102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB5318

 

Introduced 1/31/2022, by Rep. La Shawn K. Ford

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 5/356u

    Amends the Illinois Insurance Code. In provisions concerning cancer screenings, provides that a group policy of accident and health insurance that provides coverage for hospital or medical treatment or services for illness on an expense-incurred basis and is amended, delivered, issued, or renewed after the effective date of the amendatory Act shall provide coverage without imposing a deductible, coinsurance, copayment, or any other cost-sharing requirement on the benefits. Provides for coverage for an annual prostate cancer screening for male insureds. Defines "prostate cancer screening" as medically viable methods for the detection and diagnosis of prostate cancer, including a digital rectal exam and the prostate-specific antigen test and associated laboratory work, and provides that the term includes subsequent follow-up testing as directed by a health care provider, including, but not limited to, urinary analysis, serum biomarkers, and medical imaging.


LRB102 25274 BMS 34547 b

 

 

A BILL FOR

 

HB5318LRB102 25274 BMS 34547 b

1    AN ACT concerning regulation.
 
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
5changing Section 356u as follows:
 
6    (215 ILCS 5/356u)
7    Sec. 356u. Pap tests and prostate cancer screenings
8prostate-specific antigen tests.
9    (a) A group policy of accident and health insurance that
10provides coverage for hospital or medical treatment or
11services for illness on an expense-incurred basis and is
12amended, delivered, issued, or renewed after the effective
13date of this amendatory Act of the 102nd General Assembly the
14effective date of this amendatory Act of 1997 shall provide
15coverage, without imposing a deductible, coinsurance,
16copayment, or any other cost-sharing requirement, for all of
17the following:
18        (1) An annual cervical smear or Pap smear test for
19    female insureds.
20        (2) An annual prostate cancer screening digital rectal
21    examination and a prostate-specific antigen test, for male
22    insureds upon the recommendation of a physician licensed
23    to practice medicine in all its branches for:

 

 

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1            (A) asymptomatic men age 50 and over;
2            (B) African-American men age 40 and over; and
3            (C) men age 40 and over with a family history of
4        prostate cancer.
5        (3) Surveillance tests for ovarian cancer for female
6    insureds who are at risk for ovarian cancer.
7    (b) This Section shall not apply to agreements, contracts,
8or policies that provide coverage for a specified disease or
9other limited benefit coverage.
10    (c) For the purposes of this Section:
11    "At risk for ovarian cancer" means:
12        (1) having a family history (i) with one or more
13    first-degree relatives with ovarian cancer, (ii) of
14    clusters of women relatives with breast cancer, or (iii)
15    of nonpolyposis colorectal cancer; or
16        (2) testing positive for BRCA1 or BRCA2 mutations.
17    "Prostate cancer screening" means medically viable methods
18for the detection and diagnosis of prostate cancer, including
19a digital rectal exam and the prostate-specific antigen test
20and associated laboratory work. "Prostate cancer screening"
21includes subsequent follow-up testing as directed by a health
22care provider, including, but not limited to:
23        (1) urinary analysis;
24        (2) serum biomarkers; and
25        (3) medical imaging, including, but not limited to,
26    magnetic resonance imaging.

 

 

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1    "Surveillance tests for ovarian cancer" means annual
2screening using (i) CA-125 serum tumor marker testing, (ii)
3transvaginal ultrasound, (iii) pelvic examination.
4(Source: P.A. 94-122, eff. 1-1-06.)