The introduction of SB2195 is poised to significantly impact Illinois state law by enhancing the legal framework around healthcare coverage for assistive devices. By requiring that health insurance policies provide coverage for prosthetic and orthotic devices, the bill aims to alleviate financial burdens faced by individuals who rely on such devices for daily functioning and physical activities. This legislation also aligns with ongoing efforts to improve healthcare accessibility and equity for all citizens. Coverage will now include repairs and replacements of devices as well.
Summary
SB2195 amends the Illinois Insurance Code to mandate coverage for prosthetic and customized orthotic devices under individual and group health insurance policies. The bill ensures that any person covered will receive benefits for expenses incurred in acquiring these devices from licensed providers in Illinois. As of the effective date of January 1, 2025, this legislation will require health plans and insurance policies to include coverage that is no less favorable than other medical and surgical benefits, thereby making these essential aids more accessible to individuals in need.
Sentiment
The general sentiment surrounding SB2195 appears to be positive among legislators and healthcare advocates who recognize the need for expanded coverage of prosthetic and orthotic devices. The bill received overwhelming support in the voting process, with 111 votes in favor and none against. However, discussions may arise surrounding the implementation logistics, potential costs for insurers, and the necessity to balance coverage with the financial sustainability of health plans.
Contention
Although there is significant support for SB2195, possible points of contention might center on the organizational implications for insurance companies and healthcare providers in covering these additional requirements. Concerns may also be raised about the long-term financial impact on state healthcare budgets and insurance premiums. The bill does contain provisions allowing for prior authorization of covered devices, which could be a source of debate regarding access and timely provision of necessary healthcare equipment.
To create orthotics and prosthetics parity and ensure coverage of orthotics and prosthetics for the performance of physical activities for children 18 years of age and younger.
To Modify The Arkansas Health Care Consumer Act; And To Require Coverage For Prosthetic Devices For Athletics Or Recreation And Prosthetic Devices For Showering Or Bathing.