IllinoisHB5225104th General Assembly (2025–2026)HouseWALLET

AUTISM SPECTRUM-DIAGNOSIS

Sponsored By: Sponsor information unavailable

Became Law

Summary

Amends the Illinois Speech-Language Pathology and Audiology Practice Act. Allows a speech-language pathologist to diagnose autism spectrum disorders if: (1) the child is under 3 years of age; and (2) the speech-language pathologist is trained in autism diagnostic evaluation methods as part of the curriculum of an approved program, through worksite training, or through continuing education. Provides that if a diagnosis requires a plan of care that includes elements that are outside the scope of practice of a speech-language pathologist, the speech-language pathologist must refer the patient to the appropriate medical personnel for further evaluation or management. Makes conforming changes in the Medical Assistance Article of the Illinois Public Aid Code, and provisions of the Illinois Insurance Code concerning autism spectrum disorders. Effective July 1, 2027.

health care licensesassignmentslicensed activities

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Bill Overview

Analyzed Economic Effects

4 provisions identified: 2 benefits, 0 costs, 2 mixed.

Medicaid covers ABA therapy for kids

Illinois Medicaid covers applied behavior analysis (ABA) for children with autism when ordered by a doctor, licensed psychologist, or qualified SLP in Early Intervention, and evaluated by a recognized or licensed behavior analyst. The state enrolls and pays qualified ABA staff, and services can be delivered at home, in clinics, or in community settings; provider enrollment occurs no later than September 1, 2023. Coverage may be limited to age ranges based on evidence. This reduces out‑of‑pocket costs for enrolled families.

Private plans must cover autism care

Private health plans in Illinois cover autism diagnosis and treatment for people under 21, including ABA, speech, OT/PT, and psychiatric and psychological care. Plans pay up to $36,000 each year per person for autism care, with the limit raised yearly for medical inflation, and they cannot count non‑autism care toward that limit. Copays, deductibles, and coinsurance must match what the plan uses for other illnesses. Plans cannot drop, refuse, or limit coverage because of an autism diagnosis, use of benefits, or where care is given (home, school, or clinic). If a plan questions medical necessity, you can appeal and a doctor with autism expertise reviews it; insurers may ask your provider for records or a treatment plan, and early intervention services must use state‑certified specialists. People diagnosed under earlier rules stay covered if treatment is medically necessary.

SLPs can diagnose autism for toddlers

Licensed speech‑language pathologists can diagnose autism for children under age 3 in the Illinois Early Intervention Program. The child must have no known co‑occurring medical conditions, and the SLP must complete approved training and certify at license renewal at least 5 hours of continuing education in toddler autism evaluation. The SLP must refer the child to medical providers for needs outside the SLP’s scope.

Federal trigger may pause state costs

If federal health officials require Illinois to pay for these private‑plan autism benefits under the Affordable Care Act, that part of the state mandate stops to the extent of that cost. Coverage under Section 1902 of the Social Security Act (Medicaid) still applies.

Sponsors & Cosponsors

Sponsors

There is no primary sponsor on record.

Cosponsors

  • Angelica Guerrero-Cuellar

    Affiliation unavailable

  • Brad Stephens

    Affiliation unavailable

  • Christopher Belt

    Affiliation unavailable

  • Cristina Castro

    Affiliation unavailable

  • Curtis J. Tarver, II

    Affiliation unavailable

  • Dagmara Avelar

    Affiliation unavailable

  • Dan Swanson

    Affiliation unavailable

  • Daniel Didech

    Affiliation unavailable

  • Dave Vella

    Affiliation unavailable

  • Diane Blair-Sherlock

    Affiliation unavailable

  • Doris Turner

    Affiliation unavailable

  • Emanuel "Chris" Welch

    Affiliation unavailable

  • Emil Jones, III

    Affiliation unavailable

  • Harry Benton

    Affiliation unavailable

  • Jackie Haas

    Affiliation unavailable

  • Javier L. Cervantes

    Affiliation unavailable

  • Jay Hoffman

    Affiliation unavailable

  • Jehan Gordon-Booth

    Affiliation unavailable

  • Jennifer Sanalitro

    Affiliation unavailable

  • Joyce Mason

    Affiliation unavailable

  • Julie A. Morrison

    Affiliation unavailable

  • Justin Cochran

    Affiliation unavailable

  • Katie Stuart

    Affiliation unavailable

  • Kimberly A. Lightford

    Affiliation unavailable

  • La Shawn K. Ford

    Affiliation unavailable

  • Lakesia Collins

    Affiliation unavailable

  • Laura Ellman

    Affiliation unavailable

  • Lawrence "Larry" Walsh, Jr.

    Affiliation unavailable

  • Lilian Jiménez

    Affiliation unavailable

  • Mary Edly-Allen

    Affiliation unavailable

  • Mary Gill

    Affiliation unavailable

  • Matt Hanson

    Affiliation unavailable

  • Maura Hirschauer

    Affiliation unavailable

  • Meg Loughran Cappel

    Affiliation unavailable

  • Michael Crawford

    Affiliation unavailable

  • Michael E. Hastings

    Affiliation unavailable

  • Michael W. Halpin

    Affiliation unavailable

  • Michelle Mussman

    Affiliation unavailable

  • Napoleon Harris III

    Affiliation unavailable

  • Natalie A. Manley

    Affiliation unavailable

  • Nicholas K. Smith

    Affiliation unavailable

  • Nicole La Ha

    Affiliation unavailable

  • Nicolle Grasse

    Affiliation unavailable

  • Norma Hernandez

    Affiliation unavailable

  • Ram Villivalam

    Affiliation unavailable

  • Rick Ryan

    Affiliation unavailable

  • Robert F. Martwick

    Affiliation unavailable

  • Seth Lewis

    Affiliation unavailable

  • Sharon Chung

    Affiliation unavailable

  • Suzy Glowiak Hilton

    Affiliation unavailable

  • Theresa Mah

    Affiliation unavailable

  • Tracy Katz Muhl

    Affiliation unavailable

  • Yolonda Morris

    Affiliation unavailable

Roll Call Votes

All Roll Calls

Yes: 324 • No: 0

House vote 5/27/2026

Senate Committee Amendment No. 1 House Concurs

Yes: 107 • No: 0

House vote 5/27/2026

Senate Committee Amendment No. 1 Motion to Concur Recommends Be Adopted Health Care Licenses Committee;

Yes: 13 • No: 0

Senate vote 5/21/2026

Third Reading - Passed;

Yes: 57 • No: 0

Senate vote 5/6/2026

Do Pass as Amended Licensed Activities;

Yes: 9 • No: 0

House vote 4/16/2026

Third Reading - Short Debate - Passed

Yes: 110 • No: 0

House vote 4/15/2026

House Floor Amendment No. 3 Recommends Be Adopted Health Care Licenses Committee;

Yes: 14 • No: 0

House vote 3/25/2026

Do Pass as Amended / Short Debate Health Care Licenses Committee;

Yes: 14 • No: 0

Actions Timeline

  1. Public Act . . . . . . . . . 104-0561

    7/10/2026House
  2. Effective Date January 1, 2028

    7/10/2026House
  3. Governor Approved

    7/10/2026House
  4. Sent to the Governor

    6/25/2026House
  5. Added as Alternate Co-Sponsor Sen. Napoleon Harris III

    6/1/2026Senate
  6. Added as Alternate Co-Sponsor Sen. Mary Edly-Allen

    5/31/2026Senate
  7. Added as Alternate Co-Sponsor Sen. Julie A. Morrison

    5/31/2026Senate
  8. Added as Alternate Co-Sponsor Sen. Suzy Glowiak Hilton

    5/31/2026Senate
  9. Added as Alternate Co-Sponsor Sen. Robert F. Martwick

    5/31/2026Senate
  10. Added Co-Sponsor Rep. Dan Swanson

    5/27/2026House
  11. Passed Both Houses

    5/27/2026House
  12. House Concurs

    5/27/2026House
  13. Senate Committee Amendment No. 1 House Concurs 107-000-000

    5/27/2026House
  14. Senate Committee Amendment No. 1 Motion to Concur Recommends Be Adopted Health Care Licenses Committee; 013-000-000

    5/27/2026House
  15. Added as Alternate Co-Sponsor Sen. Cristina Castro

    5/25/2026Senate
  16. Senate Committee Amendment No. 1 Motion to Concur Rules Referred to Health Care Licenses Committee

    5/25/2026House
  17. Added as Alternate Co-Sponsor Sen. Emil Jones, III

    5/22/2026Senate
  18. Senate Committee Amendment No. 1 Motion to Concur Referred to Rules Committee

    5/21/2026House
  19. Senate Committee Amendment No. 1 Motion Filed Concur Rep. Natalie A. Manley

    5/21/2026House
  20. Placed on Calendar Order of Concurrence Senate Amendment(s) 1

    5/21/2026House
  21. Arrived in House

    5/21/2026House
  22. Added as Alternate Co-Sponsor Sen. Ram Villivalam

    5/21/2026Senate
  23. Added as Alternate Co-Sponsor Sen. Michael W. Halpin

    5/21/2026Senate
  24. Added as Alternate Co-Sponsor Sen. Christopher Belt

    5/21/2026Senate
  25. Added as Alternate Co-Sponsor Sen. Kimberly A. Lightford

    5/21/2026Senate

Bill Text

  • Engrossed

  • Enrolled

  • House Amendment 1

  • House Amendment 2

  • House Amendment 3

  • Introduced

  • Senate Amendment 1

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