There are both federal and state laws requiring insurance providers cover not only physical health issues, but also mental health. Illinois has strict laws, but some argue they’re not properly enforced and those with mental health or addiction issues don’t always understand what’s covered with insurance.
State Representative Lou Lang, a Democrat from Skokie, is sponsoring legislation that would require the Illinois Department of Insurance to effectively communicate policy coverage.
“When people have problems getting their claims paid or they have problems getting coverage by Medicaid, we know that they don’t know what to do," said Lang. "They don’t even know they have a claim they haven’t made. They don’t know who to turn to. And when they do turn to people that they think are appropriate, they sometimes get a deaf ear. ”
Brianna Lantz is a spokesperson for the Pharmaceutical Care Management Association and she has concerns with the bill. She's specifically focused on part of the legislation that would remove prior authorization requirements for medication.
“There are ways that prior (authorizations) are used for safety reasons," said Lantz. "In terms of making sure people are not being over-prescribed or are not filling prescriptions before they should be refilled.”
The measure would require the Auditor General to conduct compliance reviews and report the findings to the General Assembly annually. It has yet to be voted on outside of committee.