Illinois HB 4034: MEDICAID-RX-MENTAL ILLNESS

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104TH GENERAL ASSEMBLY 
State of Illinois 
2025 and 2026
HB4034

Introduced 4/7/2025, by Rep. Maurice A. West, II 

SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-5.12f

 Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions prohibiting prior authorization mandates and utilization management controls under the fee-for-service and managed care medical assistance programs on specified FDA-approved prescription drugs for mental illness, provides that the prohibition shall apply if a preferred or non-preferred drug is prescribed to an adult patient to treat a serious mental illness and (i) during the preceding 60 days, the patient who experienced an inadequate response was prescribed and unsuccessfully treated with a 14-day treatment trial of a drug for the same clinical condition that is included on the preferred drug list and (ii) one of the statutory conditions apply.

LRB104 12955 KTG 24520 b

A BILL FOR

HB4034LRB104 12955 KTG 24520 b

1 AN ACT concerning public aid.

2 Be it enacted by the People of the State of Illinois, 

3represented in the General Assembly:

4 Section 5. The Illinois Public Aid Code is amended by 

5changing Section 5-5.12f as follows:

6 (305 ILCS 5/5-5.12f)

7 Sec. 5-5.12f. Prescription drugs for mental illness; no 

8utilization or prior approval mandates. 

9 (a) Notwithstanding any other provision of this Code to 

10the contrary, except as otherwise provided in subsection (b), 

11for the purpose of removing barriers to the timely treatment 

12of serious mental illnesses, prior authorization mandates and 

13utilization management controls shall not be imposed under the 

14fee-for-service and managed care medical assistance programs 

15on any FDA-approved prescription drug that i