Bill Title: Reinserts the provisions of the bill, as amended by House Amendment No. 1, with changes that include the following. Provides that the amendatory Act may be referred to as the Health Care Protection Act. In the Network Adequacy and Transparency Act, provides that the Department of Insurance shall enforce certain network adequacy and transparency standards for stand-alone dental plans for plans amended, delivered, issued, or renewed on or after January 1, 2025. Provides that for the Department to enforce any new or modified federal standard before the Department adopts the standard by rule, the Department must, no later than May 15 before the start of the plan year, give public notice to the affected health insurance issuers through a bulletin. Further amends the Illinois Insurance Code, makes changes concerning provider directories. Creates the Uniform Electronic Provider Directory Information Form Task Force. Requires the Department of Insurance, with input from the Uniform Electronic Provider Directory Information Form Task Force, to develop and publish a uniform electronic provider directory information form that issuers shall make available to providers to notify the issuer of the provider's currently accurate provider directory information. Provides that certain provisions concerning prosthetic and customized orthotic devices do not apply to certain other fixed indemnities. Requires the Department to create a template for drug formularies by March 31, 2025. With regard to a prohibition on certain step therapy requirements, removes an exception for the Department of Healthcare and Family services. Makes changes concerning the calculation of a cost-sharing reduction defunding adjustment factor; retrospective review of coverage for inpatient mental health treatment at participating hospitals; the definition of "step therapy requirement"; concurrent review; and standards for utilization review criteria. Makes other changes. Amends the Illinois Health Benefits Exchange Law. Provides that beginning for plan year 2026, if a health insurance issuer offers a product as defined under federal regulations at the gold or silver level through the Illinois Health Benefits Exchange, the issuer must offer that product at both the gold and silver levels. Provides that no later than October 1, 2025 (rather than July 1, 2025), insurance companies that use a drug formulary shall post the formulary on their websites. Amends the Managed Care Reform and Patient Rights Act. Makes changes concerning definitions and utilization review programs. Further amends the Prior Authorization Reform Act. Changes the definition of "medically necessary". Amends the Illinois Public Aid Code. Makes changes concerning the applicability of the Managed Care Reform and Patient Rights Act to the Code. Effective January 1, 2025.

Spectrum: Partisan Bill (Democrat 73-1)

Status: (Engrossed) 2024-05-10 - Rule 2-10 Committee Deadline Established As May 17, 2024 [HB5395 Detail]

Text: Latest bill text (Engrossed) [HTML]

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Voting Records

Chamber	Vote	Date	Yea	Nay	NV	Abs	Total	Result	Source	View
House	Third Reading in House	2024-04-18	81	25	2	2	110	Passed	Link	View

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