Synopsis As Introduced Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance must provide coverage for medically necessary preventative physical therapy for insureds diagnosed with multiple sclerosis without any treatment limitation or calendar year maximum. Removes requirements that coverage under this provision be subject to the same waiting period, cost sharing limitation, treatment limitation, calendar year maximum, or other limitation as provided for other physical or rehabilitative therapy benefits.
Fiscal Note (Dept of Insurance)
HB 3223 has no projected fiscal impact on the Illinois Department of Insurance because it expands existing benefits and does not establish a new state mandate.
State Mandates Fiscal Note (Dept. of Commerce & Economic Opportunity)
This bill does not create a State mandate.
Senate Committee Amendment No. 1 Replaces everything after the enacting clause. Reinserts the provisions of the engrossed bill with the following changes: Removes language providing that coverage for medically necessary preventative physical therapy for insureds diagnosed with multiple sclerosis must be provided without any treatment limitation or calendar year maximum. Provides that the coverage required under the provisions shall be subject to the same deductible and coinsurance limitations as provided for other physical or rehabilitative therapy benefits covered by the policy. Provides that a group or individual policy of accident and health insurance shall offer an exception process from treatment limitations for individuals diagnosed with primary or secondary progressive multiple sclerosis. Provides requirements for the exception process and that a health insurer shall, within 72 hours after receiving an exception request, either approve or deny the request. Provides that coverage required by the provisions shall be subject to certain other general exclusions and limitations of the policy.