102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB0016

 

Introduced 1/14/2021, by Rep. Deb Conroy

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-30.11

    Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the treatment of autism spectrum disorder through applied behavior analysis shall be covered under the medical assistance program for children with a diagnosis of autism spectrum disorder when ordered by a certified, registered, or licensed health care professional with expertise in treating the effects of autism spectrum disorders when the care is determined to be medically necessary and ordered by a physician licensed to practice medicine in all its branches. Provides that certain treatment shall be covered, including, but not limited to, psychiatric, psychological, rehabilitative, and therapeutic care. Effective July 1, 2021.


LRB102 02761 KTG 12768 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB0016LRB102 02761 KTG 12768 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.
8Treatment of autism spectrum disorder through applied behavior
9analysis shall be covered under the medical assistance program
10under this Article for children with a diagnosis of autism
11spectrum disorder when ordered by (i) a physician licensed to
12practice medicine in all its branches and rendered by a
13licensed or certified health care professional with expertise
14in applied behavior analysis or (ii) a certified, registered,
15or licensed health care professional with expertise in
16treating the effects of autism spectrum disorders when the
17care is determined to be medically necessary and ordered by a
18physician licensed to practice medicine in all its branches.
19Treatment covered under this Section shall include, but not be
20limited to, the following:
21        (1) Psychiatric care, meaning direct, consultative, or
22    diagnostic services provided by a licensed psychiatrist.
23        (2) Psychological care, meaning direct or consultative

 

 

HB0016- 2 -LRB102 02761 KTG 12768 b

1    services provided by a licensed psychologist.
2        (3) Habilitative or rehabilitative care, meaning
3    professional, counseling, and guidance services and
4    treatment programs, including applied behavior analysis,
5    that are intended to develop, maintain, and restore the
6    functioning of an individual. As used in this subsection,
7    "applied behavior analysis" means the design,
8    implementation, and evaluation of environmental
9    modifications using behavioral stimuli and consequences to
10    produce socially significant improvement in human
11    behavior, including the use of direct observation,
12    measurement, and functional analysis of the relations
13    between environment and behavior. Applied behavior
14    analysis shall be covered if provided by a Board Certified
15    Behavior Analyst who possesses at least a master's degree
16    or higher level of education in qualifying fields and
17    possesses certification from the Behavior Analyst
18    Certification Board. Applied behavior analysis can also be
19    provided and shall be covered when provided by a
20    Registered Behavior Technician who is certified and in
21    direct supervision of a Board Certified Behavior Analyst.
22        (4) Therapeutic care, including behavioral, speech,
23    occupational, and physical therapies that provide
24    treatment in the following areas: (i) self care and
25    feeding; (ii) pragmatic, receptive, and expressive
26    language; (iii) cognitive functioning; (iv) applied

 

 

HB0016- 3 -LRB102 02761 KTG 12768 b

1    behavior analysis, intervention, and modification; (v)
2    motor planning; and (vi) sensory processing.
3    Such coverage may be limited to age ranges based on
4evidence-based best practices. Appropriate State plan
5amendments as well as rules regarding provision of services
6and providers will be submitted by September 1, 2019.
7(Source: P.A. 101-10, eff. 6-5-19.)
 
8    Section 99. Effective date. This Act takes effect July 1,
92021.