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| Public Act 097-0198 | ||||
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AN ACT concerning insurance.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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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,
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coinsurance, out-of-pocket expenses, aggregate lifetime
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limits, and annual limits. | ||||
"Treatment limitation" means limits on the frequency of
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treatment, days of coverage, or other similar limits on the
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scope or duration of treatment. | ||||
(b) On and after the effective date of this amendatory Act
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of the 97th General Assembly, every insurer that amends,
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delivers, issues, or renews an individual or group policy of
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accident and health insurance amended, delivered, issued, or
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renewed on or after the effective date of this amendatory Act
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of the 97th General Assembly that provides coverage for
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prescribed orally-administered cancer medications and
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intravenously administered or injected cancer medications
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shall ensure that: | ||||
(1) the financial requirements applicable to such
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prescribed orally-administered cancer medications are no
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more restrictive than the financial requirements applied
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to intravenously administered or injected cancer
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medications that are covered by the policy and that there
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are no separate cost-sharing requirements that are
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applicable only with respect to such prescribed
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orally-administered cancer medications; and | ||
(2) the treatment limitations applicable to such
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prescribed orally-administered cancer medications are no | ||
more restrictive than the treatment limitations applied to
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intravenously administered or injected cancer medications
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that are covered by the policy and that there are no
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separate treatment limitations that are applicable only
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with respect to such prescribed orally-administered cancer
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medications. | ||
(c) An insurer cannot achieve compliance with this Section
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by increasing financial requirements or imposing more
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restrictive treatment limitations on prescribed | ||
orally-administered cancer medications or intravenously
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administered or injected cancer medications covered under the
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policy on the effective date of this amendatory Act of the 97th
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General Assembly.
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