# Illinois HB4893: MEDICAID-MCO BEHAVIORAL HLTH

Illinois HB4893, MEDICAID-MCO BEHAVIORAL HLTH, is a 104th General Assembly (2025–2026) House bill sponsored by Lindsey LaPointe (Democratic); status in committee, last action 2026-05-13 (Added Co-Sponsor Rep. Kevin John Olickal) (as of 2026-11-01).

- Canonical: https://policyrisk.com/state-bill/IL-HB4893-2025-2026
- As of: 2026-11-01
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: Illinois HB4893
- State: Illinois
- Session: 104th General Assembly (2025–2026)
- Title: MEDICAID-MCO BEHAVIORAL HLTH
- Status: in committee
- Chamber: House
- Introduced: 2026-02-03
- Last action: 2026-05-13, Added Co-Sponsor Rep. Kevin John Olickal
- Sponsor: Lindsey LaPointe (Democratic)
- Cosponsors: 13
- 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. Provides that the Department of Healthcare and Family Services must incorporate minimum standards governing behavioral health pre-payment and post-payment reviews into MCO contracts effective for all services covered on and after January 1, 2027. Requires the Department to develop or adopt behavioral health-specific pre-payment and post-payment review guidelines and incorporate such guidelines by reference into MCO contracts. Provides that the Department-issued guidelines must: (1) define the documentation and clearly specify the discrete data elements that may be requested prior to and during a pre-payment or post-payment review, and applicable response timeframes, ensuring that all requests are specific, reasonable, and directly tied to the review objectives; (2) identify regulatory, statutory, and contractual standards applicable to behavioral health services; (3) establish uniform evaluation criteria and checklists; and (4) be publicly available and updated as necessary. Contains provisions on MCO contracts and required contract terms; pre-payment and post-payment review processes and notice requirements; timeframes for providers to respond to a documentation request; communication protocols; contract transparency and extrapolation from a statistical sampling of claims; the timeliness and closure of claims reviews; submission methods; reviewer qualifications; and enforcement. Effective immediately.

## Bill overview

No economic impacts identified for this bill.

## Sponsors and cosponsors

- Sponsor: Lindsey LaPointe (Democratic), House
- Cosponsor: Anne Stava (Democratic), House
- Cosponsor: Barbara Hernandez (Democratic), House
- Cosponsor: Carol Ammons (Democratic), House
- Cosponsor: Dagmara Avelar (Democratic), House
- Cosponsor: Debbie Meyers-Martin (Democratic), House
- Cosponsor: Diane Blair-Sherlock (Democratic), House
- Cosponsor: Joyce Mason (Democratic), House
- Cosponsor: Kevin John Olickal (Democratic), House
- Cosponsor: Laura Faver Dias (Democratic), House
- Cosponsor: Lisa Davis (Democratic), House
- Cosponsor: Nabeela Syed (Democratic), House
- Cosponsor: Rita Mayfield (Democratic), House
- Cosponsor: Theresa Mah (Democratic), House

## Actions (19)

- 2026-05-13: Added Co-Sponsor Rep. Kevin John Olickal (House)
- 2026-04-28: Added Co-Sponsor Rep. Debbie Meyers-Martin (House)
- 2026-04-13: Added Co-Sponsor Rep. Joyce Mason (House)
- 2026-04-06: Added Co-Sponsor Rep. Anne Stava (House)
- 2026-03-27: Rule 19(a) / Re-referred to Rules Committee (House)
- 2026-03-24: Added Co-Sponsor Rep. Carol Ammons (House)
- 2026-03-20: To Appropriations-Medicaid Subcommittee (House)
- 2026-03-19: Added Co-Sponsor Rep. Theresa Mah (House)
- 2026-03-19: Added Co-Sponsor Rep. Barbara Hernandez (House)
- 2026-03-16: Added Co-Sponsor Rep. Dagmara Avelar (House)
- 2026-03-13: Added Co-Sponsor Rep. Lisa Davis (House)
- 2026-03-13: Added Co-Sponsor Rep. Diane Blair-Sherlock (House)
- 2026-03-10: Added Co-Sponsor Rep. Nabeela Syed (House)
- 2026-03-09: Added Co-Sponsor Rep. Laura Faver Dias (House)
- 2026-03-09: Added Co-Sponsor Rep. Rita Mayfield (House)
- 2026-03-04: Assigned to Appropriations-Health and Human Services Committee (House)
- 2026-02-06: Referred to Rules Committee (House)
- 2026-02-06: First Reading (House)
- 2026-02-03: Filed with the Clerk by Rep. Lindsey LaPointe (House)

## Bill text

- Introduced: [PDF](https://www.ilga.gov/documents/legislation/104/HB/PDF/10400HB4893.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/10400HB4893.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-HB4893-2025-2026 (as of 2026-11-01).