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Bills Important to Medicine Gaining Traction in Springfield
Posted on: 5/10/2018

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ISMS is succeeding in helping to advance bills important to Illinois physicians!

Your legislative team continues to work hard in Springfield on your behalf to prevent bad proposals from moving forward and negotiate sensible changes to various measures.

Check out these ISMS priority bills that are on the move in Springfield – at press time:

  • Drug coverage protection for patients with stage IV advanced, metastatic cancer
  • Illinois House Bill 4821 would protect patients with stage IV advanced, metastatic cancer. The bill would preclude any state-licensed health benefit plan that covers treatment for stage IV cancer from excluding drug coverage. The legislation includes health plans that cover the patient directly, such as an insurer, and indirectly, such as a pharmacy benefit manager.

    Patients with stage IV cancer are in compromised and fragile health, with little fortitude to "fail first" on a prioritized drug or time to wait for an authorization before receiving the doctor’s choice of treatment.

    HB 4821 would preclude health plans from requiring the patient to fail first on a preferred medication or wait for a prior authorization. Further, the covered drugs must be:

  • Approved by the FDA.
  • Consistent with best practices for treating stage IV cancer.
  • Supported by peer-reviewed medical literature.

HB 4821 had passed the House unanimously and is now under consideration in the Senate. 

  • No independent practice for physical therapists

ISMS has successfully negotiated a compromise with the physical therapists for House Bill 4643 that would provide limited direct access and retain physician involvement, referral and diagnosis with regard to physical therapy services. The amended bill passed the House and is now under consideration in the Senate.   

  • Tobacco 21 – legislation to increase legal age for buying tobacco

Tobacco 21 legislation (Senate Bill 2332), which had previously cleared the Illinois Senate, is now assigned to the House Health & Healthcare Disparities Committee. Tobacco 21 is a national effort to raise the legal age to purchase tobacco products from 18 to 21. Several states have already enacted this legislation and numerous cities and jurisdictions have imposed local ordinances.

ISMS supports this bill, as nearly all adult smokers started as kids. Imposing a barrier to access tobacco products at an early age will prevent more young people from starting to smoke, which means a reduction in future deaths, disease and health care costs.

Earlier this year, then-ISMS President Nestor A. Ramirez, MD, MPH, was one of the speakers advocating for this legislation.

Senate Bill 2332 covers all tobacco products, including e-cigarettes. 

  • Opioid crisis in Illinois 

Aside from budget talks, legislators remained focused on solving the opioid crisis. ISMS continues to push for comprehensive solutions.

Read ISMS Responds to Opioid Epidemic

  • Supporting mental health conditions and addiction treatment for Illinois' youth

Senate Bill 2951 recently passed the Illinois Senate on an overwhelming bi-partisan vote of 55-1. The bill is now assigned to the House Mental Health Committee.

This legislation would require Illinois to seek federal approval for Medicaid coverage for:

  • A youth-focused, team-based treatment model for serious mental health conditions.
  • Assertive outreach and clinical treatment delivered beyond the four walls of a clinic for substance use.

  • Addressing Illinois’ unpaid bill backlog

Senate Bill 2858, which previously passed the Illinois Senate, has been referred to the House Rules Committee. Illinois' pile of unpaid bills has grown so large that interest payments owed for the debt are now a significant contributor to the growing debt. Essentially, the state owes compounding interest for unpaid interest penalties that have already accrued. This legislation includes a two-fold strategy to reduce the debt and interest amount owed. If it passes, the State Treasurer will have new abilities to prioritize payments on the underlying principal debt, thereby reducing the amount of interest that can accrue.

  • Stopping insurance companies from modifying an enrollee's coverage for a drug

House Bill 4146 had passed the Illinois House and was assigned to the Senate Special Committee on Oversight of Medicaid Managed Care, which has now been postponed. This legislation would prevent insurance companies from modifying an enrollee's drug formulary coverage after the enrollee is already locked into a health plan for the year.

Specifically, the bill would prevent these actions, which cause hikes in out-of-pocket costs for drugs:

  • Increasing out-of-pocket costs for a covered drug.
  • Moving a prescription drug to a more restrictive tier.
  • Removing a prescription drug from a formulary.

  • Refills for non-controlled substances

Senate Bill 3170, which had previously cleared the Senate, passed the House Health Care Licenses Committee and is now under consideration in the Illinois House. This legislation would extend the time a patient can refill a prescription for a non-controlled substance from 12 months to 15 months.  

  • Allowing ambulatory surgical treatment facilities to file liens

House Bill 4911, which had previously passed out of the Illinois House, cleared the Senate Judiciary Committee and is now under consideration in the Illinois Senate. This ISMS-backed legislation would amend the Health Care Services Lien Act to allow ambulatory surgical treatment facilities (ASTFs) to file liens.

Under current law, only health care professionals and licensed medical institutions (hospitals, home health agencies, and ambulatory surgical treatment centers [ASTCs]) are able to file liens. ASTFs are typically physician-owned facilities that do not qualify for state licensure because of their size, but are nationally accredited.

As the spring 2018 legislative session continues, ISMS will keep you informed with Physician Advocate and the Legislative Action Hub.



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