Illinois legislation · 104th General Assembly
Illinois SB3509: INS CD-BIOMARKER TESTING
Status: Signed into law, July 31, 2026
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.
What the bill says
A bill FOR 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026SB3509Introduced 2/5/2026, by Sen. Julie A. MorrisonSYNOPSIS AS INTRODUCED: ILCS 5/356z.46 215 ILCS 5/356z.46 ILCS 5/356z.46 Amends the Illinois Insurance Code. In provisions concerningbiomarker requires applicablehealth insurers, nonprofit health service plans, and health maintenanceorganizations to update and make publicly available medical policies andcoverage guidelines within 90 days after the effective date of theamendatory Act…
From the introduced text, February 5, 2026:
A BILL FOR 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026SB3509Introduced 2/5/2026, by Sen. Julie A. MorrisonSYNOPSIS AS INTRODUCED: ILCS 5/356z.46 215 ILCS 5/356z.46 ILCS 5/356z.46 Amends the Illinois Insurance Code. In provisions concerningbiomarker requires applicablehealth insurers, nonprofit health service plans, and health maintenanceorganizations to update and make publicly available medical policies andcoverage guidelines within 90 days after the effective date of theamendatory Act; provides that, if a health insurer or nonprofit healthservice plan denies a claim for coverage of testing that is supported byany specified evidence, the insurer or nonprofit health service plan shallprovide to the requesting entity specific written justification explainingin detail why the claim for coverage was denied as it pertains to theindividual for whom the test was ordered; sets forth provisions concerningutilization review and prior authorization; provides that the Departmentof Insurance may conduct periodic audits and reviews to ensure entitycompliance; and makes other changes. LRB104 19966 BAB 33416 b LRB104 19966 BAB 33416 b LRB104 19966 BAB 33416 b A BILL FOR SB3509LRB104 19966 BAB 33416 b SB3509 LRB104 19966 BAB 33416 b SB3509 LRB104 19966 BAB 33416 b AN ACT concerning regulation. Be it enacted by the People of the State of Illinois, represented in the General Assembly: Section 5.The Illinois Insurance Code is amended by changing Section 356z.46 as follows: (215 ILCS 5/356z.46) …