HB 3498

Abstract

Amends the Telehealth Act. Provides that the Act applies to all health insurance coverage offered by health insurance issuers regulated by the Department of Insurance or the Department of Healthcare and Family Services and the medical assistance program authorized under the Illinois Public Aid Code. Provides that any policy, contract, or certificate of health insurance coverage that does not distinguish between in-network and out-of-network providers shall be subject to the Act as though all providers were in-network. Provides that health insurance issuers shall cover all telehealth services rendered by a health care professional to deliver any clinically appropriate, medically necessary covered services. Restricts health insurance issuers from engaging in specified activities. Provides that health care professionals and facilities 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. Changes the term "telehealth" to "telehealth services". Makes corresponding changes. Defines terms. Amends the Illinois Insurance Code. In provisions concerning coverage for telehealth services, makes changes to definitions. Provides that coverage and reimbursement for telehealth services delivered by health care professionals and facilities shall comply with the Telehealth Act. Makes other changes. Amends the Illinois Public Aid Code. Provides that the Department and managed care organizations shall comply with the Telehealth Act and removes provisions concerning behavioral health and medical services via telehealth. Makes other changes. Amends the Illinois Administrative Procedure Act to provide for emergency rulemaking. Effective immediately. House Floor Amendment No. 1 Deletes reference to: 5 ILCS 100/5-45.10 new 225 ILCS 150/20 new 225 ILCS 150/25 new 225 ILCS 150/30 new 225 ILCS 150/35 new Replaces everything after the enacting clause. Amends the Illinois Insurance Code. Provides that an individual or group policy of accident or health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after the effective date of the amendatory Act shall cover all telehealth services rendered by a health care professional to deliver any clinically appropriate, medically necessary covered services, and shall not engage in specified activities. Provides that any policy, contract, or certificate of health insurance coverage that does not distinguish between in-network and out-of-network providers shall be subject to the Act as though all providers were in-network. Provides that health care professionals and facilities 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. Provides that there shall be no restrictions on originating site requirements for telehealth coverage or reimbursement to the distant site. Defines terms. Amends the Telehealth Act. Changes the term "telehealth" to "telehealth services". Amends the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services and managed care organizations shall comply with specified provisions of the Illinois Insurance Code and removes provisions concerning behavioral health and medical services via telehealth. Amends the Illinois Administrative Procedure Act to provide for emergency rulemaking. In provisions concerning coverage for telehealth services, removes language that provides that coverage and reimbursement for telehealth services delivered by health care professionals and facilities shall comply with the Telehealth Act. Removes changes to the Telehealth Act. Makes other changes. Effective immediately. House Floor Amendment No. 2 In provisions in the Illinois Administrative Procedure Act concerning emergency rulemaking, provides that provisions allowing the Department of Insurance and the Department of Healthcare and Family Services to adopt emergency rules are repealed on January 1, 2022 (rather than January 1, 2026). In provisions concerning coverage for telehealth services, provides that an individual or group policy of accident or health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after the effective date of the amendatory Act shall not require that in-person contact occur between a health care professional and a patient (rather than in-person contact shall not occur between a health care professional and a patient, except before an initial e-visit or virtual check-in in order to establish a patient relationship).