HB4207 - 104th General Assembly (2025-2026)

INS-HEALTH/CORONARY SCAN
Last Action
3/19/2026 - House: Placed on Calendar 2nd Reading - Short Debate
Statutes Amended In Order of Appearance
5 ILCS 375/6.11  
55 ILCS 5/5-1069.3  
65 ILCS 5/10-4-2.3  
105 ILCS 5/10-22.3f  
215 ILCS 5/356z.88 new  
215 ILCS 125/5-3  from Ch. 111 1/2, par. 1411.2
215 ILCS 130/4003  from Ch. 73, par. 1504-3
215 ILCS 165/10  from Ch. 32, par. 604
305 ILCS 5/5-16.8  
Synopsis As Introduced
Amends the Accident and Health Article of the Illinois Insurance Code. Provides that an individual or group policy of accident and health insurance that is amended, delivered, issued, or renewed on or after January 1, 2028 shall cover a medically necessary coronary calcium scan and scoring every 36 months for individuals over the age of 40. Defines "coronary calcium scan and scoring". Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Medical Assistance Article of the Illinois Public Aid Code. Effective January 1, 2027.

House Committee Amendment No. 1
Deletes reference to:
5 ILCS 375/6.11  
55 ILCS 5/5-1069.3  
65 ILCS 5/10-4-2.3  
105 ILCS 5/10-22.3f  
215 ILCS 130/4003  from Ch. 73, par. 1504-3
215 ILCS 165/10  from Ch. 32, par. 604
Replaces everything after the enacting clause. Amends the Illinois Insurance Code. Provides that an individual or group policy of accident and health insurance that is amended, delivered, issued, or renewed on or after January 1, 2028 and is subject to the Code shall provide coverage for a medically necessary coronary calcium scan and scoring if: (1) the individual is between 40 and 75 years of age; (2) the scan is ordered by a licensed health care provider; and (3) the provider has conducted and documented a cardiovascular risk assessment demonstrating clinical appropriateness consistent with evidence-based guidelines. Provides that coverage shall be provided at intervals consistent with evidence-based clinical guidelines and shall not be subject to more restrictive limitations than other diagnostic imaging services covered under the policy. Sets forth provisions concerning cost-sharing. Amends the Health Maintenance Organization Act to require the same coverage under the provisions of that Act. Amends the Illinois Public Aid Code to require coverage for a medically necessary coronary calcium scan and scoring for an eligible individual who: (A) is between 40 and 75 years of age; (B) is assessed by a licensed health care provider as having moderate or greater risk of atherosclerotic cardiovascular disease based on a documented cardiovascular risk assessment consistent with nationally recognized evidence-based clinical guidelines; (C) does not have a prior diagnosis of coronary artery disease; and (D) has not received a covered coronary artery calcium scan within the previous 5 years, unless medically necessary as determined by the Department of Healthcare and Family Services. Requires coverage without cost sharing and provides that the Department may adopt reasonable utilization controls consistent with other diagnostic imaging services covered under the medical assistance program. Provides that implementation of the coverage shall occur only to the extent that federal financial participation is available and approved by the federal Centers for Medicare and Medicaid Services.
Actions
DateChamberAction
11/20/2025HouseFiled with the Clerk by Rep. Yolonda Morris
1/14/2026HouseFirst Reading
1/14/2026HouseReferred to Rules Committee
1/20/2026HouseAdded Chief Co-Sponsor Rep. Tom Weber
1/21/2026HouseAdded Co-Sponsor Rep. La Shawn K. Ford
1/21/2026HouseAdded Co-Sponsor Rep. Anne Stava
1/28/2026HouseAdded Co-Sponsor Rep. Joyce Mason
2/03/2026HouseAdded Co-Sponsor Rep. Dagmara Avelar
2/09/2026HouseAdded Chief Co-Sponsor Rep. Michael Crawford
2/11/2026HouseAssigned to Insurance Committee
3/17/2026HouseHouse Committee Amendment No. 1 Filed with Clerk by Rep. Yolonda Morris
3/17/2026HouseHouse Committee Amendment No. 1 Referred to Rules Committee
3/18/2026HouseHouse Committee Amendment No. 1 Rules Refers to Insurance Committee
3/18/2026HouseHouse Committee Amendment No. 1 Adopted in Insurance Committee; by Voice Vote
3/18/2026HouseDo Pass as Amended / Short Debate Insurance Committee; 014-000-000
3/19/2026HousePlaced on Calendar 2nd Reading - Short Debate
3/20/2026HouseAdded Co-Sponsor Rep. Camille Y. Lilly
3/20/2026HouseAdded Co-Sponsor Rep. Sharon Chung