Illinois HB 5497: INS-BEHAV HEALTH EMERG SERVICE

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104TH GENERAL ASSEMBLY 
State of Illinois 
2025 and 2026
HB5497

Introduced 2/13/2026, by Rep. Laura Faver Dias 

SYNOPSIS AS INTRODUCED:

215 ILCS 5/370c.5 new

215 ILCS 124/25.5 new

 Amends the Illinois Insurance Code. Provides that any policy of insurance amended, delivered, issued, or renewed on or after January 1, 2027 that provides coverage for emergency services for medical or surgical conditions shall also provide coverage for behavioral health emergency services on coverage terms no more restrictive than those applied to emergency services for medical or surgical conditions. Requires coverage for post-stabilization services. Sets forth provisions concerning behavioral health emergency services parity; coverage of services provided by nonlicensed staff performing under direct supervision; restrictions on prior authorization, utilization review, and cost sharing; reimbursement rates; and rulemaking. Amends the Network Adequacy and Transparency Act. Includes behavioral health emergency services providers in network adequacy determinations under the Act. Establishes provisions concerning rulemaking for the Department of Insurance; behavioral health emergency services requirements for health insurance issuers; and enforcement coordination with specified federal law. Effective January 1, 2027.

LRB104 20224 BAB 33675 b

A BILL FOR

HB5497LRB104 20224 BAB 33675 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 1. Findings. The General Assembly finds that:

5 (1) Individuals experiencing behavioral health 

6 emergencies, including mental health and substance use 

7 challenges, may face urgent situations that require 

8 immediate support