Illinois Governor J.B. Pritzker advocated for the passage of a bill on Monday that would make the state the first in the nation to prohibit requiring prior authorization for in-patient mental health admissions for the first 72 hours. This Healthcare Protection Act aims to eliminate “step therapy,” a process where insurance companies can insist on trying alternative treatments before the doctor’s first choice.
Dr. Jennifer Neville, a physician at Memorial Hospital in Belleville, highlighted the challenges patients face when higher tier medications are necessary due to their health condition. Despite being the best choice for the patient, these prescriptions are often initially denied by insurers, leading to long appeals processes and delays in receiving appropriate treatment.
The proposed legislation also includes provisions that would require the Illinois Department of Insurance to approve rate hikes for large group plans and mandate insurance companies to maintain accurate lists of network doctors to ensure patients can promptly access medical care. A.J. Wilhelmi, president and CEO of the Illinois Health and Hospital Association, criticized cost-control strategies used by insurers at the expense of patient care.
The bill received bipartisan support in the House and is now awaiting consideration by the Senate. Governor Pritzker expressed confidence that it will be passed before the end of this session on May 24th. The proposed legislation aims to prioritize patients’ health needs over cost-saving measures for insurance companies, signaling a positive step towards improving healthcare access and outcomes in Illinois
