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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 adding | ||||||||||||||||||||||||||||
5 | Section 356g.5 as follows: | ||||||||||||||||||||||||||||
6 | (215 ILCS 5/356g.5 new) | ||||||||||||||||||||||||||||
7 | Sec. 356g.5. Comprehensive clinical breast exam. | ||||||||||||||||||||||||||||
8 | (a) The General Assembly finds that comprehensive clinical | ||||||||||||||||||||||||||||
9 | breast examinations of 6-10 minutes in length are a critical | ||||||||||||||||||||||||||||
10 | tool in the early detection of breast cancer. Studies have | ||||||||||||||||||||||||||||
11 | proven that comprehensive clinical breast examinations of 6-10 | ||||||||||||||||||||||||||||
12 | minutes in length are effective in detecting breast cancer | ||||||||||||||||||||||||||||
13 | while the disease is in its earlier and more treatable stages. | ||||||||||||||||||||||||||||
14 | Insurer reimbursement of comprehensive clinical breast | ||||||||||||||||||||||||||||
15 | examinations of 6-10 minutes in length is essential to the | ||||||||||||||||||||||||||||
16 | effort to reduce breast cancer deaths in Illinois. | ||||||||||||||||||||||||||||
17 | (b) Every insurer shall provide, in each group or | ||||||||||||||||||||||||||||
18 | individual policy, contract, or certificate of accident or | ||||||||||||||||||||||||||||
19 | health insurance issued or renewed for persons who are | ||||||||||||||||||||||||||||
20 | residents of Illinois, coverage for a complete and thorough | ||||||||||||||||||||||||||||
21 | physical examination of the breast, including but not limited | ||||||||||||||||||||||||||||
22 | to a comprehensive clinical breast examination of 6-10 minutes | ||||||||||||||||||||||||||||
23 | in length (that is, an examination of 3-5 minutes in length for |
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1 | each breast), performed by a health care provider to check for | ||||||
2 | lumps and other changes for the purpose of early detection and | ||||||
3 | prevention of breast cancer as follows: | ||||||
4 | (1) annually for women 18 years of age and older; and | ||||||
5 | (2) at any time at the recommendation of the woman's | ||||||
6 | health care provider. | ||||||
7 | (c) An insurance policy, contract, or certificate must | ||||||
8 | provide coverage for physical examinations of the breast as | ||||||
9 | described in subsection (b) regardless of whether a health care | ||||||
10 | provider performs other preventive women's health examinations | ||||||
11 | or makes a referral for other preventive women's health | ||||||
12 | examinations at the same time the health care provider performs | ||||||
13 | the breast examination. | ||||||
14 | (d) Every insurer must establish a separate and distinct | ||||||
15 | reimbursement code for comprehensive clinical breast | ||||||
16 | examinations of 6-10 minutes in length. | ||||||
17 | Section 10. The Health Maintenance Organization Act is | ||||||
18 | amended by changing Section 4-6.5 as follows:
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19 | (215 ILCS 125/4-6.5)
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20 | Sec. 4-6.5. Required health benefits; Illinois Insurance | ||||||
21 | Code
requirements. A health maintenance organization is | ||||||
22 | subject to the provisions
of Sections 155.37, 356g.5, 356t, | ||||||
23 | 356u, and 356z.1 of the Illinois Insurance Code.
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24 | (Source: P.A. 92-130, eff. 7-20-01; 92-440, eff. 8-17-01; |
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1 | 92-651, eff.
7-11-02.)
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2 | Section 15. The Voluntary Health Services Plans Act is | ||||||
3 | amended by changing Section 10 as follows:
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4 | (215 ILCS 165/10) (from Ch. 32, par. 604)
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5 | Sec. 10. Application of Insurance Code provisions. Health | ||||||
6 | services
plan corporations and all persons interested therein | ||||||
7 | or dealing therewith
shall be subject to the provisions of | ||||||
8 | Articles IIA and XII 1/2 and Sections
3.1, 133, 140, 143, 143c, | ||||||
9 | 149, 155.37, 354, 355.2, 356g.5, 356r, 356t, 356u, 356v,
356w, | ||||||
10 | 356x, 356y, 356z.1, 356z.2, 356z.4, 356z.5, 356z.6, 364.01, | ||||||
11 | 367.2, 368a, 401, 401.1,
402,
403, 403A, 408,
408.2, and 412, | ||||||
12 | and paragraphs (7) and (15) of Section 367 of the Illinois
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13 | Insurance Code.
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14 | (Source: P.A. 92-130, eff. 7-20-01; 92-440, eff. 8-17-01; | ||||||
15 | 92-651, eff. 7-11-02; 92-764, eff. 1-1-03; 93-102, eff. 1-1-04; | ||||||
16 | 93-529, eff. 8-14-03; 93-853, eff. 1-1-05; 93-1000, eff. | ||||||
17 | 1-1-05; revised 10-14-04.)
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18 | Section 99. Effective date. This Act takes effect upon | ||||||
19 | becoming law.
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