Illinois General Assembly - Full Text of HB5318
Illinois General Assembly

Previous General Assemblies

Full Text of HB5318  102nd General Assembly




HB5318 EnrolledLRB102 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 January 1, 2024
13the effective date of this amendatory Act of 1997 shall
14provide coverage, without imposing a deductible, coinsurance,
15copayment, or any other cost-sharing requirement, for all of
16the following:
17        (1) An annual cervical smear or Pap smear test for
18    female insureds.
19        (2) An annual prostate cancer screening digital rectal
20    examination and a prostate-specific antigen test, for male
21    insureds upon the recommendation of a physician licensed
22    to practice medicine in all its branches for:
23            (A) asymptomatic men age 50 and over;



HB5318 Enrolled- 2 -LRB102 25274 BMS 34547 b

1            (B) African-American men age 40 and over; and
2            (C) men age 40 and over with a family history of
3        prostate cancer.
4        (3) Surveillance tests for ovarian cancer for female
5    insureds who are at risk for ovarian cancer.
6    (b) This Section shall not apply to agreements, contracts,
7or policies that provide coverage for a specified disease or
8other limited benefit coverage.
9    (c) This Section does not apply to coverage of prostate
10cancer screenings to the extent such coverage would disqualify
11a high-deductible health plan from eligibility for a health
12savings account pursuant to Section 223 of the Internal
13Revenue Code.
14    (d) (c) For the purposes of this Section:
15    "At risk for ovarian cancer" means:
16        (1) having a family history (i) with one or more
17    first-degree relatives with ovarian cancer, (ii) of
18    clusters of women relatives with breast cancer, or (iii)
19    of nonpolyposis colorectal cancer; or
20        (2) testing positive for BRCA1 or BRCA2 mutations.
21    "Prostate cancer screening" means medically viable methods
22for the detection and diagnosis of prostate cancer, including
23a digital rectal exam and the prostate-specific antigen test
24and associated laboratory work. "Prostate cancer screening"
25includes medically necessary subsequent follow-up testing as
26directed by a health care provider, including, but not limited



HB5318 Enrolled- 3 -LRB102 25274 BMS 34547 b

2        (1) urinary analysis;
3        (2) serum biomarkers; and
4        (3) medical imaging, including, but not limited to,
5    magnetic resonance imaging.
6    "Surveillance tests for ovarian cancer" means annual
7screening using (i) CA-125 serum tumor marker testing, (ii)
8transvaginal ultrasound, (iii) pelvic examination.
9(Source: P.A. 94-122, eff. 1-1-06.)