SB2339eng 93RD GENERAL ASSEMBLY

SB2339 Engrossed LRB093 17610 SAS 43280 b

AN ACT concerning insurance.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Illinois Insurance Code is amended by adding Section 364.01 as follows:

(215 ILCS 5/364.01 new)

Sec. 364.01. Qualified cancer trials.

(a) No individual or group policy of accident and health insurance issued or renewed in this State on or after the effective date of this amendatory Act of the 93rd General Assembly may be cancelled or non-renewed for any individual based on that individual's participation in a qualified cancer trial.

(b) Qualified cancer trials must meet the following criteria:

(1) the effectiveness of the treatment has not been determined relative to established therapies;

(2) the trial is under clinical investigation as part of an approved cancer research trial in Phase II, Phase III, or Phase IV of investigation;

(3) the trial is approved by the U.S. Secretary of Health and Human Services, the Director of the National Institutes of Health, the Commissioner of the Food and Drug Administration (through an investigational new drug exemption under Section 505(l) of the federal Food, Drug, and Cosmetic Act or an investigational device exemption under Section 520(g) of that Act), or a qualified nongovernmental cancer research entity as defined in guidelines of the National Institutes of Health or a peer reviewed and approved cancer research program, as defined by the U.S. Secretary of Health and Human Services, conducted for the primary purpose of determining whether or not a cancer treatment is safe or efficacious or has any other characteristic of a cancer treatment that must be demonstrated in order for the cancer treatment to be medically necessary or appropriate;

(4) the trial is being conducted at multiple sites throughout the State;

(5) the patient's primary care physician, if any, is involved in the coordination of care; and

(6) the results of the investigational trial will be submitted for publication in peer-reviewed scientific studies, research, or literature published in or accepted for publication by medical journals that meet nationally recognized requirements for scientific manuscripts and that submit most of their published articles for review by experts who are not part of the editorial staff. These studies may include those conducted by or under the auspices of the federal government's Agency for Health Care Policy and Research, National Institutes of Health, National Cancer Institute, National Academy of Sciences, Health Care Financing Administration, and any national board recognized by the National Institutes of Health for the purpose of evaluating the medical value of health services.