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| | 104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB5131 Introduced 2/10/2026, by Rep. Kevin Schmidt SYNOPSIS AS INTRODUCED:
| | | Amends the Illinois Insurance Code. Provides that a health insurance issuer that delivers, issues for delivery, or renews in this State a health insurance policy shall not discriminate with respect to participation under the health insurance policy against a health care professional who is acting within the scope of the health care professional's license or certification under applicable State law. Provides that a health insurance issuer is not required to contract with any health care professional willing to abide by the terms and conditions for participation established by the health insurance issuer. Provides that a health insurance issuer is not prohibited from establishing varying reimbursement rates based on quality or performance measures. |
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| | A BILL FOR |
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| | HB5131 | | LRB104 19984 BAB 33435 b |
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| 1 | | AN ACT concerning regulation.
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| 2 | | Be it enacted by the People of the State of Illinois, |
| 3 | | represented in the General Assembly:
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| 4 | | Section 5. The Illinois Insurance Code is amended by |
| 5 | | adding Section 370b.2 as follows:
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| 6 | | (215 ILCS 5/370b.2 new) |
| 7 | | Sec. 370b.2. Health insurance issuer claim discrimination. |
| 8 | | (a) As used in this Section: |
| 9 | | "Discriminate" has the meaning described in 42 U.S.C. |
| 10 | | 300gg-5 and any applicable regulations. |
| 11 | | "Health care professional" has the meaning given to that |
| 12 | | term in Section 2105-15.7 of the Department of Professional |
| 13 | | Regulation Law of the Civil Administrative Code of Illinois. |
| 14 | | (b) A health insurance issuer that delivers, issues for |
| 15 | | delivery, or renews in this State a health insurance policy |
| 16 | | shall not discriminate with respect to participation under the |
| 17 | | health insurance policy against a health care professional who |
| 18 | | is acting within the scope of the health care professional's |
| 19 | | license or certification under applicable State law. |
| 20 | | (c) This Section does not require that a health insurance |
| 21 | | issuer described in subsection (b) contract with any health |
| 22 | | care professional willing to abide by the terms and conditions |
| 23 | | for participation established by the health insurance issuer. |