IL SB2381

Renumbers Section 356z.33 as Section 356z.36 of the Illinois Insurance Code to address coverage of treatment models for early serious mental illness in children and young adults under age 26.

Requires group and individual health insurance policies and managed care plans amended, delivered, issued, or renewed after December 31, 2020 to provide coverage of coordinated specialty care for first episode psychosis and assertive community treatment/community support team services.

Mandates 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 bundled payment models for treatment services rather than individual service billing, with the Department of Insurance convening workgroups to develop coding solutions by June 30, 2020.

Permits coverage suspension if premiums increase by more than 1% annually solely due to these treatment models, after independent analysis requested by an insurer 5 years following full implementation.