HB1770 - 104th General Assembly

INS-HEALTH CARE/RARE CONDITION
Last Action
3/21/2025 - House: Rule 19(a) / Re-referred to Rules Committee
House Sponsors
Rep. Lindsey LaPointe - Nicholas K. Smith
Statutes Amended In Order of Appearance
Synopsis As Introduced
Amends the Illinois Insurance Code to require an insurance policy to provide coverage for medically necessary treatments for genetic, rare, unknown or unnamed, and unique conditions, including Ehlers-Danlos syndrome and altered drug metabolism. Provides that an insurance policy that provides coverage for prescription drugs shall include coverage for opioid alternatives, coverage for medicines included in the Model List of Essential Medicines published by the World Health Organization, and coverage for custom-made medications and medical food. Provides that an insurance policy that limits the quantity of a medication in accordance with applicable State and federal law shall not require pre-approval for the treatment of patients with rare metabolism conditions that may need a higher dose of medication than what is otherwise allowed within a time frame or prescription schedule. Provides that the burden of proving that treatment is medically necessary shall not lie with the insured in cases of rejections for filing claims, preauthorization requests, and appeals related to coverage required under the Section.
Actions
Date Chamber Action
1/27/2025 House Filed with the Clerk by Rep. Lindsey LaPointe
1/28/2025 House First Reading
1/28/2025 House Referred to Rules Committee
2/25/2025 House Assigned to Insurance Committee
3/19/2025 House Added Chief Co-Sponsor Rep. Nicholas K. Smith
3/19/2025 House To Insurance Main Subcommittee
3/21/2025 House Rule 19(a) / Re-referred to Rules Committee