SB 2499 — HABILITATIVE SERVICES
Last action — Session Sine Die
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✓Introduced
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✓In Committee
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3Passed Senate
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4Passed House
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5To Executive
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6Enacted
This bill died with 95th 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This bill is no longer active — its legislative session has ended, so there is no live prognosis.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 State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Illinois Insurance Code, the Health Maintenance Organization Act, and the Voluntary Health Services Plans Act to provide coverage for habilitative services, including, but not limited to occupational therapy, physical therapy, and speech therapy for children under the age of 19 with congenital or genetic defects existing at or from birth or with a defect acquired at a young age. Amends the State Mandates Act to require implementation without reimbursement.
Bill Text
What changed in the latest version
208 added · 201 removedPlain-language change summary
The amendment to SB 2499 expands the definition of "habilitative services" to include specific therapies like occupational, physical, and speech therapy for children under 19 with various disorders, such as autism and cerebral palsy. This change is significant because it ensures that insurance plans will cover these essential services, helping children improve their daily functioning and quality of life. The bill aims to provide necessary support for families dealing with early childhood disorders, emphasizing the importance of early intervention.
*LRB09519787KBJ46166b* SB2499 95THEngrossed GENERALLRB095 ASSEMBLY19787 StateKBJ of46166 Illinoisb andAN 2008ACT SB2499concerning Introducedregulation. 2/15/2008, by Sen.
M.
Maggie Crotty SYNOPSIS AS INTRODUCED:
ILCS 375/6.11 ILCS 5/5-1069.3 ILCS 5/10-4-2.3 ILCS 5/10-22.3f ILCS 5/356z.11 new ILCS 125/5-3 from Ch.
111 1/2, par.
1411.2 ILCS 165/10 from Ch.
32, par.
604 ILCS 805/8.32 new Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Illinois Insurance Code, the Health Maintenance Organization Act, and the Voluntary Health Services Plans Act to provide coverage for habilitative services, including, but not limited to occupational therapy, physical therapy, and speech therapy for children under the age of 19 with congenital or genetic defects existing at or from birth or with a defect acquired at a young age.
Amends the State Mandates Act to require implementation without reimbursement.
LRB095 19787 KBJ 46166 b A BILL FOR SB2499 LRB095 19787 KBJ 46166 b AN ACT concerning regulation.
(55 ILCS 5/5-1069.3) SB2499 Engrossed - 2 - LRB095 19787 KBJ 46166 b Sec.
If a municipality, including a home rule municipality, is a self-insurer for purposes of providing health insurance coverage for its employees, the coverage shall include coverage for the post-mastectomy care benefits required to be covered by SB2499 Engrossed - 3 - LRB095 19787 KBJ 46166 b a policy of accident and health insurance under Section 356t and the coverage required under Sections 356g.5, 356u, 356w, 356x, 356z.6, and 356z.9, 356z.10, and 356z.11 and 356z.9 of the Illinois Insurance Code.
The Illinois Insurance Code is amended by SB2499 Engrossed - 4 - LRB095 19787 KBJ 46166 b adding Section 356z.11 as follows:
(a) InAs used in this Section, "habilitative services" means services, including, but not limited to, occupational therapy, physical therapy, and speech therapy, forand other services prescribed by the treatmentinsured’s oftreating aphysician childpursuant withto a congenitaltreatment orplan geneticto defectenhance orthe aability defectof acquireda atchild ato youngfunction age,with toa enhancecongenital, thegenetic, child’sor abilityearly toacquired function.disorder.
A congenital or genetic defectdisorder includes, but is not limited to, hereditary defects,disorders. such as autism or an autism spectrum disorder and cerebral palsy.
AAn defectearly acquired atdisorder a young age refers to ana injurydisorder resulting from illness, trauma, injury, or some other means,event or condition suffered by a child at a point in time prior to that child developing basicfunctional life skills such as, but not limited to, walking, talking, or self-help skills.
(b)Congenital, Agenetic, groupand orearly individualacquired policydisorders ofmay accidentinclude, andbut healthare insurancenot orlimited managedto, careautism plan amended, delivered, issued, or renewedan afterautism thespectrum effectivedisorder, datecerebral ofpalsy, thisand amendatoryother Actdisorders ofresulting thefrom 95thearly Generalchildhood Assemblyillness, musttrauma, provide coverage for habilitative services for children under 19 years of age with a congenital or geneticinjury. defect existing at or from birth or a defect acquired at a young age.
(b) 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 95th General Assembly must provide coverage for habilitative services for children under 19 years of age with a congenital, genetic, or early acquired disorder so long as all of the following conditions are met:
SB2499 Engrossed - 5 - LRB095 19787 KBJ 46166 b (1) A physician licensed to practice medicine in all its branches has:
(A) diagnosed the child’s congenital, genetic, or early acquired disorder;
and (B) determined the treatment to be therapeutic and not solely experimental or investigational.
(2) The treatment is administered under the supervision of a physician licensed to practice medicine in all its branches.
(c) The coverage required by this Section shall be subject to other general exclusions and limitations of the policy, including coordination of benefits, participating provider requirements, restrictions on services provided by family or household members, utilization review of health care services, including review of medical necessity, case management, experimental, and investigational treatments, and other managed care provisions.
(d) Upon request of the reimbursing insurer, the provider under whose supervision the habilitative services are being provided shall furnish medical records, clinical notes, or other necessary data to allow the insurer to substantiate that initial or continued medical treatment is medically necessary and that the patient’s condition is clinically improving.
When the treating provider anticipates that continued treatment is or will be required to permit the patient to achieve demonstrable progress, the insurer may request that the SB2499 Engrossed - 6 - LRB095 19787 KBJ 46166 b provider furnish a treatment plan consisting of diagnosis, proposed treatment by type, frequency, anticipated duration of treatment, the anticipated goals of treatment, and how frequently the treatment plan will be updated.
SB2499 - 5 - LRB095 19787 KBJ 46166 b (215 ILCS 125/5-3) (from Ch.
SB2499 Engrossed - 7 - LRB095 19787 KBJ 46166 b (2) a corporation organized under the laws of this State;
or (3) a corporation organized under the laws of another state, 30% or more of the enrollees of which are residents of this State, except a corporation subject to substantially the same requirements in its state of organization as is a "domestic company" under Article VIII SB2499 - 6 - LRB095 19787 KBJ 46166 b 1/2 of the Illinois Insurance Code.
(A) certification by an independent actuary of the SB2499 Engrossed - 8 - LRB095 19787 KBJ 46166 b adequacy of the reserves of the Health Maintenance Organization sought to be acquired;
(B) pro forma financial statements reflecting the combined balance sheets of the acquiring company and the Health Maintenance Organization sought to be acquired as of the end of the preceding year and as of a date 90 days prior to the acquisition, as well as pro SB2499 - 7 - LRB095 19787 KBJ 46166 b forma financial statements reflecting projected combined operation for a period of 2 years;
(e) In considering any management contract or service agreement subject to Section 141.1 of the Illinois Insurance Code, the Director (i) shall, in addition to the criteria specified in Section 141.2 of the Illinois Insurance Code, take into account the effect of the management contract or service SB2499 Engrossed - 9 - LRB095 19787 KBJ 46166 b agreement on the continuation of benefits to enrollees and the financial condition of the health maintenance organization to be managed or serviced, and (ii) need not take into account the effect of the management contract or service agreement on competition.
(f) Except for small employer groups as defined in the Small Employer Rating, Renewability and Portability Health SB2499 - 8 - LRB095 19787 KBJ 46166 b Insurance Act and except for medicare supplement policies as defined in Section 363 of the Illinois Insurance Code, a Health Maintenance Organization may by contract agree with a group or other enrollment unit to effect refunds or charge additional premiums under the following terms and conditions:
and (ii) the amount of the refund or additional premium shall not exceed 20% of the Health Maintenance Organization’s profitable or unprofitable experience with respect to the group or other enrollment unit for the period (and, for purposes of a refund or additional premium, the profitable or unprofitable experience shall be calculated taking into account a pro rata share of the Health Maintenance Organization’s administrative and SB2499 Engrossed - 10 - LRB095 19787 KBJ 46166 b marketing expenses, but shall not include any refund to be made or additional premium to be paid pursuant to this subsection (f)).
SB2499 - 9 - LRB095 19787 KBJ 46166 b The Health Maintenance Organization shall include a statement in the evidence of coverage issued to each enrollee describing the possibility of a refund or additional premium, and upon request of any group or enrollment unit, provide to the group or enrollment unit a description of the method used to calculate (1) the Health Maintenance Organization’s profitable experience with respect to the group or enrollment unit and the resulting refund to the group or enrollment unit or (2) the Health Maintenance Organization’s unprofitable experience with respect to the group or enrollment unit and the resulting additional premium to be paid by the group or enrollment unit.
revised 12-4-07.) SB2499 Engrossed - 11 - LRB095 19787 KBJ 46166 b Section 35.
Health services plan corporations and all persons interested therein or dealing therewith shall be subject to the provisions of SB2499 - 10 - LRB095 19787 KBJ 46166 b Articles IIA and XII 1/2 and Sections 3.1, 133, 140, 143, 143c, 149, 155.37, 354, 355.2, 356g.5, 356r, 356t, 356u, 356v, 356w, 356x, 356y, 356z.1, 356z.2, 356z.4, 356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11 356z.9, 364.01, 367.2, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412, and paragraphs (7) and (15) of Section 367 of the Illinois Insurance Code.
Action History
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Session Sine Die
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Added as Co-Sponsor Sen. Dan Rutherford
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Added Alternate Co-Sponsor Rep. Harry Osterman
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Added Alternate Co-Sponsor Rep. Patricia Reid Lindner
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Added Alternate Co-Sponsor Rep. Franco Coladipietro
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Added Alternate Co-Sponsor Rep. David Reis
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Added Alternate Co-Sponsor Rep. David R. Leitch
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Added Alternate Co-Sponsor Rep. Joseph M. Lyons
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Added Alternate Co-Sponsor Rep. Sidney H. Mathias
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Added Alternate Co-Sponsor Rep. Ruth Munson
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Added Alternate Co-Sponsor Rep. Fred Crespo
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Added Alternate Co-Sponsor Rep. Chapin Rose
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Added Alternate Co-Sponsor Rep. David E. Miller
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Added Alternate Co-Sponsor Rep. James H. Meyer
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Added Alternate Co-Sponsor Rep. Mike Boland
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Added Alternate Co-Sponsor Rep. Aaron Schock
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Added Alternate Co-Sponsor Rep. Elaine Nekritz
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Added Alternate Co-Sponsor Rep. Kevin Joyce
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Added Alternate Co-Sponsor Rep. Kurt M. Granberg
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Added Alternate Co-Sponsor Rep. Harry R. Ramey, Jr.
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Added Alternate Co-Sponsor Rep. William Davis
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Added Alternate Co-Sponsor Rep. John A. Fritchey
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Added Alternate Co-Sponsor Rep. Jim Sacia
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Added Alternate Co-Sponsor Rep. Charles E. Jefferson
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Added Alternate Co-Sponsor Rep. Lou Lang
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Added Alternate Co-Sponsor Rep. Daniel V. Beiser
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Added Alternate Co-Sponsor Rep. Thomas Holbrook
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Added Alternate Co-Sponsor Rep. Esther Golar
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Added Alternate Co-Sponsor Rep. John E. Bradley
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Added Alternate Co-Sponsor Rep. Robert F. Flider
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Added Alternate Co-Sponsor Rep. Brandon W. Phelps
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Added Alternate Co-Sponsor Rep. Dan Reitz
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Added Alternate Co-Sponsor Rep. Rich Brauer
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Added Alternate Chief Co-Sponsor Rep. Angelo Saviano
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Added Alternate Chief Co-Sponsor Rep. Sara Feigenholtz
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Added Alternate Chief Co-Sponsor Rep. Rosemary Mulligan
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Added Alternate Chief Co-Sponsor Rep. Karen May
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Added Alternate Co-Sponsor Rep. Michael K. Smith
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Added Alternate Co-Sponsor Rep. Patrick J Verschoore
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Referred to Rules Committee
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First Reading
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Chief House Sponsor Rep. Elizabeth Coulson
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Placed on Calendar Order of First Reading
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Arrived in House
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Third Reading - Passed; 054-000-000
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Added as Chief Co-Sponsor Sen. Pamela J. Althoff
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Placed on Calendar Order of 3rd Reading April 17, 2008
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Senate Floor Amendment No. 1 Adopted; Crotty
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Second Reading
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Senate Floor Amendment No. 1 Recommend Do Adopt Insurance; 010-000-000
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Senate Floor Amendment No. 1 Rules Refers to Insurance
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Added as Co-Sponsor Sen. Jeffrey M. Schoenberg
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Senate Floor Amendment No. 1 Referred to Rules
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Senate Floor Amendment No. 1 Filed with Secretary by Sen. M. Maggie Crotty
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Added as Co-Sponsor Sen. William E. Peterson
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Added as Co-Sponsor Sen. Iris Y. Martinez
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Added as Chief Co-Sponsor Sen. Donne E. Trotter
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Added as Chief Co-Sponsor Sen. David Koehler
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Placed on Calendar Order of 2nd Reading April 1, 2008
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Do Pass Insurance; 010-000-000
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Added as Chief Co-Sponsor Sen. Terry Link
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Added as Co-Sponsor Sen. William Delgado
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Assigned to Insurance
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Referred to Rules
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First Reading
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Filed with Secretary by Sen. M. Maggie Crotty
Sponsors
- M. Maggie Crotty · Cosponsor
- Patrick J Verschoore · Cosponsor
- Michael K. Smith · Cosponsor
- Rich Brauer · Cosponsor
- Dan Reitz · Cosponsor
- Brandon W. Phelps · Cosponsor
- Robert F. Flider · Cosponsor
- John E. Bradley · Cosponsor
- Esther Golar · Cosponsor
- Thomas Holbrook · Cosponsor
- Daniel V. Beiser · Cosponsor
- Lou Lang · Cosponsor
- Charles E. Jefferson · Cosponsor
- Jim Sacia · Cosponsor
- John A. Fritchey · Cosponsor
- William "Will" Davis · Cosponsor
- Jr. Harry R. Ramey · Cosponsor
- Kurt M. Granberg · Cosponsor
- Elaine Nekritz · Cosponsor
- Aaron Schock · Cosponsor
- Mike Boland · Cosponsor
- James H. Meyer · Cosponsor
- David E. Miller · Cosponsor
- Chapin Rose · Cosponsor
- Fred Crespo · Cosponsor
- Ruth Munson · Cosponsor
- Sidney H. Mathias · Cosponsor
- Joseph M. Lyons · Cosponsor
- David R. Leitch · Cosponsor
- David Reis · Cosponsor
- Franco Coladipietro · Cosponsor
- Patricia Reid Lindner · Cosponsor
- Harry Osterman · Cosponsor
- Patrick J. Joyce · Cosponsor
Sponsorship breakdown
Export CSV (upgrade) →0 sponsors · 34 co-sponsors · 149 not signed on
Sponsors (0)
None.
Co-sponsors (34)
- M. Maggie Crotty
- Patrick J Verschoore
- Michael K. Smith
- Rich Brauer
- Dan Reitz
- Brandon W. Phelps
- Robert F. Flider
- John E. Bradley
- Esther Golar
- Thomas Holbrook
- Daniel V. Beiser
- Lou Lang
- Charles E. Jefferson
- Jim Sacia
- John A. Fritchey
- William "Will" Davis Democrat
- Harry R. Ramey, Jr.
- Kurt M. Granberg
- Elaine Nekritz
- Aaron Schock
- Mike Boland
- James H. Meyer
- David E. Miller
- Chapin Rose Republican
- Fred Crespo Democrat
- Ruth Munson
- Sidney H. Mathias
- Joseph M. Lyons
- David R. Leitch
- David Reis
- Franco Coladipietro
- Patricia Reid Lindner
- Harry Osterman
- Patrick J. Joyce Democrat
Not signed on (149)
149 members have not signed on to this bill.
Show all 149 →"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.
Votes
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Unaffiliated | 45 | 0 | 0 | 4 |
| Democrat | 9 | 0 | 0 | 0 |
| Republican | 0 | 0 | 0 | 1 |
| Total | 54 | 0 | 0 | 5 |
| % of votes cast | 92% | 0% | 0% | 8% |
How each member voted (59)
| Member | Party | Vote |
|---|---|---|
| Halvorson | — | Yea |
| Lauzen | — | Yea |
| Dillard | — | Yea |
| Forby | — | Yea |
| Link | — | Yea |
| Maloney | — | Yea |
| Meeks | — | Yea |
| Brady | — | Yea |
| Millner | — | Yea |
| Noland | — | Yea |
| Pankau | — | Yea |
| Peterson | — | Not Voting |
| Sullivan | — | Yea |
| Radogno | — | Yea |
| Munoz | — | Yea |
| Schoenberg | — | Yea |
| Steans | — | Yea |
| Trotter | — | Yea |
| Viverito | — | Not Voting |
| Cullerton | — | Yea |
| Watson | — | Yea |
| Jacobs | — | Yea |
| Wilhelmi | — | Yea |
| Jones, J. | — | Yea |
| Demuzio | — | Yea |
| Clayborne | — | Yea |
| Cronin | — | Yea |
| Crotty | — | Yea |
| Dahl | — | Yea |
| DeLeo | — | Yea |
| Frerichs | — | Yea |
| Garrett | — | Yea |
| Haine | — | Yea |
| Hendon | — | Yea |
| Hultgren | — | Yea |
| Kotowski | — | Yea |
| Raoul | — | Yea |
| Righter | — | Yea |
| Risinger | — | Yea |
| Rutherford | — | Yea |
| Sandoval | — | Not Voting |
| Silverstein | — | Yea |
| Luechtefeld | — | Yea |
| Althoff | — | Not Voting |
| Martinez | — | Yea |
| Bivins | — | Yea |
| Bomke | — | Yea |
| Bond | — | Yea |
| Burzynski | — | Yea |
| David Koehler | Democrat | Yea |
| Don Harmon | Democrat | Yea |
| Emil Jones, III | Democrat | Yea |
| Eva-Dina Delgado | Democrat | Yea |
| Kimberly A. Lightford | Democrat | Yea |
| Lakesia Collins | Democrat | Yea |
| Laura M. Murphy | Democrat | Yea |
| Linda Holmes | Democrat | Yea |
| Mattie Hunter | Democrat | Yea |
| Dave Syverson | Republican | Not Voting |
Subjects
Frequently asked questions
- What does SB 2499 do?
- Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Illinois Insurance Code, the Health Maintenance Organization Act, and the Voluntary Health Services Plans Act to provide coverage for habilitative services, including, but not limited to occupational therapy, physical therapy, and speech therapy for children under the age of 19 with congenital or genetic defects existing at or from birth or with a defect acquired at a young age. Amends the State Mandates Act to require implementation without reimbursement.
- Who sponsors SB 2499?
- SB 2499 is sponsored by M. Maggie Crotty, Patrick J Verschoore, Michael K. Smith, Rich Brauer, Dan Reitz, Brandon W. Phelps, Robert F. Flider, John E. Bradley, Esther Golar, Thomas Holbrook, Daniel V. Beiser, Lou Lang, Charles E. Jefferson, Jim Sacia, John A. Fritchey, William "Will" Davis (Democrat), Harry R. Ramey, Jr., Kurt M. Granberg, Elaine Nekritz, Aaron Schock, Mike Boland, James H. Meyer, David E. Miller, Chapin Rose (Republican), Fred Crespo (Democrat), Ruth Munson, Sidney H. Mathias, Joseph M. Lyons, David R. Leitch, David Reis, Franco Coladipietro, Patricia Reid Lindner, Harry Osterman, and Patrick J. Joyce (Democrat).
- What is the current status of SB 2499?
- This bill died with 95th 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 2499?
- Track SB 2499 free on One Click Politics — get push/email alerts when it moves.
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