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Good stuff (Updated x1)

Sunday, May 26, 2024 - Posted by Rich Miller

* Peter Hancock at Capitol News Illinois has been ably following the governor’s proposed health insurance changes this spring and the last time I saw him at a Pritzker press conference, he asked very informed questions. His latest from yesterday

A package of health insurance reform measures that Gov. JB Pritzker called for at the beginning of the legislative session will soon be headed to his desk for his signature.

The Illinois House gave final approval Saturday to a pair of bills that limit the ability of insurance companies to deny coverage or steer individuals toward lower cost, and sometimes less effective, treatments and medications, strategies sometimes referred to as “utilization management.”

The package also includes measures giving the Illinois Department of Insurance authority to approve or deny premium rate changes in large-group health insurance plans while banning the sale of short-term, limited duration individual health plans, which are sometimes derisively referred to as “junk insurance.”

Go read the rest. You can read all of Hancock’s stories here.

* Meanwhile, WAND TV reporter Mike Miletich has been killing it lately. Dude is churning out multiple informative stories a day. One from yesterday

State representatives passed a plan Saturday that could drastically improve maternal healthcare for Black women in Illinois.

The legislation requires private insurance companies to cover maternal services provided by midwives, doulas and lactation consultants. Private insurance companies would be required to cover home births, home visits and support during labor, abortion or miscarriage as well.

The proposal was a top priority for Gov. JB Pritzker and Lt. Governor Juliana Stratton.

“This bill empowers Illinois women to make holistic choices for their birth experience, which is especially important for Black mothers who face unacceptably high rates of complications and mortality,” Stratton said.

Click here to read what he’s been writing.

* Blog favorite Tina Sfondeles is back in Springfield to cover the rest of the session. Excerpt from her latest

Meanwhile, Senate changes to an approved House measure that would reform the embattled Illinois Prisoner Review Board ruffled some feathers in the governor’s office.

The initial plan — in response to the killing of 11-year-old Jayden Perkins — would require board members to complete an annual training program about domestic violence and for board members to notify any registered victims of a crime when the offender of such crime is being released from state custody, among other reforms.

It would also require the board to indicate whether any reports included prior convictions of a domestic violence offense within the last five years — and would set up a task force to make recommendations to the General Assembly.

Senate changes included making all hearings available to the public for live broadcast on the board’s website and available to watch for a minimum of 18 months.

The governor’s office does not support that aspect, arguing it would require new technology and additional staffing. The office is instead pushing for the issue to be delayed and taken up by the newly set up task force. They are also concerned about the bill’s reliance on information from a Law Enforcement Agencies Data System, or LEADS report, which may not be up-to-date and may not include the information they’re seeking. Pritzker’s office has also argued that some of the sought reforms are already “standard practice.”

“The PRB is committed to increasing transparency. Hearings are currently open and records of the hearings are available via FOIA,” governor’s office spokeswoman Jordan Abudayyeh said in a statement. “It is an immense challenge to do nearly 5,000 parole revocation hearings a year and we would prefer to be a part of the conversation on how best to increase transparency instead of having requirements the board will not be able to fulfill foisted upon them.”

The governor’s office on Saturday stated that it is working on an executive order that would mirror the changes enacted in the House measure.

* I met Tribune reporter Olivia Olander for the first time yesterday. Her informative story on the governor’s health insurance reform package today is definitely worth a read. Excerpt

One of the key provisions in the legislation passed by lawmakers would put prohibitions on what is known as step therapy, in which insurers require patients to try a different, often cheaper, alternative before treatment recommended by doctors. The practice has been decried by doctors and patients who say it can delay necessary care, allowing patients’ condition to worsen; the insurance industry has framed it as a cost-saving measure.

In the version that passed in both chambers, the step therapy provisions for prescription drugs apply to medications already covered within insurance plans, Laura Minzer, president of the Illinois Life and Health Insurance Council, said Saturday.

For example, if a doctor wanted a patient to try Ozempic, it could be immediately prescribed if it was already on the list of medications covered by the patient’s insurance.

If Ozempic wasn’t on that list, there would still be an additional process to try to get an exemption, such as for cases where the patient had been on a particular medication successfully for a long time. That process keeps costs down, Minzer said.

The step therapy provision, along with many of the others in the bill, goes into effect in 2026.

* Another blog favorite, Capitol News Illinois reporter Hannah Meisel, is also a must-follow on Twitter…


Hannah then linked to this helpful story

The minimum tax rate as part of HB 4951 is 20%, an increase from the current 15% rate at all levels of operator adjusted gross revenue. The threshold increases to 25% at $30 million in adjusted gross revenue; 30% over $50 million; 35% over $100 million; and 40% over $200 million.

Of the eight mobile sports betting operators currently in Illinois, only FanDuel ($429.3 million) and DraftKings ($350 million) would reach that maximum 40% threshold based on their last 12 months of winnings.

BetRivers ($81.1 million) and Fanatics Sportsbook ($51.7 million) are the only other operators that would cross into the 30% threshold, but ESPN BET likely would reach that benchmark as well in a full 12-month span.

…Adding… Update…

* I’m sure I’ve missed some solid stuff in this post. For instance, Jerry Nowicki of Capitol News Illinois has been tweeting out lots of Statehouse info.

Make sure to click here and follow the whole show with our live session coverage.

       

4 Comments
  1. - Annonin' - Sunday, May 26, 24 @ 1:37 pm:

    Is there a mirror for the sports betting giants to hold before them so they could see how dumb the “withdrawal” verbage is? Is there room for a 4th biggest lie?


  2. - OneMan - Sunday, May 26, 24 @ 2:22 pm:

    I understand why it was the way it was, but the state misses a huge revenue opportunity when it decided not to own the machines. I would suggest making it 2% with 1% going to the municipality and take it out of the machine owners take.


  3. - Critical Observer - Sunday, May 26, 24 @ 3:42 pm:

    Whoever thought to let go of Miletich at his past station didn’t realize what they were losing. He’s doing incredible work.


  4. - AD - Sunday, May 26, 24 @ 7:26 pm:

    Can the Ozempic prior authorization still require people to go through a weight loss program or does this eliminate that requirement if a doctor prescribes it?


Sorry, comments for this post are now closed.


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