Bill Text: IL HB2799 | 2023-2024 | 103rd General Assembly | Chaptered
Bill Title: Reinserts the provisions of the introduced bill with the following changes. Provides that a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2025 (rather than after the effective date of the amendatory Act) that provides coverage for the treatment of cancer shall not apply a higher standard of clinical evidence for the coverage of proton beam therapy than the insurer applies for the coverage of any other form of radiation therapy treatment. Provides that a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2025 (rather than after the effective date of the amendatory Act) that provides coverage or benefits to any resident of the State for radiation oncology shall include coverage or benefits for medically necessary proton beam therapy for the treatment of cancer (rather than for physician-prescribed proton beam therapy for the treatment of cancer as recommended by the patient's physician). Defines "medically necessary". Effective January 1, 2024.
Spectrum: Bipartisan Bill
Status: (Passed) 2023-07-28 - Public Act . . . . . . . . . 103-0325 [HB2799 Detail]
Download: Illinois-2023-HB2799-Chaptered.html
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Public Act 103-0325 | ||||
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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 Illinois Insurance Code is amended by | ||||
adding Section 356z.61 as follows:
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(215 ILCS 5/356z.61 new) | ||||
Sec. 356z.61. Proton beam
therapy. | ||||
(a) As used in this Section: | ||||
"Medically necessary" has the meaning given to that term | ||||
in the Prior Authorization Reform Act. | ||||
"Proton beam therapy" means a type of radiation
therapy | ||||
treatment that utilizes protons as the radiation delivery | ||||
method for the
treatment of tumors and cancerous cells. | ||||
"Radiation therapy treatment"
means the delivery of | ||||
biological effective doses with proton therapy,
intensity | ||||
modulated radiation therapy, brachytherapy,
stereotactic body | ||||
radiation therapy, three-dimensional conformal
radiation | ||||
therapy, or other forms of therapy using radiation. | ||||
(b) A group or individual policy of accident and health | ||||
insurance or managed care plan that is amended, delivered, | ||||
issued, or renewed on or after January 1, 2025 that provides | ||||
coverage for the treatment of cancer shall not apply a
higher | ||||
standard of clinical evidence for the coverage of proton beam
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therapy than the insurer applies for the coverage of any other | ||
form of
radiation therapy treatment. | ||
(c) A group or individual policy of accident and health | ||
insurance or managed care plan that is amended, delivered, | ||
issued, or renewed on or after January 1, 2025 that provides | ||
coverage or benefits to any resident
of this State for | ||
radiation oncology shall include coverage or benefits
for | ||
medically necessary proton beam therapy for the treatment of
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cancer.
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Section 10. The Illinois Public Aid Code is amended by | ||
adding Section 5-47 as follows:
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(305 ILCS 5/5-47 new) | ||
Sec. 5-47. Proton beam therapy; managed care. | ||
Notwithstanding any
other provision of this Article, a managed | ||
care organization under
contract with the Department to | ||
provide services to recipients of
medical assistance shall | ||
provide coverage for proton beam therapy. As
used in this | ||
Section, "proton beam therapy" means a type of radiation
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therapy treatment that utilizes protons as the radiation | ||
delivery method for the
treatment of tumors and cancerous | ||
cells. "Radiation therapy treatment"
means the delivery of | ||
biological effective doses with proton therapy,
intensity | ||
modulated radiation therapy, brachytherapy,
stereotactic body | ||
radiation therapy, three-dimensional conformal
radiation |
therapy, or other forms of therapy using radiation.
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