Illinois’ Looming Step Therapy Ban Is ‘Game Changer,’ Could Start Trend

The Illinois legislature recently passed several health insurance reform regulations, most notably banning step therapy for covered services, prohibiting prior authorization for inpatient mental health services and eliminating short-term health plans. Health policy experts tell AIS Health, a division of MMIT, that the Healthcare Protection Act (HPA) goes further than other state laws by banning step therapy outright — a move other states could opt to follow.

Democratic Gov. JB Pritzker, who proposed the HPA in his fiscal year 2025 budget address in February, is soon expected to sign the act into law. It will apply to Medicaid, Affordable Care Act exchange, fully insured employer sponsored and state employee health plans, but it will exclude self-insured and Medicare plans that are regulated at the federal level.

0 Comments
© 2024 MMIT
Tim Casey

Tim Casey

Tim has been a reporter and editor for newspapers, websites and magazines for more than 20 years, including 10 years covering health care business topics. He has a deep knowledge of the managed care industry and pharmacy benefit management. He also has experience covering medical conferences and clinical and legislative health care issues. In 2014, the Society for Advancing Business Editing and Writing selected Tim as one of 15 journalists to participate in a national symposium on the Affordable Care Act. Tim has a B.A. in Psychology from the University of Notre Dame and an M.B.A. from Georgetown University.

Related Posts

cms-website
February 23

Panelists: CMS Prior Authorization Rule Should Help, But More Is Needed

READ MORE
hhs-flag
April 5

Feds Finalize Strict Short-Term Plan Limits, Walk Back Fixed Indemnity Crackdown

READ MORE
doc-writing-prescription
November 9

Survey Highlights Dynamic Employer Response to Rising Obesity Drug Costs

READ MORE

GAIN THERAPEUTIC AREA-SPECIFIC INTEL TO DRIVE ACCESS FOR YOUR BRAND

Sign up for publications to get unmatched business intelligence delivered to your inbox.

subscribe today