97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB1825

 

Introduced , by Rep. Ann Williams

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 5/356z.19 new

    Amends the Illinois Insurance Code. Provides that accident and health insurance policies that provide coverage for prescribed orally-administered cancer medications and intravenously administered or injected cancer medications shall ensure that the applicable financial requirements and treatment limitations are no more restrictive than the financial requirements and treatment limitations applied to intravenously administered or injected cancer medications that are covered by the policy. Provides that an insurer cannot achieve compliance with the coverage mandate by increasing financial requirements or imposing more restrictive treatment limitations on prescribed orally-administered cancer medications or intravenously administered or injected cancer medications covered under the policy. Effective immediately.


LRB097 05082 RPM 45123 b

 

 

A BILL FOR

 

HB1825LRB097 05082 RPM 45123 b

1    AN ACT concerning insurance.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Insurance Code is amended by adding
5Section 356z.19 as follows:
 
6    (215 ILCS 5/356z.19 new)
7    Sec. 356z.19. Cancer drug parity.
8    (a) As used in this Section:
9    "Financial requirement" means deductibles, copayments,
10coinsurance, out-of-pocket expenses, aggregate lifetime
11limits, and annual limits.
12    "Treatment limitation" means limits on the frequency of
13treatment, days of coverage, or other similar limits on the
14scope or duration of treatment.
15    (b) On and after the effective date of this amendatory Act
16of the 97th General Assembly, every insurer that amends,
17delivers, issues, or renews an individual or group policy of
18accident and health insurance amended, delivered, issued, or
19renewed on or after the effective date of this amendatory Act
20of the 97th General Assembly that provides coverage for
21prescribed orally-administered cancer medications and
22intravenously administered or injected cancer medications
23shall ensure that:

 

 

HB1825- 2 -LRB097 05082 RPM 45123 b

1        (1) the financial requirements applicable to such
2    prescribed orally-administered cancer medications are no
3    more restrictive than the financial requirements applied
4    to intravenously administered or injected cancer
5    medications that are covered by the policy and that there
6    are no separate cost-sharing requirements that are
7    applicable only with respect to such prescribed
8    orally-administered cancer medications; and
9        (2) the treatment limitations applicable to such
10    prescribed orally-administered cancer medications are no
11    more restrictive than the treatment limitations applied to
12    intravenously administered or injected cancer medications
13    that are covered by the policy and that there are no
14    separate treatment limitations that are applicable only
15    with respect to such prescribed orally-administered cancer
16    medications.
17    (c) An insurer cannot achieve compliance with this Section
18by increasing financial requirements or imposing more
19restrictive treatment limitations on prescribed
20orally-administered cancer medications or intravenously
21administered or injected cancer medications covered under the
22policy on the effective date of this amendatory Act of the 97th
23General Assembly.
 
24    Section 99. Effective date. This Act takes effect upon
25becoming law.