)(A) of the SocialSecurity Act if such system applies--
(1) to substantially all non-Federalacute care hospitals (as defined by the Secretary) in the geographic areaserved by such system on January 1, 1985, and
(2) tothe review of at least 75 percent of--
(A) all revenues or expenses in suchgeographic area for inpatient hospital services, and
(B) revenues or expensesin such geographic area for inpatient hospital services provided under theState’s plan approved under title XIX.
(b) Approval.--In the caseof a hospital cost control system described in subsection (a), therequirements of section 1886(c) of the Social Security Act which apply toStates shall instead apply to such system and, for such purposes, anyreference to a State is deemed a reference to such system.
(c) Effective date.--Thissection shall become effective on the date of the enactment of thisAct.
SEC. 9114.[42 U.S.C. 1395wwnote] INFORMATION ON IMPACT OF PPSPAYMENTS ON HOSPITALS.
(a) Disclosure ofInformation.--The Secretary of Health and HumanServices shall make available to the Prospective Payment AssessmentCommission, the Congressional Budget Office, the Comptroller General, andthe Congressional Research Service the most current information on thepayments being made under section 1886 of the Social Security Act toindividual hospitals. Such information shall be made available in a mannerthat permits examination of the impact of such section on hospitals.
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(b)Confidentiality.--Information disclosed undersubsection (a) shall be treated as confidential and shall not be subject tofurther disclosure in a manner that permits the identification ofindividual hospitals.
SEC. 9122. REQUIREMENT FOR MEDICAREHOSPITALS TO PARTICIPATE IN CHAMPUS AND CHAMPVA PROGRAMS.
(d)[42 U.S.C. 1395c note]Report.--The Secretary of Health and Human Servicesshall report to Congress periodically on the number of hospitals that haveterminated or failed to renew an agreement under section 1866 of the SocialSecurity Act as a result of the additional conditions imposed under theamendments made by subsection (a).
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SEC. 9128.[NoneAssigned] SENSE OF THE SENATE WITHRESPECT TO INPATIENT HOSPITAL DEDUCTIBLE.
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In view of the $92 Medicare hospital deductible increase that wentinto effect January 1, 1986, it is the sense of the Senate that theCommittee on Finance should report legislation which will reformcalculation of the annual increase in such deductible so that it is moreconsistent with annual increases in Medicare payments to hospitals.
(h)[42 U.S.C. 1395w note]Paperwork Reduction.--Chapter 35 of title 44, UnitedStates Code, shall not apply to information required for purposes ofcarrying out this section and the amendments made by this section.
* * * * * * *
(j)[42 U.S.C. 1395w note]Special Treatment of States Formerly Under Waiver.--Inthe case of a hospital in a State that has had a waiver approved undersection 1886(c) of the Social Security Act or section 402 of the SocialSecurity Amendments of 1967, for cost reporting periods beginning on orafter January 1, 1986, if the waiver is terminated--
(1) the Secretary of Health andHuman Services shall permit the hospital to change the method by which itallocates administrative and general costs to the direct medical educationcost centers to the method specified in the medicare cost report;
(2) the Secretary maymake appropriate adjustments in the regional adjusted DRG prospectivepayment rate (for the region in which the State is located), based on theassumption that all teaching hospitals in the State use the medicare costreport; and
(3) the Secretary shalladjust the hospital-specific portion of payment under section 1886(d) ofsuch Act for any such hospital that actually chooses to use the medicarecost report.
The Secretary shall implement this subsection based on thebest available data.
SEC. 9204.MORATORIUMON LABORATORY PAYMENT DEMONSTRATION.
(b)[42 U.S.C. 1395w note]Cooperation in Study.--The Secretary of Health andHuman Services and the Comptroller General shall assist representatives ofclinical laboratories in the industry’s conduct of a study todetermine whether methods exist which are better than competitive biddingfor purposes of utilizing competitive market forces in setting paymentlevels for laboratory services under title XVIII of the Social SecurityAct. If such a study is conducted by the clinical laboratory industry, theSecretary and the Comptroller General shall comment on such study andsubmit such comments and the study to the Senate Committee on Finance andthe House Committees on Ways and Means and Energy and Commerce.
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SEC. 9217.LIVERTRANSPLANTS.
(a)[None Assigned] The Senate findsthat:
(1) There have been more than 600liver transplants since 1963 and the one year survival rate at qualifiedinstitutions is now greater than 70 percent.
(2) There are 4,000 to4,700 potential candidates in the United States each year who require aliver transplant, but only a small percentage would be eligible forMedicare coverage.
(3) There are currentlyindividuals on waiting lists for liver transplants who will die withoutMedicare coverage.
(4) After extensivereview and consideration of all the available data, an National Institutesof Health expert panel concluded liver transplantation is “atherapeutic modality for end-stage liver disease that deserves broaderapplication” in a limited number of centers where they can becarried out under optimal conditions.
(5) National Institutesof Health further recommended that liver transplants be done in individualsunder 18 years of age.
(6) The CHAMPUS program,after considering all relevant data, determined that there was noscientific basis for limiting liver transplants to children under 18 yearsof age.
(7) The Department ofHealth and Human Services has determined that liver transplantation is nolonger an experimental procedure only for children under 18.
(b) Based upon the above findings, it is the sense ofthe Senate that:
(1) For the purposes of title XVIIIof the Social Security Act, the Secretary immediately reconsider theMedicare liver transplant coverage decision and implement a policy underwhich a liver transplant shall not be considered to be an experimentalprocedure for Medicare beneficiaries solely because an individual is over18 years of age.
(2) A liver transplantshall be covered under such title when reasonable and medicallynecessary.
(3) The Secretary shallplace appropriate limiting criteria on coverage, including those relatingto the patient’s condition, the disease state, and the institutionproviding the care, so as to ensure the highest quality of medical caredemonstrated to be consistent with successful outcomes.
SEC. 9517. MODIFYINGAPPLICATION OF MEDICAID HMO PROVISIONS FOR CERTAIN HEALTH CENTERS.
(c)* * *
(2)[42 U.S.C. 1396bnote] (A) Except as provided in subparagraph (B) and inparagraph (3), the amendments made by paragraph (1) shall apply toexpenditures incurred for health insuring organizations which first becomeoperational on or after January 1, 1986. For purposes of this paragraph, ahealth insuring organization is not considered to be operational until thedate on which it first enrolls patients.
(B) In the case of ahealth insuringorganization.--
(i) which first becomes operational on or after January 1, 1986, but
(ii) for which theSecretary of Health and Human Services has waived, under section 1915(b) ofthe Social Security Act and before such date, certain requirements ofsection 1902 of such Act,
clauses (ii) and (vi) of section1903(m)(2)(A) of such Act shall not apply during the period for which suchwaiver is effective.
(C) In the case of the HartfordHealth Network, Inc., clauses (ii) and (vi) of section 1903(m)(2)(A) of theSocial Security Act shall not apply during the period for which a waiver bythe Secretary of Health and Human Services, under section 1915(b) of suchAct, of certain requirements of section 1902 of such Act is in effect(pursuant to a request for a waiver under section 1915(b) of such Actsubmitted before January 1, 1986).
(D) Nothing in section1903(m)(1)(A) of the Social Security Act shall be construed as requiring ahealth-insuring organization to be organized under the health maintenanceorganization laws of a State.
(3)(A)[42 U.S.C. 1396bnote] Subject to subparagraph (C), in the case of up to 3health insuring organizations which are described in subparagraph (B), inthe case of any health insuring organization described in such subparagraphthat is operated by a public entity established by Ventura County, and inthe case of any health insuring organization described in such subparagraphthat is operated by a public entity established by Merced County, whichfirst become operational on or after January 1, 1986, and which aredesignated by the Governor, and approved by the Legislature, of California,the amendments made by paragraph (1) shall not apply.
(B) A health insuring organizationdescribed in this subparagraph is one that--
(i) is operated directly by a publicentity established by a county government in the State of California undera State enabling statute;
(ii) enrolls all medicaidbeneficiaries residing in the county or counties in which itoperates;
(iii) meets therequirements for health maintenance organizations under the Knox-Keene Act(Cal. Health and Safety Code, section 1340 et seq.) and the Waxman-DuffyAct (Cal. Welfare and Institutions Code, section 14450 et seq.);
(iv) assures a reasonablechoice of providers, which includes providers that have historically servedmedicaid beneficiaries and which does not impose any restriction whichsubstantially impairs access to covered services of adequate quality wheremedically necessary;
(v) provides for apayment adjustment for a disproportionate share hospital (as defined underState law consistent with section 1923 of the Social Security Act) in amanner consistent with the requirements of such section; and
(vi) provides forpayment, in the case of childrens’ hospital services provided tomedicaid beneficiaries who are under 21 years of age, who are children withspecial health care needs under title V of the Social Security Act, and whoare receiving care coordination services under such title, at ratesdetermined by the California Medical Assistance Commission.
(C) Subparagraph (A) shall not apply with respect to any period for which theSecretary of Health and Human Services determines that the number ofmedicaid beneficiaries enrolled with health insuring organizationsdescribed in subparagraph (B) exceeds 16 percent of the number of suchbeneficiaries in the State of California.
(D) In this paragraph,the term “medicaid beneficiary” means an individual who isentitled to medical assistance under the State plan under title XIX of theSocial Security Act, other than a qualified medicare beneficiary who isonly entitled to such assistance because of section 1902(a)(10)(E) of suchtitle.
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SEC. 9524.[NoneAssigned] WISCONSIN HEALTH MAINTENANCEORGANIZATION WAIVER.
The waiver granted to the State of Wisconsin pursuant to section1915(b) of the Social Security Act relating to the requirements of section1903(m) of such Act in conjunction with a waiver of the requirements ofsection 1902(a)(23) of such Act shall, upon request by the State, bereinstated, and shall be renewable for terms of 2 years, subject to theshowings required generally under section 1915(b) of such Act.
SEC. 9529. MEDICAIDCOVERAGE RELATING TO ADOPTION ASSISTANCE AND FOSTER CARE.
(b)* * *
(2)[42 U.S.C. 1396anote] In the case of an adoption assistance agreement(other than an agreement under part E of title IV of the Social SecurityAct) entered into before the date of the enactment of thisAct--
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(A) the requirements of subdivisions(aa) and (bb) of section 1902(a)(10)(A)(ii)(VIII) of the Social SecurityAct shall be deemed to be met if the State agency responsible for adoptionassistance agreements determines that--
(i) at the time of adoptiveplacement the child had special needs for medical or rehabilitative carethat made the child difficult to place; and
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(ii) there is in effectwith respect to such child an adoption assistance agreement between theState and an adoptive parent or parents; and
(B) therequirement of subdivision (cc) of such section shall be deemed to be metif the child was found by the State to be eligible for medical assistanceprior to such agreement being entered into.
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SEC. 12114.[42 U.S.C. 418note] Notwithstanding any provision of section 218 of theSocial Security Act, the Secretary of Health and Human Services shall, uponthe request of the Governor of Connecticut, modify the agreement under suchsection between the Secretary and the State of Connecticut to provide thatservice performed after the date of the enactment of this Act by members ofthe Division of the State Police within the Connecticut Department ofPublic Safety, who are hired on or after May 8, 1984, and who are membersof the tier II plan of the Connecticut State Employees Retirement System,shall be covered under such agreement.
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[Internal References.—SSAct §218 heading, §§1903(m)and 1915(b) have footnotes referring to P.L.99-272.]