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- Illinois Legislature Unanimously Passes Network Adequacy Bill: Now Pending Governor’s Signature
On May 24, the Illinois Legislature unanimously passed health plan network adequacy legislation (SB 2641) advocated by a multispecialty coalition of medical societies, led by the Illinois Society of Pathologists (ISP) and the CAP. The bill was initially opposed by the Illinois health insurance industry, which adopted a neutral position following negotiations and amendments offered by the State Insurance Department. Following the adoption of the amendments, the Department became a proponent of the bill.
The legislation requires health plans to submit to the Illinois Department of Insurance information demonstrating that they have contracted with hospital-based physician specialists, including pathologists, radiologists, anesthesiologists, and emergency room physicians at in-network hospitals. The Illinois Department of Insurance currently conducts network adequacy assessments of health plans but does not scrutinize health plans for provision of in-network pathology/laboratory services, or for other on-site physician specialty services at hospitals and in-network facilities.
The ISP, with the assistance of CAP, submitted a memorandum and provided testimony detailing support for the legislation. The legislation now moves to the Governor, who is expected to sign the measure into law. The bill would go into effect January 1, 2026.