Illinois Becomes First State to Eliminate Prior Authorization Requirements for Mental Health Admissions with New Healthcare Protection Act

Illinois Governor J.B. Pritzker recently visited the Metro East to advocate for a bill that would eliminate prior authorization requirements for in-patient mental health admissions in the state for the first 72 hours. This would make Illinois the first state in the country to implement such a measure. The Healthcare Protection Act would also eliminate “step therapy,” which requires patients to try alternative treatments before receiving their doctor’s recommended option.

Dr. Jennifer Neville of Memorial Hospital discussed the challenges faced by her patients when insurance companies deny necessary prescriptions, resulting in unnecessary costs and time delays. These difficulties are common in the current system, where insurance companies prioritize profits over patient care.

The legislation aims to address these issues by requiring the Illinois Department of Insurance to approve rate increases for large group plans and mandate that insurance companies maintain up-to-date lists of network doctors. This would reduce delays in patient care and ensure that doctors have control over treatment decisions.

AJ Wilhelmi of the Illinois Health and Hospital Association criticized insurance companies for prioritizing profits over patient care, emphasizing the importance of allowing physicians to make decisions based on what is best for patients rather than cost-saving strategies.

The bill has already passed with bipartisan support and is awaiting approval in the Senate, with Governor Pritzker expressing confidence that it will pass before May 24th, concluding this session’s legislative agenda aimed at improving access to mental health care and ensuring patients receive necessary treatments without unnecessary delays or denials from insurance companies.