New Illinois bill addresses health insurance concerns

ROCKFORD, Ill. (WIFR) – Giving the power of quality health care access to patients and their doctors, a new health care bill makes its way through Illinois’ legislature.

The Healthcare Protection Act targets insurance companies that decide what treatment options a patient has, and how quickly they can be received. HPA passed the Illinois House of Representatives with an 81-25 vote. Receiving bipartisan support, Governor JB Pritzker says for too long, insurance agencies have made decisions that medical professionals are more qualified to make.

“We’re protecting Illinois families,” Pritzker says. “We’re talking to doctors and patients and consumers with one message: this bill will save lives and it will lower costs for millions of Illinoisians.”

Supporters say the bill would not only stop insurance companies from unfairly hiking rates, but it would also eliminate prior authorization for crisis mental health situations and ban what is known as step-therapy; when an insurance company requires a patient to use a cheaper, less-effective treatment than the one prescribed by a doctor.

OSF Chief Medical Officer Dr. Lisa Davis says doctors would agree they spend too much time dealing with the red tape from insurance companies that could have been spent treating patients.

“Well, you need a prior authorization. We get the prior authorization, something comes up and now ‘Oh, it’s expired.’ Now you have to wait and do it again and the whole time the patients sitting here, but not getting the true care that they need,” Davis says.

HPA also puts an end to plans that don’t meet the minimum requirements of the Affordable Care Act, joining 12 other states with the same ruling. The bill would also improve network adequacy, ensuring people can easily find healthcare professionals by requiring insurance companies to update their provider directories regularly to accurately show provider availability.

“We are requiring insurance companies to use the same treatment criteria to determine medical necessity that doctors do,” Pritzker says. “That way patients get what they need.”

HPA will also require insurance agencies to post which treatments need prior authorization. Should the bill pass the Senate, Illinois will be the first state to ban prior authorization when it comes to inpatient mental health.

Expected to be discussed on the Senate floor in the coming months, HPA supporters are confident the bill will pass.

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