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| | 103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB3732 Introduced 2/9/2024, by Sen. Cristina Castro SYNOPSIS AS INTRODUCED:
| | 215 ILCS 200/10 | | 215 ILCS 200/50 | | 215 ILCS 200/65 | |
| Amends the Prior Authorization Reform Act. Provides that the Act applies to the program of group health benefits under the State Employees Group Insurance Act of 1971. Provides that a health insurance issuer shall not require prior authorization: where a medication is prescribed for a chronic condition, long-term condition, or mental health condition, has been prescribed for 6 months or more, or is a treatment for the clinical indication as supported by peer-reviewed medical publications; or for patients currently managed with an established treatment regimen. Removes language requiring a health insurance issuer to periodically review its prior authorization requirements and consider removal of prior authorization requirements under certain circumstances. Makes a conforming change. Effective July 1, 2024. |
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| | A BILL FOR |
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| | SB3732 | | LRB103 37491 RPS 67614 b |
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1 | | AN ACT concerning regulation.
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2 | | Be it enacted by the People of the State of Illinois, |
3 | | represented in the General Assembly:
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4 | | Section 5. The Prior Authorization Reform Act is amended |
5 | | by changing Sections 10, 50, and 65 as follows:
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6 | | (215 ILCS 200/10) |
7 | | Sec. 10. Applicability; scope. This Act applies to health |
8 | | insurance coverage as defined in the Illinois Health Insurance |
9 | | Portability and Accountability Act, the program of group |
10 | | health benefits under the State Employees Group Insurance Act |
11 | | of 1971, and policies issued or delivered in this State to the |
12 | | Department of Healthcare and Family Services and providing |
13 | | coverage to persons who are enrolled under Article V of the |
14 | | Illinois Public Aid Code or under the Children's Health |
15 | | Insurance Program Act, amended, delivered, issued, or renewed |
16 | | on or after the effective date of this Act, with the exception |
17 | | of employee or employer self-insured health benefit plans |
18 | | under the federal Employee Retirement Income Security Act of |
19 | | 1974, health care provided pursuant to the Workers' |
20 | | Compensation Act or the Workers' Occupational Diseases Act, |
21 | | and State, employee, unit of local government, or school |
22 | | district health plans. This Act does not diminish a health |
23 | | care plan's duties and responsibilities under other federal or |