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HB1432 Engrossed LRB095 10175 KBJ 30389 b AN ACT concerning insurance.
HB1432 Enrolled LRB095 10175 KBJ 30389 b AN ACT concerning insurance.
(2) Each insured that is covered for mental, emotional or HB1432 Engrossed - 2 - LRB095 10175 KBJ 30389 b nervous disorders or conditions shall be free to select the physician licensed to practice medicine in all its branches, licensed clinical psychologist, licensed clinical social worker, or licensed clinical professional counselor of his choice to treat such disorders, and the insurer shall pay the covered charges of such physician licensed to practice medicine in all its branches, licensed clinical psychologist, licensed clinical social worker, or licensed clinical professional counselor up to the limits of coverage, provided (i) the disorder or condition treated is covered by the policy, and (ii) the physician, licensed psychologist, licensed clinical social worker, or licensed clinical professional counselor is authorized to provide said services under the statutes of this State and in accordance with accepted principles of his profession.
(2) Each insured that is covered for mental, emotional or HB1432 Enrolled - 2 - LRB095 10175 KBJ 30389 b nervous disorders or conditions shall be free to select the physician licensed to practice medicine in all its branches, licensed clinical psychologist, licensed clinical social worker, or licensed clinical professional counselor of his choice to treat such disorders, and the insurer shall pay the covered charges of such physician licensed to practice medicine in all its branches, licensed clinical psychologist, licensed clinical social worker, or licensed clinical professional counselor up to the limits of coverage, provided (i) the disorder or condition treated is covered by the policy, and (ii) the physician, licensed psychologist, licensed clinical social worker, or licensed clinical professional counselor is authorized to provide said services under the statutes of this State and in accordance with accepted principles of his profession.
That notification may, however, HB1432 Engrossed - 3 - LRB095 10175 KBJ 30389 b be waived by the patient on a written form.
That notification may, however, HB1432 Enrolled - 3 - LRB095 10175 KBJ 30389 b be waived by the patient on a written form.
(D) major depressive disorders (single episode or HB1432 Engrossed - 4 - LRB095 10175 KBJ 30389 b recurrent);
(D) major depressive disorders (single episode or HB1432 Enrolled - 4 - LRB095 10175 KBJ 30389 b recurrent);
(K) eating disorders, including anorexia nervosa, bulimia nervosa, and Eating Disorders Not Otherwise Specified (EDNOS), as recognized by the most current edition of the DSM.
(K) anorexia nervosa and bulimia nervosa.
If the reviewing provider determines the treatment to be medically necessary, HB1432 Engrossed - 5 - LRB095 10175 KBJ 30389 b the insurer shall provide reimbursement for the treatment.
If the reviewing provider determines the treatment to be medically necessary, the insurer shall provide reimbursement for the treatment.
Future contractual or employment actions by the insurer regarding the patient’s provider may not be based on the provider’s participation in this procedure.
Future contractual or employment actions by the insurer regarding the patient’s provider may not be based on the HB1432 Enrolled - 5 - LRB095 10175 KBJ 30389 b provider’s participation in this procedure.
and (iii) for plans or policies delivered, issued for delivery, renewed, or modified after January 1, 2007 (the effective date of Public Act 94-906) this amendatory Act of the 94th General Assembly, 20 additional outpatient visits for speech therapy for HB1432 Engrossed - 6 - LRB095 10175 KBJ 30389 b treatment of pervasive developmental disorders that will be in addition to speech therapy provided pursuant to item (ii) of this subparagraph (A);
and (iii) for plans or policies delivered, issued for delivery, renewed, or modified after January 1, 2007 (the effective date of Public Act 94-906) this amendatory Act of the 94th General Assembly, 20 additional outpatient visits for speech therapy for treatment of pervasive developmental disorders that will be in addition to speech therapy provided pursuant to item (ii) of this subparagraph (A);
(B) may not include a lifetime limit on the number of days of inpatient treatment or the number of outpatient visits covered under the plan;
HB1432 Enrolled - 6 - LRB095 10175 KBJ 30389 b (B) may not include a lifetime limit on the number of days of inpatient treatment or the number of outpatient visits covered under the plan;
HB1432 Engrossed - 7 - LRB095 10175 KBJ 30389 b 94-906, eff.
94-906, eff.
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