Influential New Laws Expand Mental Healthcare in Illinois
Thresholds is thrilled to share the upcoming signage of several critical bills that will significantly improve access to quality care for Illinois residents. These bills will eliminate prior authorization for mental health stays (HB5395: Healthcare Protection Act), restrict junk insurance (HB2499: Eliminating Junk Insurance), and other instrumental changes to improve access to mental healthcare. The Healthcare Protection Act prohibits insurance companies from requiring prior authorization for the first 72 hours of an inpatient mental health stay, making a psychiatric hospitalization far more accessible when it is needed. It also bans step therapy, an insurance practice that requires a patient to try a lower-cost drug or therapy first.
“The elimination of prior authorization for the first 72 hours of inpatient mental health stays is a game-changer,” said Heather O’Donnell, Senior VP, Public Policy and Advocacy at Thresholds. “This removes a significant barrier for individuals experiencing a mental health crisis, ensuring they receive the immediate care they need and deserve.”
The ban on step therapy also eliminates a frustrating and potentially harmful practice. “Patients shouldn’t have to jump through hoops to access the treatment their doctor recommends,” O’Donnell shared. “This legislation empowers patients and providers to make informed decisions about the most effective course of care.”
HB2499 is also being signed, banning “junk insurance.” This is another victory for consumer protection, as previous plans left individuals with significant mental health needs vulnerable. This legislation gives individuals greater access to behavioral health coverage and services.
In addition, the increase of Medicaid psychiatry reimbursement rates and lifting of prior authorization for specific medications are crucial steps toward making quality mental healthcare more affordable for low-income residents. These measures will allow us to serve more Medicaid recipients and ensure they have the resources to stay on their medications and manage their conditions effectively.
The “Housing is Recovery Program” has expanded from age 21 to age 18 to include a wider range of younger adults who are exiting homelessness, demonstrating the joint commitment to addressing the root causes of mental health challenges. “Stable housing is a cornerstone of recovery,” said O’Donnell. “This program provides a crucial support system for those rebuilding their lives.”
These new laws create a more supportive environment for individuals seeking support at Thresholds and beyond. Our teams are committed to working within this improved system to deliver the highest quality care possible.
“With these advancements, we can transform mental healthcare in Illinois,” shared O’Donnell. “We look forward to continue working with individuals, families, and communities to make the most of this progress.”
Several other important bills are on their way to being signed in this year’s session, including:
- Requiring private insurance companies to reimburse behavioral health professionals at a fair rate (HB4475: Strengthening Parity, Network Adequacy & Access)
- Lowering the eligibility age for the Housing is Recovery Program from 21 to 18 (SB3297: Making the Housing is Recovery Program Available to Youth 18 and Older)
- Lifting prior authorization requirements for certain psychiatric medications (SB3668/Medicaid Omnibus)
- Increasing Medicaid psychiatry reimbursement rates (SB3668/Medicaid Omnibus)
- Establishing an Administrative Burden Task Force to reduce paperwork for mental health providers (HB5094: Establishes an Administrative Burden Task Force)
- Granting reasonable exam accommodations to people whose first language is not English and to people with disabilities (HB5457: IDFPR must grant reasonable exam accommodations)