IL HB3517

Renames Section 356z.33 to Section 356z.36 of the Illinois Insurance Code concerning coverage of treatment models for early treatment of serious mental illnesses in individuals under age 26.

Requires insurance policies and managed care plans amended, delivered, issued, or renewed after December 31, 2020 to cover coordinated specialty care for first episode psychosis treatment and assertive community treatment (ACT) or community support team (CST) services.

Mandates that the Department of Insurance update its medical necessity rules during calendar year 2021 to include nationally recognized, evidence-based clinical criteria while avoiding unnecessary anti-competitive impacts.

Requires treatment services to be paid using bundled payment models rather than individual service billing, and limits credentialing requirements to the lead psychiatrist or clinical leader who may qualify all team members.

Includes a sunset provision allowing coverage to become optional if an independent analysis after 5 years shows premiums increased more than 1% annually due solely to these treatment model requirements.