Illinois 99th Regular Session Status: Passed Senate

SB 2596 — INS CD-MULTIPLE SCLEROSIS

Last action — Session Sine Die

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  1. ✓
    Introduced
  2. ✓
    In Committee
  3. 3
    Passed Senate
  4. 4
    Passed House
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 99th Regular Session. It reached “Passed Senate” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Summary

Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed after the effective date of the amendatory Act must provide coverage for medically necessary preventative physical or rehabilitative therapy for insureds diagnosed with multiple sclerosis without any treatment limitation or calendar year maximum as determined by the patient's treating physician. Makes changes to the provision's definition of "preventative physical therapy" to include physical and other rehabilitative therapy. Removes requirements that coverage under this provision be subject to the same coinsurance, waiting period, cost sharing limitation, treatment limitation, calendar year maximum, or other limitation as provided for other physical or rehabilitative therapy benefits.

Bill Text

What changed in the latest version

56 added · 55 removed

Plain-language change summary

The revised version of Bill SB 2596 now specifies that health insurance must cover medically necessary physical and occupational therapy for individuals with autoimmune diseases, including those with multiple sclerosis. It also clarifies the definition of "medically necessary," ensuring that treatments aimed at preventing or alleviating symptoms are included without imposing limits like waiting periods or maximums on coverage. This change is significant because it aims to improve access to essential therapies for patients, which can enhance their quality of life and overall health outcomes.

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*LRB09919662EGJ44059b* SB2596 99TH GENERAL ASSEMBLY State of Illinois and 2016 SB2596 Introduced 2/16/2016, by Sen.
SB2596 Engrossed LRB099 19662 EGJ 44059 b AN ACT concerning regulation.
Terry Link SYNOPSIS AS INTRODUCED:
ILCS 5/356z.8 Amends the Illinois Insurance Code.
Provides that a group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed after the effective date of the amendatory Act must provide coverage for medically necessary preventative physical or rehabilitative therapy for insureds diagnosed with multiple sclerosis without any treatment limitation or calendar year maximum as determined by the patient's treating physician.
Makes changes to the provision's definition of "preventative physical therapy" to include physical and other rehabilitative therapy.
Removes requirements that coverage under this provision be subject to the same coinsurance, waiting period, cost sharing limitation, treatment limitation, calendar year maximum, or other limitation as provided for other physical or rehabilitative therapy benefits.
LRB099 19662 EGJ 44059 b A BILL FOR SB2596 LRB099 19662 EGJ 44059 b AN ACT concerning regulation.
The Illinois Insurance Code is amended by changing Section 356z.8 as follows:
The State Employees Group Insurance Act of 1971 is amended by changing Section 6.11A as follows:
(215 ILCS 5/356z.8) Sec.
(5 ILCS 375/6.11A) Sec.
356z.8.
6.11A.
Multiple sclerosis preventative physical or rehabilitative therapy.
Physical therapy and occupational therapy.
A group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed after the effective date of this amendatory Act of the 99th General Assembly this amendatory Act of the 94th General Assembly must provide coverage for medically necessary preventative physical or rehabilitative therapy without any treatment limitation or calendar year maximum as determined necessary by the patient's treating physician, for insureds diagnosed with multiple sclerosis.
(a) The program of health benefits provided under this Act shall provide coverage for medically necessary physical therapy and occupational therapy when that therapy is ordered for the treatment of autoimmune diseases or referred for the same purpose by (i) a physician licensed under the Medical Practice Act of 1987, (ii) a physician's assistant licensed under the Physician's Assistant Practice Act of 1987, or (iii) an advanced practice nurse licensed under the Nurse Practice Act.
For the purposes of this Section, "preventative physical or rehabilitative therapy" means physical and other rehabilitative therapy that is prescribed by a physician licensed to practice medicine in all of its branches for the purpose of treating parts of the body affected by multiple sclerosis, but only where the physical or rehabilitative therapy includes reasonably defined goals, including, but not SB2596 - 2 - LRB099 19662 EGJ 44059 b limited to, sustaining the level of function the person has achieved, with periodic evaluation of the efficacy of the physical or rehabilitative therapy against those goals.
Physical therapy benefits provided for persons affected by multiple sclerosis shall be governed by the Illinois Essential Health Benefits plan.
The coverage required under this Section shall be subject to the same deductible, coinsurance, waiting period, cost sharing limitation, treatment limitation, calendar year maximum, or other limitations as provided for other physical or rehabilitative therapy benefits covered by the policy.
(b) For the purpose of this Section, "medically necessary" means any care, treatment, intervention, service, or item that will or is reasonably expected to:
(i) prevent the onset of an illness, condition, injury, disease, or disability;
SB2596 Engrossed - 2 - LRB099 19662 EGJ 44059 b (ii) reduce or ameliorate the physical, mental, or developmental effects of an illness, condition, injury, disease, or disability;
or (iii) assist the achievement or maintenance of maximum functional activity in performing daily activities.
(c) The coverage required under this Section shall be subject to the same deductible, coinsurance, waiting period, cost sharing limitation, treatment limitation, calendar year maximum, or other limitations as provided for other physical or rehabilitative or occupational therapy benefits covered by the policy.
(d) Upon request of the reimbursing insurer, the provider of the physical therapy or occupational therapy shall furnish medical records, clinical notes, or other necessary data that substantiate that initial or continued treatment is medically necessary.
When treatment is anticipated to require continued services to achieve demonstrable progress, the insurer may request a treatment plan consisting of the diagnosis, proposed treatment by type, proposed frequency of treatment, anticipated duration of treatment, anticipated outcomes stated as goals, and proposed frequency of updating the treatment plan.
(e) When making a determination of medical necessity for treatment, an insurer must make the determination in a manner consistent with the manner in which that determination is made with respect to other diseases or illnesses covered under the SB2596 Engrossed - 3 - LRB099 19662 EGJ 44059 b policy, including an appeals process.
During the appeals process, any challenge to medical necessity may be viewed as reasonable only if the review includes a licensed health care professional with the same category of license as the professional who ordered or referred the service in question and with expertise in the most current and effective treatment.
94-1076, eff.
96-1227, eff.
12-29-06.)
1-1-11;
97-604, eff.
8-26-11.)
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Action History

  1. Session Sine Die

  2. Rule 19(a) / Re-referred to Rules Committee

  3. Final Action Deadline Extended-9(b) June 30, 2016

  4. Final Action Deadline Extended-9(b) May 31, 2016

  5. Alternate Chief Sponsor Changed to Rep. Ann M. Williams

  6. Final Action Deadline Extended-9(b) May 27, 2016

  7. Assigned to Executive Committee

  8. Referred to Rules Committee

  9. First Reading

  10. Chief House Sponsor Rep. Fred Crespo

  11. Arrived in House

  12. Third Reading - Passed; 052-000-001

  13. Added as Co-Sponsor Sen. Tim Bivins

  14. Placed on Calendar Order of 3rd Reading

  15. Senate Floor Amendment No. 1 Adopted; Link

  16. Recalled to Second Reading

  17. Senate Floor Amendment No. 1 Recommend Do Adopt Insurance; 010-000-000

  18. Senate Floor Amendment No. 1 Assignments Refers to Insurance

  19. Senate Floor Amendment No. 1 Referred to Assignments

  20. Senate Floor Amendment No. 1 Filed with Secretary by Sen. Terry Link

  21. Rule 2-10 Committee/3rd Reading Deadline Established As May 13, 2016

  22. Placed on Calendar Order of 3rd Reading April 21, 2016

  23. Second Reading

  24. Added as Co-Sponsor Sen. Andy Manar

  25. Added as Co-Sponsor Sen. Patricia Van Pelt

  26. Placed on Calendar Order of 2nd Reading April 7, 2016

  27. Do Pass Insurance; 011-000-000

  28. Added as Co-Sponsor Sen. Melinda Bush

  29. Added as Co-Sponsor Sen. Daniel Biss

  30. Added as Co-Sponsor Sen. Napoleon Harris, III

  31. Added as Chief Co-Sponsor Sen. Linda Holmes

  32. Added as Co-Sponsor Sen. Iris Y. Martinez

  33. Added as Co-Sponsor Sen. Linda Holmes

  34. Added as Chief Co-Sponsor Sen. Iris Y. Martinez

  35. Added as Chief Co-Sponsor Sen. Don Harmon

  36. Added as Co-Sponsor Sen. Thomas Cullerton

  37. Added as Co-Sponsor Sen. Michael E. Hastings

  38. Added as Co-Sponsor Sen. Emil Jones, III

  39. Added as Co-Sponsor Sen. Mattie Hunter

  40. Added as Chief Co-Sponsor Sen. Jacqueline Y. Collins

  41. Added as Co-Sponsor Sen. John G. Mulroe

  42. Added as Chief Co-Sponsor Sen. Antonio Muñoz

  43. Added as Co-Sponsor Sen. Bill Cunningham

  44. Assigned to Insurance

  45. Referred to Assignments

  46. First Reading

  47. Filed with Secretary by Sen. Terry Link

Sponsors

  • Terry Link · Cosponsor

Sponsorship breakdown

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0 sponsors · 1 co-sponsors · 182 not signed on

Sponsors (0)

None.

Co-sponsors (1)

  • Terry Link

Not signed on (182)

182 members have not signed on to this bill.

Show all 182 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

Third Reading

Passed 52 Yea · 0 Nay · 7 Other
Party YeaNayPresentNot Voting
Unaffiliated 34005
Democrat 13001
Republican 5001
Total 52007
% of votes cast 88%0%0%12%
How each member voted (59)
Member Party Vote
Sandoval — Yea
Althoff — Yea
Barickman — Yea
Bertino-Tarrant — Yea
Biss — Yea
Bivins — Yea
Bush — Yea
McConnaughay — Yea
Martinez — Yea
McCann — Yea
Mulroe — Yea
Muñoz — Yea
Landek — Yea
Cullerton, T. — Yea
Cullerton — Yea
Link — Yea
Luechtefeld — Not Voting
Manar — Yea
McCarter — Not Voting
Oberweis — Not Voting
Connelly — Yea
Raoul — Yea
Silverstein — Yea
Steans — Yea
Harris — Yea
Bennett — Yea
McGuire — Yea
Trotter — Yea
Brady — Yea
Sullivan — Yea
Clayborne — Yea
Forby — Yea
Haine — Yea
Hutchinson — Yea
Noland — Yea
Nybo — Yea
Radogno — Not Voting
Righter — Not Voting
Van Pelt — Yea
Bill Cunningham Democrat Yea
David Koehler Democrat Yea
Don Harmon Democrat Yea
Emil Jones, III Democrat Yea
Eva-Dina Delgado Democrat Not Voting
Julie A. Morrison Democrat Yea
Kimberly A. Lightford Democrat Yea
Lakesia Collins Democrat Yea
Laura M. Murphy Democrat Yea
Laura M. Murphy Democrat Yea
Linda Holmes Democrat Yea
Mattie Hunter Democrat Yea
Michael E. Hastings Democrat Yea
Steve Stadelman Democrat Yea
Chapin Rose Republican Yea
Dan McConchie Republican Not Voting
Dave Syverson Republican Yea
Neil Anderson Republican Yea
Sue Rezin Republican Yea
Travis Weaver Republican Yea

Official roll call →

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

What does SB 2596 do?
Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed after the effective date of the amendatory Act must provide coverage for medically necessary preventative physical or rehabilitative therapy for insureds diagnosed with multiple sclerosis without any treatment limitation or calendar year maximum as determined by the patient's treating physician. Makes changes to the provision's definition of "preventative physical therapy" to include physical and other rehabilitative therapy. Removes requirements that coverage under this provision be subject to the same coinsurance, waiting period, cost sharing limitation, treatment limitation, calendar year maximum, or other limitation as provided for other physical or rehabilitative therapy benefits.
Who sponsors SB 2596?
SB 2596 is sponsored by Terry Link.
What is the current status of SB 2596?
This bill died with 99th Regular Session. It reached “Passed Senate” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track SB 2596?
Track SB 2596 free on One Click Politics — get push/email alerts when it moves.

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