IL HB2456

Prohibits prior authorization mandates and utilization management controls for FDA-approved prescription drugs used to treat serious mental illnesses under Illinois medical assistance programs (fee-for-service and managed care).

Allows drug utilization review edits (drug-to-drug, drug-age, drug-dose interactions), generic drug substitution when available in the same dosage and formulation, and utilization controls required by consent decrees or federal waivers.

Defines "serious mental illness" to include 22 specific diagnoses with ICD-10-CM codes, including schizophrenia, bipolar disorder, major depressive disorder, PTSD, OCD, eating disorders, and postpartum depression/psychosis.

Applies to FDA-approved prescription drugs recognized by generally accepted standard medical references as effective for treating conditions listed in the most recent Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association.