HB4785 - 104th General Assembly (2025-2026)

DHS-BEHAVIORAL HLTH SURCHARGE
Last Action
3/25/2026 - House: Placed on Calendar 2nd Reading - Short Debate
Hearings
Human Services Committee Hearing Mar 25 2026 8:00AM Stratton Building Room C-1 Springfield, IL - House Committee Amendment 1
Statutes Amended In Order of Appearance
New Act  
Synopsis As Introduced
Creates the Preventing Crisis Cost Shifting to Medicaid Act. Provides that the General Assembly finds that (i) behavioral health crisis services, including crisis call centers, mobile crisis response, and crisis stabilization and receiving services, function as essential public health infrastructure and must be available statewide without regard to insurance status; and (ii) commercial health insurance policies issued or administered in the State generally do not provide comprehensive coverage for the full continuum of behavioral health crisis services, resulting in the cost of such services being disproportionately borne by Medicaid, local governments, and taxpayers. Requires specified entities (surcharge payors) that are authorized to issue or administer a policy or contract of accident and health insurance or a health maintenance organization contract in the State to pay a behavioral health crisis assessment to the Department of Human Services for deposit into the Statewide 9-8-8 Trust Fund. Exempts Medicaid managed care organizations from paying the behavioral health crisis assessment. Permits the Department to update the total behavioral health crisis assessment amount as necessary to ensure the continued availability, quality, or geographic equity of the statewide behavioral health crisis system. Requires the Department to establish an appropriate mechanism for enforcing a surcharge payor's liability, which may include accrued interest on unpaid liabilities at a rate not to exceed 18% per annum and late fees or penalties at a rate not to exceed 5% per month. Provides that the enforcement mechanism may also include notification to the Department of Healthcare and Family Services to offset payments on the surcharge payor's claims. Provides that the Department of Human Services shall not direct the Department of Healthcare and Family Services to offset claims payments unless the surcharge payor has maintained an outstanding liability to the Statewide 9-8-8 Trust Fund for a period longer than 45 days and has received proper notice of pending enforcement.

House Committee Amendment No. 1
Deletes reference to:
New Act  
Adds reference to:
30 ILCS 105/6z-134  
215 ILCS 5/370c.5 new  
215 ILCS 5/417 new  
Replaces everything after the enacting clause. Amends the Illinois Insurance Code. Beginning January 1, 2027, requires each covered entity to pay to the Department of Insurance a behavioral health emergency services covered lives assessment for deposit into the Behavioral Health Emergency Services Assessment Account within the Statewide 9-8-8 Trust Fund. Establishes requirements for the assessment and for payments from a covered entity. Grants the Department of Insurance authority to contract with a third party to obtain covered lives information, administer the assessment, and perform related audit or collection functions. Sets forth provisions concerning liability for when ownership is transferred and periodic adjustment of the assessment. Provides that the provisions concerning the behavioral health emergency services covered lives assessment may be referred to as the Preventing Crisis Cost Shifting to Medicaid Law. Sets forth provisions concerning network adequacy requirements for a health insurance issuer or health maintenance organization relating to behavioral health emergency services. Amends the State Finance Act. Creates the Behavioral Health Emergency Services Assessment Account within the Statewide 9-8-8 Trust Fund to be used solely, consistent with the specified purposes, for behavioral health emergency services and administrative costs related to implementation of the assessment provisions in the Illinois Insurance Code. Prohibits a provider or entity receiving funds attributable to the assessment under the Illinois Insurance Code from billing a covered entity for the specified behavioral health emergency services for a covered life. Requires the Department of Human Services to submit an annual report to the Governor and the General Assembly on the receipts and expenditures of the Behavioral Health Emergency Services Assessment Account. Contains a severability clause. Effective January 1, 2027.
Actions
DateChamberAction
2/02/2026HouseFiled with the Clerk by Rep. Lindsey LaPointe
2/06/2026HouseFirst Reading
2/06/2026HouseReferred to Rules Committee
3/04/2026HouseAssigned to Human Services Committee
3/16/2026HouseHouse Committee Amendment No. 1 Filed with Clerk by Rep. Lindsey LaPointe
3/16/2026HouseHouse Committee Amendment No. 1 Referred to Rules Committee
3/18/2026HouseHouse Committee Amendment No. 1 Rules Refers to Human Services Committee
3/25/2026HouseAdded Co-Sponsor Rep. Nicolle Grasse
3/25/2026HouseHouse Committee Amendment No. 1 Adopted in Human Services Committee; by Voice Vote
3/25/2026HouseDo Pass as Amended / Short Debate Human Services Committee; 008-004-000
3/25/2026HousePlaced on Calendar 2nd Reading - Short Debate