Illinois passes prior authorization reform bill

The Illinois General Assembly has passed a pair of health insurance reform bills, which Gov. JB Pritzker has indicated he will sign.

On May 25, the Illinois House passed legislation that will ban prior authorization for admission for inpatient psychiatric services, beginning in 2026. Payers will also be required to publish all services that require prior authorization on their website, and face stricter requirements to maintain an accurate provider network directory. 

The Illinois Department of Insurance will also gain the authority to approve or deny premium rate changes for large group policies, and the legislation bans step therapy requirements under all utilization review programs, including prescription drug plans.

Another passed bill will ban the sale of short-term individual health plans in the state, often called "junk plans." 

The legislation applies only to state-regulated health plans, such as fully funded employer group policies, state employee plans, and the state's Medicaid program. 

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