HB2799 EngrossedLRB103 30056 BMS 56479 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
5adding Section 356z.61 as follows:
 
6    (215 ILCS 5/356z.61 new)
7    Sec. 356z.61. Proton beam therapy.
8    (a) As used in this Section:
9    "Medically necessary" has the meaning given to that term
10in the Prior Authorization Reform Act.
11    "Proton beam therapy" means a type of radiation therapy
12treatment that utilizes protons as the radiation delivery
13method for the treatment of tumors and cancerous cells.
14    "Radiation therapy treatment" means the delivery of
15biological effective doses with proton therapy, intensity
16modulated radiation therapy, brachytherapy, stereotactic body
17radiation therapy, three-dimensional conformal radiation
18therapy, or other forms of therapy using radiation.
19    (b) A group or individual policy of accident and health
20insurance or managed care plan that is amended, delivered,
21issued, or renewed on or after January 1, 2025 that provides
22coverage for the treatment of cancer shall not apply a higher
23standard of clinical evidence for the coverage of proton beam

 

 

HB2799 Engrossed- 2 -LRB103 30056 BMS 56479 b

1therapy than the insurer applies for the coverage of any other
2form of radiation therapy treatment.
3    (c) A group or individual policy of accident and health
4insurance or managed care plan that is amended, delivered,
5issued, or renewed on or after January 1, 2025 that provides
6coverage or benefits to any resident of this State for
7radiation oncology shall include coverage or benefits for
8medically necessary proton beam therapy for the treatment of
9cancer.
 
10    Section 10. The Illinois Public Aid Code is amended by
11adding Section 5-47 as follows:
 
12    (305 ILCS 5/5-47 new)
13    Sec. 5-47. Proton beam therapy; managed care.
14Notwithstanding any other provision of this Article, a managed
15care organization under contract with the Department to
16provide services to recipients of medical assistance shall
17provide coverage for proton beam therapy. As used in this
18Section, "proton beam therapy" means a type of radiation
19therapy treatment that utilizes protons as the radiation
20delivery method for the treatment of tumors and cancerous
21cells. "Radiation therapy treatment" means the delivery of
22biological effective doses with proton therapy, intensity
23modulated radiation therapy, brachytherapy, stereotactic body
24radiation therapy, three-dimensional conformal radiation

 

 

HB2799 Engrossed- 3 -LRB103 30056 BMS 56479 b

1therapy, or other forms of therapy using radiation.
 
2    Section 99. Effective date. This Act takes effect January
31, 2024.