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Public Act 102-1073


 

Public Act 1073 102ND GENERAL ASSEMBLY

  
  
  

 


 
Public Act 102-1073
 
HB5318 EnrolledLRB102 25274 BMS 34547 b

    AN ACT concerning regulation.
 
    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
changing Section 356u as follows:
 
    (215 ILCS 5/356u)
    Sec. 356u. Pap tests and prostate cancer screenings
prostate-specific antigen tests.
    (a) A group policy of accident and health insurance that
provides coverage for hospital or medical treatment or
services for illness on an expense-incurred basis and is
amended, delivered, issued, or renewed after January 1, 2024
the effective date of this amendatory Act of 1997 shall
provide coverage, without imposing a deductible, coinsurance,
copayment, or any other cost-sharing requirement, for all of
the following:
        (1) An annual cervical smear or Pap smear test for
    female insureds.
        (2) An annual prostate cancer screening digital rectal
    examination and a prostate-specific antigen test, for male
    insureds upon the recommendation of a physician licensed
    to practice medicine in all its branches for:
            (A) asymptomatic men age 50 and over;
            (B) African-American men age 40 and over; and
            (C) men age 40 and over with a family history of
        prostate cancer.
        (3) Surveillance tests for ovarian cancer for female
    insureds who are at risk for ovarian cancer.
    (b) This Section shall not apply to agreements, contracts,
or policies that provide coverage for a specified disease or
other limited benefit coverage.
    (c) This Section does not apply to coverage of prostate
cancer screenings to the extent such coverage would disqualify
a high-deductible health plan from eligibility for a health
savings account pursuant to Section 223 of the Internal
Revenue Code.
    (d) (c) For the purposes of this Section:
    "At risk for ovarian cancer" means:
        (1) having a family history (i) with one or more
    first-degree relatives with ovarian cancer, (ii) of
    clusters of women relatives with breast cancer, or (iii)
    of nonpolyposis colorectal cancer; or
        (2) testing positive for BRCA1 or BRCA2 mutations.
    "Prostate cancer screening" means medically viable methods
for the detection and diagnosis of prostate cancer, including
a digital rectal exam and the prostate-specific antigen test
and associated laboratory work. "Prostate cancer screening"
includes medically necessary subsequent follow-up testing as
directed by a health care provider, including, but not limited
to:
        (1) urinary analysis;
        (2) serum biomarkers; and
        (3) medical imaging, including, but not limited to,
    magnetic resonance imaging.
    "Surveillance tests for ovarian cancer" means annual
screening using (i) CA-125 serum tumor marker testing, (ii)
transvaginal ultrasound, (iii) pelvic examination.
(Source: P.A. 94-122, eff. 1-1-06.)

Effective Date: 1/1/2023