305 ILCS 5/5-40
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-40. Human breast milk coverage.(a) Notwithstanding any other provision of this Act, pasteurized donated human breast milk, which may include human milk fortifiers if indicated by a prescribing licensed medical practitioner, shall be covered under a health plan for persons who are otherwise eligible for coverage under this Act if the covered person is an infant under the age of 6 months, a licensed medical practitioner prescribes the milk for the covered person, and all of the following conditions are met:(1) the milk is 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;(2) 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;(3) the milk has been determined to be medically     necessary for the infant; and(4) one or more of the following applies:(A) the infant's birth weight is below 1,500         grams;(B) the infant has a congenital or acquired         condition that places the infant at a high risk for development of necrotizing enterocolitis;(C) the infant has infant hypoglycemia;(D) the infant has congenital heart disease;(E) the infant has had or will have an organ         transplant;(F) the infant has sepsis; or(G) 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.(b) Notwithstanding any other provision of this Act, pasteurized donated human breast milk, which may include human milk fortifiers if indicated by a prescribing licensed medical practitioner, shall be covered under a health plan for persons who are otherwise eligible for coverage under this Act if the covered person is a child 6 months through 12 months of age, a licensed medical practitioner prescribes the milk for the covered person, and all of the following conditions are met:(1) the milk is 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;(2) the child's mother is medically or physically     unable to produce maternal breast milk  or produce maternal breast milk in sufficient quantities to meet the child's needs or the maternal breast milk is contraindicated;(3) the milk has been determined to be medically     necessary for the child; and(4) one or more of the following applies:(A) the child has spinal muscular atrophy;(B) the child's birth weight was below 1,500         grams and he or she has long-term feeding or gastrointestinal complications related to prematurity;(C) the child has had or will have an organ         transplant; or(D) 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.(c) Notwithstanding any other provision of this Act,  pasteurized donated human breast milk, which may include human  milk fortifiers if indicated by a prescribing licensed medical  practitioner, shall be covered under a health plan for persons  who are otherwise eligible for coverage under this Act if the  covered person is a child 12 months of age or older, a licensed  medical practitioner prescribes the milk for the covered  person, and all of the following conditions are met:(1) the milk is 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;(2) the child's mother is medically or physically     unable to produce maternal breast milk  or produce maternal breast milk in sufficient quantities to meet the child's needs or the maternal breast milk is contraindicated;(3) the milk has been determined to be medically     necessary for the child; and(4) the child has spinal muscular atrophy.  (Source: P.A. 101-511, eff. 1-1-20.)