SB 2085

Abstract

Amends the Illinois Insurance Code. Requires an individual or group policy of accident and health insurance or managed care organization that provides mental health benefits to provide reimbursement for benefits that are delivered through the psychiatric Collaborative Care Model. Provides that an individual or group policy of accident and health insurance or managed care organization that provides mental health benefits may deny reimbursement of any current procedural terminology code listed on the grounds of medical necessity if medical necessity determinations are in compliance with federal law and related regulations. Makes conforming changes to the Illinois Public Aid Code. Effective immediately. Senate Floor Amendment No. 1 Replaces the definition of "psychiatric Collaborative Care Model" with language providing that the term means the evidence-based, integrated behavioral health service delivery method, which includes a formal collaborative arrangement among a primary care team consisting of a primary care provider, a care manager, and a psychiatric consultant, and includes, but is not limited to, the following elements: care directed by the primary care team; structured care management; regular assessments of clinical status using validated tools; and modification of treatment as appropriate. House Floor Amendment No. 1 Changes the immediate effective date to January 1, 2020.