97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB1825
 
Introduced , by Rep. Ann Williams
 
SYNOPSIS AS INTRODUCED:
 

 
215 ILCS 5/356z.19 new

     Amends the Illinois Insurance Code. Provides that accident and health insurance policies that provide coverage for prescribed orally-administered cancer medications and intravenously administered or injected cancer medications shall ensure that the applicable financial requirements and treatment limitations are no
more restrictive than the financial requirements and treatment limitations applied
to intravenously administered or injected cancer
medications that are covered by the policy. Provides that an insurer cannot achieve compliance with the coverage mandate by increasing financial requirements or imposing more restrictive treatment limitations on prescribed orally-administered cancer medications or intravenously administered or injected cancer medications covered under the policy. Effective immediately.
  


LRB097 05082 RPM 45123 b

 
 
A BILL FOR
 

  
HB1825LRB097 05082 RPM 45123 b


  
1    AN ACT concerning insurance.
  
 
2    Be it enacted by the People of the State of Illinois,
 
3represented in the General Assembly:
  
 
 
4    Section 5. The Illinois Insurance Code is amended  by adding 
5Section 356z.19 as follows:
 
6    (215 ILCS 5/356z.19 new)
7    Sec. 356z.19. Cancer drug parity.
8    (a) As used in this Section:
9    "Financial requirement" means deductibles, copayments,

10coinsurance, out-of-pocket expenses, aggregate lifetime

11limits, and annual limits.
12    "Treatment limitation" means limits on the frequency of

13treatment, days of coverage, or other similar limits on the

14scope or duration of treatment.
15    (b) On and after the effective date of this amendatory Act

16of the 97th General Assembly, every insurer that amends,

17delivers, issues, or renews an individual or group policy of

18accident and health insurance amended, delivered, issued, or

19renewed on or after the effective date of this amendatory Act

20of the 97th General Assembly that provides coverage for

21prescribed orally-administered cancer medications and

22intravenously administered or injected cancer medications

23shall ensure that:
 
 
HB1825- 2 -LRB097 05082 RPM 45123 b

1        (1) the financial requirements applicable to such

2    prescribed orally-administered cancer medications are no

3    more restrictive than the financial requirements applied

4    to intravenously administered or injected cancer

5    medications that are covered by the policy and that there

6    are no separate cost-sharing requirements that are

7    applicable only with respect to such prescribed

8    orally-administered cancer medications; and
9        (2) the treatment limitations applicable to such

10    prescribed orally-administered cancer medications are no 
11    more restrictive than the treatment limitations applied to

12    intravenously administered or injected cancer medications

13    that are covered by the policy and that there are no

14    separate treatment limitations that are applicable only

15    with respect to such prescribed orally-administered cancer

16    medications. 
17    (c) An insurer cannot achieve compliance with this Section

18by increasing financial requirements or imposing more

19restrictive treatment limitations on prescribed 
20orally-administered cancer medications or intravenously

21administered or injected cancer medications covered under the

22policy on the effective date of this amendatory Act of the 97th

23General Assembly. 
 
 
24    Section 99. Effective date. This Act takes effect upon 
25becoming law.