Bill Text: IL SB2899 | 2025-2026 | 104th General Assembly | Enrolled

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Bill Title: Amends the Illinois Insurance Code. In provisions concerning habilitative services for children, provides that, for any child under 19 years of age with an early acquired disorder that is diagnosed as a speech-language disorder, including stuttering, the required coverage shall include rehabilitative services in addition to habilitative services. Amends the Limited Health Service Organization Act to require coverage under that Act. Amends the Illinois Public Aid Code. Provides that, subject to federal approval, for services beginning on and after July 1, 2026, the medical assistance program shall provide coverage for medically necessary rehabilitative and habilitative services for individuals under the age of 21 with an early acquired disorder that is diagnosed as a speech-language disorder, including stuttering. Effective July 1, 2026, except that provisions amending the Illinois Insurance Code and the Limited Health Service Organization Act are effective January 1, 2028.

Sponsorship: Partisan Bill (Democrat 39)

Status: (Passed) 2026-06-26 - Public Act . . . . . . . . . 104-0528 [SB2899 Detail]

Download: Illinois-2025-SB2899-Enrolled.html

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AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Illinois Insurance Code is amended by
changing Section 356z.15 as follows:
(215 ILCS 5/356z.15)
Sec. 356z.15. Habilitative services for children.
(a) As used in this Section, "habilitative services" means
occupational therapy, physical therapy, speech therapy, and
other services prescribed by the insured's treating physician
pursuant to a treatment plan to enhance the ability of a child
to function with a congenital, genetic, or early acquired
disorder. A congenital or genetic disorder includes, but is
not limited to, hereditary disorders. An early acquired
disorder refers to a disorder resulting from illness, trauma,
injury, or some other event or condition suffered by a child
prior to that child developing functional life skills such as,
but not limited to, walking, talking, or self-help skills.
Congenital, genetic, and early acquired disorders may include,
but are not limited to, autism or an autism spectrum disorder,
cerebral palsy, and other disorders resulting from early
childhood illness, trauma, or injury.
(b) A group or individual policy of accident and health

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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:
(1) A physician licensed to practice medicine in all
its branches has diagnosed the child's congenital,
genetic, or early acquired disorder.
(2) The treatment is administered by a licensed
speech-language pathologist, licensed audiologist,
licensed occupational therapist, licensed physical
therapist, licensed physician, licensed nurse, licensed
optometrist, licensed nutritionist, licensed social
worker, or licensed psychologist upon the referral of a
physician licensed to practice medicine in all its
branches.
(3) The initial or continued treatment must be
medically necessary and therapeutic and not experimental
or investigational.
(b-5) For any child under 19 years of age with an early
acquired disorder that is diagnosed as a speech-language
disorder, including stuttering, the coverage required under
this Section shall include rehabilitative services in addition
to habilitative services. As used in this subsection,
"rehabilitative services" means speech therapy that helps a

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child restore or improve skills and functions for daily living
that have been lost or impaired.
(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) Coverage under this Section does not apply to those
services that are solely educational in nature or otherwise
paid under State or federal law for purely educational
services. Nothing in this subsection (d) relieves an insurer
or similar third party from an otherwise valid obligation to
provide or to pay for services provided to a child with a
disability.
(e) Coverage under this Section for children under age 19
shall not apply to treatment of mental or emotional disorders
or illnesses as covered under Section 370 of this Code as well
as any other benefit based upon a specific diagnosis that may
be otherwise required by law.
(f) The provisions of this Section do not apply to
short-term travel, accident-only, limited, or specific disease
policies.
(g) Any denial of care for habilitative services shall be

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subject to appeal and external independent review procedures
as provided by Section 45 of the Managed Care Reform and
Patient Rights Act.
(h) 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
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.
(i) Rulemaking authority to implement this amendatory Act
of the 95th General Assembly, if any, is conditioned on the
rules being adopted in accordance with all provisions of the
Illinois Administrative Procedure Act and all rules and
procedures of the Joint Committee on Administrative Rules; any
purported rule not so adopted, for whatever reason, is
unauthorized.
(j) An insurer may not deny or refuse to provide otherwise
covered services under a group or individual policy of
accident and health insurance or a managed care plan solely

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because of the location wherein the clinically appropriate
services are provided.
(Source: P.A. 102-322, eff. 1-1-22.)
Section 10. The Limited Health Service Organization Act is
amended by changing Section 4003 as follows:
(215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
Sec. 4003. Illinois Insurance Code provisions. Limited
health service organizations shall be subject to the
provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151, 152, 153,
154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 155.49, 352c,
355.2, 355.3, 355b, 355d, 356m, 356q, 356v, 356z.4, 356z.4a,
356z.10, 356z.15, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29,
356z.32, 356z.33, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53,
356z.54, 356z.57, 356z.59, 356z.61, 356z.64, 356z.67, 356z.68,
356z.71, 356z.73, 356z.74, 356z.75, 356z.79, 356z.80, 356z.81,
356z.83, 356z.84, 356z.85, 364.3, 368a, 370a, 401, 401.1, 402,
403, 403A, 408, 408.2, 409, 412, 444, and 444.1 and Articles
IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and
XXXIIB of the Illinois Insurance Code. Nothing in this Section
shall require a limited health care plan to cover any service
that is not a limited health service. For purposes of the
Illinois Insurance Code, except for Sections 444 and 444.1 and
Articles XIII and XIII 1/2, limited health service

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organizations in the following categories are deemed to be
domestic companies:
(1) a corporation under the laws of this State; or
(2) 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
1/2 of the Illinois Insurance Code.
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445, eff.
1-1-24; 103-605, eff. 7-1-24; 103-649, eff. 1-1-25; 103-656,
eff. 1-1-25; 103-700, eff. 1-1-25; 103-718, eff. 7-19-24;
103-751, eff. 8-2-24; 103-758, eff. 1-1-25; 103-832, eff.
1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 6-9-25; 104-42,
eff. 8-1-25; 104-73, eff. 1-1-26; 104-98, eff. 1-1-26;
104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-334, eff.
8-15-25; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25; revised
11-21-25.)
Section 15. The Illinois Public Aid Code is amended by
adding Section 5-5j as follows:
(305 ILCS 5/5-5j new)
Sec. 5-5j. Speech-language rehabilitative and habilitative
services. Subject to federal approval, for services beginning

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on and after July 1, 2026, the medical assistance program
shall provide coverage for medically necessary rehabilitative
and habilitative services for individuals under the age of 21
with an early acquired disorder that is diagnosed as a
speech-language disorder, including stuttering. As used in
this Section, "rehabilitative services" means speech therapy
that helps an individual restore or improve skills and
functions for daily living that have been lost or impaired.
Section 99. Effective date. This Act takes effect July 1,
2026, except that Sections 5 and 10 take effect on January 1,
2028.