| Declaring Victory in Illinois |
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People Living with MS and Their
Supporters are Declaring Victory in Illinois
Activists from the National
Multiple Sclerosis Society –
Greater Illinois Chapter scored
a major victory late last year when
Governor Rod Blagojevich signed SB
2917 into law (now Public Law 94-
1076), making Illinois the first state to
mandate private insurance coverage for
preventive physical therapy for people
living with multiple sclerosis.
What does this mean to you?
Public Law 94-1076 significantly
improves access to health care and
dramatically improves the quality of life
for people living with MS.
Physical therapy has been clinically
proven to help MS patients maintain
current mobility and muscular strength,
though it does not result in marked
improvement in functioning. That had
been the reason why many private
insurers denied coverage in the past.
Thanks to the new law, people with MS
no longer have to battle the bureaucracy
of an insurance company in order to
continue getting coverage for the physical
therapy services that have kept them out
of a wheelchair, stopped muscle atrophy,
prevented falls and kept them active in
the community. If you have a private
insurance plan and have been struggling
with getting consistent, ongoing
coverage for physical therapy, this law
requires that you can get access to the
preventative physical therapy you need.
As defined in the new legislation, “preventative
physical therapy" includes
physical therapy that is prescribed by a
physician (anyone licensed to practice
medicine) for the purpose of treating
parts of the body affected by multiple
sclerosis. The prescription for physical
therapy must include reasonably
defined goals (including, but not limited
to, sustaining the level of function the
person has achieved) with periodic evaluation
of the efficacy of the physical
therapy against those goals.
Coverage required under this Section
will be subject to the same deductible,
coinsurance, waiting period, and costsharing
limitation, treatment limitation,
calendar year maximum, or other limitations
as provided for other physical or
rehabilitative therapy benefits covered
by the policy.
How do you find out if you
can access this law?
- Contact your doctor; consult him/her
about physical therapy and obtain a
prescription. In order for the law to be
applicable, your doctor must prescribe
physical therapy.
- Call your insurance company to
make sure they are aware of the law.
- Individuals with federal or state insurance
plans are not covered under this
law. If you currently have one of these
plans and are experiencing difficulty
accessing physical therapy, please
contact the Chapter to share your
story. We are currently compiling data
and stories to advocate for change at
the state and federal level. We need
your help to do so, so please take the
extra step and speak out.
Are you on Medicare?
Medicare covers maintainence physical
therapy for people living with MS.
Multiple sclerosis is an exemption
category with physical therapy caps
for Medicare beneficiaries. Many people
living with MS who are on Medicare are
denied access to maintenance/on-going
physical therapy. Many physical therapists
are unaware of the Medicare
exemption categories and do not know
that they can help advocate on behalf of
their patients. If you receive Medicare but
have not been able to access physical
therapy services, contact the Chapter
to receive the Medicare exemption
document to share with your physical
therapist.
We extend our deepest appreciation
to the Governor, Speaker Michael
Madigan, and SB 2917’s sponsors and
co-sponsors whose support of this vital
legislation ensured that people with MS
no longer have to worry about gaining
access to the physical therapy services
that have kept them mobile, independent
and actively contributing to their
community.
How can I make a difference for people
living with MS in Illinois? Join the Action
Alert Network at www.msillinois.org or call 800-FIGHT-MS
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