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SB 3637

PROTEOMIC BLOOD TEST COVERAGE

104th Regular Session Introduced by Kimberly Lightford

Expands Illinois Medicaid coverage to include a prescribed proteomic blood test for pregnant individuals, using results to tailor care to reduce preterm birth risk.

Rule 3-9(a) / Re-referred to Assignments
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Bill Summary · SB 3637

Summary of SB 3637 (104th Illinois General Assembly)

Title

PROTEOMIC BLOOD TEST COVERAGE

Purpose and Intent

SB 3637 would expand Illinois medical assistance (Public Aid) coverage to include a prescribed proteomic blood test for pregnant individuals. The bill's intent is to identify and manage the risk of spontaneous preterm birth and to use test results to guide care management and other interventions aimed at prolonging pregnancy and improving birth outcomes.

Key Provisions

  • New coverage requirement: Adds a new Section 5-54 to the Illinois Public Aid Code. The medical assistance program must provide coverage and reimbursement for a prescribed proteomic blood test specifically used to identify and manage the risk of spontaneous preterm birth in pregnant persons.

  • Utilization of test results: Requires that the results of the proteomic blood test be used to assign care management services and other appropriate interventions. The overarching goal is to manage risk, prolong pregnancy, and improve maternal and infant outcomes.

Who Is Affected

  • Beneficiaries: Pregnant individuals who are eligible for Illinois medical assistance (Illinois’ Medicaid program).
  • Providers/Systems: Healthcare providers and care management organizations participating in the medical assistance program, which would use the proteomic test results to determine subsequent care management actions and interventions.
  • State Programs: Illinois Department or relevant public aid authorities administering Medicaid/medical assistance funding and coverage decisions.

Procedural and Timeline Aspects

  • Legislative status: Introduced February 5, 2026 by Sen. Kimberly A. Lightford. Co-sponsored by Kimberly Lightford.
  • Committee path and actions:
    • Assigned to Appropriations – Health and Human Services (Feb 17, 2026).
    • Rule 2-10 Committee deadlines established: April 24, 2026 (Committee deadline) and May 15, 2026 (3rd Reading Deadline).
  • Effective date: Not explicitly stated in the text provided. If enacted, the effective date would typically be determined by the bill as passed or via an implementing provision; further detail would appear in the final bill language.

Potential Impact

  • Clinical/Health Outcomes: By enabling coverage for proteomic testing, the state aims to identify pregnant individuals at higher risk for spontaneous preterm birth and tailor interventions to reduce risk, potentially prolonging pregnancy and improving perinatal outcomes.
  • Access and Equity: Could improve access to advanced biomarker testing for Medicaid beneficiaries, reducing financial barriers to a diagnostic tool that informs care planning.
  • Costs and Budget: Coverage and reimbursement imply an additional expenditure within the medical assistance program; the Appropriations committee would review the fiscal implications and funding needs during the budget process.
  • Care Management: Test-driven care planning could lead to more personalized care management services for pregnant patients identified as higher risk.

Notes

  • The bill text focuses on coverage and the mandated use of test results for care management decisions; it does not specify the particular proteomic test(s) or a detailed clinical protocol, which may be addressed in implementing regulations or subsequent amendments.

Compiled from official sources — confirm details with the bill’s official record.

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