Illinois 2023-2024 Regular Session

Illinois House Bill HB5103 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB5103 Introduced , by Rep. Jed Davis SYNOPSIS AS INTRODUCED: 215 ILCS 5/356u Amends the Illinois Insurance Code. In a provision concerning coverage of certain cancer screenings, adds having a high level of CA-125, as indicated by a blood test screening, to the definition of "at risk for ovarian cancer". Provides that "surveillance tests for ovarian cancer" means all medically viable methods for the detection and diagnosis of ovarian cancer, including, but not limited to, ultrasounds, magnetic resonance imagings (MRIs), x-rays, computed tomography (CT) scans, and CA-125 blood test screenings (instead of an annual screening using (i) CA-125 serum tumor marker testing, (ii) transvaginal ultrasound, (iii) pelvic examination). LRB103 37231 RPS 67350 b A BILL FOR 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB5103 Introduced , by Rep. Jed Davis SYNOPSIS AS INTRODUCED: 215 ILCS 5/356u 215 ILCS 5/356u Amends the Illinois Insurance Code. In a provision concerning coverage of certain cancer screenings, adds having a high level of CA-125, as indicated by a blood test screening, to the definition of "at risk for ovarian cancer". Provides that "surveillance tests for ovarian cancer" means all medically viable methods for the detection and diagnosis of ovarian cancer, including, but not limited to, ultrasounds, magnetic resonance imagings (MRIs), x-rays, computed tomography (CT) scans, and CA-125 blood test screenings (instead of an annual screening using (i) CA-125 serum tumor marker testing, (ii) transvaginal ultrasound, (iii) pelvic examination). LRB103 37231 RPS 67350 b LRB103 37231 RPS 67350 b A BILL FOR
2	2	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB5103 Introduced , by Rep. Jed Davis SYNOPSIS AS INTRODUCED:
3	3	215 ILCS 5/356u 215 ILCS 5/356u
4	4	215 ILCS 5/356u
5	5	Amends the Illinois Insurance Code. In a provision concerning coverage of certain cancer screenings, adds having a high level of CA-125, as indicated by a blood test screening, to the definition of "at risk for ovarian cancer". Provides that "surveillance tests for ovarian cancer" means all medically viable methods for the detection and diagnosis of ovarian cancer, including, but not limited to, ultrasounds, magnetic resonance imagings (MRIs), x-rays, computed tomography (CT) scans, and CA-125 blood test screenings (instead of an annual screening using (i) CA-125 serum tumor marker testing, (ii) transvaginal ultrasound, (iii) pelvic examination).
6	6	LRB103 37231 RPS 67350 b LRB103 37231 RPS 67350 b
7	7	LRB103 37231 RPS 67350 b
8	8	A BILL FOR
9	9	HB5103LRB103 37231 RPS 67350 b HB5103 LRB103 37231 RPS 67350 b
10	10	HB5103 LRB103 37231 RPS 67350 b
11	11	1 AN ACT concerning regulation.
12	12	2 Be it enacted by the People of the State of Illinois,
13	13	3 represented in the General Assembly:
14	14	4 Section 5. The Illinois Insurance Code is amended by
15	15	5 changing Section 356u as follows:
16	16	6 (215 ILCS 5/356u)
17	17	7 (Text of Section before amendment by P.A. 103-30)
18	18	8 Sec. 356u. Pap tests and prostate cancer screenings.
19	19	9 (a) A group policy of accident and health insurance that
20	20	10 provides coverage for hospital or medical treatment or
21	21	11 services for illness on an expense-incurred basis and is
22	22	12 amended, delivered, issued, or renewed after January 1, 2024
23	23	13 shall provide coverage, without imposing a deductible,
24	24	14 coinsurance, copayment, or any other cost-sharing requirement,
25	25	15 for all of the following:
26	26	16 (1) An annual cervical smear or Pap smear test for
27	27	17 female insureds.
28	28	18 (2) An annual prostate cancer screening for male
29	29	19 insureds upon the recommendation of a physician licensed
30	30	20 to practice medicine in all its branches for:
31	31	21 (A) asymptomatic men age 50 and over;
32	32	22 (B) African-American men age 40 and over; and
33	33	23 (C) men age 40 and over with a family history of
34	34
35	35
36	36
37	37	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB5103 Introduced , by Rep. Jed Davis SYNOPSIS AS INTRODUCED:
38	38	215 ILCS 5/356u 215 ILCS 5/356u
39	39	215 ILCS 5/356u
40	40	Amends the Illinois Insurance Code. In a provision concerning coverage of certain cancer screenings, adds having a high level of CA-125, as indicated by a blood test screening, to the definition of "at risk for ovarian cancer". Provides that "surveillance tests for ovarian cancer" means all medically viable methods for the detection and diagnosis of ovarian cancer, including, but not limited to, ultrasounds, magnetic resonance imagings (MRIs), x-rays, computed tomography (CT) scans, and CA-125 blood test screenings (instead of an annual screening using (i) CA-125 serum tumor marker testing, (ii) transvaginal ultrasound, (iii) pelvic examination).
41	41	LRB103 37231 RPS 67350 b LRB103 37231 RPS 67350 b
42	42	LRB103 37231 RPS 67350 b
43	43	A BILL FOR
44	44
45	45
46	46
47	47
48	48
49	49	215 ILCS 5/356u
50	50
51	51
52	52
53	53	LRB103 37231 RPS 67350 b
54	54
55	55
56	56
57	57
58	58
59	59
60	60
61	61
62	62
63	63	HB5103 LRB103 37231 RPS 67350 b
64	64
65	65
66	66	HB5103- 2 -LRB103 37231 RPS 67350 b HB5103 - 2 - LRB103 37231 RPS 67350 b
67	67	HB5103 - 2 - LRB103 37231 RPS 67350 b
68	68	1 prostate cancer.
69	69	2 (3) Surveillance tests for ovarian cancer for female
70	70	3 insureds who are at risk for ovarian cancer.
71	71	4 (b) This Section shall not apply to agreements, contracts,
72	72	5 or policies that provide coverage for a specified disease or
73	73	6 other limited benefit coverage.
74	74	7 (c) This Section does not apply to coverage of prostate
75	75	8 cancer screenings to the extent such coverage would disqualify
76	76	9 a high-deductible health plan from eligibility for a health
77	77	10 savings account pursuant to Section 223 of the Internal
78	78	11 Revenue Code.
79	79	12 (d) For the purposes of this Section:
80	80	13 "At risk for ovarian cancer" means:
81	81	14 (1) having a family history (i) with one or more
82	82	15 first-degree relatives with ovarian cancer, (ii) of
83	83	16 clusters of women relatives with breast cancer, or (iii)
84	84	17 of nonpolyposis colorectal cancer; or
85	85	18 (2) testing positive for BRCA1 or BRCA2 mutations; or .
86	86	19 (3) having a high level of CA-125, as indicated by a
87	87	20 blood test screening.
88	88	21 "Prostate cancer screening" means medically viable methods
89	89	22 for the detection and diagnosis of prostate cancer, including
90	90	23 a digital rectal exam and the prostate-specific antigen test
91	91	24 and associated laboratory work. "Prostate cancer screening"
92	92	25 includes medically necessary subsequent follow-up testing as
93	93	26 directed by a health care provider, including, but not limited
94	94
95	95
96	96
97	97
98	98
99	99	HB5103 - 2 - LRB103 37231 RPS 67350 b
100	100
101	101
102	102	HB5103- 3 -LRB103 37231 RPS 67350 b HB5103 - 3 - LRB103 37231 RPS 67350 b
103	103	HB5103 - 3 - LRB103 37231 RPS 67350 b
104	104	1 to:
105	105	2 (1) urinary analysis;
106	106	3 (2) serum biomarkers; and
107	107	4 (3) medical imaging, including, but not limited to,
108	108	5 magnetic resonance imaging.
109	109	6 "Surveillance tests for ovarian cancer" means all
110	110	7 medically viable methods for the detection and diagnosis of
111	111	8 ovarian cancer, including, but not limited to, ultrasounds,
112	112	9 magnetic resonance imagings (MRIs), x-rays, computed
113	113	10 tomography (CT) scans, and CA-125 blood test screenings.
114	114	11 annual screening using (i) CA-125 serum tumor marker testing,
115	115	12 (ii) transvaginal ultrasound, (iii) pelvic examination.
116	116	13 (Source: P.A. 102-1073, eff. 1-1-23.)
117	117	14 (Text of Section after amendment by P.A. 103-30)
118	118	15 Sec. 356u. Pap tests and prostate cancer screenings.
119	119	16 (a) A group policy of accident and health insurance that
120	120	17 provides coverage for hospital or medical treatment or
121	121	18 services for illness on an expense-incurred basis and is
122	122	19 amended, delivered, issued, or renewed after January 1, 2024
123	123	20 shall provide coverage, without imposing a deductible,
124	124	21 coinsurance, copayment, or any other cost-sharing requirement,
125	125	22 for all of the following:
126	126	23 (1) An annual cervical smear or Pap smear test for all
127	127	24 insureds.
128	128	25 (2) An annual prostate cancer screening for insureds
129	129
130	130
131	131
132	132
133	133
134	134	HB5103 - 3 - LRB103 37231 RPS 67350 b
135	135
136	136
137	137	HB5103- 4 -LRB103 37231 RPS 67350 b HB5103 - 4 - LRB103 37231 RPS 67350 b
138	138	HB5103 - 4 - LRB103 37231 RPS 67350 b
139	139	1 upon the recommendation of a physician licensed to
140	140	2 practice medicine in all its branches for:
141	141	3 (A) asymptomatic individuals age 50 and over;
142	142	4 (B) African-American individuals age 40 and over;
143	143	5 and
144	144	6 (C) individuals age 40 and over with a family
145	145	7 history of or genetic predisposition to prostate
146	146	8 cancer.
147	147	9 (3) Surveillance tests for ovarian cancer for insureds
148	148	10 who are at risk for ovarian cancer.
149	149	11 (b) This Section shall not apply to agreements, contracts,
150	150	12 or policies that provide coverage for a specified disease or
151	151	13 other limited benefit coverage.
152	152	14 (c) This Section does not apply to coverage of prostate
153	153	15 cancer screenings to the extent such coverage would disqualify
154	154	16 a high-deductible health plan from eligibility for a health
155	155	17 savings account pursuant to Section 223 of the Internal
156	156	18 Revenue Code.
157	157	19 (d) For the purposes of this Section:
158	158	20 "At risk for ovarian cancer" means:
159	159	21 (1) having a family history (i) with one or more
160	160	22 first-degree relatives with ovarian cancer, (ii) of
161	161	23 clusters of relatives with breast cancer, or (iii) of
162	162	24 nonpolyposis colorectal cancer; or
163	163	25 (2) testing positive for BRCA1 or BRCA2 mutations; or .
164	164	26 (3) having a high level of CA-125, as indicated by a
165	165
166	166
167	167
168	168
169	169
170	170	HB5103 - 4 - LRB103 37231 RPS 67350 b
171	171
172	172
173	173	HB5103- 5 -LRB103 37231 RPS 67350 b HB5103 - 5 - LRB103 37231 RPS 67350 b
174	174	HB5103 - 5 - LRB103 37231 RPS 67350 b
175	175	1 blood test screening.
176	176	2 "Prostate cancer screening" means medically viable methods
177	177	3 for the detection and diagnosis of prostate cancer, including
178	178	4 a digital rectal exam and the prostate-specific antigen test
179	179	5 and associated laboratory work. "Prostate cancer screening"
180	180	6 includes medically necessary subsequent follow-up testing as
181	181	7 directed by a health care provider, including, but not limited
182	182	8 to:
183	183	9 (1) urinary analysis;
184	184	10 (2) serum biomarkers; and
185	185	11 (3) medical imaging, including, but not limited to,
186	186	12 magnetic resonance imaging.
187	187	13 "Surveillance tests for ovarian cancer" means all
188	188	14 medically viable methods for the detection and diagnosis of
189	189	15 ovarian cancer, including, but not limited to, ultrasounds,
190	190	16 magnetic resonance imagings (MRIs), x-rays, computed
191	191	17 tomography (CT) scans, and CA-125 blood test screenings.
192	192	18 annual screening using (i) CA-125 serum tumor marker testing,
193	193	19 (ii) transvaginal ultrasound, (iii) pelvic examination.
194	194	20 (Source: P.A. 102-1073, eff. 1-1-23; 103-30, eff. 1-1-25.)
195	195	21 Section 95. No acceleration or delay. Where this Act makes
196	196	22 changes in a statute that is represented in this Act by text
197	197	23 that is not yet or no longer in effect (for example, a Section
198	198	24 represented by multiple versions), the use of that text does
199	199	25 not accelerate or delay the taking effect of (i) the changes
200	200
201	201
202	202
203	203
204	204
205	205	HB5103 - 5 - LRB103 37231 RPS 67350 b
206	206
207	207
208	208	HB5103- 6 -LRB103 37231 RPS 67350 b HB5103 - 6 - LRB103 37231 RPS 67350 b
209	209	HB5103 - 6 - LRB103 37231 RPS 67350 b
210	210
211	211
212	212
213	213
214	214
215	215	HB5103 - 6 - LRB103 37231 RPS 67350 b