Illinois HB 4650: HEALTH INSURANCE POLICIES

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104TH GENERAL ASSEMBLY 
State of Illinois 
2025 and 2026
HB4650

Introduced 2/3/2026, by Rep. Lindsey LaPointe 

SYNOPSIS AS INTRODUCED:

215 ILCS 5/370c from Ch. 73, par. 982c

 Amends the Illinois Insurance Code. Provides that, in conducting utilization review of all covered health care services for the diagnosis, prevention, and treatment of mental, emotional, and nervous disorders or conditions, an insurer shall apply the criteria and guidelines set forth in the most recent version of the treatment criteria developed by an unaffiliated professional organization (instead of an unaffiliated nonprofit professional association) for the relevant clinical specialty or, for Medicaid managed care organizations, criteria and guidelines determined by the Department of Healthcare and Family Services that are consistent with generally accepted standards of mental, emotional, nervous or substance use disorder or condition care. Provides that insurers may not apply utilization review criteria developed by any entity that has a financial stake in the outcome of the utilization review decisions. Makes changes to provisions concerning utilization review relating to level of care placement, continued stay, transfer, discharge, or any other patient care decisions that are within the scope of the specified sources.

LRB104 18397 BAB 31839 b

A BILL FOR

HB4650LRB104 18397 BAB 31839 b

1 AN ACT concerning regulation.

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

3represented in the General Assembly:

4 Section 5. The Illinois Insurance Code is amended by 

5changing Section 370c as follows:

6 (215 ILCS 5/370c) (from Ch. 73, par. 982c)

7 Sec. 370c. Mental and emotional disorders. 

8 (a)(1) On and after January 1, 2022 (the effective d