SB3414 103RD GENERAL ASSEMBLY

LRB103 38590 RPS 68726 b

103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB3414

Introduced 2/8/2024, by Sen. Julie A. Morrison

SYNOPSIS AS INTRODUCED:

215 ILCS 5/356z.59

Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed before January 1, 2025 shall provide coverage for medically necessary continuous glucose monitors for individuals who are diagnosed with any form of diabetes mellitus (instead of type 1 or type 2 diabetes) and require insulin for the management of their diabetes. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2025 shall provide coverage for continuous glucose monitors, related supplies, and training in the use of continuous glucose monitors for any individual who is diagnosed with diabetes, who requires at least one daily injection or infusion of insulin, and who has been prescribed a continuous glucose monitor by a physician, a certified nurse practitioner, or a physician assistant. Provides that an individual who is diagnosed with diabetes and meets the specified requirements shall not be required to obtain prior authorization for coverage for a continuous glucose monitor, and coverage shall be continuous once the continuous glucose monitor is prescribed. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2025 shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage required under the provisions. Effective July 1, 2024.

A BILL FOR

AN ACT concerning regulation.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Illinois Insurance Code is amended by changing Section 356z.59 as follows:

(215 ILCS 5/356z.59)

Sec. 356z.59. Coverage for continuous glucose monitors.

(a) A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed before January 1, 2025 on or after January 1, 2024 shall provide coverage for medically necessary continuous glucose monitors for individuals who are diagnosed with any form of diabetes mellitus type 1 or type 2 diabetes and require insulin for the management of their diabetes. A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2025 shall provide coverage for continuous glucose monitors, related supplies, and training in the use of continuous glucose monitors for any individual who is diagnosed with diabetes, who requires at least one daily injection or infusion of insulin, and who has been prescribed a continuous glucose monitor by a physician licensed under the Medical Practice Act of 1987 to practice medicine in all of its branches, a certified nurse practitioner under the Nurse Practice Act, or a physician assistant licensed under the Physician Assistant Practice Act of 1987.

(b) Any individual who is diagnosed with diabetes and meets the requirements of this Section shall not be required to obtain prior authorization for coverage for a continuous glucose monitor, and coverage shall be continuous once the continuous glucose monitor is prescribed.

(c) A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2025 shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage provided under this Section. The provisions of this subsection do not apply to coverage under this Section to the extent such coverage would disqualify a high-deductible health plan from eligibility for a health savings account pursuant to the federal Internal Revenue Code, 26 U.S.C. 23.

(Source: P.A. 102-1093, eff. 1-1-23; 103-154, eff. 6-30-23.)

Section 99. Effective date. This Act takes effect July 1, 2024.