Governor J.B. Pritzker visited the Metro East to advocate for a measure that would ban the practice of requiring prior authorization for in-patient mental health admissions in Illinois for the first 72 hours, making it the first state in the country to do so. The Healthcare Protection Act would also eliminate “step therapy,” which forces patients to try alternative treatments before receiving the doctor’s recommended option.
Dr. Jennifer Neville of Memorial Hospital discussed the challenges her patients face when insurance companies deny prescriptions that are crucial for their health. She explained that the appeal process and delays in seeing specialists can result in unnecessary costs and time for the patient. These difficulties are all too common in the current system.
In addition to addressing prior authorization and step therapy, the legislation would also require the Illinois Department of Insurance to approve rate increases for large group plans and mandate that insurance companies maintain up-to-date lists of network doctors. This would help reduce delays in patient care and ensure that doctors have the final say in treatment decisions.
A.J. Wilhelmi, of the Illinois Health and Hospital Association, criticized insurance companies for prioritizing their profits over patient care. He emphasized the importance of allowing physicians to make decisions based on what is best for patients, rather than cost-saving strategies.
The bill has already passed the House with bipartisan support and is awaiting approval in the Senate. Governor Pritzker expressed confidence that the bill will pass before the end of the current session on May 24th. The proposed legislation aims to improve access to mental health care and ensure that patients receive the treatments they need without unnecessary delays or denials from insurance companies.