Rep. Greg Harris

Filed: 4/17/2007





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2     AMENDMENT NO. ______. Amend House Bill 147, AS AMENDED, in
3 Section 2, Sec. 2310-345, subsection (a), in the sentence
4 beginning "The summary shall include", by replacing
5 "self-examination and diagnostic radiology" with
6 "self-examination, clinical breast exams, and diagnostic
7 radiology"; and
8 in Section 2, Sec. 2310-345, subsection (c), in the sentence
9 beginning "The summary shall include", by replacing "100%
10 effective and (ii)" with "100% effective, (ii) the benefits of
11 clinical breast exams, and (iii) and (ii)"; and
12 in Section 2, Sec. 2310-345, by replacing all of subsection
13 (c-5) with the following:
14     "(c-5) The summary shall specifically address the benefits
15 of early detection and review the clinical standard
16 recommendations by the Centers for Disease Control and



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1 Prevention and the American Cancer Society for mammography,
2 clinical breast exams, and breast self-exams.
3     (c-10) The summary shall also inform individuals that
4 public and private insurance providers shall pay for clinical
5 breast exams as part of an exam, as indicated by guidelines of
6 practice."; and
7 in Section 5, by replacing all of Sec. 356g.5 with the
8 following:
9     (215 ILCS 5/356g.5 new)
10     Sec. 356g.5. Clinical breast exam.
11     (a) The General Assembly finds that clinical breast
12 examinations are a critical tool in the early detection of
13 breast cancer, while the disease is in its earlier and
14 potentially more treatable stages. Insurer reimbursement of
15 clinical breast examinations is essential to the effort to
16 reduce breast cancer deaths in Illinois.
17     (b) Every insurer shall provide, in each group or
18 individual policy, contract, or certificate of accident or
19 health insurance issued or renewed for persons who are
20 residents of Illinois, coverage for complete and thorough
21 clinical breast examinations as indicated by guidelines of
22 practice, performed by a physician licensed to practice
23 medicine in all its branches, an advanced practice nurse who
24 has a collaborative agreement with a collaborating physician



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1 that authorizes breast examinations, or a physician assistant
2 who has been delegated authority to provide breast
3 examinations, to check for lumps and other changes for the
4 purpose of early detection and prevention of breast cancer as
5 follows:
6         (1) at least every 3 years for women at least 20 years
7     of age but less than 40 years of age; and
8         (2) annually for women 40 years of age or older.
9     (c) Upon approval of a nationally recognized separate and
10 distinct clinical breast exam code that is compliant with all
11 State and federal laws, rules, and regulations, public and
12 private insurance plans shall take action to cover clinical
13 breast exams on a separate and distinct basis.".