New law bans practices aimed at lowering insurance payouts
Gov. JB Pritzker signed legislation Wednesday that puts new controls on the state's health insurance industry, including bans on certain practices companies have used to reduce costs by controlling the amount of health care services a patient receives.
The Health Care Protection Act, House Bill 5395, was among Pritzker's top legislative priorities during the just-completed legislative session.
Pritzker also signed House Bill 2499, which bans the sale of short-term, limited-duration insurance plans in
"For too long, insurance companies have used predatory tactics to make an extra dime at the expense of
Among other things, the Health Care Protection Act bars the use of a restriction known as "step therapy," also known as a "fail first" provision, that requires a patient to try and fail on one or more treatments preferred by the insurance company before they can access a treatment recommended by their doctor.
It also prohibits insurers from requiring prior authorization before a patient can receive emergency inpatient treatment at a psychiatric facility.
"
The new law also requires insurers to maintain accurate, up-to-date lists of providers in their networks. And it gives the
Pritzker first announced the plan in his State of the State address in February, saying he expected stiff resistance from the insurance industry but vowing "to spend serious political capital" if necessary to pass the legislation.
The bill was, in fact, the subject of intense behind-the-scenes negotiations between the administration, insurance industry representatives, health care providers and other stakeholder groups. In the end, the final version of the act had little opposition and drew some Republican support. It passed 45-14 in the
Part of the reason for the bipartisan support was that the more controversial provision banning the sale of short-term, limited-duration insurance plans was taken out and put into a separate bill.
Those policies are marketed as temporary plans intended mainly for people who find themselves in between coverage plans, often because of changes in employment. Supporters of the bill argued those plans provide substandard coverage and often leave individuals liable for huge medical bills. But many
That measure passed largely along party lines: 40-19 in the
Pritzker signed the two bills at a ceremony at
"The health insurance reforms passed by the
––––––––––––––––––
■ Capitol News Illinois is a nonprofit, nonpartisan news service covering government. It is distributed to hundreds of newspapers, radio and TV stations statewide. It is funded primarily by the
State health coverage commission begins work
Raleigh woman charged with falsifying vet records to receive pet insurance
Advisor News
Annuity News
Health/Employee Benefits News
Life Insurance News