Bill > HB2584

This bill amends Illinois insurance law to improve access to HIV-related medications by prohibiting health insurance providers, medical assistance programs, and Medicaid managed care organizations from requiring prior authorization for specific HIV-related prescription drugs. Specifically, the bill mandates coverage without cost-sharing for human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), and HIV treatment medications, along with their therapeutic equivalents approved by the U.S. Food and Drug Administration (FDA). The bill also expands coverage to include pre-PrEP HIV screening, sexually transmitted infection screening, kidney function analysis, routine laboratory testing, and routine provider visits. Additionally, if a patient's healthcare provider determines a specific FDA-approved medication is medically necessary, the insurance plan must cover that medication without cost-sharing. The legislation provides an easily accessible process for coverage requests and ensures that insurers cannot impose unreasonable restrictions or delays in accessing these critical medications. The bill will take effect on January 1, 2027, giving healthcare providers and insurance companies time to prepare for the new requirements.

Budget and Finance, Business and Industry

https://www.ilga.gov/legislation/BillStatus.asp?DocNum=2584&GAID=18&DocTypeID=HB&SessionID=114&GA=104