Illinois

Summary of Illinois Law

Public Law 095-1005

Senate Bill 934 as Passed - Sponsored by Senator James A. DeLeo and Representative Karen May

• Requires a group or individual health insurance policy, or managed care plan to provide coverage for the diagnosis and treatment of autism spectrum disorders
  
  
• Coverage will be provided for a treatment for an autism spectrum disorder will include care prescribed, provided, or ordered for an individual with an autism spectrum disorder by a licensed physician, licenses psychologist, or certified registered nurse practitioner if the care is determined to be medically necessary. Including:
  
  
  
  • Psychiatric care
  • Psychological care
  • Rehabilitative care
  • Therapeutic care, including speech, occupational, and physical therapy
  • Pharmacy care
  • Applied behavior analysis therapy 

  • Any care, treatment, intervention, service or item for individuals with an autism spectrum disorder which is determined by the Department of Health Care and Family Services, based upon its review of best practices or evidenced-based research, to be medically necessary.

• Coverage must be provided for an eligible beneficiary under the age of 21

• Coverage must be provided up to a maximum benefit of $36,000 per year (will be adjusted for inflation after December 30, 2009)

• Coverage is not subject to limits on the number of visits to an autism service provider

Illinois News

Autism speaks joins the Illinois autism community in applauding state legislators for enacting autism insurance legislation

NEW YORK, NY (December 13, 2008)  -- Autism Speaks today joined Illinois families and other autism advocacy organizations in applauding the state’s legislators for enacting Senate Bill 934, which contains provisions to require insurance carriers to provide coverage of evidence-based, medically necessary autism therapies. In many states, insurers explicitly exclude coverage of these therapies from policies, which places a significant financial burden on families seeking to provide their children with necessary services.

The new Illinois law requires insurers to cover up to $36,000 a year for treatments and therapies, including Applied Behavior Analysis therapy for children until age twenty-one. Applied Behavior Analysis (ABA) is recognized as an effective, evidence-based treatment for children with autism. The law specifies that there cannot be any limit put on the number of visits to an autism service provider and that the maximum per year benefit will be adjusted annually for inflation.

“With the enactment of this legislation, Illinois joins the ranks of states that have recognized the unfair and unreasonable burden being imposed on families of children with autism,” said Elizabeth Emken, Autism Speaks Vice president for Government Relations. “Autism insurance reform has gained significant national momentum. Legislatures across the country are introducing and passing bills that put an end to the discriminatory practices by insurance companies against children with an autism diagnosis.”

The passage of this legislation was the result of a grassroots advocacy effort led by hundreds of committed families with the support of local and national advocacy organizations. The bill was conceived by parent advocate Pete DiCianni on behalf of his daughter, Brianna. “It brings tears to my eyes that we have finally prevailed and that all Illinois children with autism will have access to diagnosis, treatment and therapy,” said DiCianni.

“For too long, Illinois families have been financially devastated by the lack of insurance coverage for therapies their children needed,” said Lee Jorwic, father of a child with autism and Autism Speaks’ Illinois Chapter Advocacy Chair. “I have been working with Pete DiCianni, Laura Cellini, Christopher Kennedy, and the entire autism community to peck away at the legislators in Springfield and get this legislation finally passed. Thanks to all the Autism Speaks families who responded to our calls for action that helped bring about this historic day.”

"I am very grateful for the hard work and dedication of our sponsors in the legislature and their tenacity, especially Senator James DeLeo, who sponsored five bills this session for insurance coverage for autism.  We truly have a contingent of dedicated individuals within our legislature,” said Laura Cellini, parent and a lead advocate for this effort. “This was truly a grassroots effort from our community; parents spoke out for their children and the Illinois General Assembly and Governor acted to help make a difference for thousands of children with autism and their families."

Senate Bill 934 was sponsored by Senator James A. DeLeo in the Senate and Representative Karen May in the Illinois House. 

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