Illinois General Assembly - Bill Status for SB0158
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 Bill Status of SB0158  98th General Assembly


Short Description:  PRIOR AUTHORIZATION REFORM ACT

Senate Sponsors
Sen. Linda Holmes - Christopher Belt and Omar Aquino

Last Action
DateChamber Action
  2/9/2021SenateReferred to Assignments

Statutes Amended In Order of Appearance
New Act
215 ILCS 134/45.2
215 ILCS 134/70
305 ILCS 5/5-5.12d new


Synopsis As Introduced
Creates the Prior Authorization Reform Act. Provides requirements concerning disclosure and review of prior authorization requirements, denial of claims or coverage by a utilization review program, and the implementation of prior authorization requirements or restrictions. Provides requirements concerning a utilization review program's obligations with respect to prior authorizations in nonurgent circumstances, urgent health care services, and emergency health care services. Provides that a utilization review program shall not require prior authorization under specified circumstances. Provides requirements concerning the length of prior authorizations. Provides that health care services are automatically deemed authorized if a utilization review program fails to comply with the requirements of the Act. Provides that the Director of Insurance may impose an administrative fine not to exceed $250,000 for violations of the Act. Defines terms. Amends the Managed Care Reform and Patient Rights Act to provide that an insurer that provides prescription drug benefits must comply with the requirements of the Prior Authorization Reform Act. Provides that if prior authorization for covered post-stabilization services is required by a health care plan, the plan shall comply with the requirements of the Prior Authorization Reform Act. Amends the Illinois Public Aid Code to provide that all managed care organizations shall comply with the requirements of the Prior Authorization Reform Act. Makes other changes. Effective January 1, 2022.

Actions 
DateChamber Action
  2/9/2021SenateFiled with Secretary by Sen. Linda Holmes
  2/9/2021SenateFirst Reading
  2/9/2021SenateReferred to Assignments
  3/24/2021SenateAdded as Chief Co-Sponsor Sen. Christopher Belt
  3/24/2021SenateAdded as Co-Sponsor Sen. Omar Aquino

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