HB 5451

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to authorize coverage for screening by low-dose mammography for the presence of occult breast cancer for individuals 25 (rather than 35) years of age or older who are otherwise eligible for medical assistance. Requires the Department to convene 2 separate expert panels to review quality standards for mammography and establish quality standards for breast cancer treatment. Provides that subject to Department approval, rate methodology for screening and diagnostic mammography shall be based on the quality standards established by the expert panels and State qualified ACR Designated Comprehensive Breast Imaging Centers (formerly known as Breast Imaging Centers of Excellence). Requires the expert panels to establish a comprehensive and clinical methodology to inform women who are age-appropriate for screening mammography, but who have not received a mammogram within the previous 18 months, of the importance and benefits of screening mammography. Provides that within 2 years after the completion of a pilot program providing case-managing or patient navigation services for women diagnosed with breast cancer, the Department shall establish as a permanent initiative the Patient Assistance for Beneficiaries Diagnosed with Breast Cancer. Requires the Department to submit annual reports to the General Assembly detailing program outcomes, financial expenditures, and any recommendations for adjustments to maintain or enhance the program's effectiveness. Requires the Department to establish or facilitate training and continuing education opportunities specific to breast health and mammography for radiologists. Makes other changes. Effective immediately.