104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB1102

 

Introduced 1/9/2025, by Rep. Jed Davis

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 5/356u

    Amends the Illinois Insurance Code. In a provision concerning coverage of certain cancer screenings, adds having a high level of CA-125, as indicated by a blood test screening, to the definition of "at risk for ovarian cancer". Provides that "surveillance tests for ovarian cancer" means all medically viable methods for the detection and diagnosis of ovarian cancer, including, but not limited to, ultrasounds, magnetic resonance imagings (MRIs), x-rays, computed tomography (CT) scans, and CA-125 blood test screenings (instead of an annual screening using (i) CA-125 serum tumor marker testing, (ii) transvaginal ultrasound, (iii) pelvic examination). Effective January 1, 2027.


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A BILL FOR

 

HB1102LRB104 03831 BAB 13855 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    insureds.
17        (2) An annual prostate cancer screening for insureds
18    upon the recommendation of a physician licensed to
19    practice medicine in all its branches for:
20            (A) asymptomatic individuals age 50 and over;
21            (B) African-American individuals age 40 and over;
22        and
23            (C) individuals 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 insureds
4    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 relatives with breast cancer, or (iii) of
18    nonpolyposis colorectal cancer; or
19        (2) testing positive for BRCA1 or BRCA2 mutations; or .
20        (3) having a high level of CA-125, as indicated by a
21    blood test screening.
22    "Prostate cancer screening" means medically viable methods
23for the detection and diagnosis of prostate cancer, including
24a digital rectal exam and the prostate-specific antigen test
25and associated laboratory work. "Prostate cancer screening"
26includes medically necessary subsequent follow-up testing as

 

 

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1directed by a health care provider, including, but not limited
2to:
3        (1) urinary analysis;
4        (2) serum biomarkers; and
5        (3) medical imaging, including, but not limited to,
6    magnetic resonance imaging.
7    "Surveillance tests for ovarian cancer" means all
8medically viable methods for the detection and diagnosis of
9ovarian cancer, including, but not limited to, ultrasounds,
10magnetic resonance imagings (MRIs), x-rays, computed
11tomography (CT) scans, and CA-125 blood test screenings.
12annual screening using (i) CA-125 serum tumor marker testing,
13(ii) transvaginal ultrasound, (iii) pelvic examination.
14(Source: P.A. 102-1073, eff. 1-1-23; 103-30, eff. 1-1-25.)
 
15    Section 99. Effective date. This Act takes effect January
161, 2027.