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HB4785 • 2026
DHS-BEHAVIORAL HLTH SURCHARGE
This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.
Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.
DHS-BEHAVIORAL HLTH SURCHARGE
These notes stay tied to the official amendment files and metadata from the legislature.
Plain English: Illinois General Assembly - Full Text of HB4785 Select Language × The Illinois General Assembly offers the Google Translate™ service for visitor convenience.
Added Co-Sponsor Rep. Kevin John Olickal
Added Co-Sponsor Rep. Ann M. Williams
Rule 19(a) / Re-referred to Rules Committee
House Floor Amendment No. 2 Rule 19(c) / Re-referred to Rules Committee
House Floor Amendment No. 2 Rules Refers to Human Services Committee
House Floor Amendment No. 2 Filed with Clerk by Rep. Lindsey LaPointe
House Floor Amendment No. 2 Referred to Rules Committee
Second Reading - Short Debate
Held on Calendar Order of Second Reading - Short Debate
Added Co-Sponsor Rep. Dagmara Avelar
Added Co-Sponsor Rep. Nicolle Grasse
House Committee Amendment No. 1 Adopted in Human Services Committee ; by Voice Vote
Do Pass as Amended / Short Debate Human Services Committee ; 008-004-000
Placed on Calendar 2nd Reading - Short Debate
House Committee Amendment No. 1 Rules Refers to Human Services Committee
House Committee Amendment No. 1 Filed with Clerk by Rep. Lindsey LaPointe
House Committee Amendment No. 1 Referred to Rules Committee
Assigned to Human Services Committee
First Reading
Referred to Rules Committee
Filed with the Clerk by Rep. Lindsey LaPointe
DHS-BEHAVIORAL HLTH SURCHARGE
Illinois General Assembly - Full Text of HB4785 Select Language × The Illinois General Assembly offers the Google Translate™ service for visitor convenience. In no way should it be considered accurate as to the translation of any content herein. Visitors of the Illinois General Assembly website are encouraged to use other translation services available on the internet. The English language version is always the official and authoritative version of this website. NOTE: To return to the original English language version, select the "Show Original" button on the Google Translate™ menu bar at the top of the window. 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Full Text of HB4785 Home Legislation Full Text HB4785 - 104th General Assembly Bill Status Full Text Votes Witness Slips Select Menu Bill Status Full Text Votes Witness Slips Printer Friendly Version Introduced House Amendment 001 House Amendment 002 Printer Friendly Version Introduced House Amendment 001 House Amendment 002 Open PDF 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB4785 Introduced , by Rep. Lindsey LaPointe SYNOPSIS AS INTRODUCED: New Act Creates the Preventing Crisis Cost Shifting to Medicaid Act. Provides that the General Assembly finds that (i) behavioral health crisis services, including crisis call centers, mobile crisis response, and crisis stabilization and receiving services, function as essential public health infrastructure and must be available statewide without regard to insurance status; and (ii) commercial health insurance policies issued or administered in the State generally do not provide comprehensive coverage for the full continuum of behavioral health crisis services, resulting in the cost of such services being disproportionately borne by Medicaid, local governments, and taxpayers. Requires specified entities (surcharge payors) that are authorized to issue or administer a policy or contract of accident and health insurance or a health maintenance organization contract in the State to pay a behavioral health crisis assessment to the Department of Human Services for deposit into the Statewide 9-8-8 Trust Fund. Exempts Medicaid managed care organizations from paying the behavioral health crisis assessment. Permits the Department to update the total behavioral health crisis assessment amount as necessary to ensure the continued availability, quality, or geographic equity of the statewide behavioral health crisis system. Requires the Department to establish an appropriate mechanism for enforcing a surcharge payor's liability, which may include accrued interest on unpaid liabilities at a rate not to exceed 18% per annum and late fees or penalties at a rate not to exceed 5% per month. Provides that the enforcement mechanism may also include notification to the Department of Healthcare and Family Services to offset payments on the surcharge payor's claims. Provides that the Department of Human Services shall not direct the Department of Healthcare and Family Services to offset claims payments unless the surcharge payor has maintained an outstanding liability to the Statewide 9-8-8 Trust Fund for a period longer than 45 days and has received proper notice of pending enforcement. LRB104 18498 KTG 31940 b A BILL FOR HB4785 LRB104 18498 KTG 31940 b 1 AN ACT concerning behavioral health. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 1. Short title. This Act may be cited as the 5 Preventing Crisis Cost Shifting to Medicaid Act. 6 Section 5. Legislative findings and purpose. The General 7 Assembly finds that: 8 (1) Individuals experiencing behavioral health 9 emergencies, including mental health and substance use crises, 10 require timely access to crisis services to promote safety, 11 stability, and recovery for themselves, their families, and 12 their communities. 13 (2) Behavioral health crisis services, including crisis 14 call centers, mobile crisis response, and crisis stabilization 15 and receiving services, function as essential public health 16 infrastructure and must be available statewide without regard 17 to insurance status. 18 (3) Commercial health insurance policies issued or 19 administered in this State generally do not provide 20 comprehensive coverage for the full continuum of behavioral 21 health crisis services, resulting in the cost of such services 22 being disproportionately borne by Medicaid, local governments, 23 and taxpayers. HB4785 - 2 - LRB104 18498 KTG 31940 b 1 (4) A predictable, multi-payer financing mechanism is 2 necessary to prevent cost-shifting from commercial payors to 3 Medicaid and other publicly financed systems and to ensure the 4 long-term availability and geographic equity of a statewide 5 behavioral health crisis system. 6 Section 10. Behavioral health crisis assessment. 7 (a) As used in this Section: 8 "Surcharge payor" means an entity that is authorized to 9 issue or administer a policy or contract of accident and 10 health insurance or a health maintenance organization contract 11 in this State and that made payments subject to assessment, as 12 determined by the Department of Human Services, in an amount 13 of $1,000,000 or more during the most recent fiscal year for 14 which data are available. 15 "Total behavioral health crisis assessment amount" means 16 $100,000,000, or, 2 years or later after the effective date of 17 this Act, the most recently updated total behavioral 18 assessment amount as designated by the Department of Human 19 Services by rule. 20 (b) Each surcharge payor shall pay a behavioral health 21 crisis assessment to the Department of Human Services for 22 deposit into the Statewide 9-8-8 Trust Fund. 23 (c) Each surcharge payor shall pay a portion of the total 24 behavioral health crisis assessment amount proportional to the 25 surcharge payor's payments subject to assessment during the HB4785 - 3 - LRB104 18498 KTG 31940 b 1 most recent fiscal year for which data are available, as 2 determined by the Department by rule. 3 (d) In the event of a merger, acquisition, or other 4 transfer of ownership, liability for the assessment shall be 5 assumed by the successor entity. 6 (e) The assessment imposed under this Section shall not 7 apply to Medicaid managed care organizations. 8 Section 15. Deposit of assessment revenues. All revenues 9 collected in accordance with this Act shall be deposited into 10 the Statewide 9-8-8 Trust Fund created under Section 6z-134 of 11 the State Finance Act and shall be expended in accordance with 12 the purposes of that Fund. 13 Section 20. Adjustment of total assessment amount. 14 Beginning no earlier than 2 years after the effective date of 15 this Act, the Department of Human Services may update the 16 total behavioral health crisis assessment amount as necessary 17 to ensure the continued availability, quality, or geographic 18 equity of the statewide behavioral health crisis system. 19 Any updated amount shall apply prospectively and preserve 20 proportional allocation among surcharge payors. The Department 21 shall update the amount by rule, provide public notice of any 22 update, and report any such update to the General Assembly. 23 Section 25. Enforcement. HB4785 - 4 - LRB104 18498 KTG 31940 b 1 (a) The Department of Human Services shall establish an 2 appropriate mechanism for enforcing a surcharge payor's 3 liability under this Act if a surcharge payor fails to make a 4 required payment to the Statewide 9-8-8 Trust Fund; however, 5 the Department may establish threshold liability amounts below 6 which enforcement may be modified or waived. 7 (b) The enforcement mechanism may include assessment of 8 interest on unpaid liabilities at a rate not to exceed 18% per 9 annum and late fees or penalties at a rate not to exceed 5% per 10 month. 11 (c) The enforcement mechanism may also include 12 notification to the Department of Healthcare and Family 13 Services requiring an offset of payments on claims of the 14 surcharge payor, any entity under common ownership with the 15 surcharge payor, or any successor in interest to the surcharge 16 payor in an amount equal to the payment owed to the Statewide 17 9-8-8 Trust Fund, including any interest and penalties, and 18 transfer of the withheld amounts into the Fund. 19 (d) If the Department of Healthcare and Family Services 20 offsets claims payments in accordance with a notice under 21 subsection (c), the Department of Healthcare and Family 22 Services shall not be considered to be in breach of contract or 23 any other obligation for payment of non-contracted services, 24 and a surcharge payor whose payments are offset under this 25 Section shall continue to serve all Medicaid enrollees under 26 any contract then in effect with the Department of Healthcare HB4785 - 5 - LRB104 18498 KTG 31940 b 1 and Family Services. 2 (e) The Department of Human Services shall not direct the 3 Department of Healthcare and Family Services to offset claims 4 payments unless the surcharge payor has maintained an 5 outstanding liability to the Statewide 9-8-8 Trust Fund for a 6 period longer than 45 days and has received proper notice that 7 the Department of Human Services intends to initiate 8 enforcement actions under this Section. 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