IllinoisHB1085104th General Assembly (2025–2026)HouseWALLET

INS CD-MENTAL HEALTH PARITY

Sponsored By: Sponsor information unavailable

Signed by Governor

Summary

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.

mental health & addictionassignmentsexecutive

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Bill Overview

Analyzed Economic Effects

6 provisions identified: 6 benefits, 0 costs, 0 mixed.

Covered care while providers join networks

These rules apply to covered plans amended, delivered, issued, or renewed beginning January 1, 2027, excluding Medicaid and CHIP. Plans must pay contracted rates for medically necessary behavioral health care given between a completed application and the contract’s effective date. The provider must complete a contract, submit claims after it takes effect, then tell patients the services may count as in-network. Plans must also cover medically necessary pre-contract care by fully licensed group-practice clinicians who have submitted completed network applications. Those clinicians must work under fully licensed in-network supervisors in the same practice and bill under their supervisors’ rendering provider numbers.

Minimum payments for behavioral health providers

Covered plans amended, delivered, issued, or renewed beginning January 1, 2027 must meet minimum in-network behavioral health payment rates. These cover Illinois providers and facilities, including inpatient, outpatient, office, and residential care; Medicaid and CHIP plans are excluded. Based on the April 2024 RTI study, the formula uses average Illinois medical and surgical clinician reimbursement percentages. It adds half the gap to the 75th percentile, then applies updated local benchmarks, including federal hospital payment formulas. Administrators must also comply; federal-linked floors start with benchmark changes, cannot fall below prior-year floors, and do not set patient charges.

More covered mental health care options

These protections apply to covered plans amended, delivered, issued, or renewed beginning January 1, 2027, excluding Medicaid and CHIP. Plans must cover all medically necessary same-day mental health or substance use services, whether inpatient or outpatient. This includes care from the same or different providers or facilities. Plans must also cover medically necessary care from trainees working toward state clinical licenses under qualifying fully licensed supervisors, billed under the supervisor’s rendering provider number. Medically necessary 60-minute individual psychotherapy, code 90837, must be covered without tougher paperwork requirements or more frequent audits than other psychotherapy codes.

Stronger health coverage for public employees

The law takes effect June 1, 2026. Covered county, municipal, and school employee plans must follow state mental health and substance use coverage protections. This includes the new requirements that apply to plans amended, delivered, issued, or renewed beginning January 1, 2027. Self-insured counties, including home-rule counties, municipalities, and school districts must also provide post-mastectomy benefits that meet state insurance standards.

Enforcement backs patients’ behavioral health protections

Illinois insurance regulators can enforce the new behavioral health protections through $1,000 penalties per violation against insurers or their administrators. Regulators must first give notice and an opportunity for a hearing; these are not fines on patients. The Department of Insurance must adopt implementing rules by September 1, 2026. It must review results at 2, 7, and 12 years after implementation, including network access and out-of-network use. Reports due December 31 in 2030, 2035, and 2040 must also examine patient costs and premiums.

Faster network reviews for behavioral providers

These rules apply to covered plans amended, delivered, issued, or renewed beginning January 1, 2027, excluding Medicaid and CHIP. Plans and their administrators must finish the contracting process, including credential checks, within 60 days of receiving a completed application. This deadline does not guarantee a contract. Insurers and administrators must give applying providers their credentialing policies when asked. They must also post nonproprietary application requirements, a materials checklist, and network contact information online.

Sponsors & Cosponsors

Sponsors

There is no primary sponsor on record.

Cosponsors

  • Abdelnasser Rashid

    Democratic • House

  • Adriane L. Johnson

    Democratic • Senate

  • Angelica Guerrero-Cuellar

    Democratic • House

  • Ann M. Williams

    Democratic • House

  • Anna Moeller

    Democratic • House

  • Anne Stava

    Democratic • House

  • Anthony DeLuca

    Democratic • House

  • Barbara Hernandez

    Democratic • House

  • Bill Cunningham

    Democratic • Senate

  • Bob Morgan

    Democratic • House

  • Brad Stephens

    Republican • House

  • Camille Y. Lilly

    Democratic • House

  • Carol Ammons

    Democratic • House

  • Christopher Belt

    Democratic • Senate

  • Cristina Castro

    Democratic • Senate

  • Dagmara Avelar

    Democratic • House

  • Dave Vella

    Democratic • House

  • David Koehler

    Democratic • Senate

  • Debbie Meyers-Martin

    Democratic • House

  • Don Harmon

    Democratic • Senate

  • Emanuel "Chris" Welch

    Democratic • House

  • Graciela Guzmán

    Democratic • Senate

  • Gregg Johnson

    Democratic • House

  • Harry Benton

    Democratic • House

  • Hoan Huynh

    Democratic • House

  • Jaime M. Andrade, Jr.

    Democratic • House

  • Janet Yang Rohr

    Democratic • House

  • Javier L. Cervantes

    Democratic • Senate

  • Jay Hoffman

    Democratic • House

  • Jehan Gordon-Booth

    Democratic • House

  • John M. Cabello

    Republican • House

  • Joyce Mason

    Democratic • House

  • Karina Villa

    Democratic • Senate

  • Katie Stuart

    Democratic • House

  • Kelly M. Cassidy

    Democratic • House

  • Kevin John Olickal

    Democratic • House

  • Kevin Schmidt

    Republican • House

  • Kimberly A. Lightford

    Democratic • Senate

  • La Shawn K. Ford

    Democratic • House

  • Lakesia Collins

    Democratic • Senate

  • Laura Ellman

    Democratic • Senate

  • Laura Faver Dias

    Democratic • House

  • Laura Fine

    Democratic • Senate

  • Laura M. Murphy

    Democratic • Senate

  • Lawrence "Larry" Walsh, Jr.

    Democratic • House

  • Lilian Jiménez

    Democratic • House

  • Lindsey LaPointe

    Democratic • House

  • Lisa Davis

    Democratic • House

  • Margaret A. DeLaRosa

    Democratic • House

  • Mark L. Walker

    Democratic • Senate

  • Martha Deuter

    Democratic • House

  • Mary Beth Canty

    Democratic • House

  • Mary Edly-Allen

    Democratic • Senate

  • Mary Gill

    Democratic • House

  • Matt Hanson

    Democratic • House

  • Mattie Hunter

    Democratic • Senate

  • Maura Hirschauer

    Democratic • House

  • Maurice A. West, II

    Democratic • House

  • Meg Loughran Cappel

    Democratic • Senate

  • Michael Crawford

    Democratic • House

  • Michael J. Kelly

    Democratic • House

  • Michelle Mussman

    Democratic • House

  • Mike Porfirio

    Democratic • Senate

  • Mike Simmons

    Democratic • Senate

  • Nabeela Syed

    Democratic • House

  • Nicole La Ha

    Republican • House

  • Nicolle Grasse

    Democratic • House

  • Norma Hernandez

    Democratic • House

  • Patrick J. Joyce

    Democratic • Senate

  • Paul Faraci

    Democratic • Senate

  • Rachel Ventura

    Democratic • Senate

  • Ram Villivalam

    Democratic • Senate

  • Rick Ryan

    Democratic • House

  • Robert "Bob" Rita

    Democratic • House

  • Robert F. Martwick

    Democratic • Senate

  • Robert Peters

    Democratic • Senate

  • Robyn Gabel

    Democratic • House

  • Ryan Spain

    Republican • House

  • Sara Feigenholtz

    Democratic • Senate

  • Sharon Chung

    Democratic • House

  • Sonya M. Harper

    Democratic • House

  • Stephanie A. Kifowit

    Democratic • House

  • Sue Scherer

    Democratic • House

  • Suzanne M. Ness

    Democratic • House

  • Suzy Glowiak Hilton

    Democratic • Senate

  • Terra Costa Howard

    Democratic • House

  • Theresa Mah

    Democratic • House

  • Tracy Katz Muhl

    Democratic • House

  • Will Guzzardi

    Democratic • House

  • Yolonda Morris

    Democratic • House

Roll Call Votes

All Roll Calls

Yes: 336 • No: 94

House vote • 10/30/2025

Senate Committee Amendment No. 1 House Concurs

Yes: 86 • No: 19 • Other: 1

House vote • 10/30/2025

Senate Committee Amendment No. 1 Motion to Concur Recommends Be Adopted Rules Committee;

Yes: 3 • No: 2

House vote • 10/30/2025

Senate Floor Amendment No. 3 Motion to Concur Recommends Be Adopted Rules Committee;

Yes: 3 • No: 2

House vote • 10/30/2025

Senate Floor Amendment No. 3 House Concurs

Yes: 86 • No: 19 • Other: 1

Senate vote • 10/30/2025

Senate Floor Amendment No. 3 Recommend Do Adopt Executive;

Yes: 11 • No: 2

Senate vote • 10/30/2025

Third Reading - Passed;

Yes: 48 • No: 10

Senate vote • 5/30/2025

Do Pass as Amended Executive;

Yes: 10 • No: 2

House vote • 4/7/2025

Third Reading - Short Debate - Passed

Yes: 72 • No: 33

House vote • 3/6/2025

Do Pass as Amended / Short Debate Mental Health & Addiction Committee;

Yes: 17 • No: 5

Bill Text

  • Engrossed

  • Enrolled

  • House Amendment 1

  • Introduced

  • Senate Amendment 1

  • Senate Amendment 2

  • Senate Amendment 3

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