STANDARDIZED PRIOR AUTH ACT
Sponsored By: Rita Mayfield (Democratic)
In Committee
Summary
Creates the Standardized Prior Authorization Act. Requires a health insurance issuer to maintain a complete list of services for which prior authorization is required and to make any current prior authorization requirements and restrictions readily accessible and conspicuously posted on its website or online portals to enrollees, health care professionals, and health care providers. Sets forth further provisions concerning disclosure and review of prior authorization requirements; standard prior authorizations; expedited prior authorizations; notifications of adverse determinations; appeals of adverse determinations; prohibitions on revocation of prior authorization and nonpayment by a health insurance issuer; the length of approvals; approvals for chronic conditions; continuity of prior approvals; and enforcement and administration of the Act. Requires a health insurance issuer to periodically review its prior authorization requirements and consider removal of prior authorization requirements. Provides that a failure by a health insurance issuer to comply with the deadlines and other requirements specified in the Act shall result in any health care services subject to review to be automatically deemed authorized by the health insurance issuer or its contracted private review agent. Establishes reporting and notification requirements for health insurance issuers. Grants rulemaking authority to the Department of Insurance. Repeals the Prior Authorization Reform Act. Amends the Illinois Insurance Code and the Illinois Public Aid Code to make conforming changes. Effective January 1, 2027.
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Bill Overview
No Economic Impacts Identified for this Bill
Sponsors & Cosponsors
Sponsor
Rita Mayfield
Democratic • House
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
No roll call votes available for this bill.
Actions Timeline
Rule 19(a) / Re-referred to Rules Committee
3/27/2026HouseAssigned to Insurance Committee
3/18/2026HouseReferred to Rules Committee
2/6/2026HouseFirst Reading
2/6/2026HouseFiled with the Clerk by Rep. Rita Mayfield
1/29/2026House
Bill Text
Introduced
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