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SB 3295

INS-DURABLE MEDICAL EQUIPMENT

104th Regular Session Introduced by Dan Didech and 3 co-sponsors

Illinois SB 3295 aims to regulate durable medical equipment coverage in insurance plans, potentially changing medical-necessity criteria, coverage, and reimbursement with an implem

Public Act . . . . . . . . . 104-0531
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Bill Summary · SB 3295

Summary of SB 3295 (104th Session) – Illinois

Overview

  • Title: INS-DURABLE MEDICAL EQUIPMENT
  • Sponsor: Sen. Julie A. Morrison (co-sponsors: Laura Murphy, Dan Didech, Mark Walker)
  • Filed: March 4, 2026
  • Status / Timeline Highlights:
    • Referred to Insurance Committee (Feb 3, 2026) with initial sponsorship.
    • Pursued through Senate floor via amendments; passed Senate Third Reading on April 15, 2026.
    • Introduced in House and assigned to Rules; amendments exist and timing updated (amendment changing a date from 2027 to 2028).
    • The amendment to Senate Bill 3295 on page 14 changes “2027” to “2028.”

Note: The bill text provided is an amendment to SB 3295, focusing on durable medical equipment (DME) within Illinois’ insurance framework. The exact statutory language beyond the amendment reference is not included here.

Purpose and Intent

  • The bill targets durable medical equipment (DME) to address access, coverage, or regulatory aspects within the Illinois health insurance landscape.
  • By naming “INS-DURABLE MEDICAL EQUIPMENT,” the bill likely seeks to establish or modify standards, coverage requirements, or patient protections related to DME such as wheelchairs, hospital beds, oxygen equipment, and other medically necessary devices.
  • An amendment changing a key compliance or implementation date (2027 → 2028) suggests a phased timeline for implementing the new rules or requirements.

Key Provisions and Changes (as inferred from the amendment and context)

  • Durable Medical Equipment Focus: Regulation of DME within insurance plans, potentially affecting:
    • Coverage criteria for DME
    • Prior authorization or medical necessity standards
    • Reimbursement rates or processes for suppliers
    • Network adequacy and supplier qualifications
  • Implementation Timeline:
    • Original timeline included a date in 2027; the amendment changes this to 2028, indicating a one-year delay in a specific deadline (implementation, compliance, or rule effective date).
  • Regulatory/Administrative Changes:
    • The bill appears to involve the Illinois Department of Insurance or related regulatory bodies to oversee DME coverage practices.
    • Possible alignment with consumer protections, appeal rights, or utilization management practices for DME.

Affected Parties and Stakeholders

  • Individuals Requiring DME: Patients who rely on durable medical equipment for medical needs, rehabilitation, or daily living support.
  • Health Insurance Plans: Insurers and managed care plans operating in Illinois, including those offering consumer-directed health policies.
  • DME Suppliers: Vendors and distributors of durable medical equipment who must meet new coverage or billing requirements.
  • Healthcare Providers: Physicians, therapists, and facilities involved in prescribing and certifying DME.
  • Regulatory Agencies: Illinois Department of Insurance and related state health policy bodies implementing compliance standards.

Procedural and Timeline Considerations

  • Legislative Process:
    • The bill has advanced through Senate committees and floor consideration with amendments.
    • It has been placed for House consideration with a sponsor lineup; a rule committee process is noted.
  • Key Date Change:
    • Amendment alters a target year from 2027 to 2028, signaling a revised schedule for rulemaking, funding, or phased implementation.
  • Effective Date (Not Specified Here): The exact effective date for the bill’s provisions is not provided in the excerpt. The amended date likely affects a specific provision’s start.

Practical Implications

  • If enacted, Illinois residents could see changes to how DME is covered and paid for by insurance plans, potentially improving access and reducing out-of-pocket costs for medically necessary equipment.
  • Insurers and DME suppliers may face new verification, billing, and utilization management requirements.
  • The 2028 date in the amendment could provide additional time for implementation, stakeholder rulemaking, and system updates.

Notes for Further Review

  • The full bill text would clarify:
    • Specific coverage criteria and medical necessity standards for DME
    • Exact definitions of covered DME categories
    • Reimbursement methodologies and rate setting
    • Patient appeal rights and grievance processes
    • Any funding, regulatory fees, or administrative costs associated with implementation

If you’d like, I can pull and summarize the exact statutory language once the full bill text is available.

Compiled from official sources — confirm details with the bill’s official record.

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