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HB1085 - 104th General Assembly
INS CD-MENTAL HEALTH PARITY
Last Action
House Sponsors
Rep. Lindsey LaPointe - Maurice A. West, II - Bob Morgan - Tracy Katz Muhl, Dagmara Avelar, Maura Hirschauer, Michelle Mussman, Terra Costa Howard, Anna Moeller, Theresa Mah, Kevin John Olickal, Lilian Jiménez, Jay Hoffman, Kelly M. Cassidy, Lisa Davis, Stephanie A. Kifowit, Katie Stuart, Yolonda Morris, Norma Hernandez, Sharon Chung, Michael J. Kelly, Laura Faver Dias, Mary Gill, Will Guzzardi, Nicolle Grasse, Anne Stava, Janet Yang Rohr, Michael Crawford, Robyn Gabel, Nabeela Syed, Barbara Hernandez, Martha Deuter, Abdelnasser Rashid, Mary Beth Canty, Hoan Huynh, Ryan Spain, Harry Benton, Ann M. Williams, La Shawn K. Ford, Brad Stephens, Nicole La Ha, John M. Cabello, Kevin Schmidt, Angelica Guerrero-Cuellar, Matt Hanson, Sonya M. Harper, Gregg Johnson, Suzanne M. Ness, Anthony DeLuca, Rick Ryan, Lawrence "Larry" Walsh, Jr., Emanuel "Chris" Welch, Robert "Bob" Rita, Dave Vella, Jaime M. Andrade, Jr., Carol Ammons, Joyce Mason, Jehan Gordon-Booth, Sue Scherer, Debbie Meyers-Martin, Camille Y. Lilly and Margaret A. DeLaRosaSenate Sponsors
(Sen. Don Harmon - David Koehler - Laura Fine - Bill Cunningham - Graciela Guzmán, Cristina Castro, Lakesia Collins, Paul Faraci, Mike Porfirio, Suzy Glowiak Hilton, Robert Peters, Robert F. Martwick, Mike Simmons, Patrick J. Joyce, Mary Edly-Allen, Rachel Ventura, Mark L. Walker, Laura Ellman, Christopher Belt, Sara Feigenholtz, Mattie Hunter, Adriane Johnson, Laura M. Murphy, Meg Loughran Cappel, Ram Villivalam, Kimberly A. Lightford, Javier L. Cervantes and Karina Villa)Statutes Amended In Order of Appearance
215 ILCS 125/5-3from Ch. 111 1/2, par. 1411.2
Synopsis As Introduced
Amends the Illinois Insurance Code. Establishes reimbursement rates for mental health and substance use disorder treatment services for all group or individual policies of accident and health insurance or managed care plans that are amended, delivered, issued, or renewed on or after January 1, 2027 or for any contracted third party administering the behavioral health benefits for the insurer. Requires a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2026 or any contracted third party administering the behavioral health benefits for the insurer to cover certain medically necessary mental health and substance use disorder treatment services. Provides that, if the Department of Insurance determines that an insurer or a contracted third party administering the behavioral health benefits for the insurer has violated a provision concerning mental health and substance use parity, the Department shall by order assess a civil penalty of $1,000 for each violation. Excludes certain health care plans serving Medicaid populations who are enrolled under the Illinois Public Aid Code or under the Children's Health Insurance Program Act from provisions concerning mental health and substance use parity. Requires the Department to review the impact of the proposed mental health and substance abuse mandate on network adequacy for mental health and substance use disorder treatment and access to affordable mental health and substance use care. Permits the Department to examine out-of-network utilization and out-of-pocket costs for insureds for mental health and substance use treatment and services for all plans to compare with in-network utilization. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, and the School Code to require coverage under those provisions. Effective immediately.
House Committee Amendment No. 1
Deletes reference to:
Replaces everything after the enacting clause with the provisions of the introduced bill with the following changes: Removes provisions amending the State Employees Group Insurance Act of 1971. In provisions concerning mental health and substance abuse parity, removes provision limiting the applicability of parity requirements for mental health or substance use disorder services provided by a hospital when the hospital has a contract with the insurer that provides for reimbursement for such services based on achieving specified patient health outcomes and other quality measures and includes shared savings from lower health care costs. Makes conforming changes.
Senate Committee Amendment No. 1
Deletes reference to:
Replaces everything after the enacting clause with the provisions of the engrossed bill with the following changes. Replaces provisions concerning reimbursement for in-network mental health and substance use disorder treatment services. Provides that, consistent with the principles of the federal Mental Health Parity and Addiction Equity Act of 2008, and for the purposes of strengthening network adequacy for mental health and substance use disorder services and lowering out-of-network utilization, the Department of Human Services, by rule, shall determine a reimbursement rate floor for all in-network mental health and substance use disorder services, including inpatient services, outpatient services, office visits, and residential care, delivered by Illinois providers and facilities using the Illinois data in Research Triangle Institute International's study. Sets forth provisions concerning requirements for the reimbursement rate floor. Grants the Department of Insurance enforcement and monitoring authority over the reimbursement rate floor and requires the Department to publish the rate floor set by the Department of Human Services in Title 50 of the Illinois Administrative Code. Provides that, at the end of 2 years, 7 years, and 12 years (rather than 5 years, 10 years, and 15 years) following the implementation of provisions concerning the reimbursement rate floor, the Department of Insurance shall review the impact of provisions concerning mental health and substance use parity on network adequacy for mental health and substance use disorder treatment and access to affordable mental health and substance use care. Requires the Department to submit a report to the General Assembly by no later than December 31, 2030, December 31, 2035, and December 31, 2040 (rather than by December 31, 2033, December 31, 2038, and December 31, 2043) that includes its analyses and findings following the Department's review. Makes changes in provisions granting the Department of Insurance the authority to examine out-of-network utilization and out-of-pocket costs. Provides that the Department of Insurance and the Department of Human Services (rather than only the Department of Insurance) shall adopt any rules necessary to implement provisions concerning mental health and substance use parity by no later than May 1, 2026. Removes provisions amending the Health Maintenance Organization Act. Effective immediately.
Senate Floor Amendment No. 3
Deletes reference to:
Adds reference to:
215 ILCS 5/370c.4 new
Replaces everything after the enacting clause. Amends the Illinois Insurance Code. In provisions concerning mental health and substance use parity, makes changes to defined terms. Requires specified provider reimbursement rates to comply with the reimbursement floors for all in-network mental health and substance use disorder services. Establishes the reimbursement rate floor for each Healthcare Common Procedure Coding System (HCPCS) code, Current Procedural Terminology (CPT) code, Ambulatory Payment Classification (APC), Enhanced Ambulatory Patient Group (EAPG), Medicare Severity Diagnosis Related Group (MS-DRG), All Patient Refined Diagnosis Related Group (APR-DRG), and base payment rate with adjusters and applicable outliers for a mental health or substance use disorder service. Provides that a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2027, or any contracted third party administering the behavioral health benefits for the insurer, shall cover all medically necessary mental health or substance use disorder services received by the same insured on the same day from the same or different mental health or substance use provider or facility for both outpatient and inpatient care. Sets forth provisions concerning additional coverage requirements; disclosure provisions; and provisions concerning the Department of Insurance's enforcement authority, reporting requirements, and rulemaking. Makes other changes. Amends the Counties Code, the Illinois Municipal Code, and the School Code to require coverage under the provisions of those Acts. Effective June 1, 2026.
Actions
| Date | Chamber | Action |
|---|---|---|
| 1/02/2025 | House | Prefiled with Clerk by Rep. Lindsey LaPointe |
| 1/09/2025 | House | First Reading |
| 1/09/2025 | House | Referred to Rules Committee |
| 1/29/2025 | House | Added Chief Co-Sponsor Rep. Maurice A. West, II |
| 1/29/2025 | House | Added Chief Co-Sponsor Rep. Bob Morgan |
| 1/29/2025 | House | Added Co-Sponsor Rep. Dagmara Avelar |
| 1/29/2025 | House | Added Co-Sponsor Rep. Maura Hirschauer |
| 1/29/2025 | House | Added Co-Sponsor Rep. Michelle Mussman |
| 2/03/2025 | House | Added Co-Sponsor Rep. Terra Costa Howard |
| 2/03/2025 | House | Added Co-Sponsor Rep. Anna Moeller |
| 2/03/2025 | House | Added Co-Sponsor Rep. Theresa Mah |
| 2/04/2025 | House | Assigned to Mental Health & Addiction Committee |
| 2/04/2025 | House | Added Co-Sponsor Rep. Kevin John Olickal |
| 2/04/2025 | House | Added Co-Sponsor Rep. Lilian Jiménez |
| 2/04/2025 | House | Added Co-Sponsor Rep. Jay Hoffman |
| 2/06/2025 | House | Added Co-Sponsor Rep. Kelly M. Cassidy |
| 2/06/2025 | House | Added Co-Sponsor Rep. Lisa Davis |
| 2/06/2025 | House | Added Co-Sponsor Rep. Stephanie A. Kifowit |
| 2/06/2025 | House | Added Co-Sponsor Rep. Katie Stuart |
| 2/06/2025 | House | Added Co-Sponsor Rep. Yolonda Morris |
| 2/06/2025 | House | Added Co-Sponsor Rep. Norma Hernandez |
| 2/06/2025 | House | Added Co-Sponsor Rep. Sharon Chung |
| 2/06/2025 | House | Added Co-Sponsor Rep. Michael J. Kelly |
| 2/07/2025 | House | Added Co-Sponsor Rep. Laura Faver Dias |
| 2/07/2025 | House | Added Co-Sponsor Rep. Mary Gill |
| 2/10/2025 | House | Added Co-Sponsor Rep. Will Guzzardi |
| 2/10/2025 | House | Added Co-Sponsor Rep. Nicolle Grasse |
| 2/10/2025 | House | Added Co-Sponsor Rep. Anne Stava |
| 2/11/2025 | House | Added Co-Sponsor Rep. Janet Yang Rohr |
| 2/14/2025 | House | Added Co-Sponsor Rep. Michael Crawford |
| 2/19/2025 | House | Added Co-Sponsor Rep. Robyn Gabel |
| 2/20/2025 | House | Added Co-Sponsor Rep. Nabeela Syed |
| 2/21/2025 | House | Added Co-Sponsor Rep. Barbara Hernandez |
| 2/21/2025 | House | Added Co-Sponsor Rep. Martha Deuter |
| 2/27/2025 | House | Added Co-Sponsor Rep. Abdelnasser Rashid |
| 2/27/2025 | House | Added Co-Sponsor Rep. Mary Beth Canty |
| 2/27/2025 | House | Added Co-Sponsor Rep. Hoan Huynh |
| 2/27/2025 | House | Added Co-Sponsor Rep. Ryan Spain |
| 2/28/2025 | House | Added Co-Sponsor Rep. Harry Benton |
| 3/03/2025 | House | Added Co-Sponsor Rep. Ann M. Williams |
| 3/03/2025 | House | House Committee Amendment No. 1 Filed with Clerk by Rep. Lindsey LaPointe |
| 3/03/2025 | House | House Committee Amendment No. 1 Referred to Rules Committee |
| 3/03/2025 | House | Added Co-Sponsor Rep. La Shawn K. Ford |
| 3/04/2025 | House | House Committee Amendment No. 1 Rules Refers to Mental Health & Addiction Committee |
| 3/05/2025 | House | Added Co-Sponsor Rep. Brad Stephens |
| 3/05/2025 | House | Added Co-Sponsor Rep. Nicole La Ha |
| 3/05/2025 | House | Added Co-Sponsor Rep. John M. Cabello |
| 3/06/2025 | House | House Committee Amendment No. 1 Adopted in Mental Health & Addiction Committee; by Voice Vote |
| 3/06/2025 | House | Do Pass as Amended / Short Debate Mental Health & Addiction Committee; 017-005-000 |
| 3/06/2025 | House | Placed on Calendar 2nd Reading - Short Debate |
| 3/06/2025 | House | Added Co-Sponsor Rep. Kevin Schmidt |
| 3/06/2025 | House | Added Co-Sponsor Rep. Angelica Guerrero-Cuellar |
| 3/10/2025 | House | Added Co-Sponsor Rep. Matt Hanson |
| 3/10/2025 | House | Added Co-Sponsor Rep. Sonya M. Harper |
| 3/10/2025 | House | Added Co-Sponsor Rep. Gregg Johnson |
| 3/10/2025 | House | Added Co-Sponsor Rep. Suzanne M. Ness |
| 3/12/2025 | House | Added Co-Sponsor Rep. Anthony DeLuca |
| 3/12/2025 | House | Added Co-Sponsor Rep. Rick Ryan |
| 3/17/2025 | House | Added Co-Sponsor Rep. Lawrence "Larry" Walsh, Jr. |
| 3/18/2025 | House | Second Reading - Short Debate |
| 3/18/2025 | House | Placed on Calendar Order of 3rd Reading - Short Debate |
| 3/18/2025 | House | Added Co-Sponsor Rep. Emanuel "Chris" Welch |
| 3/19/2025 | House | Added Co-Sponsor Rep. Robert "Bob" Rita |
| 3/25/2025 | House | Added Co-Sponsor Rep. Dave Vella |
| 3/28/2025 | House | Added Co-Sponsor Rep. Jaime M. Andrade, Jr. |
| 4/02/2025 | House | Added Co-Sponsor Rep. Carol Ammons |
| 4/07/2025 | House | Added Co-Sponsor Rep. Joyce Mason |
| 4/07/2025 | House | Third Reading - Short Debate - Passed 072-033-000 |
| 4/07/2025 | House | Added Co-Sponsor Rep. Tracy Katz Muhl |
| 4/07/2025 | House | Removed Co-Sponsor Rep. Tracy Katz Muhl |
| 4/08/2025 | Senate | Arrive in Senate |
| 4/08/2025 | Senate | Placed on Calendar Order of First Reading |
| 4/08/2025 | Senate | Chief Senate Sponsor Sen. Karina Villa |
| 4/08/2025 | Senate | First Reading |
| 4/08/2025 | Senate | Referred to Assignments |
| 4/08/2025 | House | Added Co-Sponsor Rep. Jehan Gordon-Booth |
| 4/10/2025 | House | Added Co-Sponsor Rep. Sue Scherer |
| 4/10/2025 | Senate | Added as Alternate Chief Co-Sponsor Sen. David Koehler |
| 4/10/2025 | Senate | Added as Alternate Chief Co-Sponsor Sen. Laura Fine |
| 4/11/2025 | Senate | Added as Alternate Chief Co-Sponsor Sen. Bill Cunningham |
| 4/14/2025 | Senate | Added as Alternate Co-Sponsor Sen. Cristina Castro |
| 4/15/2025 | Senate | Added as Alternate Co-Sponsor Sen. Lakesia Collins |
| 4/22/2025 | Senate | Added as Alternate Co-Sponsor Sen. Paul Faraci |
| 4/28/2025 | Senate | Added as Alternate Co-Sponsor Sen. Mike Porfirio |
| 4/29/2025 | Senate | Added as Alternate Co-Sponsor Sen. Suzy Glowiak Hilton |
| 4/29/2025 | Senate | Added as Alternate Co-Sponsor Sen. Robert Peters |
| 4/30/2025 | Senate | Added as Alternate Chief Co-Sponsor Sen. Graciela Guzmán |
| 4/30/2025 | Senate | Added as Alternate Co-Sponsor Sen. Robert F. Martwick |
| 4/30/2025 | Senate | Added as Alternate Co-Sponsor Sen. Mike Simmons |
| 4/30/2025 | Senate | Added as Alternate Co-Sponsor Sen. Patrick J. Joyce |
| 5/01/2025 | Senate | Added as Alternate Co-Sponsor Sen. Mary Edly-Allen |
| 5/02/2025 | Senate | Added as Alternate Co-Sponsor Sen. Rachel Ventura |
| 5/02/2025 | Senate | Added as Alternate Co-Sponsor Sen. Mark L. Walker |
| 5/05/2025 | Senate | Added as Alternate Co-Sponsor Sen. Laura Ellman |
| 5/06/2025 | Senate | Added as Alternate Co-Sponsor Sen. Christopher Belt |
| 5/22/2025 | Senate | Assigned to Executive |
| 5/22/2025 | Senate | Rule 2-10 Committee Deadline Established As May 23, 2025 |
| 5/23/2025 | Senate | Rule 2-10 Committee Deadline Established As June 1, 2025 |
| 5/27/2025 | Senate | Added as Alternate Co-Sponsor Sen. Sara Feigenholtz |
| 5/27/2025 | Senate | Senate Committee Amendment No. 1 Filed with Secretary by Sen. Karina Villa |
| 5/27/2025 | Senate | Senate Committee Amendment No. 1 Referred to Assignments |
| 5/28/2025 | Senate | Senate Committee Amendment No. 1 Assignments Refers to Executive |
| 5/28/2025 | Senate | Added as Alternate Co-Sponsor Sen. Mattie Hunter |
| 5/28/2025 | Senate | Added as Alternate Co-Sponsor Sen. Adriane Johnson |
| 5/28/2025 | Senate | Senate Committee Amendment No. 1 Postponed - Executive |
| 5/28/2025 | Senate | Postponed - Executive |
| 5/30/2025 | Senate | Senate Committee Amendment No. 2 Filed with Secretary by Sen. Karina Villa |
| 5/30/2025 | Senate | Senate Committee Amendment No. 2 Referred to Assignments |
| 5/30/2025 | Senate | Waive Posting Notice |
| 5/30/2025 | Senate | Rule 2-10 Third Reading/Passage Deadline Established As June 1, 2025 |
| 5/30/2025 | Senate | Senate Committee Amendment No. 1 Adopted |
| 5/30/2025 | Senate | Do Pass as Amended Executive; 010-002-000 |
| 5/30/2025 | Senate | Placed on Calendar Order of 2nd Reading |
| 5/30/2025 | Senate | Second Reading |
| 5/30/2025 | Senate | Placed on Calendar Order of 3rd Reading May 31, 2025 |
| 6/02/2025 | Senate | Rule 3-9(a) / Re-referred to Assignments |
| 7/10/2025 | Senate | Added as Alternate Co-Sponsor Sen. Laura M. Murphy |
| 10/15/2025 | Senate | Added as Alternate Co-Sponsor Sen. Meg Loughran Cappel |
| 10/15/2025 | Senate | Added as Alternate Co-Sponsor Sen. Ram Villivalam |
| 10/16/2025 | Senate | Added as Alternate Co-Sponsor Sen. Kimberly A. Lightford |
| 10/24/2025 | Senate | Added as Alternate Co-Sponsor Sen. Javier L. Cervantes |
| 10/28/2025 | Senate | Approved for Consideration Assignments |
| 10/28/2025 | Senate | Placed on Calendar Order of 3rd Reading October 29, 2025 |
| 10/28/2025 | Senate | Senate Floor Amendment No. 3 Filed with Secretary by Sen. Karina Villa |
| 10/28/2025 | Senate | Senate Floor Amendment No. 3 Referred to Assignments |
| 10/28/2025 | Senate | Senate Floor Amendment No. 3 Assignments Refers to Executive |
| 10/29/2025 | Senate | Senate Floor Amendment No. 3 Postponed - Executive |
| 10/29/2025 | House | Added Co-Sponsor Rep. Debbie Meyers-Martin |
| 10/30/2025 | Senate | Alternate Chief Sponsor Changed to Sen. Don Harmon |
| 10/30/2025 | Senate | Senate Floor Amendment No. 3 Recommend Do Adopt Executive; 011-002-000 |
| 10/30/2025 | Senate | Recalled to Second Reading |
| 10/30/2025 | Senate | Senate Committee Amendment No. 2 Tabled Pursuant to Rule 5-4(a) |
| 10/30/2025 | Senate | Senate Floor Amendment No. 3 Adopted; Villa |
| 10/30/2025 | Senate | Placed on Calendar Order of 3rd Reading |
| 10/30/2025 | Senate | Third Reading - Passed; 048-010-000 |
| 10/30/2025 | House | Arrived in House |
| 10/30/2025 | House | Placed on Calendar Order of Concurrence Senate Amendment(s) 1, 3 |
| 10/30/2025 | House | Senate Committee Amendment No. 1 Motion Filed Concur Rep. Lindsey LaPointe |
| 10/30/2025 | House | Senate Floor Amendment No. 3 Motion Filed Concur Rep. Lindsey LaPointe |
| 10/30/2025 | House | Senate Committee Amendment No. 1 Motion to Concur Referred to Rules Committee |
| 10/30/2025 | House | Senate Floor Amendment No. 3 Motion to Concur Referred to Rules Committee |
| 10/30/2025 | House | Senate Committee Amendment No. 1 Motion to Concur Recommends Be Adopted Rules Committee; 003-002-000 |
| 10/30/2025 | House | Senate Floor Amendment No. 3 Motion to Concur Recommends Be Adopted Rules Committee; 003-002-000 |
| 10/30/2025 | House | Added Co-Sponsor Rep. Camille Y. Lilly |
| 10/30/2025 | House | Senate Committee Amendment No. 1 House Concurs 086-019-001 |
| 10/30/2025 | House | Senate Floor Amendment No. 3 House Concurs 086-019-001 |
| 10/30/2025 | House | House Concurs |
| 10/30/2025 | House | Passed Both Houses |
| 10/30/2025 | House | Added Chief Co-Sponsor Rep. Tracy Katz Muhl |
| 10/30/2025 | House | Added Co-Sponsor Rep. Margaret A. DeLaRosa |
| 10/31/2025 | Senate | Added as Alternate Co-Sponsor Sen. Karina Villa |