Amends the Illinois Insurance Code. In provisions concerning biomarker testing: makes changes to defined terms; requires applicable health insurers, nonprofit health service plans, and health maintenance organizations to update and make publicly available medical policies and coverage guidelines within 90 days after the effective date of the amendatory Act; provides that, if a health insurer or nonprofit health service plan denies a claim for coverage of testing that is supported by any specified evidence, the insurer or nonprofit health service plan shall provide to the requesting entity specific written justification explaining in detail why the claim for coverage was denied as it pertains to the individual for whom the test was ordered; sets forth provisions concerning utilization review and prior authorization; provides that the Department of Insurance may conduct periodic audits and reviews to ensure entity compliance; and makes other changes.
Senate Committee Amendment No. 1: Replaces everything after the enacting clause. Reinserts the provisions of the introduced bill with the following changes. In provisions concerning biomarker testing, removes provisions concerning requests for exceptions to restricted coverage; the publication of medical policies and coverage guidelines; written justifications for denial of coverage; prior authorization; and periodic audits and reviews. Provides that the biomarker testing requirements are subject to, and shall operate in accordance with, specified provisions of the Prior Authorization Reform Act and the Managed Care Reform and Patient Rights Act. Provides that the changes made by the amendatory Act apply to policies, contracts, and certificates of insurance amended, delivered, issued, or renewed on or after January 1, 2028. Makes other changes. Effective January 1, 2028.
Senate Floor Amendment No. 2: Makes changes to cross-references to the Prior Authorization Reform Act and the Managed Care Reform and Patient Rights Act.

Statutes affected:
Introduced: 215 ILCS 5/356
Engrossed: 215 ILCS 5/356