Rep. Greg Harris
Filed: 4/17/2007
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1 | AMENDMENT TO HOUSE BILL 147
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2 | AMENDMENT NO. ______. Amend House Bill 147, AS AMENDED, in | ||||||
3 | Section 2, Sec. 2310-345, subsection (a), in the sentence | ||||||
4 | beginning "The summary shall include", by replacing | ||||||
5 | "self-examination and diagnostic radiology" with | ||||||
6 | "self-examination , clinical breast exams, and diagnostic | ||||||
7 | radiology"; and
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8 | in Section 2, Sec. 2310-345, subsection (c), in the sentence | ||||||
9 | beginning "The summary shall include", by replacing "100% | ||||||
10 | effective and (ii)" with "100% effective , (ii) the benefits of | ||||||
11 | clinical breast exams, and (iii)
and (ii) "; and | ||||||
12 | in Section 2, Sec. 2310-345, by replacing all of subsection | ||||||
13 | (c-5) with the following: | ||||||
14 | " (c-5) The summary shall specifically address the benefits
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15 | of early detection and review the clinical standard | ||||||
16 | recommendations by the Centers for Disease Control and |
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1 | Prevention and the American Cancer Society for mammography, | ||||||
2 | clinical breast exams, and breast self-exams. | ||||||
3 | (c-10) The summary shall also inform individuals that | ||||||
4 | public and private insurance providers shall pay for clinical | ||||||
5 | breast exams as part of an exam, as indicated by guidelines of | ||||||
6 | practice. "; and | ||||||
7 | in Section 5, by replacing all of Sec. 356g.5 with the | ||||||
8 | following: | ||||||
9 | (215 ILCS 5/356g.5 new) | ||||||
10 | Sec. 356g.5. Clinical breast exam. | ||||||
11 | (a) The General Assembly finds that clinical breast | ||||||
12 | examinations are a critical tool in the early detection of | ||||||
13 | breast cancer, while the disease is in its earlier and | ||||||
14 | potentially more treatable stages. Insurer reimbursement of | ||||||
15 | clinical breast examinations is essential to the effort to | ||||||
16 | 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 complete and thorough | ||||||
21 | clinical breast examinations as indicated by guidelines of | ||||||
22 | practice, performed by a physician licensed to practice | ||||||
23 | medicine in all its branches, an advanced practice nurse who | ||||||
24 | has a collaborative agreement with a collaborating physician |
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1 | that authorizes breast
examinations, or a physician assistant | ||||||
2 | who has been delegated authority to provide breast | ||||||
3 | examinations, to check for lumps and other changes for the | ||||||
4 | purpose of early detection and prevention of breast cancer as | ||||||
5 | follows: | ||||||
6 | (1) at least every 3 years for women at least 20 years | ||||||
7 | of age but less than 40 years of age; and | ||||||
8 | (2) annually for women 40 years of age or older. | ||||||
9 | (c) Upon approval of a nationally recognized separate and | ||||||
10 | distinct clinical breast exam code that is compliant with all | ||||||
11 | State and federal laws, rules, and regulations, public and | ||||||
12 | private insurance plans shall take action to cover clinical | ||||||
13 | breast exams on a separate and distinct basis. ".
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