INSURANCE CLAIM DISCRIMINATION

Illinois General Assembly - Full Text of HB5131

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB5131

Introduced 2/10/2026, by Rep. Kevin Schmidt

SYNOPSIS AS INTRODUCED:

215 ILCS 5/370b.2 new

Amends the Illinois Insurance Code. Provides that a health insurance
issuer that delivers, issues for delivery, or renews in this State a health
insurance policy shall not discriminate with respect to participation
under the health insurance policy against a health care professional who
is acting within the scope of the health care professional's license or
certification under applicable State law. Provides that a health insurance
issuer is not required to contract with any health care professional
willing to abide by the terms and conditions for participation established
by the health insurance issuer. Provides that a health insurance issuer is
not prohibited from establishing varying reimbursement rates based on
quality or performance measures.
LRB104 19984 BAB 33435 b

A BILL FOR

HB5131
LRB104 19984 BAB 33435 b
1

AN ACT concerning regulation.

2

Be it enacted by the People of the State of Illinois,
3
represented in the General Assembly:

4

Section 5.
The Illinois Insurance Code is amended by
5
adding Section 370b.2 as follows:

6

(215 ILCS 5/370b.2 new)
7

Sec. 370b.2.
Health insurance issuer claim discrimination.
8

(a) As used in this Section:
9

"Discriminate" has the meaning described in 42 U.S.C.
10
300gg-5 and any applicable regulations.
11

"Health care professional" has the meaning given to that
12
term in Section 2105-15.7 of the Department of Professional
13
Regulation Law of the Civil Administrative Code of Illinois.
14

(b) A health insurance issuer that delivers, issues for
15
delivery, or renews in this State a health insurance policy
16
shall not discriminate with respect to participation under the
17
health insurance policy against a health care professional who
18
is acting within the scope of the health care professional's
19
license or certification under applicable State law.
20

(c) This Section does not require that a health insurance
21
issuer described in subsection (b) contract with any health
22
care professional willing to abide by the terms and conditions
23
for participation established by the health insurance issuer.

HB5131
- 2 -
LRB104 19984 BAB 33435 b
1

(d) This Section does not prohibit a health insurance
2
issuer described in subsection (b) from establishing varying
3
reimbursement rates based on quality or performance measures.

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