Rep. Norine K. Hammond
Filed: 3/3/2023
 
 

 

 

 
10300HB2799ham001LRB103 30056 BMS 58407 a



1
AMENDMENT TO HOUSE BILL 2799 




2    AMENDMENT NO. ______. Amend House Bill 2799 by replacing 
3everything after the enacting clause with the following:


 
 
4    "Section 5. The Illinois Insurance Code is amended  by 
5adding Section 356z.61 as follows:
 
6    (215 ILCS 5/356z.61 new)
7    Sec. 356z.61. Proton beam
therapy.
8    (a) As used in this Section:
9    "Medically necessary" has the meaning given to that term 
10in the Prior Authorization Reform Act. 
11    "Proton beam therapy" means a type of radiation
therapy 
12treatment that utilizes protons as the radiation delivery 
13method for the
treatment of tumors and cancerous cells.
14    "Radiation therapy treatment"
means the delivery of 
15biological effective doses with proton therapy,
intensity 
16modulated radiation therapy, brachytherapy,
stereotactic body 
 
 
10300HB2799ham001- 2 -LRB103 30056 BMS 58407 a

1radiation therapy, three-dimensional conformal
radiation 
2therapy, or other forms of therapy using radiation. 
3    (b) A group or individual policy of accident and health 
4insurance or managed care plan that is amended, delivered, 
5issued, or renewed on or after January 1, 2025 that provides 
6coverage for the treatment of cancer shall not apply a
higher 
7standard of clinical evidence for the coverage of proton beam

8therapy than the insurer applies for the coverage of any other 
9form of
radiation therapy treatment. 
10    (c) A group or individual policy of accident and health 
11insurance or managed care plan that is amended, delivered, 
12issued, or renewed on or after January 1, 2025 that provides 
13coverage or benefits to any resident
of this State for 
14radiation oncology shall include coverage or benefits
for 
15medically necessary proton beam therapy for the treatment of

16cancer. 
 
17    Section 10. The Illinois Public Aid Code is amended  by 
18adding Section 5-47 as follows:
 
19    (305 ILCS 5/5-47 new)
20    Sec. 5-47. Proton beam therapy; managed care. 
21Notwithstanding any
other provision of this Article, a managed 
22care organization under
contract with the Department to 
23provide services to recipients of
medical assistance shall 
24provide coverage for proton beam therapy. As
used in this 
 
 
10300HB2799ham001- 3 -LRB103 30056 BMS 58407 a

1Section, "proton beam therapy" means a type of radiation

2therapy treatment that utilizes protons as the radiation 
3delivery method for the
treatment of tumors and cancerous 
4cells. "Radiation therapy treatment"
means the delivery of 
5biological effective doses with proton therapy,
intensity 
6modulated radiation therapy, brachytherapy,
stereotactic body 
7radiation therapy, three-dimensional conformal
radiation 
8therapy, or other forms of therapy using radiation.
  
 
9    Section 99. Effective date. This Act takes effect January 
101, 2024.".