State Representative Margaret Croke’s Legislation Removing Referral Requirements For Patients with HMO Plans Passes Senate, Heads to Governor’s Desk

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SPRINGFIELD, IL. – Today, State Representative Margaret Croke’s legislation removing referral requirements for patients enrolled in HMO insurance plans passed the Senate, and now heads to the Governor’s desk for signature. House Bill 1186 allows Illinois patients with HMO health care plans to see in-network specialists without first obtaining a referral from their primary care physicians. State Representative Margaret Croke introduced the bill, which was sponsored in the Senate by State Senator Laura Fine, to help reduce barriers in health care. 

“Removing referral requirements is critical to ensuring that Illinoisans have access to the specialists they need without delay. That’s why I first introduced this legislation to ease the path for Illinoisans to see in-network providers,” said State Representative Margaret Croke. “I’m grateful to Senator Laura Fine for sponsoring this legislation in the Senate, and I’m thrilled to see it headed to Governor Pritzker’s desk. This is just one of the many ways Illinois will lead the way to making health care more accessible.” 

According to the American Academy of Family Physicians (AAFP), referrals often increase the time patients have to wait for specialized care — they may have to wait to see their primary care doctor, then wait between longer to see a specialist, and have to navigate a generally “cumbersome and confusing” referral system which can lead to stress for both patients and providers. In the interim, patients might end up seeking out additional primary care visits, or they might visit an urgent care or emergency room, which can create unnecessary costs.

State Representative Margaret Croke’s bill passed the House in March, and passed out of the Senate Insurance committee in April.

To read more about HB1186, visit ilga.gov.