Illinois General Assembly - Full Text of HB3308
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Full Text of HB3308  102nd General Assembly




HB3308 EnrolledLRB102 11877 BMS 17213 b

1    AN ACT concerning regulation.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Illinois Administrative Procedure Act is
5amended by adding Section 5-45.8 as follows:
6    (5 ILCS 100/5-45.8 new)
7    Sec. 5-45.8. Emergency rulemaking; Illinois Insurance
8Code. To provide for the expeditious and timely implementation
9of changes made to the Illinois Insurance Code by this
10amendatory Act of the 102nd General Assembly, emergency rules
11implementing the changes made to the Illinois Insurance Code
12by this amendatory Act of the 102nd General Assembly may be
13adopted in accordance with Section 5-45 by the Department of
14Insurance. The adoption of emergency rules authorized by
15Section 5-45 and this Section is deemed to be necessary for the
16public interest, safety, and welfare. This Section is repealed
17on January 1, 2022.
18    Section 10. The Illinois Insurance Code is amended by
19changing Section 356z.22 as follows:
20    (215 ILCS 5/356z.22)
21    Sec. 356z.22. Coverage for telehealth services.



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1    (a) For purposes of this Section:
2    "Asynchronous store and forward system" has the meaning
3given to that term in Section 5 of the Telehealth Act.
4    "Distant site" has the meaning given to that term in
5Section 5 of the Telehealth Act means the location at which the
6health care provider rendering the telehealth service is
8    "E-visits" has the meaning given to that term in Section 5
9of the Telehealth Act.
10    "Facility" means any hospital facility licensed under the
11Hospital Licensing Act or the University of Illinois Hospital
12Act, a federally qualified health center, a community mental
13health center, a behavioral health clinic, a substance use
14disorder treatment program licensed by the Division of
15Substance Use Prevention and Recovery of the Department of
16Human Services, or other building, place, or institution that
17is owned or operated by a person that is licensed or otherwise
18authorized to deliver health care services.
19    "Health care professional" has the meaning given to that
20term in Section 5 of the Telehealth Act.
21    "Interactive telecommunications system" has the meaning
22given to that term in Section 5 of the Telehealth Act. As used
23in this Section, "interactive telecommunications system" does
24not include virtual check-ins means an audio and video system
25permitting 2-way, live interactive communication between the
26patient and the distant site health care provider.



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1    "Originating site" has the meaning given to that term in
2Section 5 of the Telehealth Act.
3    "Telehealth services" has the meaning given to that term
4in Section 5 of the Telehealth Act. As used in this Section,
5"telehealth services" do not include asynchronous store and
6forward systems, remote patient monitoring technologies,
7e-visits, or virtual check-ins means the delivery of covered
8health care services by way of an interactive
9telecommunications system.
10    "Virtual check-in" has the meaning given to that term in
11Section 5 of the Telehealth Act.
12    (b) An If an individual or group policy of accident or
13health insurance that is amended, delivered, issued, or
14renewed on or after the effective date of this amendatory Act
15of the 102nd General Assembly shall cover telehealth services,
16e-visits, and virtual check-ins rendered by a health care
17professional when clinically appropriate and medically
18necessary to insureds, enrollees, and members in the same
19manner as any other benefits covered under the policy. An
20individual or group policy of accident or health insurance may
21provide reimbursement to a facility that serves as the
22originating site at the time a telehealth service is rendered.
23provides coverage for telehealth services, then it must comply
24with the following:
25    (c) To ensure telehealth service, e-visit, and virtual
26check-in access is equitable for all patients in receipt of



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1health care services under this Section and health care
2professionals and facilities are able to deliver medically
3necessary services that can be appropriately delivered via
4telehealth within the scope of their licensure or
5certification, coverage required under this Section shall
6comply with all of the following:
7        (1) An individual or group policy of accident or
8    health insurance shall providing telehealth services may
9    not:
10            (A) require that in-person contact occur between a
11        health care professional provider and a patient before
12        the provision of a telehealth service;
13            (B) require patients, the health care
14        professionals, or facilities provider to prove or
15        document a hardship or access barrier to an in-person
16        consultation for coverage and reimbursement of
17        telehealth services, e-visits, or virtual check-ins to
18        be provided through telehealth;
19            (C) require the use of telehealth services,
20        e-visits, or virtual check-ins when the health care
21        professional provider has determined that it is not
22        appropriate; or
23            (D) require the use of telehealth services when a
24        patient chooses an in-person consultation; .
25            (E) require a health care professional to be
26        physically present in the same room as the patient at



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1        the originating site, unless deemed medically
2        necessary by the health care professional providing
3        the telehealth service;
4            (F) create geographic or facility restrictions or
5        requirements for telehealth services, e-visits, or
6        virtual check-ins;
7            (G) require health care professionals or
8        facilities to offer or provide telehealth services,
9        e-visits, or virtual check-ins;
10            (H) require patients to use telehealth services,
11        e-visits, or virtual check-ins, or require patients to
12        use a separate panel of health care professionals or
13        facilities to receive telehealth service, e-visit, or
14        virtual check-in coverage and reimbursement; or
15            (I) impose upon telehealth services, e-visits, or
16        virtual check-ins utilization review requirements that
17        are unnecessary, duplicative, or unwarranted or impose
18        any treatment limitations, prior authorization,
19        documentation, or recordkeeping requirements that are
20        more stringent than the requirements applicable to the
21        same health care service when rendered in-person,
22        except procedure code modifiers may be required to
23        document telehealth.
24        (2) Deductibles, copayments, or coinsurance, or any
25    other cost-sharing applicable to services provided through
26    telehealth shall not exceed the deductibles, copayments,



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1    or coinsurance, or any other cost-sharing required by the
2    individual or group policy of accident or health insurance
3    for the same services provided through in-person
4    consultation.
5        (3) An individual or group policy of accident or
6    health insurance shall notify health care professionals
7    and facilities of any instructions necessary to facilitate
8    billing for telehealth services, e-visits, and virtual
9    check-ins.
10    (d) For purposes of reimbursement, an individual or group
11policy of accident or health insurance that is amended,
12delivered, issued, or renewed on or after the effective date
13of this amendatory Act of the 102nd General Assembly shall
14reimburse an in-network health care professional or facility,
15including a health care professional or facility in a tiered
16network, for telehealth services provided through an
17interactive telecommunications system on the same basis, in
18the same manner, and at the same reimbursement rate that would
19apply to the services if the services had been delivered via an
20in-person encounter by an in-network or tiered network health
21care professional or facility. This subsection applies only to
22those services provided by telehealth that may otherwise be
23billed as an in-person service. This subsection is inoperative
24on and after January 1, 2028, except that this subsection is
25operative after that date with respect to mental health and
26substance use disorder telehealth services.



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1    (e) The Department and the Department of Public Health
2shall commission a report to the General Assembly administered
3by an established medical college in this State wherein
4supervised clinical training takes place at an affiliated
5institution that uses telehealth services, subject to
6appropriation. The report shall study the telehealth coverage
7and reimbursement policies established in subsections (b) and
8(d) of this Section, to determine if the policies improve
9access to care, reduce health disparities, promote health
10equity, have an impact on utilization and cost-avoidance,
11including direct or indirect cost savings to the patient, and
12to provide any recommendations for telehealth access expansion
13in the future. An individual or group policy of accident or
14health insurance shall provide data necessary to carry out the
15requirements of this subsection upon request of the
16Department. The Department and the Department of Public Health
17shall submit the report by December 31, 2026. The established
18medical college may utilize subject matter expertise to
19complete any necessary actuarial analysis.
20    (f) Nothing in this Section is intended to limit the
21ability of an individual or group policy of accident or health
22insurance and a health care professional or facility to
23voluntarily negotiate alternate reimbursement rates for
24telehealth services. Such voluntary negotiations shall take
25into consideration the ongoing investment necessary to ensure
26these telehealth platforms may be continuously maintained,



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1seamlessly updated, and integrated with a patient's electronic
2medical records.
3    (g) An (b-5) If an individual or group policy of accident
4or health insurance that is amended, delivered, issued, or
5renewed on or after the effective date of this amendatory Act
6of the 102nd General Assembly shall provide provides coverage
7for telehealth services, it must provide coverage for licensed
8dietitian nutritionists and certified diabetes educators who
9counsel senior diabetes patients in the senior diabetes
10patients' homes to remove the hurdle of transportation for
11senior diabetes patients to receive treatment, in accordance
12with the Dietitian Nutritionist Practice Act.
13    (h) Any policy, contract, or certificate of health
14insurance coverage that does not distinguish between
15in-network and out-of-network health care professionals and
16facilities shall be subject to this Section as though all
17health care professionals and facilities were in-network.
18    (i) Health care professionals and facilities shall
19determine the appropriateness of specific sites, technology
20platforms, and technology vendors for a telehealth service, as
21long as delivered services adhere to all federal and State
22privacy, security, and confidentiality laws, rules, or
23regulations, including, but not limited to, the Health
24Insurance Portability and Accountability Act of 1996 and the
25Mental Health and Developmental Disabilities Confidentiality



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1    (j) (c) Nothing in this Section shall be deemed as
2precluding a health insurer from providing benefits for other
3telehealth services, including, but not limited to, services
4not required for coverage provided through an asynchronous
5store and forward system, remote patient monitoring services,
6remote monitoring services, other monitoring services, or oral
7communications otherwise covered under the policy.
8    (k) There shall be no restrictions on originating site
9requirements for telehealth coverage or reimbursement to the
10distant site under this Section other than requiring the
11telehealth services to be medically necessary and clinically
13    (l) The Department may adopt rules, including emergency
14rules subject to the provisions of Section 5-45 of the
15Illinois Administrative Procedure Act, to implement the
16provisions of this Section.
17(Source: P.A. 100-1009, eff. 1-1-19.)
18    Section 15. The Telehealth Act is amended by changing
19Sections 5, 10, and 15 as follows:
20    (225 ILCS 150/5)
21    Sec. 5. Definitions. As used in this Act:
22    "Asynchronous store and forward system" means the
23transmission of a patient's medical information through an
24electronic communications system at an originating site to a



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1health care professional or facility at a distant site that
2does not require real-time or synchronous interaction between
3the health care professional and the patient.
4    "Distant site" means the location at which the health care
5professional rendering the telehealth service is located.
6    "Established patient" means a patient with a relationship
7with a health care professional in which there has been an
8exchange of an individual's protected health information for
9the purpose of providing patient care, treatment, or services.
10    "E-visit" means a patient-initiated non-face-to-face
11communication through an online patient portal between an
12established patient and a health care professional.
13    "Facility" includes a facility that is owned or operated
14by a hospital under the Hospital Licensing Act or University
15of Illinois Hospital Act, a facility under the Nursing Home
16Care Act, a rural health clinic, a federally qualified health
17center, a local health department, a community mental health
18center, a behavioral health clinic as defined in 89 Ill. Adm.
19Code 140.453, an encounter rate clinic, a skilled nursing
20facility, a substance use treatment program licensed by the
21Division of Substance Use Prevention and Recovery of the
22Department of Human Services, a school-based health center as
23defined in 77 Ill. Adm. Code 641.10, a physician's office, a
24podiatrist's office, a supportive living program provider, a
25hospice provider, home health agency, or home nursing agency
26under the Home Health, Home Services, and Home Nursing Agency



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1Licensing Act, a facility under the ID/DD Community Care Act,
2community-integrated living arrangements as defined in the
3Community-Integrated Living Arrangements Licensure and
4Certification Act, and a provider who receives reimbursement
5for a patient's room and board.
6    "Health care professional" includes, but is not limited
7to, physicians, physician assistants, optometrists, advanced
8practice registered nurses, clinical psychologists licensed in
9Illinois, prescribing psychologists licensed in Illinois,
10dentists, occupational therapists, pharmacists, physical
11therapists, clinical social workers, speech-language
12pathologists, audiologists, hearing instrument dispensers,
13licensed certified substance use disorder treatment providers
14and clinicians, and mental health professionals and clinicians
15authorized by Illinois law to provide mental health services,
16and qualified providers listed under paragraph (8) of
17subsection (e) of Section 3 of the Early Intervention Services
18System Act, dietitian nutritionists licensed in Illinois, and
19health care professionals associated with a facility.
20    "Interactive telecommunications system" means an audio and
21video system, an audio-only telephone system (landline or
22cellular), or any other telecommunications system permitting
232-way, synchronous interactive communication between a patient
24at an originating site and a health care professional or
25facility at a distant site. "Interactive telecommunications
26system" does not include a facsimile machine, electronic mail



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1messaging, or text messaging.
2    "Originating site" means the location at which the patient
3is located at the time telehealth services are provided to the
4patient via telehealth.
5    "Remote patient monitoring" means the use of connected
6digital technologies or mobile medical devices to collect
7medical and other health data from a patient at one location
8and electronically transmit that data to a health care
9professional or facility at a different location for
10collection and interpretation.
11    "Telehealth services" means the evaluation, diagnosis, or
12interpretation of electronically transmitted patient-specific
13data between a remote location and a licensed health care
14professional that generates interaction or treatment
15recommendations. "Telehealth services" includes telemedicine
16and the delivery of health care services, including mental
17health treatment and substance use disorder treatment and
18services to a patient, regardless of patient location,
19provided by way of an interactive telecommunications system,
20asynchronous store and forward system, remote patient
21monitoring technologies, e-visits, or virtual check-ins as
22defined in subsection (a) of Section 356z.22 of the Illinois
23Insurance Code.
24    "Virtual check-in" means a brief patient-initiated
25communication using a technology-based service, excluding
26facsimile, between an established patient and a health care



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1professional. "Virtual check-in" does not include
2communications from a related office visit provided within the
3previous 7 days, nor communications that lead to an office
4visit or procedure within the next 24 hours or soonest
5available appointment.
6(Source: P.A. 100-317, eff. 1-1-18; 100-644, eff. 1-1-19;
7100-930, eff. 1-1-19; 101-81, eff. 7-12-19; 101-84, eff.
9    (225 ILCS 150/10)
10    Sec. 10. Practice authority. A health care professional
11treating a patient located in this State through telehealth
12services must be licensed or authorized to practice in
14(Source: P.A. 100-317, eff. 1-1-18.)
15    (225 ILCS 150/15)
16    Sec. 15. Use of telehealth services.
17    (a) A health care professional may engage in the practice
18of telehealth services in Illinois to the extent of his or her
19scope of practice as established in his or her respective
20licensing Act consistent with the standards of care for
21in-person services. This Act shall not be construed to alter
22the scope of practice of any health care professional or
23authorize the delivery of health care services in a setting or
24in a manner not otherwise authorized by the laws of this State.



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1    (b) Telehealth services provided pursuant to this Section
2shall be consistent with all federal and State privacy,
3security, and confidentiality laws, rules, or regulations.
4(Source: P.A. 100-317, eff. 1-1-18.)
5    Section 20. The Early Intervention Services System Act is
6amended by changing Sections 3 and 11 and by adding Section 3b
7as follows:
8    (325 ILCS 20/3)  (from Ch. 23, par. 4153)
9    Sec. 3. Definitions. As used in this Act:
10    (a) "Eligible infants and toddlers" means infants and
11toddlers under 36 months of age with any of the following
13        (1) Developmental delays.
14        (2) A physical or mental condition which typically
15    results in developmental delay.
16        (3) Being at risk of having substantial developmental
17    delays based on informed clinical opinion.
18        (4) Either (A) having entered the program under any of
19    the circumstances listed in paragraphs (1) through (3) of
20    this subsection but no longer meeting the current
21    eligibility criteria under those paragraphs, and
22    continuing to have any measurable delay, or (B) not having
23    attained a level of development in each area, including
24    (i) cognitive, (ii) physical (including vision and



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1    hearing), (iii) language, speech, and communication, (iv)
2    social or emotional, or (v) adaptive, that is at least at
3    the mean of the child's age equivalent peers; and, in
4    addition to either item (A) or item (B), (C) having been
5    determined by the multidisciplinary individualized family
6    service plan team to require the continuation of early
7    intervention services in order to support continuing
8    developmental progress, pursuant to the child's needs and
9    provided in an appropriate developmental manner. The type,
10    frequency, and intensity of services shall differ from the
11    initial individualized family services plan because of the
12    child's developmental progress, and may consist of only
13    service coordination, evaluation, and assessments.
14    (b) "Developmental delay" means a delay in one or more of
15the following areas of childhood development as measured by
16appropriate diagnostic instruments and standard procedures:
17cognitive; physical, including vision and hearing; language,
18speech and communication; social or emotional; or adaptive.
19The term means a delay of 30% or more below the mean in
20function in one or more of those areas.
21    (c) "Physical or mental condition which typically results
22in developmental delay" means:
23        (1) a diagnosed medical disorder or exposure to a
24    toxic substance bearing a relatively well known expectancy
25    for developmental outcomes within varying ranges of
26    developmental disabilities; or



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1        (2) a history of prenatal, perinatal, neonatal or
2    early developmental events suggestive of biological
3    insults to the developing central nervous system and which
4    either singly or collectively increase the probability of
5    developing a disability or delay based on a medical
6    history.
7    (d) "Informed clinical opinion" means both clinical
8observations and parental participation to determine
9eligibility by a consensus of a multidisciplinary team of 2 or
10more members based on their professional experience and
12    (e) "Early intervention services" means services which:
13        (1) are designed to meet the developmental needs of
14    each child eligible under this Act and the needs of his or
15    her family;
16        (2) are selected in collaboration with the child's
17    family;
18        (3) are provided under public supervision;
19        (4) are provided at no cost except where a schedule of
20    sliding scale fees or other system of payments by families
21    has been adopted in accordance with State and federal law;
22        (5) are designed to meet an infant's or toddler's
23    developmental needs in any of the following areas:
24            (A) physical development, including vision and
25        hearing,
26            (B) cognitive development,



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1            (C) communication development,
2            (D) social or emotional development, or
3            (E) adaptive development;
4        (6) meet the standards of the State, including the
5    requirements of this Act;
6        (7) include one or more of the following:
7            (A) family training,
8            (B) social work services, including counseling,
9        and home visits,
10            (C) special instruction,
11            (D) speech, language pathology and audiology,
12            (E) occupational therapy,
13            (F) physical therapy,
14            (G) psychological services,
15            (H) service coordination services,
16            (I) medical services only for diagnostic or
17        evaluation purposes,
18            (J) early identification, screening, and
19        assessment services,
20            (K) health services specified by the lead agency
21        as necessary to enable the infant or toddler to
22        benefit from the other early intervention services,
23            (L) vision services,
24            (M) transportation,
25            (N) assistive technology devices and services,
26            (O) nursing services,



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1            (P) nutrition services, and
2            (Q) sign language and cued language services;
3        (8) are provided by qualified personnel, including but
4    not limited to:
5            (A) child development specialists or special
6        educators, including teachers of children with hearing
7        impairments (including deafness) and teachers of
8        children with vision impairments (including
9        blindness),
10            (B) speech and language pathologists and
11        audiologists,
12            (C) occupational therapists,
13            (D) physical therapists,
14            (E) social workers,
15            (F) nurses,
16            (G) dietitian nutritionists,
17            (H) vision specialists, including ophthalmologists
18        and optometrists,
19            (I) psychologists, and
20            (J) physicians;
21        (9) are provided in conformity with an Individualized
22    Family Service Plan;
23        (10) are provided throughout the year; and
24        (11) are provided in natural environments, to the
25    maximum extent appropriate, which may include the home and
26    community settings, unless justification is provided



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1    consistent with federal regulations adopted under Sections
2    1431 through 1444 of Title 20 of the United States Code.
3    (f) "Individualized Family Service Plan" or "Plan" means a
4written plan for providing early intervention services to a
5child eligible under this Act and the child's family, as set
6forth in Section 11.
7    (g) "Local interagency agreement" means an agreement
8entered into by local community and State and regional
9agencies receiving early intervention funds directly from the
10State and made in accordance with State interagency agreements
11providing for the delivery of early intervention services
12within a local community area.
13    (h) "Council" means the Illinois Interagency Council on
14Early Intervention established under Section 4.
15    (i) "Lead agency" means the State agency responsible for
16administering this Act and receiving and disbursing public
17funds received in accordance with State and federal law and
19    (i-5) "Central billing office" means the central billing
20office created by the lead agency under Section 13.
21    (j) "Child find" means a service which identifies eligible
22infants and toddlers.
23    (k) "Regional intake entity" means the lead agency's
24designated entity responsible for implementation of the Early
25Intervention Services System within its designated geographic



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1    (l) "Early intervention provider" means an individual who
2is qualified, as defined by the lead agency, to provide one or
3more types of early intervention services, and who has
4enrolled as a provider in the early intervention program.
5    (m) "Fully credentialed early intervention provider" means
6an individual who has met the standards in the State
7applicable to the relevant profession, and has met such other
8qualifications as the lead agency has determined are suitable
9for personnel providing early intervention services, including
10pediatric experience, education, and continuing education. The
11lead agency shall establish these qualifications by rule filed
12no later than 180 days after the effective date of this
13amendatory Act of the 92nd General Assembly.
14    (n) "Telehealth" has the meaning given to that term in
15Section 5 of the Telehealth Act.
16(Source: P.A. 101-10, eff. 6-5-19.)
17    (325 ILCS 20/3b new)
18    Sec. 3b. Services delivered by telehealth. An early
19intervention provider may deliver via telehealth any type of
20early intervention service outlined in subsection (e) of
21Section 3 to the extent of the early intervention provider's
22scope of practice as established in the provider's respective
23licensing Act consistent with the standards of care for
24in-person services. This Section shall not be construed to
25alter the scope of practice of any early intervention provider



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1or authorize the delivery of early intervention services in a
2setting or in a manner not otherwise authorized by the laws of
3this State.
4    (325 ILCS 20/11)  (from Ch. 23, par. 4161)
5    Sec. 11. Individualized Family Service Plans.
6    (a) Each eligible infant or toddler and that infant's or
7toddler's family shall receive:
8        (1) timely, comprehensive, multidisciplinary
9    assessment of the unique strengths and needs of each
10    eligible infant and toddler, and assessment of the
11    concerns and priorities of the families to appropriately
12    assist them in meeting their needs and identify supports
13    and services to meet those needs; and
14        (2) a written Individualized Family Service Plan
15    developed by a multidisciplinary team which includes the
16    parent or guardian. The individualized family service plan
17    shall be based on the multidisciplinary team's assessment
18    of the resources, priorities, and concerns of the family
19    and its identification of the supports and services
20    necessary to enhance the family's capacity to meet the
21    developmental needs of the infant or toddler, and shall
22    include the identification of services appropriate to meet
23    those needs, including the frequency, intensity, and
24    method of delivering services. During and as part of the
25    initial development of the individualized family services



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1    plan, and any periodic reviews of the plan, the
2    multidisciplinary team may seek consultation from the lead
3    agency's designated experts, if any, to help determine
4    appropriate services and the frequency and intensity of
5    those services. All services in the individualized family
6    services plan must be justified by the multidisciplinary
7    assessment of the unique strengths and needs of the infant
8    or toddler and must be appropriate to meet those needs. At
9    the periodic reviews, the team shall determine whether
10    modification or revision of the outcomes or services is
11    necessary.
12    (b) The Individualized Family Service Plan shall be
13evaluated once a year and the family shall be provided a review
14of the Plan at 6 month intervals or more often where
15appropriate based on infant or toddler and family needs. The
16lead agency shall create a quality review process regarding
17Individualized Family Service Plan development and changes
18thereto, to monitor and help assure that resources are being
19used to provide appropriate early intervention services.
20    (c) The initial evaluation and initial assessment and
21initial Plan meeting must be held within 45 days after the
22initial contact with the early intervention services system.
23The 45-day timeline does not apply for any period when the
24child or parent is unavailable to complete the initial
25evaluation, the initial assessments of the child and family,
26or the initial Plan meeting, due to exceptional family



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1circumstances that are documented in the child's early
2intervention records, or when the parent has not provided
3consent for the initial evaluation or the initial assessment
4of the child despite documented, repeated attempts to obtain
5parental consent. As soon as exceptional family circumstances
6no longer exist or parental consent has been obtained, the
7initial evaluation, the initial assessment, and the initial
8Plan meeting must be completed as soon as possible. With
9parental consent, early intervention services may commence
10before the completion of the comprehensive assessment and
11development of the Plan.
12    (d) Parents must be informed that early intervention
13services shall be provided to each eligible infant and
14toddler, to the maximum extent appropriate, in the natural
15environment, which may include the home or other community
16settings. Parents must also be informed of the availability of
17early intervention services provided through telehealth
18services. Parents shall make the final decision to accept or
19decline early intervention services, including whether
20accepted services are delivered in person or via telehealth
21services. A decision to decline such services shall not be a
22basis for administrative determination of parental fitness, or
23other findings or sanctions against the parents. Parameters of
24the Plan shall be set forth in rules.
25    (e) The regional intake offices shall explain to each
26family, orally and in writing, all of the following:



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1        (1) That the early intervention program will pay for
2    all early intervention services set forth in the
3    individualized family service plan that are not covered or
4    paid under the family's public or private insurance plan
5    or policy and not eligible for payment through any other
6    third party payor.
7        (2) That services will not be delayed due to any rules
8    or restrictions under the family's insurance plan or
9    policy.
10        (3) That the family may request, with appropriate
11    documentation supporting the request, a determination of
12    an exemption from private insurance use under Section
13    13.25.
14        (4) That responsibility for co-payments or
15    co-insurance under a family's private insurance plan or
16    policy will be transferred to the lead agency's central
17    billing office.
18        (5) That families will be responsible for payments of
19    family fees, which will be based on a sliding scale
20    according to the State's definition of ability to pay
21    which is comparing household size and income to the
22    sliding scale and considering out-of-pocket medical or
23    disaster expenses, and that these fees are payable to the
24    central billing office. Families who fail to provide
25    income information shall be charged the maximum amount on
26    the sliding scale.



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1    (f) The individualized family service plan must state
2whether the family has private insurance coverage and, if the
3family has such coverage, must have attached to it a copy of
4the family's insurance identification card or otherwise
5include all of the following information:
6        (1) The name, address, and telephone number of the
7    insurance carrier.
8        (2) The contract number and policy number of the
9    insurance plan.
10        (3) The name, address, and social security number of
11    the primary insured.
12        (4) The beginning date of the insurance benefit year.
13    (g) A copy of the individualized family service plan must
14be provided to each enrolled provider who is providing early
15intervention services to the child who is the subject of that
17    (h) Children receiving services under this Act shall
18receive a smooth and effective transition by their third
19birthday consistent with federal regulations adopted pursuant
20to Sections 1431 through 1444 of Title 20 of the United States
21Code. Beginning July 1, 2022, children who receive early
22intervention services prior to their third birthday and are
23found eligible for an individualized education program under
24the Individuals with Disabilities Education Act, 20 U.S.C.
251414(d)(1)(A), and under Section 14-8.02 of the School Code
26and whose birthday falls between May 1 and August 31 may



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1continue to receive early intervention services until the
2beginning of the school year following their third birthday in
3order to minimize gaps in services, ensure better continuity
4of care, and align practices for the enrollment of preschool
5children with special needs to the enrollment practices of
6typically developing preschool children.
7(Source: P.A. 101-654, eff. 3-8-21.)
8    Section 99. Effective date. This Act takes effect upon
9becoming law.