HB4893
View on ILGAMEDICAID-MCO BEHAVIORIAL HLTH
What this bill does
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.
Calculating prediction drivers...
Pipeline Progress
Current stage: In Committee · Last action 246 days ago · STAGNANT
How does a bill become law in Illinois?
-
Introduction of Bill
A member of the Senate or the House introduces a bill, which is assigned a unique identifying number (e.g., "H.B. ___" for House bills and "S.B. ___" for Senate bills). If not enacted, it must be reintroduced in the next General Assembly with a new number.
-
Committee Work — Hearings
The bill goes to the appropriate committee, which holds hearings to gather expert opinions and determine the need for the legislation.
-
Committee Work — Markup, Amendments, Report
The committee may make amendments to the bill. If approved, a committee report endorsing the bill is issued.
-
Floor Debate
The bill is debated and can be further amended. The debate transcripts are accessible online for public viewing.
-
Passage and Consideration in Second Chamber
If the bill passes in the first chamber, it moves to the second chamber for a similar review process. If both chambers approve, it goes to the governor.
-
Gubernatorial Action
The governor can sign the bill into law, veto it, or take no action (resulting in an automatic law after 60 days). The type of veto can be total or amendatory. Once signed, the bill becomes a Public Act and is assigned a Public Act number.
Sponsor Context
Bills sponsored by Lindsey LaPointe advance 0% more often than the chamber average.
Campaign finance
This is SBE campaign receipts to the people on this bill, not Moneyball and not earmarked to the bill.
Money is campaign receipts to matched candidate committees, not earmarked to this bill. Window 2025-01-01 – 2026-09-13.
Sponsor and voter funding
| Member | Role | Receipts | Total received | Top donors |
|---|---|---|---|---|
| Lindsey LaPointe | Chief sponsor | 336 | $263,682.75 | Chicago Investments II L P ($11,300.00); Illinois PAC for Education (IPACE) ($10,000.00); Health Care Council of Illinois (HCCI) ($10,000.00) |
Top donors across these members
| Donor | Occupation | Employer | Receipts | Total |
|---|---|---|---|---|
| Chicago Investments II L P | — | — | 3 | $11,300.00 |
| Illinois PAC for Education (IPACE) | — | — | 2 | $10,000.00 |
| Health Care Council of Illinois (HCCI) | — | — | 1 | $10,000.00 |
| Chicagoland Operators Joint Labor-Management PAC | — | — | 4 | $9,500.00 |
| Illinois Hospital Association PAC | — | — | 5 | $9,000.00 |
| Community First Healthcare of Illinois, Inc. | — | — | 2 | $8,000.00 |
| Realtor Political Action Committee | — | — | 2 | $7,500.00 |
| Leo Smith | Policy Director | Chicago CRED | 2 | $5,500.00 |
| Affordable Assisted Living Coalition | — | — | 1 | $5,000.00 |
| AFSCME Illinois Council No31 PAC | — | — | 2 | $5,000.00 |
| Illinois Trial Lawyers Association PAC | — | — | 2 | $4,500.00 |
| Lindsey LaPointe | Government | State of Illinois | 3 | $4,000.00 |
| Carpentry Advancement Political Action | — | — | 3 | $4,000.00 |
| LiUNA Chicago Laborers District Council | — | — | 2 | $4,000.00 |
| Teamsters Volunteers in Politics | — | — | 3 | $3,500.00 |
| Illinois Laborers' Legislative Committee | — | — | 2 | $3,500.00 |
| David Berkey | CEO | Illinois Health Practice Alliance | 7 | $3,183.46 |
| Ben Lazare Consulting | — | — | 3 | $3,000.00 |
| Illinois Psychological Association | — | — | 3 | $3,000.00 |
| Timothy Sheehan | Consultant | Richmond Street Consultants | 2 | $3,000.00 |
| Spirit-PAC | — | — | 3 | $3,000.00 |
| Aaron Mallory | Entrepreneur | n/a | 2 | $3,000.00 |
| Molina Healthcare, Inc. | — | — | 1 | $3,000.00 |
| Fraternal Order of Police Chicago Lodge | — | — | 1 | $3,000.00 |
| Illinois State Medical Society PAC | — | — | 2 | $3,000.00 |
Hearings
This bill has not been scheduled for a committee hearing.
Action History
3 actions recorded. Last action: 2026-02-06 — Referred toRules Committee. Each action's meaning and outcome signal are classified automatically.
All actions (table)
| Date | Chamber | Action | Category | Signal |
|---|---|---|---|---|
| 2026-02-03 | House | Filed with the Clerk byRep. Lindsey LaPointe House Rule 6(b) | Introduction & Filing | — |
| 2026-02-06 | House | First Reading Senate Rule 5-1(d)/5-2; House Rule 37(d)/38 | Introduction & Filing | — |
| 2026-02-06 | House | Referred toRules Committee Senate Rule 3-8(a); House Rule 18(a) | Committee Assignment | — |