103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB2350
 
Introduced 2/14/2023, by Rep. Kelly M. Cassidy
 
SYNOPSIS AS INTRODUCED:
 

 



215 ILCS 5/356u

     Amends the Accident and Health Article of the Illinois Insurance Code. In provisions concerning pap tests and prostate cancer screenings, provides that required coverage includes  an annual cervical smear or Pap smear test for all (rather than female) insureds. Provides that required coverage includes an annual prostate cancer screening for insureds (rather than male insureds)  upon the recommendation of a physician licensed to practice medicine in all of its branches for specified individuals. Provides that required coverage includes an annual prostate cancer screening for insureds who are age 40 and over with a genetic predisposition to prostate cancer.
  


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A BILL FOR
 

  
HB2350LRB103 26427 BMS 52790 b


  
1    AN ACT concerning regulation.
  
 
2    Be it enacted by the People of the State of Illinois,
 
3represented in the General Assembly:
  
 
 
4    Section 5. The Illinois Insurance Code is amended  by 
5changing Section 356u as follows:
 


6    (215 ILCS 5/356u)




7    Sec. 356u. Pap tests and prostate cancer screenings. 

8    (a) A group policy of accident and health insurance that 
9provides coverage
for hospital or medical treatment or 
10services for illness on an
expense-incurred basis and is 
11amended, delivered, issued, or renewed after January 1, 2024 
12shall provide coverage, without imposing a deductible, 
13coinsurance, copayment, or any other cost-sharing requirement, 
14for all of
the
following:


15        (1) An annual cervical smear or Pap smear test for all 
16    female insureds.


17        (2) An annual prostate cancer screening for male 
18    insureds upon the recommendation of a physician licensed

19    to practice medicine in all its branches for:


20            (A) asymptomatic individuals men age 50 and over;


21            (B) African-American individuals men age 40 and 
22        over; and


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.

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, 
6or policies that
provide coverage for a specified disease or 
7other limited benefit coverage.

8    (c) This Section does not apply to coverage of prostate 
9cancer screenings to the extent such coverage would disqualify 
10a high-deductible health plan from eligibility for a health 
11savings account pursuant to Section 223 of the Internal 
12Revenue 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 
21for the detection and diagnosis of prostate cancer, including 
22a digital rectal exam and the prostate-specific antigen test 
23and associated laboratory work.  "Prostate cancer screening" 
24includes medically necessary subsequent follow-up testing as 
25directed by a health care provider, including, but not limited 
26to:
 
 
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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 
6screening using (i) CA-125 serum tumor marker testing, (ii) 
7transvaginal ultrasound, (iii) pelvic examination.

8(Source: P.A. 102-1073, eff. 1-1-23.)