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IL HB4908

IL HB4908
INS CD-SITE-NEUTRAL PAYMENT


summary

Introduced
02/03/2026
In Committee
02/17/2026
Crossed Over
Passed
Dead

Introduced Session

104th General Assembly

Bill Summary

Amends the State Employees Group Insurance Act of 1971. Provides that the Department of Central Management Services shall require all contracts, managed care arrangements, and third-party administrator agreements under the State Employees Group Insurance Program to apply site-neutral payment principles for covered services. Grants the Department rulemaking authority, including specified rules. Amends the Illinois Insurance Code. Requires the Department of Insurance to instruct health insurance companies operating in the State to apply site-neutral payment principles for any covered service for any health insurance product the health insurance company sells, manages, offers, or markets in the State. Grants the Department rulemaking authority, including specified rules. Effective January 1, 2027.

AI Summary

This bill mandates the implementation of "site-neutral payment" principles, meaning that payment for a covered healthcare service will be the same regardless of where it is provided, as long as the service is clinically similar and performed by a licensed provider. This applies to the State Employees Group Insurance Program, requiring the Department of Central Management Services to ensure all contracts and agreements adhere to these principles, and also to all health insurance companies operating in Illinois, who will be instructed by the Department of Insurance to apply these principles to all their health insurance products sold, managed, offered, or marketed in the state. The bill also grants rulemaking authority to both departments to define specific services, reimbursement rates, and compliance requirements, and will take effect on January 1, 2027.

Committee Categories

Business and Industry

Sponsors (1)

Last Action

House Insurance Committee Hearing (14:00:00 2/24/2026 Room C-1 Stratton Building) (on 02/24/2026)

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