HB4821 Summary

• Prohibits health insurance policies from requiring patients with stage 4 advanced, metastatic cancer to fail treatment with one drug before covering FDA-approved alternative drugs, if the alternative is supported by peer-reviewed medical literature and consistent with best practices.

• Adds Section 356z.29 to the Illinois Insurance Code establishing coverage requirements for stage 4 cancer drug treatments across all individual and group accident and health insurance policies issued or renewed in Illinois.

• Extends the stage 4 cancer drug coverage requirements to state employees, county employees, municipal employees, school district employees, health maintenance organizations, limited health service organizations, voluntary health services plans, and Medicaid recipients.

• Includes a provision rendering the section inoperative if federal law or Department of Health and Human Services guidance requires the state to defray costs of these coverage restrictions, except for Medicaid coverage.

• Conditions all rulemaking authority on compliance with the Illinois Administrative Procedure Act and Joint Committee on Administrative Rules procedures.