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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 | changing Section 356u as follows:
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| 6 | (215 ILCS 5/356u)
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| 7 | Sec. 356u. Pap tests and prostate cancer screenings.
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| 8 | (a) A group policy of accident and health insurance that | ||||||
| 9 | provides coverage
for hospital or medical treatment or | ||||||
| 10 | services for illness on an
expense-incurred basis and is | ||||||
| 11 | amended, delivered, issued, or renewed after January 1, 2024 | ||||||
| 12 | shall provide coverage, without imposing a deductible, | ||||||
| 13 | coinsurance, copayment, or any other cost-sharing requirement, | ||||||
| 14 | for all of
the
following:
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| 15 | (1) An annual cervical smear or Pap smear test for all | ||||||
| 16 | female insureds.
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| 17 | (2) An annual prostate cancer screening for male | ||||||
| 18 | insureds upon the recommendation of a physician licensed
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| 19 | to practice medicine in all its branches for:
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| 20 | (A) asymptomatic individuals men age 50 and over;
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| 21 | (B) African-American individuals men age 40 and | ||||||
| 22 | over; and
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| 23 | (C) individuals men age 40 and over with a family | ||||||
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| 1 | history of or genetic predisposition to prostate | ||||||
| 2 | cancer.
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| 3 | (3) Surveillance tests for ovarian cancer for female | ||||||
| 4 | insureds who are at risk for ovarian cancer. | ||||||
| 5 | (b) This Section shall not apply to agreements, contracts, | ||||||
| 6 | or policies that
provide coverage for a specified disease or | ||||||
| 7 | other limited benefit coverage.
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| 8 | (c) This Section does not apply to coverage of prostate | ||||||
| 9 | cancer screenings to the extent such coverage would disqualify | ||||||
| 10 | a high-deductible health plan from eligibility for a health | ||||||
| 11 | savings account pursuant to Section 223 of the Internal | ||||||
| 12 | Revenue Code. | ||||||
| 13 | (d) For the purposes of this Section: | ||||||
| 14 | "At risk for ovarian cancer" means: | ||||||
| 15 | (1) having a family history (i) with one or more | ||||||
| 16 | first-degree relatives with ovarian cancer, (ii) of | ||||||
| 17 | clusters of women relatives with breast cancer, or (iii) | ||||||
| 18 | of nonpolyposis colorectal cancer; or | ||||||
| 19 | (2) testing positive for BRCA1 or BRCA2 mutations. | ||||||
| 20 | "Prostate cancer screening" means medically viable methods | ||||||
| 21 | for the detection and diagnosis of prostate cancer, including | ||||||
| 22 | a digital rectal exam and the prostate-specific antigen test | ||||||
| 23 | and associated laboratory work. "Prostate cancer screening" | ||||||
| 24 | includes medically necessary subsequent follow-up testing as | ||||||
| 25 | directed by a health care provider, including, but not limited | ||||||
| 26 | to: | ||||||
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| 1 | (1) urinary analysis; | ||||||
| 2 | (2) serum biomarkers; and | ||||||
| 3 | (3) medical imaging, including, but not limited to, | ||||||
| 4 | magnetic resonance imaging. | ||||||
| 5 | "Surveillance tests for ovarian cancer" means annual | ||||||
| 6 | screening using (i) CA-125 serum tumor marker testing, (ii) | ||||||
| 7 | transvaginal ultrasound, (iii) pelvic examination.
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| 8 | (Source: P.A. 102-1073, eff. 1-1-23.)
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| 9 | Section 99. Effective date. This Act takes effect January | ||||||
| 10 | 1, 2025.
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