HB 4203

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Full Text of HB4203
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	HB4203 - 104th General Assembly
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			Senate Amendment 001
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		HB4203 Enrolled		LRB104 15932 BAB 29167 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 on or after January 1,
122028 [2024] shall provide coverage, without imposing a
13deductible, coinsurance, copayment, or any other cost-sharing
14requirement, for 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
		HB4203 Enrolled	- 2 -	LRB104 15932 BAB 29167 b
1        history of or genetic predisposition to prostate
2        cancer.
3        (3) An annual screening [Surveillance tests] for ovarian
4    cancer for insureds who are at risk for ovarian cancer
5    using (i) CA-125 serum tumor marker testing, (ii) 
6    transvaginal ultrasound, and (iii) pelvic examination.
7    (a-5) A group policy of accident and health insurance that 
8provides coverage for hospital or medical treatment or 
9services for illness on an expense-incurred basis and is 
10amended, delivered, issued, or renewed on or after January 1, 
112028 shall, in addition to the coverage required under 
12paragraph (3) of subsection (a), provide coverage for all 
13medically viable methods for the detection and diagnosis of 
14ovarian cancer for insureds who are at risk for ovarian 
15cancer, including, but not limited to, ultrasounds, magnetic 
16resonance imagings (MRIs), x-rays, computed tomography (CT) 
17scans, and CA-125 blood test screenings. The coverage required 
18under this subsection may be subject to a deductible, 
19coinsurance, or other cost sharing.
20    (b) This Section shall not apply to agreements, contracts,
21or policies that provide coverage for a specified disease or
22other limited benefit coverage.
23    (c) This Section does not apply to coverage of prostate
24cancer screenings to the extent such coverage would disqualify
25a high-deductible health plan from eligibility for a health
26savings account pursuant to Section 223 of the Internal
		HB4203 Enrolled	- 3 -	LRB104 15932 BAB 29167 b
1Revenue Code.
2    (d) For the purposes of this Section:
3    "At risk for ovarian cancer" means:
4        (1) having a family history (i) with one or more
5    first-degree relatives with ovarian cancer, (ii) of
6    clusters of relatives with breast cancer, or (iii) of
7    nonpolyposis colorectal cancer; [or]
8        (2) testing positive for BRCA1 or BRCA2 mutations; or [.]
9        (3) having a high level of CA-125, as indicated by a 
10    blood test screening.
11    "Prostate cancer screening" means medically viable methods
12for the detection and diagnosis of prostate cancer, including
13a digital rectal exam and the prostate-specific antigen test
14and associated laboratory work. "Prostate cancer screening"
15includes medically necessary subsequent follow-up testing as
16directed by a health care provider, including, but not limited
17to:
18        (1) urinary analysis;
19        (2) serum biomarkers; and
20        (3) medical imaging, including, but not limited to,
21    magnetic resonance imaging.
22    ["Surveillance tests for ovarian cancer" means annual ]
23[screening using (i) CA-125 serum tumor marker testing, (ii) ]
24[transvaginal ultrasound, (iii) pelvic examination.]
25(Source: P.A. 102-1073, eff. 1-1-23; 103-30, eff. 1-1-25.)
26    Section 99. Effective date. This Act takes effect January
		HB4203 Enrolled	- 4 -	LRB104 15932 BAB 29167 b
11, 2028.