Synopsis As Introduced Amends the Illinois Insurance Code in the provisions concerning autism spectrum disorders, habilitative services for children, and mental and emotional disorders to provide that certain coverage provided under those respective provisions through a group or individual policy of accident and health insurance or managed care plan shall be subject to the parity requirements of the provision concerning mental health parity. Sets forth a provision concerning mental health parity. Provides that every insurer that amends, delivers, issues, or renews a group policy of accident and health insurance in the State providing coverage for hospital or medical treatment and for the treatment of mental, emotional, nervous, or substance use disorders or conditions shall ensure adherence to the provisions concerning financial requirements and treatment limitations. Sets forth provisions concerning aggregate lifetime and annual limits. Amends the Health Maintenance Organization Act to comport with the provision of the Illinois Insurance Code concerning mental health parity. Makes other changes. Effective immediately.
House Committee Amendment No. 1 Changes references of individuals licensed pursuant to the Illinois Alcoholism and Other Drug Abuse and Dependency Act to licensed or certified professionals at programs licensed pursuant to the Illinois Alcoholism and Other Drug Abuse and Dependency Act. Provides that an insurer that provides coverage for hospital or medical expenses under a group policy of accident and health insurance or health care plan shall provide coverage under the policy for treatment of serious mental illness and substance use disorders (instead of serious mental illness). Sets forth a definition for "substance use disorder". Provides that medical necessity determinations for substance use disorders shall be made in accordance with appropriate patient placement criteria established by the American Society of Addiction Medicine. Provides that the provision concerning mental health parity shall be interpreted in a manner consistent with the interim final regulations promulgated by the U.S. Department of Health and Human Services, including the prohibition against applying certain cumulative financial requirements or cumulative quantitative treatment limitations. Makes other changes.
Replaces everything after the enacting clause. Reinserts the engrossed bill with changes. Removes provisions in the Illinois Insurance Code concerning autism spectrum disorders and habilitative services for children. Provides that the provisions concerning mental health parity do not apply to individual health insurance coverage. Effective immediately.