Rep. Norine K. Hammond

Filed: 3/3/2023

 

 


 

 


 
10300HB2799ham001LRB103 30056 BMS 58407 a

1
AMENDMENT TO HOUSE BILL 2799

2    AMENDMENT NO. ______. Amend House Bill 2799 by replacing
3everything after the enacting clause with the following:
 
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

 

 

10300HB2799ham001- 2 -LRB103 30056 BMS 58407 a

1radiation therapy, three-dimensional conformal radiation
2therapy, or other forms of therapy using radiation.
3    (b) 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 for the treatment of cancer shall not apply a higher
7standard of clinical evidence for the coverage of proton beam
8therapy than the insurer applies for the coverage of any other
9form of radiation therapy treatment.
10    (c) A group or individual policy of accident and health
11insurance or managed care plan that is amended, delivered,
12issued, or renewed on or after January 1, 2025 that provides
13coverage or benefits to any resident of this State for
14radiation oncology shall include coverage or benefits for
15medically necessary proton beam therapy for the treatment of
16cancer.
 
17    Section 10. The Illinois Public Aid Code is amended by
18adding Section 5-47 as follows:
 
19    (305 ILCS 5/5-47 new)
20    Sec. 5-47. Proton beam therapy; managed care.
21Notwithstanding any other provision of this Article, a managed
22care organization under contract with the Department to
23provide services to recipients of medical assistance shall
24provide coverage for proton beam therapy. As used in this

 

 

10300HB2799ham001- 3 -LRB103 30056 BMS 58407 a

1Section, "proton beam therapy" means a type of radiation
2therapy treatment that utilizes protons as the radiation
3delivery method for the treatment of tumors and cancerous
4cells. "Radiation therapy treatment" means the delivery of
5biological effective doses with proton therapy, intensity
6modulated radiation therapy, brachytherapy, stereotactic body
7radiation therapy, three-dimensional conformal radiation
8therapy, or other forms of therapy using radiation.
 
9    Section 99. Effective date. This Act takes effect January
101, 2024.".