HB2799 EnrolledLRB103 30056 BMS 56479 b HB2799 Enrolled LRB103 30056 BMS 56479 b
HB2799 Enrolled LRB103 30056 BMS 56479 b
1 AN ACT concerning insurance.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 5. The Illinois Insurance Code is amended by
5 adding Section 356z.61 as follows:
6 (215 ILCS 5/356z.61 new)
7 Sec. 356z.61. Proton beam therapy.
8 (a) As used in this Section:
9 "Medically necessary" has the meaning given to that term
10 in the Prior Authorization Reform Act.
11 "Proton beam therapy" means a type of radiation therapy
12 treatment that utilizes protons as the radiation delivery
13 method for the treatment of tumors and cancerous cells.
14 "Radiation therapy treatment" means the delivery of
15 biological effective doses with proton therapy, intensity
16 modulated radiation therapy, brachytherapy, stereotactic body
17 radiation therapy, three-dimensional conformal radiation
18 therapy, or other forms of therapy using radiation.
19 (b) A group or individual policy of accident and health
20 insurance or managed care plan that is amended, delivered,
21 issued, or renewed on or after January 1, 2025 that provides
22 coverage for the treatment of cancer shall not apply a higher
23 standard of clinical evidence for the coverage of proton beam
HB2799 Enrolled LRB103 30056 BMS 56479 b
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1 therapy than the insurer applies for the coverage of any other
2 form of radiation therapy treatment.
3 (c) A group or individual policy of accident and health
4 insurance or managed care plan that is amended, delivered,
5 issued, or renewed on or after January 1, 2025 that provides
6 coverage or benefits to any resident of this State for
7 radiation oncology shall include coverage or benefits for
8 medically necessary proton beam therapy for the treatment of
9 cancer.
10 Section 10. The Illinois Public Aid Code is amended by
11 adding Section 5-47 as follows:
12 (305 ILCS 5/5-47 new)
13 Sec. 5-47. Proton beam therapy; managed care.
14 Notwithstanding any other provision of this Article, a managed
15 care organization under contract with the Department to
16 provide services to recipients of medical assistance shall
17 provide coverage for proton beam therapy. As used in this
18 Section, "proton beam therapy" means a type of radiation
19 therapy treatment that utilizes protons as the radiation
20 delivery method for the treatment of tumors and cancerous
21 cells. "Radiation therapy treatment" means the delivery of
22 biological effective doses with proton therapy, intensity
23 modulated radiation therapy, brachytherapy, stereotactic body
24 radiation therapy, three-dimensional conformal radiation
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1 therapy, or other forms of therapy using radiation.
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