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.


LRB103 38830 KTG 68967 b

 

 

A BILL FOR

 

SB3315LRB103 38830 KTG 68967 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 (1) ordered by a physician licensed to
12practice medicine in all its branches or a psychologist
13licensed by the Department of Financial and Professional
14Regulation and (2) evaluated by a behavior analyst as
15recognized by the Department or licensed by the Department of
16Financial and Professional Regulation to practice applied
17behavior analysis in this State. Coverage of comprehensive
18applied behavior analysis and focused applied behavior
19analysis shall be based on medical necessity. Such coverage
20may be limited to age ranges based on evidence-based best
21practices. Appropriate State plan amendments as well as rules
22regarding provision of services and providers will be
23submitted by September 1, 2019. Pursuant to the flexibilities

 

 

SB3315- 2 -LRB103 38830 KTG 68967 b

1allowed by the federal Centers for Medicare and Medicaid
2Services to Illinois under the Medical Assistance Program, the
3Department shall enroll and reimburse qualified staff to
4perform applied behavior analysis services in advance of
5Illinois licensure activities performed by the Department of
6Financial and Professional Regulation. Registered behavior
7technicians shall not be required to enroll but shall be
8considered enrolled through their supervising staff qualified
9to perform applied behavior analysis. These services shall be
10covered if they are provided in a home or community setting or
11in an office-based setting. The Department may conduct annual
12on-site reviews of the services authorized under this Section.
13Provider enrollment shall occur no later than September 1,
142023.
15(Source: P.A. 102-558, eff. 8-20-21; 102-953, eff. 5-27-22;
16103-102, eff. 7-1-23.)
 
17    Section 99. Effective date. This Act takes effect upon
18becoming law.