Illinois HB 4207: TRANSPORTATION-FLOOD INSURANCE

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 Full Text of HB4207

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HB4207 EngrossedLRB104 15812 BAB 29011 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 

5adding Section 356z.88 as follows:

6 (215 ILCS 5/356z.88 new)

7 Sec. 356z.88. Coronary calcium scan and scoring.

8 (a) An individual or group policy of accident and health 

9insurance that is amended, delivered, issued, or renewed on or 

10after January 1, 2028 and is subject to this Code shall provide 

11coverage for a medically necessary coronary calcium scan and 

12scoring if:

13 (1) the individual is between 40 and 75 years of age;

14 (2) the scan is ordered by a licensed health care 

15 provider; and

16 (3) the provider has conducted and documented a 

17 cardiovascular risk assessment demonstrating clinical 

18 appropriateness consistent with evidence-based 

19 guidelines.

20 (b) Coverage shall be provided at intervals consistent 

21with evidence-based clinical guidelines and shall not be 

22subject to more restrictive limitations than other diagnostic 

23imaging services covered under the policy.

HB4207 Engrossed- 2 -LRB104 15812 BAB 29011 b

1 (c) For policies subject to cost-sharing requirements, the 

2cost sharing for a coronary calcium scan and scoring shall not 

3exceed the cost sharing applied to comparable diagnostic 

4imaging services.

5 (d) Nothing in this Section shall be construed to require 

6coverage in a manner inconsistent with federal law. 

7 Section 10. The Health Maintenance Organization Act is 

8amended by changing Section 5-3 as follows:

9 (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 141