Current:Home > reviewsPritzker signs law banning health insurance companies’ ‘predatory tactics,’ including step therapy -Dynamic Wealth Solutions
Pritzker signs law banning health insurance companies’ ‘predatory tactics,’ including step therapy
View
Date:2025-04-19 07:38:46
SPRINGFIELD, Ill. (AP) — Illinois Gov. J.B. Pritzker on Wednesday signed into law measures to block what he called insurance companies’ “predatory tactics to make an extra dime” by shortchanging consumers on their medical needs.
The Democrat signed legislation codifying one of his top initiatives of last spring’s legislation session, the Healthcare Protection Act, which outlaws step therapy, prior authorization for mental health crises and junk insurance.
At a Rush University System for Health facility in Chicago, Pritzker said the law is aimed at “empowering” patients and their doctors by “putting medical decisions back in their hands.”
“For too long, insurance companies have used predatory tactics to make an extra dime at the expense of Illinois consumers,” Pritzker said. “For too long, patients have (been) delayed or been denied medically necessary treatments because of profit-driver utilization management practices.”
The laws, parts of which take effect on Jan. 1, 2025 and others a year later, ban so-called step therapy, also known as “fail first.” The managed-care practice requires patients to use more cost-effective treatments first before allowing a more expensive option even if that is the physician-recommended course.
“Coverage doesn’t always equal care — until today,” said Bill Smith, founder and CEO of the nonprofit mental health advocacy group, Inseparable. “This law is for you if you or your loved ones have ever struggled to get the right medication to treat mental illness and have been told by your insurance company that you have to fail first with the wrong drugs before getting the treatment, that you need.”
The legislation was drawn up after consulting medical professionals on the roadblocks they face to providing effective care, according to Pritzker’s office.
Pre-authorization requirements for in-patient mental health emergencies is banned under the laws, as well as so-called junk insurance, policies that offer limited coverage or lack consumer protections. Insurance plans now must meet federal Affordable Care Act standards.
“It may be cheaper than being fully insured, but many of these junk plans do not cover behavioral health. They do not cover pre-existing conditions. They may not even cover hospitalization,” said one of sponsors of the legislation, Democratic Rep. Bob Morgan. “What kind of health plan doesn’t cover hospitalization? A plan that is not a plan at all.”
A rule issued last spring by the Biden administration shortens the length of such short-term insurance plans and their renewal periods and mandates that insurers provide information on their plans’ limitations.
Insurers must clearly explain prior authorization requirements in their advertising under the laws. And when in-network professionals must be used, the laws set standards for the numbers of network doctors and their appointment availability so that patients can quickly access care.
Last year, lawmakers and Pritzker put restrictions on unfair rate increases for individual policyholders under employers. The new laws extend that regulation to large group insurers too.
veryGood! (43)
Related
- Which apps offer encrypted messaging? How to switch and what to know after feds’ warning
- Judge gives preliminary approval for NCAA settlement allowing revenue-sharing with athletes
- These Amazon Prime Day Deals on Beauty Products You’ve Seen All Over TikTok Are Going Fast & Start at $5
- Love Is Blind's Hannah Jiles Shares Before-and-After Look at Weight Loss Transformation
- 'Most Whopper
- Angel Dreamer Wealth Society: Your Pathway to Financial Freedom through Expert Investment Education and AI Technology
- While Alabama fans grieve on Paul Finebaum Show, Kalen DeBoer enjoys path to recovery
- 2 ex-officers convicted in fatal beating of Tyre Nichols get home detention while 1 stays in jail
- McConnell absent from Senate on Thursday as he recovers from fall in Capitol
- Saints vs. Chiefs highlights: Chiefs dominate Saints in 'Monday Night Football' matchup
Ranking
- Friday the 13th luck? 13 past Mega Millions jackpot wins in December. See top 10 lottery prizes
- These Amazon Prime Day Deals on Beauty Products You’ve Seen All Over TikTok Are Going Fast & Start at $5
- Reese Witherspoon Reveals Where Big Little Lies Season 3 Really Stands
- Love Is Blind Star Garrett’s New Transformation Has Fans Convinced He’s Married
- Trump wants to turn the clock on daylight saving time
- Homeownership used to mean stable housing costs. That's a thing of the past.
- Toyota pushes back EV production plans in America
- These police officers had red flags in their past, then used force in a case that ended in death
Recommendation
Pressure on a veteran and senator shows what’s next for those who oppose Trump
Defendant pleads no contest in shooting of Native activist at protest of Spanish conquistador statue
'No chemistry': 'Love is Blind's' Leo and Brittany address their breakup
25 Rare October Prime Day 2024 Deals You Don’t Want to Miss—Save Big on Dyson, Ninja, Too Faced & More
US wholesale inflation accelerated in November in sign that some price pressures remain elevated
6-year-old dies after stepfather allegedly beat him with baseball bat
What does climate change mean to you? Here's what different generations say.
Jeep, Ram, Nissan, Tesla, Volkswagen among 359k vehicles recalled: Check car recalls here