SB0420 Summary

• Illinois Department of Healthcare and Family Services must cover FDA-approved medication-assisted treatments for alcohol and opioid dependence without utilization controls, prior authorization requirements, or lifetime limits.

• Opioid antagonists (including naloxone) prescribed for opioid overdose treatment, including medication product, administration devices, and pharmacy fees, must be covered under the medical assistance program.

• Low-dose mammography coverage expanded to include breast tomosynthesis (three-dimensional imaging) for eligible women 35 years and older seeking breast cancer screening.

• All durable medical equipment providers must obtain accreditation from a federal Centers for Medicare and Medicaid Services-approved organization within 15 months of rule adoption to bill the Department.

• Department may exempt certain replacement wheelchair parts from prior approval requirements and determine wholesale pricing for wheelchairs and wheelchair accessories using methods other than actual acquisition costs.