IL SB3741

Amends Illinois Insurance Code Section 370c to prohibit prior authorization requirements (including limitations on dosage) for FDA-approved medications prescribed for substance use disorder treatment, except those established under American Society of Addiction Medicine criteria.

Requires insurers to place all FDA-approved substance use disorder medications on the lowest formulary tier for both brand and generic drugs, and prohibits step therapy requirements except those established under addiction medicine treatment criteria.

Prohibits insurers from excluding coverage for court-ordered substance use disorder medications and associated counseling or wraparound services.

Amends Illinois Public Aid Code Section 5-5 to clarify that medication-assisted treatment for alcohol and opioid dependence under Medicaid cannot be subject to prior authorization, utilization controls, lifetime limits, or dosage limitations.

Establishes requirements for insurers conducting utilization review to achieve 90% interrater reliability pass rates and maintain documentation of testing and remediation actions for substance use disorder and mental health benefit determinations.