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HB 3769

OCCUPATIONAL THERAPY REFERRALS

104th Regular Session Introduced by Mary Edly-Allen and 7 co-sponsors

HB 3769 lets licensed OTs/OTAs start and deliver many OT services without a prior referral, including school-based care; referrers kick in after 10 visits or other defined triggers

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Bill Summary · HB 3769

Summary — HB 3769 (Illinois) — Occupational Therapy Referrals

Status: Rule 19(a) / Re‑referred to Rules Committee (referred back to Rules 4/11/2025)
Introduced: March 4, 2025 (Rep. Bob Morgan; added Chief Co‑Sponsor Rep. Jawaharial Williams)
Bill: Amends Section 3.1 of the Illinois Occupational Therapy Practice Act (225 ILCS 75/3.1). Section scheduled to be repealed January 1, 2029.

Purpose / Intent

HB 3769 clarifies and expands the circumstances in which licensed occupational therapists (OTs) and occupational therapy assistants (OTAs) may evaluate and provide services without a prior referral from a physician or other health care provider, while also specifying when an OT must refer a patient to another health care professional.

Key provisions

  • Authorizes licensed OTs and OTAs to initiate, consult, evaluate, educate, monitor, and provide occupational therapy services for individuals, groups, and populations without a referral so long as the services are within the licensee’s scope of practice.
  • Explicitly states that a referral is not required when services are provided for:
    • Consultation
    • Habilitation services
    • Screening
    • Education
    • Wellness and prevention services
    • Environmental assessments
    • Work‑related ergonomic services
  • Confirms that no referral is required for evaluation or intervention for children and youths when services are provided in a school‑based or educational environment (including the child’s home).
  • Adds/refines referral triggers: Except for services already within scope or those listed above, an OT must refer the patient to the patient’s treating health care professional of record (or to a health care professional of the patient’s choosing if none exists) when:
    1. The patient does not demonstrate measurable or functional improvement after 10 visits (the bill removes the prior alternative trigger of “15 business days, whichever occurs first”); or
    2. The patient returns for the same or a similar condition within a specified period after discharge when there was no diagnosis by a health care professional of a chronic disease that may benefit from OT (engrossed text is partially garbled on this point but intends to require referral in such situations); or
    3. The patient’s condition at evaluation or during services is determined to be beyond the OT’s scope of practice.

Who is affected

  • Licensed occupational therapists and occupational therapy assistants in Illinois (practice autonomy and referral obligations).
  • Patients receiving OT services — particularly school‑age children, individuals seeking wellness/prevention or ergonomic services, and those receiving initial evaluations without a medical referral.
  • Schools and educational programs that deliver OT services.
  • Treating physicians and other healthcare professionals who may receive referrals under the new criteria.
  • Payers/insurers — potential implications for coverage and reimbursement when services are initiated without a traditional referral.

Procedural / timeline notes

  • Section 3.1 as amended remains scheduled for statutory repeal on January 1, 2029 (per existing statute language).
  • Legislative actions to date include committee referral to Health Care Licenses, passage out of that committee (3/19/2025), readings on the floor, and re‑referral to Rules on 4/11/2025. The engrossed bill text contains formatting errors in places; the summary above reflects the bill’s clear, stated policy changes and intent.

Potential impacts to consider

  • Likely increases access and speed of OT services (fewer administrative referral barriers), especially for preventive, school‑based, and ergonomic services.
  • May shift some clinical decision and triage responsibilities onto OTs/OTAs (with explicit duty to refer under the listed conditions).
  • Insurance payment and billing policies could need adjustment to align coverage with services provided without a physician referral.

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

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