HB4562 103RD GENERAL ASSEMBLY

LRB103 37130 RPS 67249 b

103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB4562

Introduced 1/31/2024, by Rep. Camille Y. Lilly

SYNOPSIS AS INTRODUCED:

215 ILCS 5/356u.10 new

Amends the Illinois Insurance Code. Defines terms. Provides that a group policy of accident and health insurance that provides coverage for hospital or medical treatment or services for illness on an expense-incurred basis and that is amended, delivered, issued, or renewed after January 1, 2025 shall provide coverage, without imposing any cost-sharing requirement, for clinical genetic testing for an inherited gene mutation for individuals with a personal or family history of cancer that is recommended by a health care professional; and evidence-based cancer imaging for individuals with an increased risk of cancer as recommended by National Comprehensive Cancer Network clinical practice guidelines. Provides that the requirements do not apply to coverage of genetic testing or evidence-based cancer imaging to the extent such coverage would disqualify a high-deductible health plan from eligibility for a health savings account pursuant to the Internal Revenue Code.

A BILL FOR

AN ACT concerning regulation.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Illinois Insurance Code is amended by adding Section 356u.10 as follows:

(215 ILCS 5/356u.10 new)

Sec. 356u.10. Genetic testing and evidence-based cancer imaging.

(a) For the purposes of this Section:

"Cost-sharing requirement" means a deductible, coinsurance, copayment, or any similar out-of-pocket expense.

"Evidence-based cancer imaging" means evidence-based cancer imaging modalities in accordance with the most recent version of the National Comprehensive Cancer Network clinical practice guidelines.

"Genetic testing for an inherited mutation" means germline multi-gene testing for an inherited mutation associated with an increased risk of cancer in accordance with evidence-based, clinical practice guidelines.

(b) A group policy of accident and health insurance that provides coverage for hospital or medical treatment or services for illness on an expense-incurred basis and that is amended, delivered, issued, or renewed after January 1, 2025 shall provide coverage, without imposing any cost-sharing requirement, for all of the following:

(1) clinical genetic testing for an inherited gene mutation for individuals with a personal or family history of cancer that is recommended by a health care professional; and

(2) evidence-based cancer imaging for individuals with an increased risk of cancer as recommended by National Comprehensive Cancer Network clinical practice guidelines.

(c) This Section shall not apply to coverage of genetic testing or evidence-based cancer imaging to the extent such coverage would disqualify a high-deductible health plan from eligibility for a health savings account pursuant to Section 223 of the Internal Revenue Code.