Illinois 104th General Assembly Status: Introduced 1 D cosponsors

SB3163      — DHFS-MANAGED CARE PROTECTIONS

Last action — Rule 3-9(a) / Re-referred to Assignments

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

This bill has been introduced in the Senate. Introduced February 02, 2026. It must pass committee before a floor vote.

Next likely step: a committee referral and hearing.

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.

In plain language

The bill requires managed care organizations to adopt a universal provider application for credentialing healthcare professionals.

This bill mandates that managed care organizations must use a universal provider application to credential healthcare providers. It also establishes support systems for providers navigating the enrollment process in the Illinois Medicaid Program.

What this means for you
  • Healthcare: Healthcare providers will benefit from a streamlined credentialing process with a universal application.

Summary

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to adopt rules that require managed care organizations (MCOs) to utilize a universal provider application developed by a council for affordable quality healthcare, as defined, for the purpose of credentialing a health care professional or a health care provider who seeks to participate in an MCO's provider network. Provides that the rules may also require the use of a CAQH application for the renewal of credentials; and that the Department may revise the CAQH universal provider application or the application for renewal of credentials to conform to industry or national standards for credentialing health care professionals or health care providers. Provides that within 180 days after the adoption of rules, health and dental plan carriers must accept the universal provider application and the application for the renewal of credentials approved by the Department. Requires all MCOs to provide a provider network consultant to act as a liaison between a health care provider and the MCO. Require the Department to employ provider enrollment consultants to assist health care providers with enrollment in the Illinois Medicaid Program Advanced Cloud Technology system, help navigate the enrollment and provider credentialing process by serving as the liaison between health care providers and MCOs, and other matters. Amends the Illinois Insurance Code. In provisions concerning recoupments, requires a health care professional or health care provider to be provided a remittance advice that includes an explanation of a recoupment or offset taken by a managed care organization. Removes provisions permitting insurers contracted with the Department of Healthcare and Family Services to recoup or offset payments due to a federal Medicaid requirement. Provides that no contract between an MCO and health care professional or provider may provide for recoupments in violation of the Code. Effective January 1, 2027.

Bill Text

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

Read SB3163 on the official Illinois source →

Action History

  1. Rule 3-9(a) / Re-referred to Assignments

  2. Rule 2-10 Committee/3rd Reading Deadline Established As May 22, 2026

  3. Rule 2-10 Committee/3rd Reading Deadline Established As May 15, 2026

  4. Rule 2-10 Committee Deadline Established As April 24, 2026

  5. Assigned to Appropriations- Health and Human Services

  6. Referred to Assignments

  7. First Reading

  8. Filed with Secretary by Sen. David Koehler

Sponsors

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 182 not signed on

Sponsors (1)

Co-sponsors (0)

None.

Not signed on (182)

182 members have not signed on to this bill.

Show all 182 →

"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 SB3163      do?
Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to adopt rules that require managed care organizations (MCOs) to utilize a universal provider application developed by a council for affordable quality healthcare, as defined, for the purpose of credentialing a health care professional or a health care provider who seeks to participate in an MCO's provider network. Provides that the rules may also require the use of a CAQH application for the renewal of credentials; and that the Department may revise the CAQH universal provider application or the application for renewal of credentials to conform to industry or national standards for credentialing health care professionals or health care providers. Provides that within 180 days after the adoption of rules, health and dental plan carriers must accept the universal provider application and the application for the renewal of credentials approved by the Department. Requires all MCOs to provide a provider network consultant to act as a liaison between a health care provider and the MCO. Require the Department to employ provider enrollment consultants to assist health care providers with enrollment in the Illinois Medicaid Program Advanced Cloud Technology system, help navigate the enrollment and provider credentialing process by serving as the liaison between health care providers and MCOs, and other matters. Amends the Illinois Insurance Code. In provisions concerning recoupments, requires a health care professional or health care provider to be provided a remittance advice that includes an explanation of a recoupment or offset taken by a managed care organization. Removes provisions permitting insurers contracted with the Department of Healthcare and Family Services to recoup or offset payments due to a federal Medicaid requirement. Provides that no contract between an MCO and health care professional or provider may provide for recoupments in violation of the Code. Effective January 1, 2027.
Who sponsors SB3163     ?
SB3163      is sponsored by David Koehler (Democrat).
What is the current status of SB3163     ?
This bill has been introduced in the Senate. Introduced February 02, 2026. It must pass committee before a floor vote.
Where can I track SB3163     ?
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Last checked for changes 3 months ago · updated continuously

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