HB 3308

Abstract

Amends the Illinois Insurance Code. Includes the delivery of covered health care services by way of telephone usage in the definition of "telehealth services". Provides that health care services that are covered under an individual or group policy of accident or health insurance must be covered when delivered via telehealth services when clinically appropriate, subject to specified conditions (rather than requiring an individual or group policy of accident or health insurance to comply with specified conditions if it provides coverage for telehealth services). Provides that patient cost-sharing may be no more than if the health care service were delivered in person. Provides that no excepted benefit policy may deny or reduce any benefit to a patient based on the use of clinically appropriate telehealth services in the course of satisfying the policy's benefit criteria. House Committee Amendment No. 1 Replaces everything after the enacting clause with the provisions of the introduced bill with the following changes. In provisions concerning health care services that are covered under an individual or group policy of accident and health insurance that must be covered when delivered via telehealth services when clinically appropriate, provides that reimbursement to a health care provider for telehealth services for behavioral health services provided through an interactive telecommunications system shall be made on the same basis, in the same manner, and at the same rate as would be applied for the same services if they had been delivered in-person and shall include reasonable compensation to a facility that serves as the originating site at the time a telehealth service is rendered. Provides that with respect to telehealth benefits provided in an individual or group policy of accident or health insurance, insurers may not (rather than an individual or group policy of accident or health insurance may not) require patients to use a separate panel of health care providers to receive telehealth service coverage and reimbursement; create geographic or facility restrictions or requirements for telehealth services; require patients or health care providers to prove a hardship or access barrier before the approval of telehealth services for coverage or reimbursement; negotiate different contract rates for telehealth services and in-person services for behavioral health services; or impose upon telehealth services utilization review requirements that are unnecessary, duplicative, or unwarranted or impose any treatment limitations, prior authorization, documentation, or recordkeeping requirements that are more stringent than the requirements applicable to the same health care service when rendered in-person. Provides that health care providers shall determine the appropriateness of specific sites, technology platforms, and technology vendors for a telehealth service, as long as delivered services adhere to privacy laws. Defines terms. House Floor Amendment No. 2 Adds reference to: 215 ILCS 5/356z.43 new 225 ILCS 150/5 225 ILCS 150/15 325 ILCS 20/3 from Ch. 23, par. 4153 325 ILCS 20/3b new 325 ILCS 20/11 from Ch. 23, par. 4161 Replaces everything after the enacting clause with the provisions of the introduced bill with the following changes. Provides that a health insurer shall reimburse a network provider for behavioral health services delivered through telehealth on at least the same basis and at the same rate as if delivered in-person. Provides that a health insurer may establish reasonable requirements and parameters for telehealth services. Further amends the Illinois Insurance Code. Creates the Telehealth Payment Parity Task Force to review and study the use of telehealth services in the State with respect to payment and reimbursement parity for health care providers providing such services. Sets forth provisions concerning election of a chairperson, compensation, and appointments of members of the Telehealth Payment Parity Task Force. Provides that the task force shall submit its findings and recommendations to the Governor and General Assembly by December 31, 2021. Provides that the task force is dissolved on January 1, 2023. Amends the Telehealth Act. In provisions concerning use of telehealth, provides that services provided by telehealth shall be consistent with all federal and State privacy, security, and confidentiality laws. Provides that health care professionals shall determine the appropriateness of specific sites, technology platforms, and technology vendors for a telehealth service, as long as delivered services adhere to specified privacy laws. Provides that health care professionals shall maintain documentation and recordkeeping in accordance with specified provisions of the Illinois Administrative Code. Amends the Early Intervention Services System Act. Permits an early intervention provider to deliver via telehealth any type of early intervention services authorized under the Act to the extent of his or her scope of practice as established in his or her respective licensing Act consistent with the standards of care for in-person services. Requires parents to be informed of the availability of early intervention services provided through telehealth. Provides that parents shall make the final decision as to whether accepted early intervention services are delivered in person or via telehealth. Defines terms. Makes other changes. Effective immediately. Senate Committee Amendment No. 1 Deletes reference to: 215 ILCS 5/356z.43 new Adds reference to: 5 ILCS 100/5-45.8 new 225 ILCS 150/10 Replaces everything after the enacting clause with the provisions of the engrossed bill with the following changes. Provides that an individual or group policy of accident or health insurance that is amended, delivered, issued, or renewed on or after the effective date of the amendatory Act shall cover telehealth services, e-visits, and virtual check-ins rendered by a health care professional when clinically appropriate and medically necessary to insureds, enrollees, and members in the same manner as any other benefits covered under the policy. Provides that an individual or group policy of accident or health insurance may provide reimbursement to a facility that serves as the originating site at the time a telehealth service is rendered. Sets forth provisions with which coverage for telehealth services shall comply. Provides that an individual or group policy of accident or health insurance shall notify health care professionals and facilities of any instructions necessary to facilitate billing for telehealth services, e-visits, and virtual check-ins. Provides that the Department of Insurance and the Department of Public Health shall commission a report to the General Assembly and shall submit the report by December 31, 2026. Provides that the Department of Insurance may adopt rules to implement the provisions. Provides that specified provisions are inoperative on and after January 1, 2028. Removes provisions concerning the Telehealth Payment Parity Task Force. Defines terms. Further amends the Telehealth Act. Changes a reference to "telehealth" to "telehealth services." Removes language that provides that health care professionals shall maintain documentation and recordkeeping in accordance with specified provisions of the Illinois Administrative Code. Defines terms. Amends the Illinois Administrative Procedure Act to provide for emergency rulemaking. Makes other changes. Effective immediately.