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Bill

HB 2628

Relating to restitution.

2025 Regular Session

Requires most health plans and public programs in Illinois to cover habilitative and rehabilitative speech therapy for stuttering starting Jan 1, 2027.

In committee upon adjournment.
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Bill Summary · HB 2628

Summary — HB 2628 (Ins. Cd. — Stuttering Coverage) — Illinois (2025)

Note: The materials provided also included an unrelated Arizona bill numbered HB 2628 (pharmacists administering emergency medication). This summary covers the Illinois HB 2628 titled “INS CD‑STUTTERING COVERAGE,” introduced by Rep. Marcus C. Evans, Jr.

Purpose / Intent

Require health insurance plans and specified public employer health programs in Illinois to cover speech therapy services for stuttering (both habilitative and rehabilitative), broadening access to treatment regardless of whether stuttering is classified as developmental.

Key provisions

  • Coverage requirement:
    • Any group or individual accident and health insurance policy, or managed care plan, that is amended, delivered, issued, or renewed on or after January 1, 2027, and that otherwise provides habilitative or rehabilitative services must provide coverage for:
    • Habilitative speech therapy as a treatment for stuttering (regardless of classification as developmental), and
    • Rehabilitative speech therapy as a treatment for stuttering.
    • If a plan covers both habilitative and rehabilitative services, it must cover both habilitative and rehabilitative speech therapy for stuttering.
  • Scope and limits:
    • The bill “sets forth requirements and limitations for the coverage”; the excerpt references multiple sections of the Illinois Insurance Code that will govern the details (medical necessity criteria, benefit limits, prior authorization, provider standards, etc.) though specific numerical limits or clinical criteria are not included in the excerpt provided.
  • Applicability across public programs and entities:
    • Amends multiple statutes to extend the coverage requirement to:
    • State Employees Group Insurance Act (state employee plans)
    • County self‑insured plans
    • Municipal self‑insured plans
    • School district health plans
    • Health Maintenance Organizations (HMOs)
    • Limited Health Service Organizations
    • Voluntary Health Services Plans
    • Illinois Public Aid (Medicaid) Code
  • Fiscal/administrative note:
    • Amends the State Mandates Act to require implementation “without reimbursement,” indicating local governments must absorb any direct costs arising from the mandate.

Who is affected

  • Primary: People who stutter (children and adults) seeking habilitative or rehabilitative speech therapy.
  • Payers: Private insurers (individual and group policies), managed care plans, HMOs, state and local government employers that self‑insure, and Medicaid/Public Aid.
  • Providers: Speech‑language pathologists and clinics providing stuttering therapy.
  • Employers and local governments: potential direct costs for self‑insured plans, since implementation is required without reimbursement.

Effective date and procedural status

  • Applies to policies amended, delivered, issued, or renewed on or after January 1, 2027.
  • Introduced in the Illinois General Assembly in February 2025 (sponsor: Rep. Marcus C. Evans, Jr.). (The excerpt shows legislative drafting and many statutory cross‑references; procedural steps beyond introduction were not included in full in the excerpt.)

Potential impacts (summary)

  • Increased access to evidence‑based speech therapy for stuttering by making coverage mandatory across a broad set of plans.
  • Potential increase in plan costs and administrative needs (benefit design, claims processing, utilization management).
  • Local governments and school districts that self‑insure may incur additional costs and must implement the mandate without state reimbursement.

If you want, I can:
- Pull and summarize the exact regulatory/clinical criteria and any numeric limits referenced in the full Insurance Code sections cited; or
- Draft a short explainer on habilitative vs. rehabilitative speech therapy and typical coverage considerations for stuttering.

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

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