Prairie State Wire

ISMS-backed House Bill 1085, initiated by Thresholds, recently passed the Illinois Senate during the Fall Veto Session in Springfield. The bill aims to establish a formula for minimum reimbursement rates for behavioral healthcare services using Illinois-specific data collected by the Research Triangle Institute. The legislation had previously passed the Illinois House in April.

The proposed law seeks to improve access to mental health care by increasing reimbursement rates for behavioral healthcare services, which are currently lower than those for other physical health services. It also addresses network adequacy by aiming to reduce barriers that prevent behavioral healthcare professionals from joining insurance networks, such as insufficient reimbursement rates.

House Bill 1085 includes requirements for insurance coverage of mental health and substance use services received on the same day and mandates coverage for 60-minute therapy sessions.

Under this legislation, the Illinois Department of Insurance (IDOI) would be responsible for adopting rules based on data from the Research Triangle Institute—data already used by insurance companies and Medicaid agencies—to set minimum reimbursement rates for mental health services. The IDOI would also have authority to monitor and enforce these rates.

The bill provides a pathway for behavioral health trainees to work toward licensure under supervision from a fully licensed provider.

If signed into law by Governor Pritzker, these changes would apply to insurance plans beginning January 1, 2027. However, it is important to note that the legislation does not apply to Medicaid patients or individuals covered by state employee health plans.