Summary as Introduced
Amends the Illinois Insurance Code. Defines terms. Provides that 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 that is amended, delivered, issued, or renewed after January 1, 2025 shall provide coverage, without imposing any cost-sharing requirement, for clinical genetic testing for an inherited gene mutation for individuals with a personal or family history of cancer that is recommended by a health care professional; and evidence-based cancer imaging for individuals with an increased risk of cancer as recommended by National Comprehensive Cancer Network clinical practice guidelines. Provides that the requirements do not apply to coverage of genetic testing or evidence-based cancer imaging to the extent such coverage would disqualify a high-deductible health plan from eligibility for a health savings account pursuant to the Internal Revenue Code.
Staff Analysis
Amends the Illinois Insurance Code. Provides that a group policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed after January 1, 2026, shall provide coverage for clinical genetic testing for an inherited gene mutation for individuals with a personal or family history of cancer as recommended by a health care professional in accordance with current evidence-based clinical practice guidelines. Requires, for individuals with a genetic test that is positive for an inherited mutation associated with an increased risk of cancer, coverage to include any evidence-based screenings, as recommended by a health care professional in accordance with current evidence-based clinical practice guidelines, to the extent that the management recommendation is not already covered by the policy, except that the coverage for the evidence-based screenings may be subject to a deductible, coinsurance, or other cost-sharing limitation.