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IL SB2286

IL SB2286
INS-PREVENTIVE CARE PRIOR AUTH


summary

Introduced
02/07/2025
In Committee
02/07/2025
Crossed Over
Passed
Dead

Introduced Session

104th General Assembly

Bill Summary

Amends the Prior Authorization Reform Act. Provides that, notwithstanding any other provision of law, a health insurance issuer or a contracted utilization review organization may not require prior authorization for preventive health services recommended by a health care professional. Amends the Illinois Insurance Code. Provides that a policy of group health insurance coverage or individual health insurance coverage shall, at a minimum, provide coverage and shall not require prior authorization or impose any cost-sharing requirements, including a copayment, coinsurance, or deductible, for specified preventive health services. Effective January 1, 2027.

AI Summary

This bill amends two existing laws to improve access to preventive healthcare services in Illinois. It modifies the Illinois Insurance Code to prohibit health insurance policies from requiring prior authorization or imposing any cost-sharing requirements (such as copayments, coinsurance, or deductibles) for certain preventive health services. These services include evidence-based items rated "A" or "B" by the United States Preventive Services Task Force, recommended immunizations from the Centers for Disease Control and Prevention, preventive care for infants and children supported by the Health Resources and Services Administration, and additional preventive care for women. The bill also adds a new section to the Prior Authorization Reform Act that explicitly prevents health insurance issuers and utilization review organizations from requiring prior authorization for preventive health services recommended by a healthcare professional. This legislation aims to remove financial and administrative barriers that might discourage individuals from obtaining important preventive care, thereby potentially improving overall public health outcomes. The bill is set to take effect on January 1, 2027, giving insurance providers time to adjust their policies and procedures to comply with the new requirements.

Sponsors (2)

Last Action

Added as Co-Sponsor Sen. Rachel Ventura (on 03/04/2025)

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