summary
Introduced
01/09/2025
01/09/2025
In Committee
06/02/2025
06/02/2025
Crossed Over
04/07/2025
04/07/2025
Passed
12/12/2025
12/12/2025
Dead
Signed/Enacted/Adopted
12/12/2025
12/12/2025
Introduced Session
104th General Assembly
Bill Summary
Amends the Illinois Insurance Code. In provisions concerning mental health and substance use parity, makes changes to defined terms. Requires specified provider reimbursement rates to comply with the reimbursement floors for all in-network mental health and substance use disorder services. Establishes the reimbursement rate floor for each Healthcare Common Procedure Coding System (HCPCS) code, Current Procedural Terminology (CPT) code, Ambulatory Payment Classification (APC), Enhanced Ambulatory Patient Group (EAPG), Medicare Severity Diagnosis Related Group (MS-DRG), All Patient Refined Diagnosis Related Group (APR-DRG), and base payment rate with adjusters and applicable outliers for a mental health or substance use disorder service. 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, 2027, or any contracted third party administering the behavioral health benefits for the insurer, shall cover all medically necessary mental health or substance use disorder services received by the same insured on the same day from the same or different mental health or substance use provider or facility for both outpatient and inpatient care. Sets forth provisions concerning additional coverage requirements; disclosure provisions; and provisions concerning the Department of Insurance's enforcement authority, reporting requirements, and rulemaking. Makes other changes. Amends the Counties Code, the Illinois Municipal Code, and the School Code to require coverage under the provisions of those Acts. Effective June 1, 2026.
AI Summary
This bill amends several Illinois codes to strengthen mental health and substance use disorder insurance coverage by introducing comprehensive parity requirements. The bill establishes detailed reimbursement rate floors for mental health and substance use disorder services, ensuring that insurance providers reimburse these services at rates comparable to medical/surgical services. Specifically, the bill requires that group and individual health insurance policies cover all medically necessary mental health services received on the same day, including services provided by behavioral health trainees working under licensed supervision. The legislation mandates that insurers complete the provider credentialing process within 60 days, provide transparent credentialing information, and reimburse providers at contracted rates during the application process. Additionally, the bill requires 60-minute psychotherapy sessions to be covered without excessive documentation requirements and establishes a framework for the Department of Insurance to monitor and enforce these provisions. The changes will apply to insurance policies amended, delivered, issued, or renewed on or after January 1, 2027, with the Department required to conduct periodic reviews of the law's impact on network adequacy and access to mental health care. The bill aims to improve mental health treatment accessibility by addressing historical disparities in insurance coverage and reimbursement rates.
Committee Categories
Government Affairs, Health and Social Services
Sponsors (90)
Don Harmon (D)*,
Lindsey LaPointe (D)*,
Carol Ammons (D),
Jaime Andrade (D),
Dee Avelar (D),
Christopher Belt (D),
Harry Benton (D),
John Cabello (R),
Mary Beth Canty (D),
Kelly Cassidy (D),
Cristina Castro (D),
Javier Cervantes (D),
Sharon Chung (D),
Lakesia Collins (D),
Terra Costa Howard (D),
Michael Crawford (D),
Bill Cunningham (D),
Lisa Davis (D),
Margaret DeLaRosa (D),
Anthony DeLuca (D),
Martha Deuter (D),
Mary Edly-Allen (D),
Laura Ellman (D),
Paul Faraci (D),
Laura Faver Dias (D),
Sara Feigenholtz (D),
Laura Fine (D),
La Shawn Ford (D),
Robyn Gabel (D),
Mary Gill (D),
Suzy Glowiak Hilton (D),
Jehan Gordon-Booth (D),
Nicolle Grasse (D),
Angelica Guerrero-Cuellar (D),
Graciela Guzmán (D),
Will Guzzardi (D),
Matt Hanson (D),
Sonya Harper (D),
Barbara Hernandez (D),
Norma Hernandez (D),
Maura Hirschauer (D),
Jay Hoffman (D),
Mattie Hunter (D),
Hoan Huynh (D),
Lilian Jiménez (D),
Adriane Johnson (D),
Gregg Johnson (D),
Patrick Joyce (D),
Tracy Katz Muhl (D),
Michael Kelly (D),
Stephanie Kifowit (D),
Dave Koehler (D),
Nicole La Ha (R),
Kimberly Lightford (D),
Camille Lilly (D),
Meg Loughran Cappel (D),
Theresa Mah (D),
Rob Martwick (D),
Joyce Mason (D),
Debbie Meyers-Martin (D),
Anna Moeller (D),
Bob Morgan (D),
Yolonda Morris (D),
Laura Murphy (D),
Michelle Mussman (D),
Suzanne Ness (D),
Kevin Olickal (D),
Robert Peters (D),
Mike Porfirio (D),
Abdelnasser Rashid (D),
Bob Rita (D),
Rick Ryan (D),
Sue Scherer (D),
Kevin Schmidt (R),
Mike Simmons (D),
Ryan Spain (R),
Anne Stava-Murray (D),
Brad Stephens (R),
Katie Stuart (D),
Nabeela Syed (D),
Dave Vella (D),
Rachel Ventura (D),
Karina Villa (D),
Ram Villivalam (D),
Mark Walker (D),
Larry Walsh (D),
Chris Welch (D),
Maurice West (D),
Ann Williams (D),
Janet Yang Rohr (D),
Last Action
Public Act . . . . . . . . . 104-0446 (on 12/12/2025)
bill text
bill summary
Loading...
bill summary
Loading...
bill summary
Loading...