Bill Text: IL SB3315 | 2023-2024 | 103rd General Assembly | Introduced

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Bill Title: Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions concerning the treatment of autism spectrum disorder through applied behavior analysis, provides that coverage of comprehensive applied behavior analysis and focused applied behavior analysis shall be based on medical necessity (rather than such coverage may be limited to age ranges based on evidence-based best practices). Provides that registered behavior technicians shall not be required to enroll in the medical assistance program as providers of applied behavior analysis services but shall be considered enrolled through their supervising staff qualified to perform applied behavior analysis. Effective immediately.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Failed) 2025-01-07 - Session Sine Die [SB3315 Detail]

Download: Illinois-2023-SB3315-Introduced.html

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103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB3315 Introduced 2/7/2024, by Sen. Bill Cunningham SYNOPSIS AS INTRODUCED:
305 ILCS 5/5-30.11
Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions concerning the treatment of autism spectrum disorder through applied behavior analysis, provides that coverage of comprehensive applied behavior analysis and focused applied behavior analysis shall be based on medical necessity (rather than such coverage may be limited to age ranges based on evidence-based best practices). Provides that registered behavior technicians shall not be required to enroll in the medical assistance program as providers of applied behavior analysis services but shall be considered enrolled through their supervising staff qualified to perform applied behavior analysis. Effective immediately.
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A BILL FOR
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AN ACT concerning public aid.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Illinois Public Aid Code is amended by
changing Section 5-30.11 as follows:
(305 ILCS 5/5-30.11)
Sec. 5-30.11. Treatment of autism spectrum disorder.
Treatment of autism spectrum disorder through applied behavior
analysis shall be covered under the medical assistance program
under this Article for children with a diagnosis of autism
spectrum disorder when (1) ordered by a physician licensed to
practice medicine in all its branches or a psychologist
licensed by the Department of Financial and Professional
Regulation and (2) evaluated by a behavior analyst as
recognized by the Department or licensed by the Department of
Financial and Professional Regulation to practice applied
behavior analysis in this State. Coverage of comprehensive
applied behavior analysis and focused applied behavior
analysis shall be based on medical necessity. Such coverage
may be limited to age ranges based on evidence-based best
practices. Appropriate State plan amendments as well as rules
regarding provision of services and providers will be
submitted by September 1, 2019. Pursuant to the flexibilities

SB3315 - 2 - LRB103 38830 KTG 68967 b
allowed by the federal Centers for Medicare and Medicaid
Services to Illinois under the Medical Assistance Program, the
Department shall enroll and reimburse qualified staff to
perform applied behavior analysis services in advance of
Illinois licensure activities performed by the Department of
Financial and Professional Regulation. Registered behavior
technicians shall not be required to enroll but shall be
considered enrolled through their supervising staff qualified
to perform applied behavior analysis. These services shall be
covered if they are provided in a home or community setting or
in an office-based setting. The Department may conduct annual
on-site reviews of the services authorized under this Section.
Provider enrollment shall occur no later than September 1,
2023.
(Source: P.A. 102-558, eff. 8-20-21; 102-953, eff. 5-27-22;
103-102, eff. 7-1-23.)