| |||||||
| |||||||
| |||||||
| 1 | AN ACT concerning health.
| ||||||
| 2 | Be it enacted by the People of the State of Illinois,
| ||||||
| 3 | represented in the General Assembly:
| ||||||
| 4 | Section 5. The Autism Spectrum Disorders Reporting Act is | ||||||
| 5 | amended by adding Sections 32 and 33 as follows: | ||||||
| 6 | (410 ILCS 201/32 new) | ||||||
| 7 | Sec. 32. Reporting; access to applied behavior analysis. | ||||||
| 8 | By no later than December 31 of each year the Department of | ||||||
| 9 | Healthcare and Family Services (HFS) shall submit a report, | ||||||
| 10 | covering the State fiscal year immediately preceding that | ||||||
| 11 | date, to the General Assembly regarding access to applied | ||||||
| 12 | behavior analysis therapy for persons diagnosed with autism | ||||||
| 13 | spectrum disorder. The report shall include, but is not | ||||||
| 14 | limited to, the following information: | ||||||
| 15 | (1) The number of providers enrolled in the Illinois | ||||||
| 16 | Medical Assistance Program certified to provide applied | ||||||
| 17 | behavioral analysis therapy services in the Department of | ||||||
| 18 | Healthcare and Family Services' fee-for-service or managed | ||||||
| 19 | care service delivery system, in accordance with | ||||||
| 20 | administrative rule and Department of Healthcare and | ||||||
| 21 | Family Services policy. | ||||||
| 22 | (2) The number of HFS-enrolled children in Illinois | ||||||
| 23 | with an autism spectrum disorder diagnosis receiving | ||||||
| |||||||
| |||||||
| 1 | applied behavior analysis therapy services pursuant to the | ||||||
| 2 | Department of Healthcare and Family Services' | ||||||
| 3 | fee-for-service or managed care service delivery system. | ||||||
| 4 | (3) Subject to data availability, the number of | ||||||
| 5 | HFS-enrolled children with an autism spectrum disorder | ||||||
| 6 | diagnosis for whom applied behavioral analysis therapy | ||||||
| 7 | services have been recommended or requested, but who are | ||||||
| 8 | not receiving applied behavioral analysis therapy | ||||||
| 9 | services. | ||||||
| 10 | (4) Subject to data availability for HFS-enrolled | ||||||
| 11 | children in Illinois with an autism spectrum disorder | ||||||
| 12 | diagnosis, the number of prior authorization service | ||||||
| 13 | denials for applied behavioral analysis therapy services | ||||||
| 14 | and the number of appeals resulting from those denials for | ||||||
| 15 | applied behavioral analysis therapy services. | ||||||
| 16 | (5) Recommendations on improving applied behavioral | ||||||
| 17 | analysis therapy provider network adequacy and enrollee | ||||||
| 18 | access. | ||||||
| 19 | (410 ILCS 201/33 new) | ||||||
| 20 | Sec. 33. Education and outreach materials; autism spectrum | ||||||
| 21 | disorder. The Department shall develop and distribute | ||||||
| 22 | education and outreach materials, developed to address common | ||||||
| 23 | literacy levels, that will inform and educate parents of | ||||||
| 24 | children with autism spectrum disorder who are enrolled in | ||||||
| 25 | Medicaid and eligible to receive relevant services and explain | ||||||
| |||||||
| |||||||
| 1 | how to access those services.
| ||||||