SPRINGFIELD, Ill. (WCIA) – Marilyn Zydlo's son Jimmy was diagnosed with stage three advanced Hodgkin's lymphoma in 2020 and had to undergo twelve rounds of chemotherapy.

“It left him bedridden, extremely debilitated,” Zydlo said.”He had it every two weeks, and we had to undergo certain types of anti-nausea medicines to try and help him.”

But Zydlo, who is also the Illinois Region Dare to Dream ambassador with the Leukemia & Lymphoma Society (LLS), said they faced some hurdles getting him the treatment he needed. His insurance company had him take an alternative medication first. Then if that didn't work he could take the medication his doctor prescribed him. This process is called step therapy.

“It’s just like this domino effect of this constant, ‘Why am I more worried about getting this authorization and approval from the insurance companies and the prescription plans and just doing what the doctor is telling us to do to help care for my son,'” Zydlo said.

Her son eventually got the medication he needed, halfway through his chemo treatment.

“It's heartbreaking to watch your child suffer or your family member, whoever it is, because you can't get the right medicine at the right time until the insurance companies decided you need the next medicine,” Zydlo said.

Jimmy is now in remission and Zydlo has taken her son's story to the Capitol, joining others to call on lawmakers to pass a bill that would ban that process in Illinois.

“It's very frustrating to have insurance companies dictate what we can and cannot prescribe to our patients,” Dr. Shikha Jain, a GI medical oncologist at the University of Illinois Cancer Center, said.

Jain said step therapy is an issue many physicians deal with on a regular basis.

“When insurance companies deny care or require you to go through step therapy, it often requires us to jump through numerous hoops that can then delay care ultimately to our patients, and also wastes a lot of time and add an increased administrative burden,” Jain said.

The effort to ban step therapy is part of Governor J.B. Pritzker's Healthcare Protection Act aimed at making some major changes to the healthcare industry. The governor unveiled the proposal during his State of the State address in February.

“For far too long insurance companies and not doctors have been free to determine what treatment options patients should have and how quickly they can receive it,” Pritzker said during a press conference in Belleville Monday. “With this bill, we're putting power back in the hands of doctors and patients.”

The bill passed out of the House last week with some bipartisan support and is now in the Senate for further consideration.

“Any improvements that we can make in the healthcare delivery system, to empower providers to create efficiencies to lift up our patients, it's good for health care, it's good for attracting and retaining talent in our communities, and it's good for patients,” State Rep. Ryan Spain (R-Peoria), the deputy Republican leader in the House who voted for the bill, said in a press conference in Peoria on Monday.

In addition to banning step therapy, the measure would also require insurance companies to adopt definitions regarding medical necessity that are the same as the guidelines doctors use. It would also ban prior authorization for in-patient adult and child mental health services.

The proposal would also ban “junk insurance” plans, which aren’t required to follow standards laid out under the Affordable Care Act like covering people with preexisting conditions.

If the bill becomes law, Illinois would join twelve other states that already ban these kinds of plans.

Opponents of the bill, like health insurance companies, argue that by eliminating step therapies, costs could increase for people on their plans. Governor Pritzker’s team said this bill was written to keep costs down.

image/jpeg ILSTATECAPITOL.jpeg?w=900

Members representing pharmacies, pharmacy benefits managers, consumers and state departments participate in the House Healthcare Availability & Accessibility Committee on Monday. [Blue Room Stream]

Health insurance reform has been the dominant issue in Springfield this session and lawmakers are toying with more changes to further regulate pharmacy benefits managers (PBM).

Members of the House are slowing down the process on legislation that had been moving forward from Rep. Thaddeus Jones (D-Calumet City) and spent Monday trying to learn what PBMs do. But the hearing often left more questions than answers about the complex branch of the health insurance industry and was largely missing a key voice on the topic — the PBMs.

The Evanston/Skokie School District 65 Board of Education heard updates about its middle school dual language program and 5th Ward school construction plans at its meeting Monday. The meeting followed the first of three public hearings on the potential closure of the Dr. Bessie Rhodes School of Global Studies. The board announced its plan to...

The post District 65 board hears updates on dual language program, 5th Ward school appeared first on The Daily Northwestern.

PEORIA, Ill. (WMBD) -- The Board of Education for Peoria Public Schools voted unanimously to enter into an agreement with the city of Peoria over the Distillery TIF district.

As part of the agreement, the city will pay Peoria Public Schools 20% of all additional TIF funds generated each year over the TIF's 23-year lifespan.

In tax increment financing districts, or TIF's, the property values are frozen. As those values grow, additional funds can be used for investment in that area, leading to a new assessed value of property in the area. TIF's are generally used in areas that governing bodies see as in need of redevelopment.

If effective, TIF districts can lead to heightened redevelopment in areas that most likely would not have seen it otherwise.

In agreeing to this, the district will have a revenue stream while redevelopment is underway, softening the impact of those lost tax dollars.

"If there's no additional taxes coming from there, there is zero additional taxes coming out," said Associate Superintendent of Human Resources Alexander Ikejiaku,"But in this case, the city is guaranteeing the district, knowing how much the district needs that money."

Ikejiaku said that hopefully this will lead to all parties benefitting. Not just the city and PPS, but the general public as well.

"Hopefully the assessed evaluation will grow, and the city will start realizing even more tax dollars from there," he said.

The Board also approved the purchase of 500 iPads for a cost of $159,500. This will be paid by the K8 School Partnership Acceleration grant.

The meeting also featured a showcase of different music groups from each of the districts' three high schools.

image/jpeg Peoria-Public-Schools.jpg?w=630

Obtained by FOX 32 on Monday, copies of both subpoenas provide insights into the focus of the federal inquiry.

Subscribe to FOX 32 Chicago: https://www.youtube.com/fox32chicago?sub_confirmation=1

Watch FOX 32 Chicago Live: https://www.fox32chicago.com/live

FOX 32 Chicago delivers breaking news, live events, investigations, politics, entertainment, business news and local stories from Chicago and across the nation.

Watch more FOX 32 Chicago on YouTube:

FOX 32 Headlines: https://www.youtube.com/playlist?list=PL2-nR6U1joOT92lWD_QLYoNijiDo9uYaP
Good Day Chicago: https://www.youtube.com/playlist?list=PL2-nR6U1joORm02SSjflpEVzL0ydEqeFu
Special reports and stories: https://www.youtube.com/playlist?list=PL2-nR6U1joOTGGgDx9B31HcT9IM60Al0-

Download the FOX 32 Chicago News app: https://fox32chicago.onelink.me/KNQ9?pid=social&c=youtube&af_web_dp=https%3A%2F%2Fwww.fox32chicago.com%2Fapps

Download the FOX 32 Chicago Weather app: https://www.fox32chicago.com/apps

Follow FOX 32 Chicago on Facebook: https://www.facebook.com/Fox32Chicago/
Follow FOX 32 Chicago on Twitter: https://twitter.com/fox32news/
Follow FOX 32 Chicago on Instagram: https://www.instagram.com/fox32chicago/

Subscribe to the FOX 32 Chicago newsletter: https://www.fox32chicago.com/newsletters