Full Text of SB1683 96th General Assembly
SB1683eng 96TH GENERAL ASSEMBLY
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| AN ACT concerning insurance.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Section 5. The State Employees Group Insurance Act of 1971 | 5 |
| is amended by changing Section 6.4 as follows:
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| (5 ILCS 375/6.4) (from Ch. 127, par. 526.4)
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| Sec. 6.4. Prescription drugs; cancer treatment. If the | 8 |
| program of
health benefits provides coverage for prescribed | 9 |
| drugs approved by the
federal Food and Drug Administration for | 10 |
| the treatment of certain types of
cancer, it may not exclude | 11 |
| coverage of any drug on the basis that the drug
has been | 12 |
| prescribed for the treatment of a type of cancer for which the
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| drug has not been approved by the federal Food and Drug | 14 |
| Administration.
The drug, however, must be approved by the | 15 |
| federal Food and Drug
Administration and must be recognized for | 16 |
| the treatment of the specific
type of cancer for which the drug | 17 |
| has been prescribed in
any one of the following established | 18 |
| reference compendia:
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| (a) the American Medical Association Drug Evaluations;
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| (a) (b) the American Hospital Formulary Service Drug | 21 |
| Information; or
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| (c) the United States Pharmacopeia Drug Information; or
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| (b) National Comprehensive Cancer Network's Drugs & |
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| Biologics Compendium; | 2 |
| (c) Thomson Micromedex's Drug Dex; | 3 |
| (d) Elsevier Gold Standard's Clinical Pharmacology; or | 4 |
| (e) other authoritative compendia as identified from | 5 |
| time to time by the federal Secretary of Health and Human | 6 |
| Services; or | 7 |
| if not in the compendia, recommended for that particular type | 8 |
| of cancer
in formal clinical studies, the results of which have | 9 |
| been published in at
least two peer reviewed professional | 10 |
| medical journals published in the
United States or Great | 11 |
| Britain.
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| Any coverage required by this Section shall also include | 13 |
| those medically
necessary services associated with the | 14 |
| administration of a drug.
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| Despite the provisions of this Section, coverage shall
not | 16 |
| be required for any experimental or investigational drugs or | 17 |
| any drug
that the federal Food and Drug Administration has | 18 |
| determined to be
contraindicated for treatment of the specific | 19 |
| type of cancer for which the
drug has been prescribed. This | 20 |
| Section shall apply only to cancer drugs.
Nothing in this | 21 |
| Section shall be construed, expressly or by implication, to
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| create, impair, alter, limit, notify, enlarge, abrogate or | 23 |
| prohibit
reimbursement for drugs used in the treatment of any | 24 |
| other disease or
condition.
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| (Source: P.A. 87-980.)
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| Section 10. The Illinois Insurance Code is amended by | 2 |
| changing Section 356z.7 as follows:
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| (215 ILCS 5/356z.7) (was 215 ILCS 5/370r)
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| Sec. 356z.7. Prescription drugs; cancer treatment. No | 5 |
| group policy of
accident or health insurance that provides | 6 |
| coverage for prescribed
drugs approved by the federal Food and | 7 |
| Drug Administration for the
treatment of certain types of | 8 |
| cancer shall exclude coverage of any drug on
the basis that the | 9 |
| drug has been prescribed for the treatment of a type of
cancer | 10 |
| for which the drug has not been approved by the federal Food | 11 |
| and
Drug Administration. The drug, however, must be approved by | 12 |
| the federal
Food and Drug Administration and must be recognized | 13 |
| for the treatment of the
specific type of cancer for which the | 14 |
| drug has been prescribed in any
one of the following | 15 |
| established reference compendia:
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| (a) the American Medical Association Drug Evaluations;
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| (a) (b) the American Hospital Formulary Service Drug | 18 |
| Information; or
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| (c) the United States Pharmacopeia Drug Information;
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| (b) National Comprehensive Cancer Network's Drugs & | 21 |
| Biologics Compendium; | 22 |
| (c) Thomson Micromedex's Drug Dex; | 23 |
| (d) Elsevier Gold Standard's Clinical Pharmacology; or | 24 |
| (e) other authoritative compendia as identified from | 25 |
| time to time by the federal Secretary of Health and Human |
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| Services; | 2 |
| or if not in the compendia, recommended for that particular | 3 |
| type of cancer
in formal clinical studies, the results of which | 4 |
| have been published in at
least two peer reviewed professional | 5 |
| medical journals published in the
United States or Great | 6 |
| Britain.
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| Any coverage required by this Section shall also include | 8 |
| those medically
necessary services associated with the | 9 |
| administration of a drug.
| 10 |
| Despite the provisions of this Section, coverage shall
not | 11 |
| be required for any experimental or investigational drugs or | 12 |
| any drug
that the federal Food and Drug Administration has | 13 |
| determined to be
contraindicated for treatment of the specific | 14 |
| type of cancer for which the
drug has been prescribed. This | 15 |
| Section shall apply only to cancer drugs.
Nothing in this | 16 |
| Section shall be construed, expressly or by implication, to
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| create, impair, alter, limit, notify, enlarge, abrogate or | 18 |
| prohibit
reimbursement for drugs used in the treatment of any | 19 |
| other disease or
condition.
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| (Source: P.A. 95-331, eff. 8-21-07.)
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| Section 15. The Health Maintenance Organization Act is | 22 |
| amended by changing Section 4-6.3 as follows:
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| (215 ILCS 125/4-6.3)
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| Sec. 4-6.3. Prescription drugs; cancer treatment. No |
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SB1683 Engrossed |
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LRB096 09562 RPM 19723 b |
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| health
maintenance organization that provides coverage for | 2 |
| prescribed drugs
approved by the federal Food and Drug | 3 |
| Administration for the treatment of
certain types of cancer | 4 |
| shall exclude coverage of any drug on the basis
that the drug | 5 |
| has been prescribed for the treatment of a type of cancer for
| 6 |
| which the drug has not been approved by the federal Food and | 7 |
| Drug
Administration. The drug, however, must be approved by the | 8 |
| federal Food and
Drug Administration and must be recognized for | 9 |
| the treatment of the
specific type of cancer for which the drug | 10 |
| has been prescribed in any
one of the following established | 11 |
| reference compendia:
(a) the American Medical Association Drug | 12 |
| Evaluations;
(b) | 13 |
| (a) the American Hospital Formulary Service Drug | 14 |
| Information; or
(c) the United States Pharmacopeia Drug | 15 |
| Information; | 16 |
| (b) National Comprehensive Cancer Network's Drugs & | 17 |
| Biologics Compendium; | 18 |
| (c) Thomson Micromedex's Drug Dex; | 19 |
| (d) Elsevier Gold Standard's Clinical Pharmacology; or | 20 |
| (e) other authoritative compendia as identified from | 21 |
| time to time by the federal Secretary of Health and Human | 22 |
| Services; | 23 |
| or
if not in the compendia, recommended for that particular | 24 |
| type of cancer
in formal clinical studies, the results of which | 25 |
| have been published in at
least two peer reviewed professional | 26 |
| medical journals published in the
United States or Great |
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SB1683 Engrossed |
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LRB096 09562 RPM 19723 b |
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| Britain.
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| Any coverage required by this Section shall also include | 3 |
| those medically
necessary services associated with the | 4 |
| administration of a drug.
| 5 |
| Despite the provisions of this Section, coverage shall
not | 6 |
| be required for any experimental or investigational drugs or | 7 |
| any drug
that the federal Food and Drug Administration has | 8 |
| determined to be
contraindicated for treatment of the specific | 9 |
| type of cancer for which the
drug has been prescribed. This | 10 |
| Section shall apply only to cancer drugs.
Nothing in this | 11 |
| Section shall be construed, expressly or by implication, to
| 12 |
| create, impair, alter, limit, notify, enlarge, abrogate or | 13 |
| prohibit
reimbursement for drugs used in the treatment of any | 14 |
| other disease or
condition.
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| (Source: P.A. 87-980; 88-45.)
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| Section 99. Effective date. This Act takes effect upon | 17 |
| becoming law.
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