Bill Text: IL HB1779 | 2021-2022 | 102nd General Assembly | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed on or after January 1, 2022 shall include coverage for biomarker testing. Provides that biomarker testing shall be covered and conducted in an efficient manner to provide the most complete range of results to the patient's health care provider without requiring multiple biopsies, biospecimen samples, or other delays or disruptions in patient care. Provides that biomarker testing must be covered for the purposes of diagnosis, treatment, appropriate management, or ongoing monitoring of an enrollee's disease or condition when the test is supported by medical and scientific evidence. Provides that when coverage of biomarker testing for the purpose of diagnosis, treatment, or ongoing monitoring of any medical condition is restricted for use by health insurers, nonprofit health service plans, or health maintenance organizations, the patient and prescribing practitioner shall have access to a clear, readily accessible, and convenient processes to request an exception, and the process shall be made readily accessible on the insurer's website. Defines "biomarker" and "biomarker testing". Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code.
Spectrum: Moderate Partisan Bill (Democrat 50-10)
Status: (Passed) 2021-07-30 - Public Act . . . . . . . . . 102-0203 [HB1779 Detail]
Download: Illinois-2021-HB1779-Introduced.html
Bill Title: Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed on or after January 1, 2022 shall include coverage for biomarker testing. Provides that biomarker testing shall be covered and conducted in an efficient manner to provide the most complete range of results to the patient's health care provider without requiring multiple biopsies, biospecimen samples, or other delays or disruptions in patient care. Provides that biomarker testing must be covered for the purposes of diagnosis, treatment, appropriate management, or ongoing monitoring of an enrollee's disease or condition when the test is supported by medical and scientific evidence. Provides that when coverage of biomarker testing for the purpose of diagnosis, treatment, or ongoing monitoring of any medical condition is restricted for use by health insurers, nonprofit health service plans, or health maintenance organizations, the patient and prescribing practitioner shall have access to a clear, readily accessible, and convenient processes to request an exception, and the process shall be made readily accessible on the insurer's website. Defines "biomarker" and "biomarker testing". Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code.
Spectrum: Moderate Partisan Bill (Democrat 50-10)
Status: (Passed) 2021-07-30 - Public Act . . . . . . . . . 102-0203 [HB1779 Detail]
Download: Illinois-2021-HB1779-Introduced.html
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| 1 | AN ACT concerning regulation.
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| 2 | Be it enacted by the People of the State of Illinois,
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| 3 | represented in the General Assembly:
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| 4 | Section 5. The Illinois Insurance Code is amended by | |||||||||||||||||||
| 5 | adding Section 356z.43 as follows:
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| 6 | (215 ILCS 5/356z.43 new) | |||||||||||||||||||
| 7 | Sec. 356z.43. Biomarker testing; advanced or metastatic | |||||||||||||||||||
| 8 | stage 3 or 4 cancer. | |||||||||||||||||||
| 9 | (a) As used in this Section, "biomarker testing" means | |||||||||||||||||||
| 10 | diagnostic testing of the cancer patient's biospecimen, such | |||||||||||||||||||
| 11 | as tissue, blood, or other bodily fluids, for DNA or RNA | |||||||||||||||||||
| 12 | alterations to identify an individual with a subtype of cancer | |||||||||||||||||||
| 13 | in order to guide patient treatment. | |||||||||||||||||||
| 14 | (b) An individual or group health care service plan | |||||||||||||||||||
| 15 | contract that is issued, amended, delivered, or renewed on or | |||||||||||||||||||
| 16 | after January 1, 2022 shall not require prior authorization | |||||||||||||||||||
| 17 | for biomarker testing for an insured with advanced or | |||||||||||||||||||
| 18 | metastatic stage 3 or 4 cancer, nor shall prior authorization | |||||||||||||||||||
| 19 | be required for biomarker testing of cancer progression or | |||||||||||||||||||
| 20 | recurrence in the insured with advanced or metastatic stage 3 | |||||||||||||||||||
| 21 | or 4 cancer.
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