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Neutral Bill Mar 16, 2026

MEDICAID-RX-MENTAL ILLNESS

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 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. Removes provisions conditioning the receipt of prescription drugs without prior authorization on: (i) the patient changing providers while receiving a previously authorized prescription drug; (ii) the patient changing insurance coverage while receiving a previously authorized prescription drug; and (iii) the patient's prescription for a previously authorized drug modifies the dosage, dosage frequency, or both, of the drug as part of the same treatment for which the drug was previously prescribed.

https://legiscan.com/IL/bill/HB2438/2025
Maurice West State Representative
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