HB 4055

Abstract

Amends the Prior Authorization Reform Act. Changes the definition of "emergency services" to provide that for the purposes of the provisions, emergency services are not required to be provided in the emergency department of a hospital. Provides that notwithstanding any other provision of law, a health insurance issuer or a contracted utilization review organization may not require prior authorization or approval by the health plan for emergency services. House Floor Amendment No. 2 Deletes reference to: 215 ILCS 200/15 215 ILCS 200/20.5 new Adds reference to: 215 ILCS 200/77 new Replaces everything after the enacting clause. Amends the Prior Authorization Reform Act. Provides that notwithstanding any other provision of law, a health insurance issuer or a contracted utilization review organization may not require a prior authorization for drug therapies approved by the U.S. Food and Drug Administration for the treatment of hereditary bleeding disorders any more frequently than 6 months or the length of time the prescription for that dosage remains valid, whichever period is shorter. Effective January 1, 2026.