# Illinois HB4378: DHFS-MANAGED CARE PROTECTIONS

Illinois HB4378, DHFS-MANAGED CARE PROTECTIONS, is a 104th General Assembly (2025–2026) House bill sponsored by Dagmara Avelar (Democratic); status in committee, last action 2026-04-22 (Added Co-Sponsor Rep. Tracy Katz Muhl) (as of 2026-11-01).

- Canonical: https://policyrisk.com/state-bill/IL-HB4378-2025-2026
- As of: 2026-11-01
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: Illinois HB4378
- State: Illinois
- Session: 104th General Assembly (2025–2026)
- Title: DHFS-MANAGED CARE PROTECTIONS
- Status: in committee
- Chamber: House
- Introduced: 2026-01-12
- Last action: 2026-04-22, Added Co-Sponsor Rep. Tracy Katz Muhl
- Sponsor: Dagmara Avelar (Democratic)
- Cosponsors: 1
- Subjects: appropriations-health and human services
- Touches household money: no
- Economic provisions PRIA read: 0

## Summary

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to adopt rules that require managed care organizations (MCOs) to utilize a universal provider application developed by a council for affordable quality healthcare, as defined, for the purpose of credentialing a health care professional or a health care provider who seeks to participate in an MCO's provider network. Provides that the rules shall also require the use of a CAQH application for the renewal of credentials; and that the Department may revise the CAQH universal provider application or the application for renewal of credentials to conform to industry or national standards for credentialing health care professionals or health care providers. Provides that within 180 days after the adoption of rules, health and dental plan carriers must accept the universal provider application and the application for the renewal of credentials approved by the Department. Requires all MCOs to provide a provider network consultant to act as a liaison between a health care provider and the MCO. Require the Department to employ provider enrollment consultants to assist health care providers with enrollment in the Illinois Medicaid Program Advanced Cloud Technology system, help navigate the enrollment and provider credentialing process by serving as the liaison between health care providers and MCOs, and other matters. Amends the Illinois Insurance Code. In provisions concerning recoupments, requires a health care professional or health care provider to be provided a remittance advice that includes an explanation of a recoupment or offset taken by a managed care organization. Removes provisions permitting insurers contracted with the Department of Healthcare and Family Services to recoup or offset payments due to a federal Medicaid requirement. Provides that no contract between an MCO and health care professional or provider may provide for recoupments in violation of the Code. Effective January 1, 2027.

## Bill overview

No economic impacts identified for this bill.

## Sponsors and cosponsors

- Sponsor: Dagmara Avelar (Democratic), House
- Cosponsor: Tracy Katz Muhl (Democratic), House

## Actions (7)

- 2026-04-22: Added Co-Sponsor Rep. Tracy Katz Muhl (House)
- 2026-03-27: Rule 19(a) / Re-referred to Rules Committee (House)
- 2026-03-20: To Appropriations-Medicaid Subcommittee (House)
- 2026-02-24: Assigned to Appropriations-Health and Human Services Committee (House)
- 2026-01-14: Referred to Rules Committee (House)
- 2026-01-14: First Reading (House)
- 2026-01-12: Filed with the Clerk by Rep. Dagmara Avelar (House)

## Bill text

- Introduced: [PDF](https://www.ilga.gov/documents/legislation/104/HB/PDF/10400HB4378.pdf)

## Related bills

- HB5198: AFFORDABLE HOUSING-CILAS (passed house)
- SB1937: PENSION CODE-VARIOUS (passed senate)
- HB2563: CONDO-RESERVE STUDY (in committee)
- HB4701: LIMITATIONS FACILITY FEES ACT (in committee)
- SB3008: DHS-ABLE PROGRAM INFO MATERIAL (passed senate)
- SB3484: VEH CD-PLATES-REGISTRATION (signed)

## Sources
- [Introduced (PDF)](https://www.ilga.gov/documents/legislation/104/HB/PDF/10400HB4378.pdf)

## Related
- [HB5198: AFFORDABLE HOUSING-CILAS](https://policyrisk.com/state-bill/IL-HB5198-2025-2026)
- [SB1937: PENSION CODE-VARIOUS](https://policyrisk.com/state-bill/IL-SB1937-2025-2026)
- [HB2563: CONDO-RESERVE STUDY](https://policyrisk.com/state-bill/IL-HB2563-2025-2026)
- [HB4701: LIMITATIONS FACILITY FEES ACT](https://policyrisk.com/state-bill/IL-HB4701-2025-2026)
- [SB3008: DHS-ABLE PROGRAM INFO MATERIAL](https://policyrisk.com/state-bill/IL-SB3008-2025-2026)
- [SB3484: VEH CD-PLATES-REGISTRATION](https://policyrisk.com/state-bill/IL-SB3484-2025-2026)
- [Illinois bills](https://policyrisk.com/states/illinois/bills)
- [Illinois state hub](https://policyrisk.com/states/illinois)
- [All state legislation](https://policyrisk.com/state-bills)

Source: PRIA, https://policyrisk.com/state-bill/IL-HB4378-2025-2026 (as of 2026-11-01).