Vol. 68, Issue 22
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IN THIS ISSUE
- WHA Presents State Capitol Briefing on 2024 Health Care Workforce Report
- Illinois Legislature Passes Bill Prohibiting Prior Authorization for Inpatient Mental Health Admissions
- Attending the Wisconsin Rural Health Conference? Enter to Win a $500 Amazon Gift Card
- 2024 Community Benefit Survey Now Open; WHA Hosting Free Training
- Wisconsin Hospitals State PAC & Conduit Fundraising Halfway to Goal
- Health Care Emergency Readiness Planning: Severe Weather and Other Natural Disaster Planning Resources Available at ASPRTRACIE.GOV
- Grassroots Spotlight: Lt. Gov. Rodriguez Visits The Richland Hospital and Clinics
EDUCATION EVENTS
Apr. 9, 2025
2025 Advocacy DayApr. 22, 2025
Nursing ServicesMay. 14, 2025
2025 WHA Workforce ForumClick here to view quality event calendar
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Thursday, May 30, 2024
Illinois Legislature Passes Bill Prohibiting Prior Authorization for Inpatient Mental Health Admissions
As reported in Becker's this week, the Illinois General Assembly has passed a new health insurance reform bill, which Governor JB Pritzker is expected to sign.
The enrolled bill, passed on May 25, prohibits state-regulated insurers from requiring prior authorization for inpatient admissions for mental health treatment at participating hospitals. In addition, the coverage would not be subject to concurrent review for the first 72 hours as long as the hospital notifies the insurer of the admission and initial treatment plan within the first two days of admission. Finally, the treatment could not be retroactively denied for the first 72 hours of treatment except in limited circumstances. These provisions would go into effect on Jan. 1, 2026.
The bill contains additional requirements on insurers, including implementing new penalties for failing to keep the network plan directory up to date; and requiring insurers that use a drug formulary to post the formulary on their website in a manner that is searchable and accessible to the general public.
The enrolled bill, passed on May 25, prohibits state-regulated insurers from requiring prior authorization for inpatient admissions for mental health treatment at participating hospitals. In addition, the coverage would not be subject to concurrent review for the first 72 hours as long as the hospital notifies the insurer of the admission and initial treatment plan within the first two days of admission. Finally, the treatment could not be retroactively denied for the first 72 hours of treatment except in limited circumstances. These provisions would go into effect on Jan. 1, 2026.
The bill contains additional requirements on insurers, including implementing new penalties for failing to keep the network plan directory up to date; and requiring insurers that use a drug formulary to post the formulary on their website in a manner that is searchable and accessible to the general public.