Synopsis As Introduced Amends the Illinois Insurance Code and the Illinois Public Aid Code. With regard to the respective requirements concerning coverage and payment for screening by low-dose mammography for all women 35 years of age or older for the presence of occult breast cancer, includes a screening MRI when medically necessary, as determined by a physician licensed to practice medicine in all of its branches, and if the American Cancer Society's guidelines for appropriate use for women at high risk for breast cancer are met. Further amends the Illinois Public Aid Code. Provides that on and after January 1, 2016, the Department of Healthcare and Family Services shall ensure that all networks of care for adult clients of the Department include access to at least one breast imaging Center of Imaging Excellence as certified by the American College of Radiology. Provides that on and after January 1, 2017, providers participating in a breast cancer treatment quality improvement program approved by the Department shall be reimbursed for breast cancer treatment at a rate that is no lower than 95% of the Medicare program's rates for the data elements included in the breast cancer treatment quality program. Makes changes concerning the case-managing and patient navigation pilot program. Sets forth provisions concerning departmental requirements for networks of care. Provides that on and after January 1, 2016, the Department shall ensure that provider and hospital reimbursement for certain required post-mastectomy care benefits are no lower than the Medicare reimbursement rate. Provides that on and after January 1, 2016 and subject to funding availability, the Department shall administer a grant program to build the public infrastructure for breast cancer imaging and diagnostic services across the State. Effective immediately.
Amends the Illinois Insurance Code. Provides that for the purposes of defining low-dose mammography, digital mammography shall include breast tomosynthesis. Defines "breast tomosynthesis". Makes similar changes in the Health Maintenance Organization Act and the Illinois Public Aid Code.
Fiscal Note (Dept. of Insurance)
HB 3673 has no projected fiscal impact to the Illinois Department of Insurance.
Replaces everything after the enacting clause with the engrossed bill with the following changes: Removes references to breast tomosynthesis and to the American Cancer Society's guidelines for the appropriate use of screening MRIs for women at high risk for breast cancer.