House Sponsors: KLINGLER-LYONS,JOSEPH-RONEN-WOOD-CURRIE, FRITCHEY, ERWIN, FLOWERS, JONES,LOU AND SCHAKOWSKY. Short description: MASTECTOMY PROSTHETIC DEVICE Synopsis of Bill as introduced: Amends the Illinois Insurance Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, and the Voluntary Health Services Plans Act. Requires coverage for reconstructive surgery and prosthetic devices for the purpose of achieving or restoring symmetry after a mastectomy. Requires coverage for reconstructive surgery for childrens' deformities when the procedure is medically necessary to return the patient to a more normal appearance. HOUSE AMENDMENT NO. 1. Deletes reference to: 215 ILCS 130/4003 Adds reference to: 5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356t 215 ILCS 130/3009 from Ch. 73, par. 1503-9 Replaces everything after the enacting clause. Amends the Illinois Insurance Code to provide that insurance coverage includes benefits for reconstructive breast surgery performed after a mastectomy. Requires coverage for a second opinion and prohibits retaliatory actions by insurers. Provides that care after lymph node dissections and lumpectomies must be provided in the same manner as care after a mastectomy. Amends the State Employees 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, and the Voluntary Health Services Plans Act to require that health coverage provided under those Acts provide the same benefits for reconstructive surgery and post-surgical care as required under the Illinois Insurance Code. Effective immediately. HOUSE AMENDMENT NO. 3. Provides that in determining the appropriateness of reconstructive surgery performed on a nondiseased breast to achieve symmetry, the physician and patient must make the determination in accordance with utilization review guidelines. Provides that with respect to reconstructive surgery for children's deformities, cosmetic surgery to reshape a normal body part is not covered. Last action on Bill: SESSION SINE DIE Last action date: 99-01-12 Location: House Amendments to Bill: AMENDMENTS ADOPTED: HOUSE - 2 SENATE - 0 END OF INQUIRY Full Text Bill Status