Illinois Expands Access to Earlier, More Precise Preterm Birth Risk Assessment.

Beginning July 1, Illinois Medicaid expanded coverage for evidence-based preterm birth risk assessment, supporting clinicians in earlier identification of all patients at increased risk of preterm birth to help tailor prenatal care.

The Challenge of Identifying Preterm Birth Risk Before Warning Signs Appear

Using traditional methods alone, 50% of women who deliver early are not identified ahead of time.

Without an early indication of risk, it can be difficult to provide proactive care and determine which patients may benefit from additional monitoring and resources.

What SB3365 Means for Your Practice

Illinois’ expansion of Medicaid coverage for proteomic biomarker testing is expected to make tools such as the PreTRM® Test more accessible to pregnant women who can benefit from early identification of preterm birth risk. For clinicians, this creates an opportunity to incorporate evidence-based risk assessment into prenatal care pathways and support more informed, personalized care decisions.

The legislation also provides reimbursement for care management services and interventions shown to improve outcomes. Together, access to biomarker testing and support for care management allow clinicians to identify higher-risk patients earlier, connect them with appropriate resources, and strengthen coordinated care for Medicaid patients across Illinois. 

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Questions you might have

References

  1.  Hamilton BE, Osterman MJK. Births: Provisional Data for 2024. Vital Statistics Rapid Release. 2025;38.
  2. Callaghan WM, et al. The contribution of preterm birth to infant mortality rates in the United States. Pediatrics. 2006;118(4):1566-73.
  3. Iams JD, et al. Prevention of Preterm Parturition. N Engl J Med. 2014;370:254-61. DOI: 10.1056/NEJMcp1103640.