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(305 ILCS 5/5-52) (Text of Section from P.A. 103-593) Sec. 5-52. Custom prosthetic and orthotic devices; reimbursement rates. Subject to federal approval, for dates of service beginning on and after January 1, 2025, the Department shall increase the current 2024 Medicaid rate by 7% under the medical assistance program for custom prosthetic and orthotic devices. (Source: P.A. 103-593, eff. 6-7-24.) (Text of Section from P.A. 103-703) (This Section may contain text from a Public Act with a delayed effective date) Sec. 5-52. Coverage for hormonal therapy to treat menopause. The medical assistance program shall provide coverage for medically necessary hormone therapy treatment to treat menopause that has been induced by a hysterectomy.(Source: P.A. 103-703, eff. 1-1-26.) (Text of Section from P.A. 103-914) (This Section may contain text from a Public Act with a delayed effective date) Sec. 5-52. Genetic testing and evidence-based screenings for an inherited gene mutation. (a) In this Section, "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) Subject to federal approval, the medical assistance program, after January 1, 2026, shall provide coverage for clinical genetic testing for an inherited gene mutation for individuals with a personal or family history of cancer, as recommended by a health care professional in accordance with current evidence-based clinical practice guidelines, including, but not limited to, the current version of the National Comprehensive Cancer Network clinical practice guidelines. (c) For individuals with a genetic test that is positive for an inherited mutation associated with an increased risk of cancer, coverage required under this Section shall include any evidence-based screenings, as recommended by a health care professional in accordance with current evidence-based clinical practice guidelines, to the extent that the management recommendation is not already covered by the medical assistance program. In this subsection, "evidence-based cancer screenings" means medically recommended evidence-based screening modalities in accordance with current clinical practice guidelines.(Source: P.A. 103-914, eff. 1-1-25.) |
