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| | 102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB1779 Introduced 2/17/2021, by Rep. Mary E. Flowers SYNOPSIS AS INTRODUCED:
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Amends the Illinois Insurance Code to provide that an individual or group health care service plan contract that is issued, amended, delivered, or renewed on or after January 1, 2022 shall not require prior authorization for biomarker testing for an insured with advanced or metastatic stage 3 or 4 cancer, nor shall prior authorization be required for biomarker testing of cancer progression or recurrence in the insured with advanced or metastatic stage 3 or 4 cancer. Defines "biomarker testing".
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| | A BILL FOR |
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| | HB1779 | | LRB102 10161 BMS 18161 b |
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| 1 | | AN ACT concerning regulation.
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| 2 | | Be it enacted by the People of the State of Illinois,
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| 3 | | represented in the General Assembly:
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| 4 | | Section 5. The Illinois Insurance Code is amended by |
| 5 | | adding Section 356z.43 as follows:
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| 6 | | (215 ILCS 5/356z.43 new) |
| 7 | | Sec. 356z.43. Biomarker testing; advanced or metastatic |
| 8 | | stage 3 or 4 cancer. |
| 9 | | (a) As used in this Section, "biomarker testing" means |
| 10 | | diagnostic testing of the cancer patient's biospecimen, such |
| 11 | | as tissue, blood, or other bodily fluids, for DNA or RNA |
| 12 | | alterations to identify an individual with a subtype of cancer |
| 13 | | in order to guide patient treatment. |
| 14 | | (b) An individual or group health care service plan |
| 15 | | contract that is issued, amended, delivered, or renewed on or |
| 16 | | after January 1, 2022 shall not require prior authorization |
| 17 | | for biomarker testing for an insured with advanced or |
| 18 | | metastatic stage 3 or 4 cancer, nor shall prior authorization |
| 19 | | be required for biomarker testing of cancer progression or |
| 20 | | recurrence in the insured with advanced or metastatic stage 3 |
| 21 | | or 4 cancer.
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