Illinois 104th General Assembly Status: Introduced 14 D cosponsors

HB4893      — MEDICAID-MCO BEHAVIORAL HLTH

Last action — Added Co-Sponsor Rep. Kevin John Olickal

  1. 1
    Introduced
  2. 2
    In Committee
  3. 3
    Passed House
  4. 4
    Passed Senate
  5. 5
    To Executive
  6. 6
    Enacted

This bill has been introduced in the House. Introduced February 03, 2026. It must pass committee before a floor vote.

Next likely step: a committee referral and hearing.

Odds of enactment

Low chance

Based on the sponsor, cosponsors, and committee posture, this bill has a low chance of becoming law.

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A statistical estimate from our own model of past outcomes — an insight, not a guarantee. Policymaking is volatile.

Prognosis

Not enough signal yet

Not enough signal yet to read this bill's trajectory — we surface a likelihood only once there's real movement (stage, sponsorship, committee, or votes) to point to.

Based on stage, sponsorship breadth, committee status, recorded votes, and cross-state momentum — a description of the observable signals, not a prediction.

Summary

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services must incorporate minimum standards governing behavioral health pre-payment and post-payment reviews into MCO contracts effective for all services covered on and after January 1, 2027. Requires the Department to develop or adopt behavioral health-specific pre-payment and post-payment review guidelines and incorporate such guidelines by reference into MCO contracts. Provides that the Department-issued guidelines must: (1) define the documentation and clearly specify the discrete data elements that may be requested prior to and during a pre-payment or post-payment review, and applicable response timeframes, ensuring that all requests are specific, reasonable, and directly tied to the review objectives; (2) identify regulatory, statutory, and contractual standards applicable to behavioral health services; (3) establish uniform evaluation criteria and checklists; and (4) be publicly available and updated as necessary. Contains provisions on MCO contracts and required contract terms; pre-payment and post-payment review processes and notice requirements; timeframes for providers to respond to a documentation request; communication protocols; contract transparency and extrapolation from a statistical sampling of claims; the timeliness and closure of claims reviews; submission methods; reviewer qualifications; and enforcement. Effective immediately.

Bill Text

We don't have the full text on file for this bill yet.

Read HB4893 on the official Illinois source →

Action History

  1. Added Co-Sponsor Rep. Kevin John Olickal

  2. Added Co-Sponsor Rep. Debbie Meyers-Martin

  3. Added Co-Sponsor Rep. Joyce Mason

  4. Added Co-Sponsor Rep. Anne Stava

  5. Rule 19(a) / Re-referred to Rules Committee

  6. Added Co-Sponsor Rep. Carol Ammons

  7. To Appropriations-Medicaid Subcommittee

  8. Added Co-Sponsor Rep. Theresa Mah

  9. Added Co-Sponsor Rep. Barbara Hernandez

  10. Added Co-Sponsor Rep. Dagmara Avelar

  11. Added Co-Sponsor Rep. Lisa Davis

  12. Added Co-Sponsor Rep. Diane Blair-Sherlock

  13. Added Co-Sponsor Rep. Nabeela Syed

  14. Added Co-Sponsor Rep. Laura Faver Dias

  15. Added Co-Sponsor Rep. Rita Mayfield

  16. Assigned to Appropriations-Health and Human Services Committee

  17. Referred to Rules Committee

  18. First Reading

  19. Filed with the Clerk by Rep. Lindsey LaPointe

Sponsors

Sponsorship breakdown

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1 sponsors · 13 co-sponsors · 169 not signed on

Sponsors (1)

Co-sponsors (13)

Not signed on (169)

169 members have not signed on to this bill.

Show all 169 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

What does HB4893      do?
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services must incorporate minimum standards governing behavioral health pre-payment and post-payment reviews into MCO contracts effective for all services covered on and after January 1, 2027. Requires the Department to develop or adopt behavioral health-specific pre-payment and post-payment review guidelines and incorporate such guidelines by reference into MCO contracts. Provides that the Department-issued guidelines must: (1) define the documentation and clearly specify the discrete data elements that may be requested prior to and during a pre-payment or post-payment review, and applicable response timeframes, ensuring that all requests are specific, reasonable, and directly tied to the review objectives; (2) identify regulatory, statutory, and contractual standards applicable to behavioral health services; (3) establish uniform evaluation criteria and checklists; and (4) be publicly available and updated as necessary. Contains provisions on MCO contracts and required contract terms; pre-payment and post-payment review processes and notice requirements; timeframes for providers to respond to a documentation request; communication protocols; contract transparency and extrapolation from a statistical sampling of claims; the timeliness and closure of claims reviews; submission methods; reviewer qualifications; and enforcement. Effective immediately.
Who sponsors HB4893     ?
HB4893      is sponsored by Lindsey LaPointe (Democrat), Rita Mayfield (Democrat), Laura Faver Dias (Democrat), Nabeela Syed (Democrat), Diane Blair-Sherlock (Democrat), Lisa Davis (Democrat), Dagmara Avelar (Democrat), Barbara Hernandez (Democrat), Theresa Mah (Democrat), Carol Ammons (Democrat), Anne Stava (Democrat), Joyce Mason (Democrat), Debbie Meyers-Martin (Democrat), and Kevin John Olickal (Democrat).
What is the current status of HB4893     ?
This bill has been introduced in the House. Introduced February 03, 2026. It must pass committee before a floor vote.
Where can I track HB4893     ?
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Last checked for changes 3 months ago · updated continuously

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