Healthcare (Insurance)

Amends the Accident and Health Article of the Illinois Insurance Code. Provides that an individual or group policy of accident and health insurance that is amended, delivered, issued, or renewed on or after January 1, 2028 shall cover a medically necessary coronary calcium scan and scoring every 36 months for individuals over the age of 40. Defines "coronary calcium scan and scoring". Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Medical Assistance Article of the Illinois Public Aid Code. Effective January 1, 2027.

Amends the Prior Authorization Reform Act. Provides that a chronic health condition is a condition that is expected to last on year or more and requires ongoing medical attention to effectively manage the condition or prevent an adverse health event limits one or more activities of daily living. Replaces "chronic or long-term condition" with "chronic health condition". Provides that, if a health insurance issuer requires a prior authorization for a recurring health care service or maintenance medication for the treatment of a chronic health condition, the approval shall remain valid from the date the health care professional or health care provider receives the prior authorization approval for the duration of the chronic health condition or the length of the treatment, as determined by the patient's health care professional, unless the standard of treatment for that health condition changes.

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 July 1, 2025 shall provide coverage for the full cost of an annual PET scan for insureds age 35 or older who elect to get a PET scan, regardless of whether the PET scan was ordered by a physician licensed to practice medicine in all its branches and regardless of whether the insured displays symptoms. Sets forth findings and definitions. Effective immediately.