HB 5497

Amends the Illinois Insurance Code. Provides that any policy of insurance amended, delivered, issued, or renewed on or after January 1, 2027 that provides coverage for emergency services for medical or surgical conditions shall also provide coverage for behavioral health emergency services on coverage terms no more restrictive than those applied to emergency services for medical or surgical conditions. Requires coverage for post-stabilization services. Sets forth provisions concerning behavioral health emergency services parity; coverage of services provided by nonlicensed staff performing under direct supervision; restrictions on prior authorization, utilization review, and cost sharing; reimbursement rates; and rulemaking. Amends the Network Adequacy and Transparency Act. Includes behavioral health emergency services providers in network adequacy determinations under the Act. Establishes provisions concerning rulemaking for the Department of Insurance; behavioral health emergency services requirements for health insurance issuers; and enforcement coordination with specified federal law. Effective January 1, 2027.