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IllinoisHB1864104th General Assembly (2025–2026)HouseWALLET

DENTAL CARE-ELECTRONIC BILLING

Sponsored By: Robert "Bob" Rita (Democratic)

Became Law

insuranceassignments

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Bill Overview

Analyzed Economic Effects

4 provisions identified: 2 benefits, 0 costs, 2 mixed.

Dental plans must offer benefits portal

Beginning January 1, 2027, each dental plan must give a HIPAA-compliant online portal. It shows real-time eligibility, covered services, deductibles left, coinsurance, and plan and lifetime maximums. It also lists limits and prior authorizations and shows coverage by ADA CDT code and payment amounts. Providers can submit claims and attachments through the portal and get per-claim remittance details. The portal is free for dental care providers.

Dentists can refuse all electronic payments

Beginning January 1, 2027, carriers cannot force dentists to take only electronic payments. Dentists may choose other payment methods.

Exemptions and two-year grace for dentists

Beginning January 1, 2027, some dental providers do not have to file claims electronically. This applies if a tech outage lasts over 14 days, a solo dentist works under 16 hours a week, or a dentist is temporarily running another’s practice. Exempt providers must file an exemption form with the Illinois Department of Insurance, which provides the form by January 1, 2027. If you start or buy a practice and were previously exempt, you have two years from that date to comply.

Standard electronic claims rules for dentists

Dental plan carriers and dentists must exchange claims, payments, and eligibility checks electronically using HIPAA-standard transactions. A claim must be sent this way for the plan to pay it. They must follow all State and federal privacy and security laws. The Department of Insurance sets uniform rules and may create exemptions. Carriers and providers cannot add extra electronic requirements beyond the State standards.

Sponsors & Cosponsors

Sponsor

  • Robert "Bob" Rita

    Democratic • House

Cosponsors

  • Camille Y. Lilly

    Democratic • House

  • Dave Syverson

    Republican • Senate

  • Hoan Huynh

    Democratic • House

  • Javier L. Cervantes

    Democratic • Senate

Roll Call Votes

All Roll Calls

Yes: 340 • No: 5

House vote • 5/31/2025

Senate Committee Amendment No. 1 House Concurs

Yes: 117 • No: 0

House vote • 5/29/2025

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

Yes: 15 • No: 0

Senate vote • 5/21/2025

Third Reading - Passed;

Yes: 58 • No: 0

Senate vote • 5/14/2025

Do Pass as Amended Insurance;

Yes: 10 • No: 0

House vote • 4/9/2025

Third Reading - Short Debate - Passed

Yes: 116 • No: 0

House vote • 4/8/2025

House Floor Amendment No. 1 Recommends Be Adopted Insurance Committee;

Yes: 14 • No: 0

House vote • 3/18/2025

Do Pass / Short Debate Insurance Committee;

Yes: 10 • No: 5

Actions Timeline

  1. Public Act . . . . . . . . . 104-0203

    8/15/2025House

  2. Effective Date January 1, 2027; some provisions

    8/15/2025House

  3. Effective Date August 15, 2025; some provisions

    8/15/2025House

  4. Governor Approved

    8/15/2025House

  5. Sent to the Governor

    6/24/2025House

  6. Passed Both Houses

    5/31/2025House

  7. House Concurs

    5/31/2025House

  8. Senate Committee Amendment No. 1 House Concurs 117-000-000

    5/31/2025House

  9. Senate Committee Amendment No. 1 Motion to Concur Recommends Be Adopted Insurance Committee; 015-000-000

    5/29/2025House

  10. Senate Committee Amendment No. 1 Motion to Concur Rules Referred to Insurance Committee

    5/28/2025House

  11. Senate Committee Amendment No. 1 Motion to Concur Referred to Rules Committee

    5/21/2025House

  12. Senate Committee Amendment No. 1 Motion Filed Concur Rep. Robert "Bob" Rita

    5/21/2025House

  13. Placed on Calendar Order of Concurrence Senate Amendment(s) 1

    5/21/2025House

  14. Arrived in House

    5/21/2025House

  15. Third Reading - Passed; 058-000-000

    5/21/2025Senate

  16. Placed on Calendar Order of 3rd Reading May 20, 2025

    5/15/2025Senate

  17. Second Reading

    5/15/2025Senate

  18. Placed on Calendar Order of 2nd Reading May 15, 2025

    5/14/2025Senate

  19. Do Pass as Amended Insurance; 010-000-000

    5/14/2025Senate

  20. Senate Committee Amendment No. 1 Adopted

    5/13/2025Senate

  21. Senate Committee Amendment No. 1 Assignments Refers to Insurance

    5/13/2025Senate

  22. Senate Committee Amendment No. 1 Referred to Assignments

    5/12/2025Senate

  23. Senate Committee Amendment No. 1 Filed with Secretary by Sen. Javier L. Cervantes

    5/12/2025Senate

  24. Rule 2-10 Committee Deadline Established As May 23, 2025

    5/9/2025Senate

  25. Assigned to Insurance

    5/6/2025Senate

Bill Text

  • Engrossed

    PDF

  • Enrolled

    PDF

  • House Amendment 1

    PDF

  • Introduced

    PDF

  • Senate Amendment 1

    PDF

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