IL SB2896

Requires group and individual health insurance policies and managed care plans amended, delivered, issued, or renewed on or after January 1, 2025, to cover all out-of-network medically necessary mental health and substance use services (inpatient and outpatient) as if they were in-network for cost sharing purposes, with no action required by the insured.

Establishes minimum reimbursement rates for mental health and substance use providers: at least 116% of Medicare Fee Schedule for out-of-network services and 141% for in-network services (or 119% and 144% respectively for non-Medicare-covered services).

Requires insurers to complete mental health and substance use provider credentialing within 30 calendar days of receiving a completed application, provide applicants written receipt within 5 days, and treat applicants as participating providers if credentialing is not completed within 30 days.

Mandates coverage and full reimbursement for multiple medically necessary mental health or substance use services received on the same day, supervisory billing for services provided under licensed provider supervision, and 60-minute individual psychotherapy visits (CPT Code 90837).

Authorizes the Department of Insurance to assess civil penalties of $20,000 per violation for non-compliance and requires adoption of implementing rules by November 1, 2024; applies parity requirements to third-party administrators administering behavioral health benefits.