January 11, 2019
To the Honorable Members of
The Illinois House of Representatives,
100th General Assembly:
Today, I return House Bill 5769 from the 100th General Assembly with specific recommendations for change. This legislation requires the development of uniform electronic prior authorization forms for use among commercial insurers and Medicaid managed care organizations. Simplifying prior authorization processes and forms will reduce administrative burden for health care professionals and facilitate Illinoisans’ access to care.
However, the legislation leaves unclear how new automatic approvals of requests to which insurers or managed care organizations fail to respond within established time periods would interact with existing requirements to approve or deny requests within those same time periods.
I encourage the removal of the ambiguous subsections to allow for further examination of this potential conflict to ensure existing consumer protections are maintained. I hope this issue, as well as the applicability of the legislation to all relevant health insurance plans, is addressed in future legislation prior to implementation of the uniform electronic form.
Therefore, pursuant to Section 9(e) of Article IV of the Illinois Constitution of 1970, I hereby return House Bill 4515, entitled “AN ACT concerning regulation,” with the following specific recommendations for change:
By deleting page 3, lines 1 through 9; and
By deleting page 5, lines 8 through 14.
With these changes, House Bill 5769 would have my approval.