Bringing the diagnostician in-house forces licensee ownership. ABA is already a licensed-ownership mandate in Illinois, so this is consistent with keeping outside capital in a separate management company. Flip: diagnosis in a licensee-owned entity.
Who may give the diagnosis in Illinois
The medical-necessity diagnosis is made by a licensed physician or a licensed psychologist. A BCBA may not diagnose ASD, so the diagnostician you would bring in-house is a psychologist or a physician, and both are professions the state may treat differently from behavior analysis.
How Illinois treats psychology and medicine ownership
Clinical psychology in Illinois must operate through a professional entity owned entirely by licensed clinical psychologists, and no non-licensee may hold any part of the ownership, management, or control of a professional service corporation. Medicine is physician-only under the Medical Corporation Act.
What bringing the diagnostician in-house does
Bringing the diagnostician in-house forces licensee ownership. ABA is already a licensed-ownership mandate in Illinois, so this is consistent with keeping outside capital in a separate management company. Flip: diagnosis in a licensee-owned entity.
How to structure it in Illinois
Keep the ABA entity ABA-only and non-licensee owned, and put the diagnosis in a separate licensee-owned entity connected through a management company on fair-market-value, not volume-based, terms so the referral survives the federal Anti-Kickback Statute; or rely on an outside referral with no remuneration flowing for the referral. If the diagnostician is a physician and the payer is Medicaid, the federal physician self-referral rules add a layer that a psychologist does not trigger. The full three-entity structure is set out in the diagnostician question hub.
The corporate-practice, professional-entity, and anti-kickback rules summarized here are amended and reinterpreted, and verbatim text is a starting point rather than a conclusion. The official Illinois code, the applicable federal safe harbor, and qualified healthcare-regulatory and tax counsel are the authoritative sources.