Prior Authorization in Illinois
Illinois enacted comprehensive PA reform through SB 3208 and subsequent legislation. The state requires PA decisions within 72 hours for prescription drugs (24 hours for urgent). Illinois also passed step therapy override protections and requires insurers to accept standard PA request forms.
Key Facts About PA in Illinois
- ✓ PA decisions for Rx required within 72 hours; urgent within 24 hours
- ✓ Step therapy override protections are codified in law
- ✓ Insurers must accept standard PA request forms
- ✓ External review available through the Illinois Department of Insurance
Quick Stats
- Typical Appeal Filing Window: 30 days
- External Review Available: Yes
- Major Payers: 4
Top Payers in Illinois
RxCheckUp generates payer-specific Letters of Medical Necessity for each of these Illinois carriers:
BCBS Illinois (HCSC)UnitedHealthcareAetnaCigna