Illinois General Assembly - Bill Status for HB4475
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 Bill Status of HB4475  103rd General Assembly


Short Description:  INS CD-BEHAVIORIAL HEALTH

House Sponsors
Rep. Lindsey LaPointe - Maurice A. West, II - Jenn Ladisch Douglass, Suzanne M. Ness, Kelly M. Cassidy, Anne Stava-Murray, Hoan Huynh, Kevin John Olickal, Norma Hernandez, Dagmara Avelar, Will Guzzardi, Gregg Johnson, Michelle Mussman, Terra Costa Howard, Nabeela Syed, Tracy Katz Muhl, Theresa Mah, Laura Faver Dias, Bob Morgan, Jay Hoffman, Katie Stuart and Stephanie A. Kifowit

Last Action
DateChamber Action
  4/4/2024HousePlaced on Calendar 2nd Reading - Short Debate

Statutes Amended In Order of Appearance
5 ILCS 100/5-45.55 new
215 ILCS 5/370c.3 new


Synopsis As Introduced
Amends the Illinois Insurance Code. Provides that the amendatory Act may be referred to as the Strengthening Mental Health and Substance Use Parity Act. Provides that a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2025, or any third-party administrator administering the behavioral health benefits for the insurer, shall cover all out-of-network medically necessary mental health and substance use benefits and services (inpatient and outpatient) as if they were in-network for purposes of cost sharing for the insured. Provides that the insured has the right to select the provider or facility of their choice and the modality, whether the care is provided via in-person visit or telehealth, for medically necessary care. Sets forth minimum reimbursement rates for certain behavioral health benefits. Sets forth provisions concerning responsibility for compliance with parity requirements; coverage and payment for multiple covered mental health and substance use services, mental health or substance use services provided under the supervision of a licensed mental health or substance treatment provider, and 60-minute individual psychotherapy; timely credentialing of mental health and substance use providers; Department of Insurance enforcement and rulemaking; civil penalties; and other matters. Amends the Illinois Administrative Procedure Act to authorize emergency rulemaking. Effective immediately.

House Committee Amendment No. 1
Deletes reference to:
5 ILCS 100/5-45.55 new
Adds reference to:
215 ILCS 125/5-3from Ch. 111 1/2, par. 1411.2

Replaces everything after the enacting clause. Provides that the amendatory Act may be referred to as the Strengthening Mental Health and Substance Use Parity Act. Amends the Illinois Insurance Code. Provides that for all group or individual policies of accident and health insurance or managed care plans that are amended, delivered, issued, or renewed on or after January 1, 2026, or any contracted third party administering the behavioral health benefits for the insurer, reimbursement for in-network mental health and substance use disorder treatment services delivered by Illinois providers and facilities must be, on average, at least as favorable as professional services provided by in-network primary care providers. Requires a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2025, or a contracted third party administering the behavioral health benefits for the insurer, to cover all medically necessary mental health or substance use disorder services received by the same insured on the same day from the same or different mental health or substance use provider or facility for both outpatient and inpatient care. Requires coverage of medically necessary mental health or substance use disorder services provided by behavioral health trainees under certain circumstances. Requires coverage of medically necessary 60-minute psychotherapy billed using the CPT Code 90837 for Individual Therapy. Sets forth provisions concerning timely contracting for becoming a participating mental health or substance use disorder treatment provider, enforcement, and rulemaking. Amends the Health Maintenance Organization Act to require health maintenance organizations to comply with the provisions of the Illinois Insurance Code added by the amendatory Act. Effective immediately.

Actions 
DateChamber Action
  1/17/2024HouseFiled with the Clerk by Rep. Lindsey LaPointe
  1/17/2024HouseFirst Reading
  1/17/2024HouseReferred to Rules Committee
  2/7/2024HouseAdded Chief Co-Sponsor Rep. Maurice A. West, II
  2/7/2024HouseAdded Chief Co-Sponsor Rep. Jenn Ladisch Douglass
  2/9/2024HouseAdded Co-Sponsor Rep. Suzanne M. Ness
  2/9/2024HouseAdded Co-Sponsor Rep. Kelly M. Cassidy
  2/9/2024HouseAdded Co-Sponsor Rep. Anne Stava-Murray
  2/9/2024HouseAdded Co-Sponsor Rep. Hoan Huynh
  2/9/2024HouseAdded Co-Sponsor Rep. Kevin John Olickal
  2/9/2024HouseAdded Co-Sponsor Rep. Norma Hernandez
  2/14/2024HouseAssigned to Mental Health & Addiction Committee
  2/20/2024HouseAdded Co-Sponsor Rep. Dagmara Avelar
  2/20/2024HouseAdded Co-Sponsor Rep. Will Guzzardi
  2/21/2024HouseAdded Co-Sponsor Rep. Gregg Johnson
  2/22/2024HouseAdded Co-Sponsor Rep. Michelle Mussman
  2/27/2024HouseAdded Co-Sponsor Rep. Terra Costa Howard
  3/7/2024HouseAdded Co-Sponsor Rep. Nabeela Syed
  3/20/2024HouseAdded Co-Sponsor Rep. Tracy Katz Muhl
  3/27/2024HouseAdded Co-Sponsor Rep. Theresa Mah
  4/1/2024HouseAdded Co-Sponsor Rep. Laura Faver Dias
  4/2/2024HouseHouse Committee Amendment No. 1 Filed with Clerk by Rep. Lindsey LaPointe
  4/2/2024HouseHouse Committee Amendment No. 1 Referred to Rules Committee
  4/3/2024HouseHouse Committee Amendment No. 1 Rules Refers to Mental Health & Addiction Committee
  4/4/2024HouseHouse Committee Amendment No. 1 Adopted in Mental Health & Addiction Committee; by Voice Vote
  4/4/2024HouseDo Pass as Amended / Short Debate Mental Health & Addiction Committee; 017-000-000
  4/4/2024HousePlaced on Calendar 2nd Reading - Short Debate
  4/10/2024HouseAdded Co-Sponsor Rep. Bob Morgan
  4/12/2024HouseAdded Co-Sponsor Rep. Jay Hoffman
  4/12/2024HouseAdded Co-Sponsor Rep. Katie Stuart
  4/15/2024HouseAdded Co-Sponsor Rep. Stephanie A. Kifowit

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