Bill Text: IL HB2799 | 2023-2024 | 103rd General Assembly | Chaptered

---

Bill Title: Reinserts the provisions of the introduced bill with the following changes. Provides that a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2025 (rather than after the effective date of the amendatory Act) that provides coverage for the treatment of cancer shall not apply a higher standard of clinical evidence for the coverage of proton beam therapy than the insurer applies for the coverage of any other form of radiation therapy treatment. Provides that a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2025 (rather than after the effective date of the amendatory Act) that provides coverage or benefits to any resident of the State for radiation oncology shall include coverage or benefits for medically necessary proton beam therapy for the treatment of cancer (rather than for physician-prescribed proton beam therapy for the treatment of cancer as recommended by the patient's physician). Defines "medically necessary". Effective January 1, 2024.

Spectrum: Bipartisan Bill

Status: (Passed) 2023-07-28 - Public Act . . . . . . . . . 103-0325 [HB2799 Detail]

Download: Illinois-2023-HB2799-Chaptered.html

---

Public Act 103-0325
HB2799 Enrolled LRB103 30056 BMS 56479 b
AN ACT concerning insurance.
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
adding Section 356z.61 as follows:
(215 ILCS 5/356z.61 new)
Sec. 356z.61. Proton beam therapy.
(a) As used in this Section:
"Medically necessary" has the meaning given to that term
in the Prior Authorization Reform Act.
"Proton beam therapy" means a type of radiation therapy
treatment that utilizes protons as the radiation delivery
method for the treatment of tumors and cancerous cells.
"Radiation therapy treatment" means the delivery of
biological effective doses with proton therapy, intensity
modulated radiation therapy, brachytherapy, stereotactic body
radiation therapy, three-dimensional conformal radiation
therapy, or other forms of therapy using radiation.
(b) A group or individual policy of accident and health
insurance or managed care plan that is amended, delivered,
issued, or renewed on or after January 1, 2025 that provides
coverage for the treatment of cancer shall not apply a higher
standard of clinical evidence for the coverage of proton beam

therapy than the insurer applies for the coverage of any other
form of radiation therapy treatment.
(c) A group or individual policy of accident and health
insurance or managed care plan that is amended, delivered,
issued, or renewed on or after January 1, 2025 that provides
coverage or benefits to any resident of this State for
radiation oncology shall include coverage or benefits for
medically necessary proton beam therapy for the treatment of
cancer.
Section 10. The Illinois Public Aid Code is amended by
adding Section 5-47 as follows:
(305 ILCS 5/5-47 new)
Sec. 5-47. Proton beam therapy; managed care.
Notwithstanding any other provision of this Article, a managed
care organization under contract with the Department to
provide services to recipients of medical assistance shall
provide coverage for proton beam therapy. As used in this
Section, "proton beam therapy" means a type of radiation
therapy treatment that utilizes protons as the radiation
delivery method for the treatment of tumors and cancerous
cells. "Radiation therapy treatment" means the delivery of
biological effective doses with proton therapy, intensity
modulated radiation therapy, brachytherapy, stereotactic body
radiation therapy, three-dimensional conformal radiation

therapy, or other forms of therapy using radiation.