IllinoisSB2152104th General Assembly (2025–2026)Senate

PRIOR AUTHORIZATION REFORM

Sponsored By: Cristina Castro (Democratic)

In Committee

Summary

Amends the Prior Authorization Reform Act. Provides that the Act applies to policies issued or delivered to persons who are enrolled in the State Employee Group Health Insurance Program to the extent required under a provision of the State Employees Group Insurance Act of 1971 concerning required health benefits. Provides that a health insurance issuer shall not require prior authorization where a covered medication, with the exception of benzodiazepines or Schedule II narcotic drugs: (1) is prescribed for the management and treatment of multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus, diabetes type 1, diabetes type 2, or pre-diabetes; and (2) is for a patient currently managed with an established treatment regimen for at least 12 months. Provides that nothing in the provision prevents a health care plan from denying an enrollee coverage or imposing a prior authorization requirement if the United States Food and Drug Administration has issued a statement about the drug that calls into question the clinical safety of the drug, the drug manufacturer has notified the United States Food and Drug Administration of a manufacturing discontinuance or potential discontinuance of the drug, or the drug manufacturer has removed the drug from the market. In a provision concerning the length of prior authorization approval for treatment of chronic or long-term condition, excludes a provision of the State Employees Group Insurance Act of 1971 concerning coverage for injectable medicines to improve glucose or weight loss. Effective January 1, 2027.

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Bill Overview

No Economic Impacts Identified for this Bill

Sponsors & Cosponsors

Sponsor

  • Cristina Castro

    Democratic • Senate

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

No roll call votes available for this bill.

Actions Timeline

  1. Rule 3-9(a) / Re-referred to Assignments

    4/11/2025Senate
  2. Rule 2-10 Committee Deadline Established As April 11, 2025

    4/4/2025Senate
  3. Rule 2-10 Committee Deadline Established As April 4, 2025

    3/21/2025Senate
  4. Postponed - Insurance

    3/5/2025Senate
  5. Assigned to Insurance

    2/25/2025Senate
  6. Directed to Multiple Committees Refer to Insurance Committee then Appropriations

    2/25/2025Senate
  7. Referred to Assignments

    2/7/2025Senate
  8. First Reading

    2/7/2025Senate
  9. Filed with Secretary by Sen. Cristina Castro

    2/7/2025Senate

Bill Text

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