Current through Public Act 103-1052
Section 305 ILCS 5/5-52 - [Effective 1/1/2025] (Text of Section from P.A. 103-914) Custom prosthetic and orthotic devices; reimbursement rates(a) In this Section, "genetic testing for an inherited mutation" means germline multi-gene testing for an inherited mutation associated with an increased risk of cancer in accordance with evidence-based, clinical practice guidelines.(b) Subject to federal approval, the medical assistance program, after January 1, 2026, shall provide coverage for clinical genetic testing for an inherited gene mutation for individuals with a personal or family history of cancer, as recommended by a health care professional in accordance with current evidence-based clinical practice guidelines, including, but not limited to, the current version of the National Comprehensive Cancer Network clinical practice guidelines.(c) For individuals with a genetic test that is positive for an inherited mutation associated with an increased risk of cancer, coverage required under this Section shall include any evidence-based screenings, as recommended by a health care professional in accordance with current evidence-based clinical practice guidelines, to the extent that the management recommendation is not already covered by the medical assistance program. In this subsection, "evidence-based cancer screenings" means medically recommended evidence-based screening modalities in accordance with current clinical practice guidelines.Added by P.A. 103-0914,§ 40, eff. 1/1/2025.This section is set out more than once due to postponed, multiple, or conflicting amendments.