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- Advocacy Win: Illinois Pathologists and CAP Secure New Network Adequacy Law
On August 9, Gov. J.B. Pritzker enacted a new health plan network adequacy law (Senate Bill 2641) spearheaded by the Illinois Society of Pathologists (ISP) and the CAP after years of advocacy.
Illinois is now the eighth state to enact the CAP’s position requiring health plans maintain robust network adequacy within in-network hospitals to provide enrollee access for physician specialists. Specifically, as of January 1, 2026, health plans must annually demonstrate to the director of the Department of Insurance that in-network hospitals have at least one radiologist, pathologist, anesthesiologist, and emergency room physician as a preferred provider in a network plan. The department may further select additional specialties for such requirements applicable to health plans.
The CAP and ISP worked closely with a multi-physician specialty coalition comprised of radiology, anesthesiology, and emergency medicine and the Illinois State Medical Society (ISMS) to advance the bill. The CAP previously advocated in 2017 for similar legislation but the bill failed in the Senate due to insurance industry opposition.
The new law will take effect on January 1, 2026.