Insurers Must Now Cover Reconstructive Services for Victims of Domestic Violence

October 27, 2023

A recent notice was sent out by the Illinois Department of Healthcare and Family Services (HFS) confirming that coverage for reconstructive services for victims of domestic violence based on a new Illinois law will take effect Jan. 1, 2025.

This law is a direct result of ISMS advocacy driven through a resolution! Authored by Tariq Issa and Divya Meher Surabhi when they were ISMS medical student members, the resolution called for legislation to be enacted that would require all third-party payers, including Medicaid Managed Care Organizations (MCOs), to reimburse aesthetic services for treatment of physical injury in addition to the medically required restorative care provided to victims of domestic and intimate partner abuse. Through this resolution, ISMS caused legislation to be introduced.

Last summer House Bill 1384 was signed into law, which amends the Accident and Health Insurance Article of the Illinois Insurance Code. The amendment provides that, effective Jan. 1, 2025, private health insurers, managed care plans and all other third-party payers cannot deny coverage for medically necessary reconstructive services that are intended to restore physical appearance for injuries sustained due to domestic violence.

If you have questions, please contact ISMS Senior Vice President of State Legislative Affairs Erin O'Brien by email.