HB4844 Summary

• Requires group and individual health insurance policies and managed care plans amended, delivered, issued, or renewed after the effective date to cover evidence-based treatment for serious mental illnesses and serious emotional disturbances during early stages, including assertive community treatment, community support team treatment, and first episode psychosis treatment.

• Payment for covered bundled treatment services shall be based on all components of the treatment model combined rather than individual services, with coverage scope comparable to services covered under the Medical Assistance Program.

• Eliminates disability or functional impairment as preconditions for medical necessity determinations, presuming medical necessity following psychiatric inpatient hospitalization when treatment is recommended by qualified mental health professionals.

• Renders coverage requirements inoperative if federal regulations require the State to defray costs, exempting the State from assuming any cost obligation for this coverage.

• Makes conforming amendments to the State Employees Group Insurance Act, Counties Code, Illinois Municipal Code, School Code, Health Maintenance Organization Act, Limited Health Service Organization Act, and Voluntary Health Services Plans Act; effective immediately.