SPRINGFIELD, Ill. (WAND) — Illinois will soon ban insurance companies from automatically coding a health service lower than what is provided to patients.

Gov. JB Pritzker signed a bill Friday stating all downcoding determinations must be made or reviewed by a real person, and insurance companies will be required to notify doctors if a service is downcoded.

The law also bans insurers from downcoding in a discriminatory manner against doctors who routinely treat patients with complex health conditions.

"Downcoding is patently unfair to medical professionals and the patient," said Rep. Bill Hauter (R-Morton). "It ignores our training, experience, skill and education. All of this goes into medical decision-making. It ignores all that."

Insurance companies will also be required to provide healthcare professionals a clear process to dispute downcoded claims within 90 days.

This law will take effect Jan. 1, 2028. 

"Downcoding, quite frankly, is just an unfair system," said Sen. Dave Koehler (D-Peoria). "There was some discussion about also trying to limit upcoding, but upcoding is primarily illegal." 

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