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| | 103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024 SB0101 Introduced 1/24/2023, by Sen. Laura Fine SYNOPSIS AS INTRODUCED: |
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Amends the Illinois Insurance Code. Provides that no group or individual policy of accident and health insurance or managed care plan shall deny or delay coverage for medically necessary treatment because the insured, enrollee, or beneficiary previously received any treatment, including the same or similar treatment, for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections or pediatric acute onset neuropsychiatric syndrome, or because the insured, enrollee, or beneficiary has been diagnosed with or receives treatment for an otherwise diagnosed condition. Provides that coverage of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome shall adhere to the treatment recommendations developed by a medical professional consortium convened for the purposes of researching, identifying, and publishing best practice standards for diagnosis and treatment of such disorders or syndrome that are accessible for medical professionals and are based on evidence of positive patient outcomes. Provides that coverage for any form of medically necessary treatment shall not be limited over a lifetime of an insured, enrollee, or beneficiary, unless the patient is no longer benefiting from the treatment, or by policy period. Provides that nothing in the provisions prevents insurers from requesting treatment notes and anticipated duration of treatment and outcomes. Effective immediately.
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| | A BILL FOR |
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| | SB0101 | | LRB103 25077 BMS 51412 b |
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1 | | AN ACT concerning regulation.
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2 | | Be it enacted by the People of the State of Illinois,
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3 | | represented in the General Assembly:
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4 | | Section 5. The Illinois Insurance Code is amended by |
5 | | changing Section 356z.25 as follows: |
6 | | (215 ILCS 5/356z.25) |
7 | | Sec. 356z.25. Coverage for treatment of pediatric |
8 | | autoimmune neuropsychiatric disorders associated with |
9 | | streptococcal infections and pediatric acute onset |
10 | | neuropsychiatric syndrome. A group or individual policy of |
11 | | accident and health insurance or managed care plan that is |
12 | | amended, delivered, issued, or renewed after July 18, 2017 |
13 | | (the effective date of Public Act 100-24) shall provide |
14 | | coverage for treatment of pediatric autoimmune |
15 | | neuropsychiatric disorders associated with streptococcal |
16 | | infections and pediatric acute-onset neuropsychiatric |
17 | | syndrome, including, but not limited to, the use of |
18 | | intravenous immunoglobulin therapy. |
19 | | No group or individual policy of accident and health |
20 | | insurance or managed care plan shall deny or delay coverage |
21 | | for medically necessary treatment under this Section solely |
22 | | because the insured, enrollee, or beneficiary previously |
23 | | received any treatment, including the same or similar |