Illinois Governor J.B. Pritzker toured the Metro East on Monday to support a groundbreaking bill that would make his state the first in the nation to prohibit the practice of requiring prior authorization for in-patient mental health admissions for the first 72 hours. The Healthcare Protection Act aims to eliminate “step therapy,” a process where insurance companies can insist on trying alternative treatments before the doctor’s first choice.
Dr. Jennifer Neville, a physician at Memorial Hospital in Belleville, spoke about the challenges patients face when they need higher tier medications due to their health conditions. Despite being the best option for their patient, these prescriptions are often initially denied by insurers, leading to long appeals processes and delays in receiving appropriate treatment.
The legislation includes provisions that would require the Illinois Department of Insurance to approve rate hikes for large group plans and mandates insurance companies to maintain accurate lists of network doctors, ensuring patients can promptly access medical care. A.J. Wilhelmi, president and CEO of the Illinois Health and Hospital Association, criticized cost-control strategies used by insurers that sacrifice patient care for financial gain.
The bill has received bipartisan support in the House and is now awaiting consideration by the Senate. Governor Pritzker expressed confidence that it will be passed before the end of this session on May 24th. The proposed legislation prioritizes patients’ health needs over cost-saving measures for insurance companies, taking a positive step towards improving healthcare access and outcomes in Illinois.