IL
Illinois House Bill HB2799

Illinois 2023-2024 Regular Session

Illinois House Bill HB2799 Compare Versions

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1-Public Act 103-0325
21 HB2799 EnrolledLRB103 30056 BMS 56479 b HB2799 Enrolled LRB103 30056 BMS 56479 b
32 HB2799 Enrolled LRB103 30056 BMS 56479 b
4-AN ACT concerning insurance.
5-Be it enacted by the People of the State of Illinois,
6-represented in the General Assembly:
7-Section 5. The Illinois Insurance Code is amended by
8-adding Section 356z.61 as follows:
9-(215 ILCS 5/356z.61 new)
10-Sec. 356z.61. Proton beam therapy.
11-(a) As used in this Section:
12-"Medically necessary" has the meaning given to that term
13-in the Prior Authorization Reform Act.
14-"Proton beam therapy" means a type of radiation therapy
15-treatment that utilizes protons as the radiation delivery
16-method for the treatment of tumors and cancerous cells.
17-"Radiation therapy treatment" means the delivery of
18-biological effective doses with proton therapy, intensity
19-modulated radiation therapy, brachytherapy, stereotactic body
20-radiation therapy, three-dimensional conformal radiation
21-therapy, or other forms of therapy using radiation.
22-(b) A group or individual policy of accident and health
23-insurance or managed care plan that is amended, delivered,
24-issued, or renewed on or after January 1, 2025 that provides
25-coverage for the treatment of cancer shall not apply a higher
26-standard of clinical evidence for the coverage of proton beam
3+1 AN ACT concerning insurance.
4+2 Be it enacted by the People of the State of Illinois,
5+3 represented in the General Assembly:
6+4 Section 5. The Illinois Insurance Code is amended by
7+5 adding Section 356z.61 as follows:
8+6 (215 ILCS 5/356z.61 new)
9+7 Sec. 356z.61. Proton beam therapy.
10+8 (a) As used in this Section:
11+9 "Medically necessary" has the meaning given to that term
12+10 in the Prior Authorization Reform Act.
13+11 "Proton beam therapy" means a type of radiation therapy
14+12 treatment that utilizes protons as the radiation delivery
15+13 method for the treatment of tumors and cancerous cells.
16+14 "Radiation therapy treatment" means the delivery of
17+15 biological effective doses with proton therapy, intensity
18+16 modulated radiation therapy, brachytherapy, stereotactic body
19+17 radiation therapy, three-dimensional conformal radiation
20+18 therapy, or other forms of therapy using radiation.
21+19 (b) A group or individual policy of accident and health
22+20 insurance or managed care plan that is amended, delivered,
23+21 issued, or renewed on or after January 1, 2025 that provides
24+22 coverage for the treatment of cancer shall not apply a higher
25+23 standard of clinical evidence for the coverage of proton beam
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33-therapy than the insurer applies for the coverage of any other
34-form of radiation therapy treatment.
35-(c) A group or individual policy of accident and health
36-insurance or managed care plan that is amended, delivered,
37-issued, or renewed on or after January 1, 2025 that provides
38-coverage or benefits to any resident of this State for
39-radiation oncology shall include coverage or benefits for
40-medically necessary proton beam therapy for the treatment of
41-cancer.
42-Section 10. The Illinois Public Aid Code is amended by
43-adding Section 5-47 as follows:
44-(305 ILCS 5/5-47 new)
45-Sec. 5-47. Proton beam therapy; managed care.
46-Notwithstanding any other provision of this Article, a managed
47-care organization under contract with the Department to
48-provide services to recipients of medical assistance shall
49-provide coverage for proton beam therapy. As used in this
50-Section, "proton beam therapy" means a type of radiation
51-therapy treatment that utilizes protons as the radiation
52-delivery method for the treatment of tumors and cancerous
53-cells. "Radiation therapy treatment" means the delivery of
54-biological effective doses with proton therapy, intensity
55-modulated radiation therapy, brachytherapy, stereotactic body
56-radiation therapy, three-dimensional conformal radiation
32+HB2799 Enrolled- 2 -LRB103 30056 BMS 56479 b HB2799 Enrolled - 2 - LRB103 30056 BMS 56479 b
33+ HB2799 Enrolled - 2 - LRB103 30056 BMS 56479 b
34+1 therapy than the insurer applies for the coverage of any other
35+2 form of radiation therapy treatment.
36+3 (c) A group or individual policy of accident and health
37+4 insurance or managed care plan that is amended, delivered,
38+5 issued, or renewed on or after January 1, 2025 that provides
39+6 coverage or benefits to any resident of this State for
40+7 radiation oncology shall include coverage or benefits for
41+8 medically necessary proton beam therapy for the treatment of
42+9 cancer.
43+10 Section 10. The Illinois Public Aid Code is amended by
44+11 adding Section 5-47 as follows:
45+12 (305 ILCS 5/5-47 new)
46+13 Sec. 5-47. Proton beam therapy; managed care.
47+14 Notwithstanding any other provision of this Article, a managed
48+15 care organization under contract with the Department to
49+16 provide services to recipients of medical assistance shall
50+17 provide coverage for proton beam therapy. As used in this
51+18 Section, "proton beam therapy" means a type of radiation
52+19 therapy treatment that utilizes protons as the radiation
53+20 delivery method for the treatment of tumors and cancerous
54+21 cells. "Radiation therapy treatment" means the delivery of
55+22 biological effective doses with proton therapy, intensity
56+23 modulated radiation therapy, brachytherapy, stereotactic body
57+24 radiation therapy, three-dimensional conformal radiation
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59-therapy, or other forms of therapy using radiation.
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