104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB2428
 
Introduced 2/4/2025, by Rep. Nabeela Syed
 
SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-30.11
    Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that on January 1, 2026 the reimbursement rates for applied behavior analysis services for the treatment of autism spectrum disorder shall be increased by 3.5% above the reimbursement rates in effect on December 31, 2025.


LRB104 08118 KTG 18164 b

 
 
A BILL FOR
 
HB2428LRB104 08118 KTG 18164 b

1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois, 
3represented in the General Assembly:
 
4    Section 5. The Illinois Public Aid Code is amended by 
5changing Section 5-30.11 as follows:
 
6    (305 ILCS 5/5-30.11)
7    Sec. 5-30.11. Treatment of autism spectrum disorder.  
8    (a) Treatment of autism spectrum disorder through applied 
9behavior analysis shall be covered under the medical 
10assistance program under this Article for children with a 
11diagnosis of autism spectrum disorder when (1) ordered by a 
12physician licensed to practice medicine in all its branches or 
13a psychologist licensed by the Department of Financial and 
14Professional Regulation and (2) evaluated by a behavior 
15analyst as recognized by the Department or licensed by the 
16Department of Financial and Professional Regulation to 
17practice applied behavior analysis in this State. Such 
18coverage may be limited to age ranges based on evidence-based 
19best practices. Appropriate State plan amendments as well as 
20rules regarding provision of services and providers will be 
21submitted by September 1, 2019. Pursuant to the flexibilities 
22allowed by the federal Centers for Medicare and Medicaid 
23Services to Illinois under the Medical Assistance Program, the 
 
 
HB2428- 2 -LRB104 08118 KTG 18164 b

1Department shall enroll and reimburse qualified staff to 
2perform applied behavior analysis services in advance of 
3Illinois licensure activities performed by the Department of 
4Financial and Professional Regulation. These services shall be 
5covered if they are provided in a home or community setting or 
6in an office-based setting. The Department may conduct annual 
7on-site reviews of the services authorized under this Section. 
8Provider enrollment shall occur no later than September 1, 
92023. 
10    (b) On January 1, 2026 the reimbursement rates for applied 
11behavior analysis services covered under this Section shall be 
12increased by 3.5% above the reimbursement rates in effect on 
13December 31, 2025. 
14(Source: P.A. 102-558, eff. 8-20-21; 102-953, eff. 5-27-22; 
15103-102, eff. 7-1-23.)