Governor Signs Series of Bills Mandating Coverage of Certain Services

Through May and June of this year, Gov. Pritzker signed a series of bills into law mandating health insurers in the state provide certain coverage for the following services:

• SB2969 (signed June 15, 2022): medically necessary continuous glucose monitors for individuals with Type 1 or Type 2 diabetes, effective January 1, 2023
  Press Release on SB2969
• HB5318 (signed June 10, 2022): annual prostate cancer screening and medically necessary follow-up testing without imposing a deductible, coinsurance, copayment or any other cost-sharing, effective January 1, 2024
  Press Release on HB5318
• HB4430 (signed June 10, 2022): HIV pre- and post-exposure prophylaxis drugs (PrEP and PEP) when dispensed by a pharmacist and at no less than 85% of the rate when provided by a physician, effective January 1, 2023
  Press Release on HB4430
• HB4349 (signed May 13, 2022): medically necessary treatment of cranial facial anomalies, effective January 1, 2024
• HB5254 (signed May 13, 2022): medically necessary hormone therapy to treat menopause induced by a hysterectomy, effective January 1, 2024
• HB5585 (signed May 13, 2022): access to home health services for the duration of medically necessary care, effective January 1, 2024
• SB3819 (signed May 13, 2022): community-based pediatric palliative care and hospice care, effective January 1, 2024
• HB4271 (signed May 6, 2022): medically necessary breast reduction surgery, effective January 1, 2024

These provisions will apply to policies amended, delivered, issued or renewed in Illinois on or after the respective effective dates. Employers sponsoring health plans issued in Illinois should be aware of these developments and contact their carrier for further information.