summary
Introduced
01/17/2025
01/17/2025
In Committee
04/29/2025
04/29/2025
Crossed Over
04/03/2025
04/03/2025
Passed
06/09/2025
06/09/2025
Dead
Signed/Enacted/Adopted
06/09/2025
06/09/2025
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 mandates comprehensive insurance coverage for Alzheimer's disease and related dementia treatments, requiring group and individual health insurance policies and managed care plans issued or renewed on or after January 1, 2027, to provide coverage for all medically necessary diagnostic testing and U.S. Food and Drug Administration (FDA)-approved treatments or medications prescribed to slow the progression of these conditions. Importantly, such treatments will not be subject to step therapy, which is a practice where insurers require patients to try less expensive or generic treatments before covering more advanced medications. The bill amends multiple state codes, including the State Employees Group Insurance Act, Counties Code, Illinois Municipal Code, School Code, Health Maintenance Organization Act, Limited Health Service Organization Act, and Voluntary Health Services Plans Act, to ensure consistent coverage across different types of insurance providers. The legislation aims to improve access to cutting-edge Alzheimer's treatments by removing potential financial and administrative barriers for patients, with the coverage to be determined by physicians licensed to practice medicine. Most provisions of the bill will take effect on January 1, 2027, with the State Employees Group Insurance Program changes specifically taking effect on July 1, 2027.
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
Public Act . . . . . . . . . 104-0001 (on 06/09/2025)
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