Selling a behavioral health practice in Illinois

Substance use treatment: the 25 percent rule

Each license issued by SUPR is valid only for the premises and organization name on the application, and it is not transferable. Under 77 Ill. Adm. Code 2060, a license becomes null and void when ownership changes by more than 25 percent of the aggregate ownership interest within a one-year period, or when 50 percent or more of a not-for-profit's board changes within a year.

Because the threshold is low, it reaches well beyond full sales. A recapitalization in which an investor buys 30 percent of your company can still void the license. Build the new license application into any deal that crosses the threshold, and check whether an earlier ownership change in the same 12 months counts toward it.

ABA therapy: licensure and Medicaid

Illinois licenses behavior analysts under the Behavior Analyst Licensing Act, whose administrative rules took effect May 23, 2024. Buyers will confirm that every analyst holds an Illinois license, not just BACB certification.

Illinois Medicaid covers ABA for dates of service on or after November 1, 2020, for children from birth through age 20 diagnosed with autism, under both fee-for-service and managed care, subject to prior authorization. Because the benefit is relatively new, buyers look closely at Medicaid volume growth, authorization trends with each managed care plan, and the share of commercial revenue.

Attorney General notice

Public Act 103-0526 requires health care facilities and provider organizations, which include groups of health care professionals, to give the Attorney General 30 days' notice of covered mergers, acquisitions, and contracting affiliations. Behavioral health group practices and MSO transactions can fall within it. If notice applies, the Attorney General can ask for more information, and the deal cannot close until 30 days after the parties substantially comply.

What Illinois buyers underwrite

These items move price the most in Illinois.

Licensing path

Whether the deal crosses the 25 percent SUPR threshold and how long a new license takes.

Clinician licensure

Illinois licenses for analysts, therapists, and prescribers, plus tenure and caseload.

Payer contracts

Medicaid managed care and commercial contracts in the practice's name.

Timeline

Attorney General notice, if it applies, and licensing steps.