HB 3845

  • Illinois House Bill
  • 102nd Regular Session
  • Introduced in House
  • House
  • Senate
  • Governor

Ins-Health Care/Rare Condition


Amends the Illinois Insurance Code to require an insurance policy to provide coverage for medically necessary treatments for genetic, rare, unknown or unnamed, and unique conditions, including Ehlers-Danlos syndrome and altered drug metabolism. Provides that an insurance policy that provides coverage for prescription drugs shall include coverage for opioid alternatives, coverage for medicines included in the Model List of Essential Medicines published by the World Health Organization, and coverage for custom-made medications and medical food. Provides that an insurance policy that limits the quantity of a medication in accordance with applicable State and federal law shall not require pre-approval for the treatment of patients with rare metabolism conditions that may need a higher dose of medication than what is otherwise allowed within a time frame or prescription schedule. Provides that the burden of proving that treatment is medically necessary shall not lie with the insured in cases of rejections for filing claims, preauthorization requests, and appeals related to coverage required under the Section.

Bill Sponsors (3)


No votes to display


Mar 27, 2021


Rule 19(a) / Re-referred to Rules Committee

Mar 16, 2021


Assigned to Insurance Committee

Mar 05, 2021


Added Co-Sponsor Rep. Kelly M. Cassidy

Feb 24, 2021


Added Co-Sponsor Rep. Nicholas K. Smith

Feb 22, 2021


Referred to Rules Committee


First Reading

Feb 19, 2021


Filed with the Clerk by Rep. Lindsey LaPointe

Bill Text

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