HB 3509

Abstract

Amends the State Employees Group Insurance Act of 1971, Illinois Insurance Code, and the Illinois Public Aid Code. Provides that pasteurized donated human breast milk shall be covered under health insurance and the medical assistance program under the Illinois Public Aid Code. Describes the requirements that must be met to have pasteurized human breast milk covered under health insurance and the medical assistance program. Effective January 1, 2020. House Committee Amendment No. 1 Provides that one of the requirements to have coverage of pasteurized donated human breast milk is that the milk is obtained from a human milk bank licensed by the Department of Public Health (rather than the milk is obtained from a human milk bank that meets quality guidelines established by the Human Breast Milk Banking Association of North America, or that is licensed by the Department of Public Health). Senate Committee Amendment No. 1 Replaces everything after the enacting clause with the engrossed bill with the following changes. Provides that all of the following conditions must be met for the donated human breast milk to be covered: the milk is obtained from a human milk bank that is licensed by the Department of Public Health; the infant is critically ill and the infant's mother is medically or physically unable to produce maternal breast milk or produce maternal breast milk in sufficient quantities to meet the infant's needs or the maternal breast milk is contraindicated; the milk has been determined to be medically necessary for the infant; and one or more of the following applies: the infant's birth weight is below 1,500 grams, the infant has a congenital or acquired condition that places the infant at a high risk for development of necrotizing enterocolitis, the infant has infant hypoglycemia, the infant has congenital heart disease, the infant has had or will have an organ transplant, the infant has sepsis, or the infant has any other serious congenital or acquired condition for which the use of donated human breast milk is medically necessary and supports the treatment and recovery of the infant. Effective January 1, 2020. Senate Floor Amendment No. 3 Replaces everything after the enacting clause with the bill, as amended by Senate Amendment No. 1, with the following changes. Provides that the milk must be prescribed by a licensed medical practitioner (instead of a physician). Provides that milk must be obtained from a human milk bank that meets quality guidelines established by the Human Milk Banking Association of North America or is licensed by the Department of Public Health (rather than licensed by the Department of Public Health). Removes a requirement that the infant must be critically ill. Adds provisions requiring coverage for a child 6 months through 12 months of age if the child would qualify if he or she was under the age of 6 months and the child has spinal muscular atrophy; the child's birth weight was below 1,500 grams and he or she has long-term feeding or gastrointestinal complications related to prematurity; the child has had or will have an organ transplant; or the child has a congenital or acquired condition for which the use of donated human breast milk is medically necessary and supports the treatment and recovery of the child. In the Public Aid Code, adds provisions requiring coverage for a child 12 months of age or older if the child would qualify if he or she was under the age of 6 months and has spinal muscular atrophy. Makes other changes. Effective January 1, 2020.