Bill Text: IL HB4162 | 2019-2020 | 101st General Assembly | Introduced
Bill Title: Amends the Illinois Insurance Code. Provides that individual or group policies of accident or health insurance that cover telehealth services must provide coverage for telehealth services used to treat a mental, emotional, nervous, or substance use disorder or condition.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2020-06-23 - Rule 19(b) / Re-referred to Rules Committee [HB4162 Detail]
Download: Illinois-2019-HB4162-Introduced.html
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1 | AN ACT concerning regulation.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Illinois Insurance Code is amended by | ||||||||||||||||||||||||
5 | changing Section 356z.22 as follows:
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6 | (215 ILCS 5/356z.22) | ||||||||||||||||||||||||
7 | Sec. 356z.22. Coverage for telehealth services. | ||||||||||||||||||||||||
8 | (a) For purposes of this Section: | ||||||||||||||||||||||||
9 | "Distant site" means the location at which the health care | ||||||||||||||||||||||||
10 | provider rendering the telehealth service is located. | ||||||||||||||||||||||||
11 | "Interactive telecommunications system" means an audio and | ||||||||||||||||||||||||
12 | video system permitting 2-way, live interactive communication | ||||||||||||||||||||||||
13 | between the patient and the distant site health care provider. | ||||||||||||||||||||||||
14 | "Telehealth services" means the delivery of covered health | ||||||||||||||||||||||||
15 | care services by way of an interactive telecommunications | ||||||||||||||||||||||||
16 | system. | ||||||||||||||||||||||||
17 | (b) If an individual or group policy of accident or health | ||||||||||||||||||||||||
18 | insurance provides coverage for telehealth services, then it | ||||||||||||||||||||||||
19 | must comply with the following: | ||||||||||||||||||||||||
20 | (1) An individual or group policy of accident or health | ||||||||||||||||||||||||
21 | insurance providing telehealth services may not: | ||||||||||||||||||||||||
22 | (A) require that in-person contact occur between a | ||||||||||||||||||||||||
23 | health care provider and a patient; |
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1 | (B) require the health care provider to document a | ||||||
2 | barrier to an in-person consultation for coverage of | ||||||
3 | services to be provided through telehealth; | ||||||
4 | (C) require the use of telehealth when the health | ||||||
5 | care provider has determined that it is not | ||||||
6 | appropriate; or | ||||||
7 | (D) require the use of telehealth when a patient | ||||||
8 | chooses an in-person consultation. | ||||||
9 | (2) Deductibles, copayments, or coinsurance applicable | ||||||
10 | to services provided through telehealth shall not exceed | ||||||
11 | the deductibles, copayments, or coinsurance required by | ||||||
12 | the individual or group policy of accident or health | ||||||
13 | insurance for the same services provided through in-person | ||||||
14 | consultation. | ||||||
15 | (b-5) If an individual or group policy of accident or | ||||||
16 | health insurance provides coverage for telehealth services, it | ||||||
17 | must provide coverage for licensed dietitian nutritionists and | ||||||
18 | certified diabetes educators who counsel senior diabetes | ||||||
19 | patients in the senior diabetes patients' homes to remove the | ||||||
20 | hurdle of transportation for senior diabetes patients to | ||||||
21 | receive treatment. | ||||||
22 | (b-10) If an individual or group policy of accident or | ||||||
23 | health insurance provides coverage for telehealth services, it | ||||||
24 | must provide coverage for telehealth services used to treat a | ||||||
25 | mental, emotional, nervous, or substance use disorder or | ||||||
26 | condition as defined in paragraph (4) of subsection (a) of |
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1 | Section 370c. | ||||||
2 | (c) Nothing in this Section shall be deemed as precluding a | ||||||
3 | health insurer from providing benefits for other services, | ||||||
4 | including, but not limited to, remote monitoring services, | ||||||
5 | other monitoring services, or oral communications otherwise | ||||||
6 | covered under the policy.
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7 | (Source: P.A. 100-1009, eff. 1-1-19 .)
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