INSURANCE-MENTAL HEALTH Senate SponsorsSen. Laura Fine-Sara Feigenholtz-Adriane Johnson, Doris Turner, Robert Peters, Karina Villa, Mike Simmons-Kimberly A. Lightford, Ram Villivalam-Jacqueline Y. Collins, Melinda Bush, Mattie Hunter, Christopher Belt, David Koehler, Celina Villanueva, Julie A. Morrison and Laura M. Murphy 1/10/2023SenateSession Sine Die 215 ILCS 5/370cfrom Ch. 73, par. 982c215 ILCS 180/35215 ILCS 180/40Amends the Illinois Insurance Code. Provides that every insurer that amends, delivers, issues, or renews a group or individual policy of accident and health insurance or a qualified health plan offered through the health insurance marketplace in the State and Medicaid managed care organizations providing coverage for hospital or medical treatment shall provide coverage for medically necessary treatment of mental, emotional, nervous, or substance use disorders or conditions. Provides that an insurer shall not limit benefits or coverage for medically necessary services on the basis that those services should be or could be covered by a public program. Provides that an insurer shall base any medical necessity determination or the utilization review criteria on current generally accepted standards of mental, emotional, nervous, or substance use disorder or condition care. Provides that in conducting utilization review of covered health care services and benefits for the diagnosis, prevention, and treatment of mental, emotional, and nervous disorders or conditions in children, adolescents, and adults, an insurer shall exclusively apply the criteria and guidelines set forth in the most recent versions of the treatment criteria developed by the nonprofit professional association for the relevant clinical specialty. Provides that an insurer shall not apply different, additional, conflicting, or more restrictive utilization review criteria than the criteria and guidelines set forth in the treatment criteria. Provides that the Director may, after appropriate notice and opportunity for hearing, assess a civil penalty between $5,000 and $20,000 for each violation. Amends the Health Carrier External Review Act. Provides that the independent review organization shall comply with specified requirements for an adverse determination or final adverse determination involving mental, emotional, nervous, or substance use disorders or conditions. Makes other changes. Effective immediately. 2/25/2021SenateFiled with Secretary by Sen. Laura Fine 2/25/2021SenateFirst Reading 2/25/2021SenateReferred to Assignments 3/5/2021SenateAdded as Chief Co-Sponsor Sen. Sara Feigenholtz 3/17/2021SenateAdded as Chief Co-Sponsor Sen. Adriane Johnson 3/18/2021SenateAdded as Co-Sponsor Sen. Doris Turner 3/18/2021SenateAdded as Co-Sponsor Sen. Kimberly A. Lightford 3/19/2021SenateAdded as Co-Sponsor Sen. Robert Peters 3/23/2021SenateAdded as Co-Sponsor Sen. Karina Villa 3/24/2021SenateAdded as Co-Sponsor Sen. Mike Simmons 3/29/2021SenateAdded as Chief Co-Sponsor Sen. Kimberly A. Lightford 3/30/2021SenateAdded as Co-Sponsor Sen. Ram Villivalam 3/31/2021SenateAdded as Chief Co-Sponsor Sen. Jacqueline Y. Collins 3/31/2021SenateAdded as Co-Sponsor Sen. Melinda Bush 4/1/2021SenateAdded as Co-Sponsor Sen. Mattie Hunter 4/6/2021SenateAdded as Co-Sponsor Sen. Christopher Belt 4/8/2021SenateAdded as Co-Sponsor Sen. David Koehler 4/12/2021SenateAdded as Co-Sponsor Sen. Celina Villanueva 4/20/2021SenateAdded as Co-Sponsor Sen. Julie A. Morrison 4/20/2021SenateAdded as Co-Sponsor Sen. Laura M. Murphy 1/10/2023SenateSession Sine Die