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Synopsis As Introduced Amends the Illinois Insurance Code. Provides that no individual or group policy of accident and health insurance amended, issued, delivered, or renewed in the State after the effective date of the amendatory Act that covers the treatment of stage 4 advanced, metastatic cancer shall limit or exclude coverage for a drug by mandating that the insured shall first be required to fail to successfully respond to a different drug or prove a history of failure of the drug unless the use of the drug is consistent with best practices for the treatment of stage 4 advanced, metastatic cancer and is supported by peer-reviewed medical literature. Makes conforming changes in the State Employee Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code.
House Floor Amendment No. 1 In provisions amending the Illinois Insurance Code concerning a policy that covers the treatment of stage 4 advanced, metastatic cancer, prohibits the policy from limiting or excluding coverage for a drug by mandating that the insured shall first be required to fail to successfully respond to a different drug or prove a history of failure of the drug as long as (rather than unless) the use of the drug is consistent with best practices for the treatment of stage 4 advanced, metastatic cancer and is supported by peer-reviewed medical literature.
Senate Committee Amendment No. 1 In provisions amending the Illinois Insurance Code, provides that a provision concerning the prohibition of coverage restrictions or exclusions for the treatment of stage 4 advanced, metastatic cancer is inoperative other than any such coverage authorized under specified provisions of the Social Security Act and the State shall not assume any obligation for the cost of the prohibition of coverage restrictions or exclusions for the treatment of stage 4 advanced, metastatic cancer if, at any time, the Secretary of the United States Department of Health and Human Services, or its successor agency, promulgates rules or regulations to be published in the Federal Register, publishes a comment in the Federal Register, or issues an opinion, guidance, or other action that would require the State, pursuant to any provision of the Patient Protection and Affordable Care Act, to defray the cost of that prohibition of coverage restrictions or exclusions.
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