IL HB2845

Requires Medicaid managed care plans amended, delivered, issued, or renewed after the effective date to provide coverage for diagnosis and treatment of autism spectrum disorders for individuals under 21 years of age.

Coverage for autism spectrum disorder treatment includes psychiatric care, psychological care, habilitative or rehabilitative care (including applied behavior analysis), and therapeutic care such as behavioral, speech, occupational, and physical therapies.

Coverage has no limits on the number of visits to service providers but is subject to the same copayment, deductible, and coinsurance provisions that apply to other medical services covered by the plan.

Prohibits managed care organizations from denying, refusing to renew, or terminating coverage based on an individual's autism spectrum disorder diagnosis or use of these benefits.

Requires treatment providers to furnish medical records and clinical notes upon request to demonstrate medical necessity and improved clinical status; requires managed care organizations to make medical necessity determinations consistent with methods used for other illnesses and include autism spectrum disorder experts in appeals reviews.