summary
Introduced
01/23/2026
01/23/2026
In Committee
04/17/2026
04/17/2026
Crossed Over
Passed
Dead
Introduced Session
Potential new amendment
104th General Assembly
Bill Summary
Amends the Illinois Insurance Code. Provides that coverage for treatment in a residential treatment center shall include residential coverage for the diagnosis and treatment of substance use disorders. Provides that this coverage shall include unlimited medically necessary treatment for substance use disorder treatment services provided in residential settings. Prohibits the coverage from applying financial requirements or treatment limitations to residential substance use disorder benefits that are more restrictive than the predominant financial requirements and treatment limitations applied to other medical and surgical benefits covered by the policy. Sets forth provisions concerning cost sharing; application of coverage requirements; prior authorization; clinical review; discharge plans; other forms of utilization review; and the criteria for medical necessity determinations.
AI Summary
This bill amends the Illinois Insurance Code to ensure comprehensive coverage for substance use disorder treatment in residential settings. It mandates that insurance policies provide coverage for diagnosis and treatment of substance use disorders in residential treatment centers, including unlimited medically necessary treatment. The bill prohibits insurers from imposing more restrictive financial requirements or treatment limitations on residential substance use disorder benefits compared to other medical and surgical benefits. It also outlines provisions regarding cost-sharing, application of coverage, prior authorization, clinical review, discharge plans, and the criteria for determining medical necessity, ensuring that these aspects are handled fairly and consistently with other medical treatments.
Committee Categories
Business and Industry
Sponsors (6)
Lindsey LaPointe (D)*,
Dee Avelar (D),
Laura Faver Dias (D),
Barbara Hernandez (D),
Maura Hirschauer (D),
Camille Lilly (D),
Last Action
House Floor Amendment No. 1 Rule 19(c) / Re-referred to Rules Committee (on 04/17/2026)
Taxonomy
Health
- ‐ Drug Abuse, Treatment, and Education
- ‐ Health Insurance Reform
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location | Created |
|---|---|---|
| State Bill Page | https://www.ilga.gov/Legislation/BillStatus?DocNum=4585&GAID=18&DocTypeID=HB&SessionID=114&GA=104 | 01/23/2026 |
| House Amendment 001 | https://www.ilga.gov/Legislation/BillStatus/FullText?LegDocId=210490&DocName=10400HB4585ham001&DocNum=4585&DocTypeID=HB&LegID=165445&GAID=18&SessionID=114&SpecSess=&Session= | 04/14/2026 |
| BillText | https://www.ilga.gov/Legislation/BillStatus/FullText?LegDocId=206792&DocName=10400HB4585&DocNum=4585&DocTypeID=HB&LegID=165445&GAID=18&SessionID=114&SpecSess=&Session= | 01/23/2026 |
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