DHFS-MCO-MENTAL HLTH MEDS
Summary
Amends the Medical Assistance Article of the Illinois Public Aid Code. In a provision prohibiting prior authorization mandates and utilization management controls under the fee-for-service and managed care medical assistance programs for FDA-approved prescription drugs that treat mental illness, requires the Department of Healthcare and Family Services and managed care organizations to report quarterly on compliance with the specified prohibitions beginning with dates of service on and after July 1, 2025. Requires the Department to post on its website a report on fee-for-service prescriptions and the reports from each managed care organization. Sets forth the information that must be contained in the quarterly reports, including, but not limited to: (i) the number of denied prescriptions and estimated net cost to the State for those covered prescriptions summarized by each of the allowed categories specified in the Code; (ii) the number of denied prescriptions and estimated net cost to the State for those prescriptions summarized by each of the non-allowed categories specified in the Code; and (iii) the number of denied prescriptions and estimated gross cost to the State for those prescriptions summarized by any other reason not specified in the Code. Requires the Department to sanction those managed care organizations that do not file the required reports. Effective immediately.
Bill status
in committee
1 of 4 stages cleared
Introduction
Jan 2025
Committee Review
Floor Vote
Governor
Introduced Jan 31, 2025
Last action Mar 28, 2025
Floor votes
How they voted
No floor votes recorded yet.
Full legislative history
Actions timeline
Total actions
7
Key actions
1
Committee
4
Mar 21, 2025
Committee
Rule 19(a) / Re-referred to Rules Committee
lower
Mar 4, 2025
Lower · Passed
To Medicaid Subcommittee
lower
Feb 25, 2025
Committee
Assigned to Human Services Committee
lower
Feb 4, 2025
Committee
Referred to Rules Committee
lower
1 primary · 0 co-sponsors
Sponsors
Role
Legislator
Party
State
District
P
Lindsey LaPointe
DDemocratic
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