Illinois General Assembly - Full Text of HB5318
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Full Text of HB5318  102nd General Assembly


Rep. La Shawn K. Ford

Filed: 2/17/2022





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2    AMENDMENT NO. ______. Amend House Bill 5318 by replacing
3everything after the enacting clause with the following:
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:



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1        (1) An annual cervical smear or Pap smear test for
2    female insureds.
3        (2) An annual prostate cancer screening digital rectal
4    examination and a prostate-specific antigen test, for male
5    insureds upon the recommendation of a physician licensed
6    to practice medicine in all its branches for:
7            (A) asymptomatic men age 50 and over;
8            (B) African-American men age 40 and over; and
9            (C) men age 40 and over with a family history of
10        prostate cancer.
11        (3) Surveillance tests for ovarian cancer for female
12    insureds who are at risk for ovarian cancer.
13    (b) This Section shall not apply to agreements, contracts,
14or policies that provide coverage for a specified disease or
15other limited benefit coverage.
16    (c) This Section does not apply to coverage of prostate
17cancer screenings to the extent such coverage would disqualify
18a high-deductible health plan from eligibility for a health
19savings account pursuant to Section 223 of the Internal
20Revenue Code.
21    (d) (c) For the purposes of this Section:
22    "At risk for ovarian cancer" means:
23        (1) having a family history (i) with one or more
24    first-degree relatives with ovarian cancer, (ii) of
25    clusters of women relatives with breast cancer, or (iii)
26    of nonpolyposis colorectal cancer; or



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1        (2) testing positive for BRCA1 or BRCA2 mutations.
2    "Prostate cancer screening" means medically viable methods
3for the detection and diagnosis of prostate cancer, including
4a digital rectal exam and the prostate-specific antigen test
5and associated laboratory work. "Prostate cancer screening"
6includes medically necessary subsequent follow-up testing as
7directed by a health care provider, including, but not limited
9        (1) urinary analysis;
10        (2) serum biomarkers; and
11        (3) medical imaging, including, but not limited to,
12    magnetic resonance imaging.
13    "Surveillance tests for ovarian cancer" means annual
14screening using (i) CA-125 serum tumor marker testing, (ii)
15transvaginal ultrasound, (iii) pelvic examination.
16(Source: P.A. 94-122, eff. 1-1-06.)".