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HB 3006

Non-Profit Transparency and Accountability Act.

2025 Regular Session Introduced by Elías Coop-González and 2 co-sponsors

HB 3006 expands Illinois Medicaid to cover medically necessary hormone therapy for menopause beyond hysterectomy, boosting access but likely raising costs and guidance needs.

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Bill Summary · HB 3006

Bill Summary — HB 3006 (INS‑HORMONE THERAPY‑MENOPAUSE)

Primary sponsor: Rep. Laura Faver Dias
Chief co‑sponsor: Rep. Katie Stuart
Introduced: February 2025 (filed Feb. 6 / referenced Feb. 19, 2025)
Statutory reference amended: 305 ILCS 5/5‑56 (Illinois Public Aid Code)
Effective date: Upon becoming law

Purpose / Intent

HB 3006 expands Medicaid (the Illinois medical assistance program) coverage for hormone replacement therapy (HRT) related to menopause. Its intent is to remove a prior limitation that restricted coverage to menopause induced by hysterectomy and to require coverage for medically necessary hormone therapy to treat menopause more broadly.

Key provisions

  • Amends Section 5‑56 of the Illinois Public Aid Code (305 ILCS 5/5‑56).
  • Replaces the existing phrase limiting coverage to “menopause that has been induced by a hysterectomy” with language requiring the medical assistance program to provide coverage for “medically necessary hormone therapy treatment to treat menopause” (no hysterectomy requirement).
  • No changes in the bill text to specific clinical criteria, dollar amounts, or formulary details; those remain subject to program rules and medical necessity standards.
  • Effective immediately upon enactment.

Who is affected

  • Primary: Illinois Medicaid enrollees experiencing menopause (including natural, surgical, or otherwise non‑hysterectomy induced menopause) who may now be eligible for covered hormone therapy when deemed medically necessary.
  • State agencies: Illinois Department of Healthcare and Family Services (or applicable Medicaid administrator) for benefit administration, coverage policies, and potential updates to provider and beneficiary guidance.
  • Providers and pharmacies: Changes may affect prescribing, prior authorization, and billing practices for menopause‑related HRT.

Procedural status / timeline

  • Filed in the House in February 2025 (Rep. Dias), added co‑sponsor 2/14/25.
  • Passed the House (readings and recorded votes in May 2025); received from the House 5/19/2025 and referred under Rule 19(a) to the Senate Rules Committee.
  • If enacted, the law takes effect immediately.

Potential impacts / implementation notes

  • Increases access to HRT for a broader population of menopausal Medicaid recipients.
  • May increase Medicaid expenditures; the bill contains no appropriation or fiscal estimate in the text provided.
  • Administrative actions will likely be needed to define “medically necessary” in practice (coverage criteria, prior authorization, formulary placement).

Compiled from official sources — confirm details with the bill’s official record.

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