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IL HB1360

IL HB1360
INS CD-ALZHEIMER'S TREATMENT


summary

Introduced
01/14/2025
In Committee
04/11/2025
Crossed Over
Passed
Dead

Introduced Session

104th General Assembly

Bill Summary

Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2027 shall provide coverage for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia, in accordance with the U.S. Food and Drug Administration label, as determined by a physician licensed to practice medicine in all its branches. Provides that coverage of U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia shall not be subject to step therapy. Amends the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, and the Voluntary Health Services Plans Act to require coverage under those provisions. Effective immediately.

AI Summary

This bill requires health insurance policies and managed care plans in Illinois to provide coverage for diagnostic testing and U.S. Food and Drug Administration (FDA)-approved treatments for Alzheimer's disease and related dementias, starting January 1, 2027. Specifically, the bill mandates that group and individual health insurance policies must cover all medically necessary diagnostic tests and FDA-approved medications designed to slow the progression of Alzheimer's and related dementias, as determined by a licensed physician. Importantly, these treatments will not be subject to step therapy, a practice where patients must try less expensive treatments before accessing more advanced medications. The bill applies to various types of health coverage, including state employee group insurance, county and municipal health plans, school district insurance, health maintenance organizations, limited health service organizations, and voluntary health service plans. The legislation aims to improve access to Alzheimer's treatments by ensuring comprehensive coverage and removing potential barriers to receiving specialized medications. The changes will take effect on January 1, 2027, with some provisions becoming effective immediately upon the bill becoming law.

Committee Categories

Business and Industry

Sponsors (11)

Last Action

Rule 19(a) / Re-referred to Rules Committee (on 04/11/2025)

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