summary
Introduced
01/24/2024
01/24/2024
In Committee
03/15/2024
03/15/2024
Crossed Over
Passed
Dead
01/08/2025
01/08/2025
Introduced Session
103rd General Assembly
Bill Summary
Amends the Illinois Insurance Code. Provides that the amendatory Act may be referred to as the Strengthening Mental Health and Substance Use Parity Act. Provides that a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2025, or any third-party administrator administering the behavioral health benefits for the insurer, shall cover all out-of-network medically necessary mental health and substance use benefits and services (inpatient and outpatient) as if they were in-network for purposes of cost sharing for the insured. Provides that the insured has the right to select the provider or facility of their choice and the modality, whether the care is provided via in-person visit or telehealth, for medically necessary care. Sets forth minimum reimbursement rates for certain behavioral health benefits. Sets forth provisions concerning responsibility for compliance with parity requirements; coverage and payment for multiple covered mental health and substance use services, mental health or substance use services provided under the supervision of a licensed mental health or substance treatment provider, and 60-minute individual psychotherapy; timely credentialing of mental health and substance use providers; Department of Insurance enforcement and rulemaking; civil penalties; and other matters. Amends the Illinois Administrative Procedure Act to authorize emergency rulemaking. Effective immediately.
AI Summary
This bill, known as the Strengthening Mental Health and Substance Use Parity Act, aims to improve mental health and substance use parity by addressing network adequacy and nonquantitative treatment limitations that restrict access to care. Key provisions include:
- Requiring group or individual health insurance policies and managed care plans to cover all out-of-network medically necessary mental health and substance use benefits and services as in-network, allowing the insured to choose their provider and modality (in-person or telehealth).
- Establishing minimum reimbursement rates for out-of-network and in-network mental health and substance use services, including services provided under the supervision of a licensed provider.
- Requiring coverage and payment for multiple covered mental health and substance use services provided on the same day.
- Mandating timely credentialing of mental health and substance use providers by insurers and third-party administrators.
- Granting the Department of Insurance authority to enforce the law, including the ability to impose civil penalties for violations.
- Authorizing the Department to adopt emergency rules to implement the Act by November 1, 2024.
The goal is to address discriminatory insurance practices and improve access to affordable mental health and substance use treatment for Illinoisans.
Committee Categories
Business and Industry
Sponsors (2)
Last Action
Session Sine Die (on 01/07/2025)
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://www.ilga.gov/legislation/BillStatus.asp?DocNum=2896&GAID=17&DocTypeID=SB&SessionID=112&GA=103 |
| BillText | https://www.ilga.gov/legislation/103/SB/10300SB2896.htm |
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