Illinois General Assembly - Full Text of Public Act 097-0198
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Public Act 097-0198


 

Public Act 0198 97TH GENERAL ASSEMBLY

  
  
  

 


 
Public Act 097-0198
 
HB1825 EnrolledLRB097 05082 RPM 45123 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 356z.19 as follows:
 
    (215 ILCS 5/356z.19 new)
    Sec. 356z.19. Cancer drug parity.
    (a) As used in this Section:
    "Financial requirement" means deductibles, copayments,
coinsurance, out-of-pocket expenses, aggregate lifetime
limits, and annual limits.
    "Treatment limitation" means limits on the frequency of
treatment, days of coverage, or other similar limits on the
scope or duration of treatment.
    (b) On and after the effective date of this amendatory Act
of the 97th General Assembly, every insurer that amends,
delivers, issues, or renews an individual or group policy of
accident and health insurance amended, delivered, issued, or
renewed on or after the effective date of this amendatory Act
of the 97th General Assembly that provides coverage for
prescribed orally-administered cancer medications and
intravenously administered or injected cancer medications
shall ensure that:
        (1) the financial requirements applicable to such
    prescribed orally-administered cancer medications are no
    more restrictive than the financial requirements applied
    to intravenously administered or injected cancer
    medications that are covered by the policy and that there
    are no separate cost-sharing requirements that are
    applicable only with respect to such prescribed
    orally-administered cancer medications; and
        (2) the treatment limitations applicable to such
    prescribed orally-administered cancer medications are no
    more restrictive than the treatment limitations applied to
    intravenously administered or injected cancer medications
    that are covered by the policy and that there are no
    separate treatment limitations that are applicable only
    with respect to such prescribed orally-administered cancer
    medications.
    (c) An insurer cannot achieve compliance with this Section
by increasing financial requirements or imposing more
restrictive treatment limitations on prescribed
orally-administered cancer medications or intravenously
administered or injected cancer medications covered under the
policy on the effective date of this amendatory Act of the 97th
General Assembly.

Effective Date: 1/1/2012