BillTrack50 logo
Free Signup Login
Bill

Bill > SB0126

IL SB0126

INS CD-ALZHEIMER'S TREATMENT

summary

Introduced
01/17/2025
In Committee
04/29/2025
Crossed Over
04/03/2025
Passed
05/20/2025
Dead

Introduced Session

104th General Assembly

Bill Summary

Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2027 shall provide coverage for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia, in accordance with the U.S. Food and Drug Administration label, as determined by a physician licensed to practice medicine in all its branches. Provides that coverage of U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia shall not be subject to step therapy. Amends the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, and the Voluntary Health Services Plans Act to require coverage under those provisions. Effective immediately.

AI Summary

This bill requires health insurance policies and managed care plans in Illinois to provide comprehensive coverage for Alzheimer's disease and related dementia treatments starting January 1, 2027. Specifically, the bill mandates that insurance providers cover all medically necessary diagnostic testing and U.S. Food and Drug Administration (FDA)-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or related dementias, as determined by a licensed physician. The bill uniquely stipulates that these treatments cannot be subject to step therapy, which is a practice where insurers require patients to try less expensive treatments before covering more advanced therapies. The legislation applies to various types of health insurance, including group and individual policies, state employee health plans, county and municipal health plans, and school district health plans. An important caveat is that the coverage requirement does not apply to managed care plans contracted with the Department of Healthcare and Family Services. The bill allows pharmacists to make certain substitutions of prescription drugs consistent with existing pharmacy practices. The changes will take effect on January 1, 2027, with the bill becoming law immediately upon passage.

Committee Categories

Business and Industry

Sponsors (60)

Mary Gill (D)*,  Laura Murphy (D)*,  Carol Ammons (D),  Jaime Andrade (D),  Dee Avelar (D),  Christopher Belt (D),  Javier Cervantes (D),  Sharon Chung (D),  Terra Costa Howard (D),  Michael Crawford (D),  Margaret Croke (D),  Anthony DeLuca (D),  Martha Deuter (D),  Mary Edly-Allen (D),  Laura Ellman (D),  Paul Faraci (D),  Sara Feigenholtz (D),  Amy Grant (R),  Nicolle Grasse (D),  Graciela Guzmán (D),  Matt Hanson (D),  Napoleon Harris (D),  Barbara Hernandez (D),  Norma Hernandez (D),  Maura Hirschauer (D),  Linda Holmes (D),  Adriane Johnson (D),  Tracy Katz Muhl (D),  Michael Kelly (D),  Stephanie Kifowit (D),  Nicole La Ha (R),  Lindsey LaPointe (D),  Seth Lewis (R),  Camille Lilly (D),  Meg Loughran Cappel (D),  Natalie Manley (D),  Joyce Mason (D),  Anna Moeller (D),  Bob Morgan (D),  Julie Morrison (D),  Marty Moylan (D),  Michelle Mussman (D),  Kevin Olickal (D),  Abdelnasser Rashid (D),  Rick Ryan (D),  Jennifer Sanalitro (R),  Sue Scherer (D),  Mike Simmons (D),  Nick Smith (D),  Anne Stava-Murray (D),  Katie Stuart (D),  Sally Turner (R),  Dave Vella (D),  Karina Villa (D),  Mark Walker (D),  Chris Welch (D),  Maurice West (D),  Ann Williams (D),  Omar Williams (D),  Janet Yang Rohr (D), 

Last Action

Passed Both Houses (on 05/20/2025)

bill text

bill summary

Loading...

bill summary

Loading...
Loading...