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| 1 | AN ACT concerning insurance.
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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 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,
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| 10 | coinsurance, out-of-pocket expenses, aggregate lifetime
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| 11 | limits, and annual limits. | ||||||
| 12 | "Treatment limitation" means limits on the frequency of
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| 13 | treatment, days of coverage, or other similar limits on the
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| 14 | scope or duration of treatment. | ||||||
| 15 | (b) On and after the effective date of this amendatory Act
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| 16 | of the 97th General Assembly, every insurer that amends,
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| 17 | delivers, issues, or renews an individual or group policy of
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| 18 | accident and health insurance amended, delivered, issued, or
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| 19 | renewed on or after the effective date of this amendatory Act
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| 20 | of the 97th General Assembly that provides coverage for
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| 21 | prescribed orally-administered cancer medications and
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| 22 | intravenously administered or injected cancer medications
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| 23 | shall ensure that: | ||||||
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| 1 | (1) the financial requirements applicable to such
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| 2 | prescribed orally-administered cancer medications are no
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| 3 | more restrictive than the financial requirements applied
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| 4 | to intravenously administered or injected cancer
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| 5 | medications that are covered by the policy and that there
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| 6 | are no separate cost-sharing requirements that are
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| 7 | applicable only with respect to such prescribed
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| 8 | orally-administered cancer medications; and | ||||||
| 9 | (2) the treatment limitations applicable to such
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| 10 | prescribed orally-administered cancer medications are no | ||||||
| 11 | more restrictive than the treatment limitations applied to
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| 12 | intravenously administered or injected cancer medications
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| 13 | that are covered by the policy and that there are no
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| 14 | separate treatment limitations that are applicable only
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| 15 | with respect to such prescribed orally-administered cancer
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| 16 | medications. | ||||||
| 17 | (c) An insurer cannot achieve compliance with this Section
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| 18 | by increasing financial requirements or imposing more
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| 19 | restrictive treatment limitations on prescribed | ||||||
| 20 | orally-administered cancer medications or intravenously
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| 21 | administered or injected cancer medications covered under the
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| 22 | policy on the effective date of this amendatory Act of the 97th
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| 23 | General Assembly.
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