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| [ Engrossed ] | [ House Amendment 001 ] |
90_HB0161
215 ILCS 5/370c from Ch. 73, par. 982c
Amends the Illinois Insurance Code. Provides that
treatment for mental, emotional, or nervous disorders or
conditions by a licensed clinical professional counselor
shall be covered. Effective immediately.
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LRB9000024JScw
1 AN ACT to amend the Illinois Insurance Code by changing
2 Section 370c.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Illinois Insurance Code is amended by
6 changing Section 370c as follows:
7 (215 ILCS 5/370c) (from Ch. 73, par. 982c)
8 Sec. 370c. Mental, emotional, or nervous disorders or
9 conditions.
10 (1) On and after the effective date of this Section,
11 every insurer which delivers, issues for delivery or renews
12 or modifies group A&H policies providing coverage for
13 hospital or medical treatment or services for illness on an
14 expense-incurred basis shall offer to the applicant or group
15 policyholder subject to the insurers standards of
16 insurability, coverage for reasonable and necessary treatment
17 and services for mental, emotional or nervous disorders or
18 conditions up to the limits provided in the policy for other
19 disorders or conditions, except (i) the insured may be
20 required to pay up to 50% of expenses incurred as a result of
21 the treatment or services, and (ii) the annual benefit limit
22 may be limited to the lesser of $10,000 or 25% of the
23 lifetime policy limit.
24 (2) Each insured that is covered for mental, emotional
25 or nervous disorders or conditions shall be free to select
26 the physician licensed to practice medicine in all its
27 branches, licensed clinical psychologist, licensed clinical
28 professional counselor, or licensed clinical social worker of
29 his choice to treat such disorders, and the insurer shall pay
30 the covered charges of such physician licensed to practice
31 medicine in all its branches, licensed clinical psychologist,
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1 licensed clinical professional counselor, or licensed
2 clinical social worker up to the limits of coverage, provided
3 (i) the disorder or condition treated is covered by the
4 policy, and (ii) the physician, licensed psychologist,
5 licensed clinical professional counselor, or licensed
6 clinical social worker is authorized to provide said services
7 under the statutes of this State and in accordance with
8 accepted principles of his profession.
9 Insofar as this Section applies solely to licensed
10 clinical social workers and licensed clinical professional
11 counselors, those persons who may provide services to
12 individuals shall do so after the licensed clinical social
13 worker or licensed clinical professional counselor has
14 informed the patient of the desirability of the patient
15 conferring with the patient's primary care physician and the
16 licensed clinical social worker or licensed clinical
17 professional counselor has provided written notification to
18 the patient's primary care physician, if any, that services
19 are being provided to the patient. That notification may,
20 however, be waived by the patient on a written form. Those
21 forms shall be retained by the licensed clinical social
22 worker or the licensed clinical professional counselor for a
23 period of not less than 5 years.
24 (Source: P.A. 86-1434.)
25 Section 99. Effective date. This Act takes effect upon
26 becoming law.