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IL SB2596
Bill
AI Summary
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Requires state employee health insurance to cover medically necessary physical therapy and occupational therapy for treatment of autoimmune diseases when ordered or referred by a physician, physician's assistant, or advanced practice nurse.
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Defines "medically necessary" as care that prevents illness, reduces effects of conditions, or helps maintain maximum functional activity in daily living.
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Specifies that physical therapy benefits for multiple sclerosis patients are governed by the Illinois Essential Health Benefits plan.
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Requires insurers to apply the same deductibles, coinsurance, waiting periods, and other cost-sharing limitations to this coverage as apply to other physical or occupational therapy benefits.
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Mandates that medical necessity appeals must be reviewed by a licensed health care professional with the same license category as the professional who ordered the service and with expertise in current treatment methods.
Legislative Description
INS CD-MULTIPLE SCLEROSIS
Last Action
Rule 19(a) / Re-referred to Rules Committee
6/30/2016