94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006
SB1464


 
Introduced 2/23/2005, by Sen. Donne E. Trotter
 
SYNOPSIS AS INTRODUCED:
 		
















5 ILCS 375/6.11





215 ILCS 5/356z.7 new





305 ILCS 5/5-16.8









    Amends the State Employees Group Insurance Act of 1971, the Illinois Insurance Code, and the Illinois Public Aid Code to require coverage of breast examinations by magnetic resonance imaging (MRI) for women who are considered to be at high risk for breast cancer if the MRI is recommended by the woman's physician. Requires the coverage to be according to the same schedule as for mammogram examinations. Provides a definition of "high risk for breast cancer". Effective January 1, 2006.
















LRB094 08119 LJB 38304 b

















FISCAL NOTE ACT MAY APPLY
















 


 


A BILL FOR









 











SB1464

LRB094 08119 LJB 38304 b






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    AN ACT concerning insurance.

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


 
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    Section 5. The State Employees Group Insurance Act of 1971 
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is amended  by changing Section 6.11 as follows:
 



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    (5 ILCS 375/6.11)


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    Sec. 6.11. Required health benefits; Illinois Insurance 
8
Code
requirements.  The program of health
benefits shall provide 
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the post-mastectomy care benefits required to be covered
by a 
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policy of accident and health insurance under Section 356t of 
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the Illinois
Insurance Code.  The program of health benefits 
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shall provide the coverage
required under Sections 356u, 356w, 
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356x, 356z.2, 356z.4, and 356z.6, and 356z.7 of the
Illinois 
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Insurance Code.
The program of health benefits must comply with 
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Section 155.37 of the
Illinois Insurance Code.

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(Source: P.A. 92-440, eff. 8-17-01; 92-764, eff. 1-1-03; 
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93-102, eff. 1-1-04; 93-853, eff. 1-1-05.)

 
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    Section 10. The Illinois Insurance Code is amended  by 
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adding Section 356z.7 as follows:
 
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    (215 ILCS 5/356z.7  new)
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    Sec. 356z.7. Magnetic resonance imaging breast 
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examination. An individual or group policy of accident and 
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health insurance or a managed care plan amended, delivered, 
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issued, or renewed after the effective date of this amendatory 
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Act of the 94th General Assembly shall provide coverage for a 
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breast examination by magnetic resonance imaging (MRI) for 
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insured females who are considered to be at high risk for 
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breast cancer if the MRI is recommended by the insured female's 
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physician. Coverage under this Section shall be provided 
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according to the same schedule within the provisions of the 
 


 






SB1464
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LRB094 08119 LJB 38304 b




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policy or plan as for mammogram examinations.
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    For the purposes of this Section, "high risk for breast 
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cancer" means the woman:
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        (1) has a family history of breast cancer; or
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        (2) has a background, ethnicity, or coexisting medical 
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    condition or uses medication that the physician believes 
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    puts the woman at elevated risk for breast cancer.
 
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    Section 15. The Illinois Public Aid Code is amended  by 
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changing Section 5-16.8 as follows:
 



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    (305 ILCS 5/5-16.8)


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    Sec. 5-16.8. Required health benefits. The medical 
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assistance program
shall
(i) provide the post-mastectomy care 
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benefits required to be covered by a policy of
accident and 
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health insurance under Section 356t and the coverage required

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under Sections 356u, 356w, 356x, and 356z.6, and 356z.7 of the 
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Illinois
Insurance Code and (ii) be subject to the provisions 
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of Section 364.01 of the Illinois
Insurance Code.

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(Source: P.A. 93-853, eff. 1-1-05; 93-1000, eff. 1-1-05; 
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revised 10-14-04.)

 

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    Section 99. Effective date. This Act takes effect January 
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1, 2006.