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SB3114Introduced in the Senate

TRANSPARENCY IN DOWNCODING ACT

Passed

Introduced by David Koehler, District 46

What does this bill do?

Plain-English breakdown

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Official description

Creates the Transparency in Downcoding Act. Provides that, subject to federal requirements, the Act applies to certain policies of health insurance amended, delivered, issued, or renewed on or after the effective date of the Act, except for employee or employer self-insured health benefit plans under the federal Employee Retirement Income Security Act of 1974 and health care provided pursuant to the Workers' Compensation Act or the Workers' Occupational Diseases Act. Prohibits home rule units from regulating downcoding of medical claims in policies issued, amended, delivered, or renewed on or after January 1, 2028. Prohibits a health care payor from implementing any policy or using any algorithm or other automated process, system, or tool that bypasses the evaluation of all information included by the billing health care professional to downcode a claim. Provides that a health care payor may use an automated process to identify claims that may justify a downcoding determination. Provides that all downcoding determinations must be made or reviewed by a natural person following American Medical Association Current Procedural Terminology coding guidelines in effect at the time. Prohibits a health care payor from downcoding a claim based solely on the reported diagnosis codes. Sets forth provisions concerning notification requirements and the dispute process for downcoded claims. Prohibits a health care payor from using downcoding practices in a targeted or discriminatory manner against health care professionals who routinely treat patients with complex or chronic conditions. Establishes administration and enforcement provisions. Amends the Illinois Public Aid Code. Provides that, notwithstanding any other provision of law to the contrary, all managed care organizations shall comply with the requirements of the Transparency in Downcoding Act. Effective January 1, 2028.

Where it stands

Public Act . . . . . . . . . 104-0568

July 10, 2026

How did lawmakers vote?

House votes

2 recorded votes · each counted separately

Senate votes

4 recorded votes · each counted separately

HouseStage: House Third Reading · May 27, 2026

111

Yes

0

No

0

Absent or Not Voting

111 representatives recorded in this House vote. Colors show vote categories only, not whether a vote was good or bad.

See how each representative voted

RepresentativeDistrictVote
Aaron Ortiz1Yes
Eva Dina Delgado3Yes
Lilian Jimenez4Yes
Kimberly Du Buclet5Yes
Sonya Harper6Yes
Emanuel Welch7Yes
Yolanda Morris9Yes
Jawaharial Williams10Yes
Ann Williams11Yes
Margaret Croke12Yes

Bill history

  1. Filed with Secretary by Sen. David Koehler

  2. First Reading

  3. Referred to Assignments

  4. Assigned to Insurance

  5. Added as Chief Co-Sponsor Sen. Julie A. Morrison

  6. Added as Co-Sponsor Sen. Laura Fine

  7. Postponed - Insurance

  8. Added as Co-Sponsor Sen. Andrew S. Chesney

  9. Added as Co-Sponsor Sen. Christopher Belt

  10. Added as Co-Sponsor Sen. Graciela Guzmán

  11. Added as Co-Sponsor Sen. Paul Faraci

  12. Added as Co-Sponsor Sen. Suzy Glowiak Hilton

  13. Added as Co-Sponsor Sen. Linda Holmes

  14. Added as Co-Sponsor Sen. Ram Villivalam

  15. Added as Co-Sponsor Sen. Mike Porfirio

  16. Added as Co-Sponsor Sen. Meg Loughran Cappel

  17. Added as Chief Co-Sponsor Sen. Cristina Castro

  18. Added as Co-Sponsor Sen. Doris Turner

  19. Added as Chief Co-Sponsor Sen. Robert Peters

  20. Added as Co-Sponsor Sen. Sally J. Turner

  21. Postponed - Insurance

  22. Added as Co-Sponsor Sen. Sue Rezin

  23. Added as Co-Sponsor Sen. Napoleon Harris III

  24. Do Pass Insurance; 010-000-000

  25. Placed on Calendar Order of 2nd Reading March 12, 2026

  26. Second Reading

  27. Placed on Calendar Order of 3rd Reading March 24, 2026

  28. Added as Co-Sponsor Sen. Rachel Ventura

  29. Senate Floor Amendment No. 1 Filed with Secretary by Sen. David Koehler

  30. Senate Floor Amendment No. 1 Referred to Assignments

  31. Added as Co-Sponsor Sen. Elgie R. Sims, Jr.

  32. Added as Co-Sponsor Sen. Lakesia Collins

  33. Senate Floor Amendment No. 1 Assignments Refers to Insurance

  34. Senate Floor Amendment No. 1 Recommend Do Adopt Insurance; 011-000-000

  35. Rule 2-10 Third Reading Deadline Established As May 8, 2026

  36. Senate Floor Amendment No. 2 Filed with Secretary by Sen. David Koehler

  37. Senate Floor Amendment No. 2 Referred to Assignments

  38. Rule 2-10 Third Reading Deadline Established As May 15, 2026

  39. Senate Floor Amendment No. 2 Assignments Refers to Insurance

  40. Senate Floor Amendment No. 2 Recommend Do Adopt Insurance; 013-000-000

  41. Recalled to Second Reading

  42. Senate Floor Amendment No. 1 Withdrawn by Sen. David Koehler

  43. Senate Floor Amendment No. 2 Adopted; Koehler

  44. Placed on Calendar Order of 3rd Reading

  45. Third Reading - Passed; 059-000-000

  46. Added as Co-Sponsor Sen. Michael W. Halpin

  47. Added as Co-Sponsor Sen. Mike Simmons

  48. Arrived in House

  49. Chief House Sponsor Rep. Sharon Chung

  50. First Reading

  51. Referred to Rules Committee

  52. Assigned to Insurance Committee

  53. Committee/Final Action Deadline Extended-9(b) May 31, 2026

  54. Added as Co-Sponsor Sen. Chris Balkema

  55. Added Alternate Co-Sponsor Rep. Nicolle Grasse

  56. Added Alternate Co-Sponsor Rep. Dagmara Avelar

  57. Added Alternate Co-Sponsor Rep. Ryan Spain

  58. Added Alternate Chief Co-Sponsor Rep. William E Hauter

  59. Added Alternate Chief Co-Sponsor Rep. Jeff Keicher

  60. Added Alternate Chief Co-Sponsor Rep. Katie Stuart

  61. Added Alternate Co-Sponsor Rep. Dave Vella

  62. Added Alternate Co-Sponsor Rep. Rick Ryan

  63. Added as Co-Sponsor Sen. Emil Jones, III

  64. Do Pass / Short Debate Insurance Committee; 015-000-000

  65. Placed on Calendar 2nd Reading - Short Debate

  66. Second Reading - Short Debate

  67. Held on Calendar Order of Second Reading - Short Debate

  68. Added Alternate Chief Co-Sponsor Rep. Jawaharial Williams

  69. Placed on Calendar Order of 3rd Reading - Short Debate

  70. Third Reading - Short Debate - Passed 111-000-000

  71. Passed Both Houses

  72. Added Alternate Co-Sponsor Rep. Justin Cochran

  73. Added Alternate Co-Sponsor Rep. Anthony DeLuca

  74. Added Alternate Co-Sponsor Rep. Joyce Mason

  75. Added Alternate Co-Sponsor Rep. Mary Gill

  76. Added Alternate Co-Sponsor Rep. Michael J. Kelly

  77. Added Alternate Co-Sponsor Rep. Natalie A. Manley

  78. Added Alternate Co-Sponsor Rep. Matt Hanson

  79. Added Alternate Co-Sponsor Rep. Martha Deuter

  80. Added Alternate Co-Sponsor Rep. Tracy Katz Muhl

  81. Added Alternate Co-Sponsor Rep. Harry Benton

  82. Added Alternate Co-Sponsor Rep. Gregg Johnson

  83. Added Alternate Co-Sponsor Rep. William "Will" Davis

  84. Added Alternate Co-Sponsor Rep. Jennifer Gong-Gershowitz

  85. Added Alternate Co-Sponsor Rep. Kelly M. Cassidy

  86. Added Alternate Co-Sponsor Rep. Michelle Mussman

  87. Added Alternate Co-Sponsor Rep. Maurice A. West, II

  88. Added Alternate Co-Sponsor Rep. Mary Beth Canty

  89. Added Alternate Co-Sponsor Rep. Bob Morgan

  90. Added Alternate Co-Sponsor Rep. Stephanie A. Kifowit

  91. Added Alternate Co-Sponsor Rep. Amy Briel

  92. Added Alternate Co-Sponsor Rep. Sue Scherer

  93. Added Alternate Co-Sponsor Rep. Lisa Davis

  94. Added Alternate Co-Sponsor Rep. Rita Mayfield

  95. Added Alternate Co-Sponsor Rep. Michael Crawford

  96. Added Alternate Co-Sponsor Rep. Lawrence "Larry" Walsh, Jr.

  97. Sent to the Governor

  98. Governor Approved

  99. Effective Date January 1, 2028

  100. Public Act . . . . . . . . . 104-0568

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