HB2350 EngrossedLRB103 26427 BMS 52790 b

1    AN ACT concerning regulation.
 
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
5changing Section 356u as follows:
 
6    (215 ILCS 5/356u)
7    Sec. 356u. Pap tests and prostate cancer screenings.
8    (a) A group policy of accident and health insurance that
9provides coverage for hospital or medical treatment or
10services for illness on an expense-incurred basis and is
11amended, delivered, issued, or renewed after January 1, 2024
12shall provide coverage, without imposing a deductible,
13coinsurance, copayment, or any other cost-sharing requirement,
14for all of the following:
15        (1) An annual cervical smear or Pap smear test for all
16    female insureds.
17        (2) An annual prostate cancer screening for male
18    insureds upon the recommendation of a physician licensed
19    to practice medicine in all its branches for:
20            (A) asymptomatic individuals men age 50 and over;
21            (B) African-American individuals men age 40 and
22        over; and
23            (C) individuals men age 40 and over with a family

 

 

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1        history of or genetic predisposition to prostate
2        cancer.
3        (3) Surveillance tests for ovarian cancer for female
4    insureds who are at risk for ovarian cancer.
5    (b) This Section shall not apply to agreements, contracts,
6or policies that provide coverage for a specified disease or
7other limited benefit coverage.
8    (c) This Section does not apply to coverage of prostate
9cancer screenings to the extent such coverage would disqualify
10a high-deductible health plan from eligibility for a health
11savings account pursuant to Section 223 of the Internal
12Revenue Code.
13    (d) For the purposes of this Section:
14    "At risk for ovarian cancer" means:
15        (1) having a family history (i) with one or more
16    first-degree relatives with ovarian cancer, (ii) of
17    clusters of women relatives with breast cancer, or (iii)
18    of nonpolyposis colorectal cancer; or
19        (2) testing positive for BRCA1 or BRCA2 mutations.
20    "Prostate cancer screening" means medically viable methods
21for the detection and diagnosis of prostate cancer, including
22a digital rectal exam and the prostate-specific antigen test
23and associated laboratory work. "Prostate cancer screening"
24includes medically necessary subsequent follow-up testing as
25directed by a health care provider, including, but not limited
26to:

 

 

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1        (1) urinary analysis;
2        (2) serum biomarkers; and
3        (3) medical imaging, including, but not limited to,
4    magnetic resonance imaging.
5    "Surveillance tests for ovarian cancer" means annual
6screening using (i) CA-125 serum tumor marker testing, (ii)
7transvaginal ultrasound, (iii) pelvic examination.
8(Source: P.A. 102-1073, eff. 1-1-23.)
 
9    Section 99. Effective date. This Act takes effect January
101, 2025.