101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB4162
 
Introduced , by Rep. Ryan Spain
 
SYNOPSIS AS INTRODUCED:



215 ILCS 5/356z.22

 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.



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FISCAL NOTE ACT MAY APPLY
 
 
A BILL FOR
 


HB4162LRB101 16137 BMS 65504 b



1 AN ACT concerning regulation.


2 Be it enacted by the People of the State of Illinois,

3represented in the General Assembly:



4 Section 5. The Illinois Insurance Code is amended by 
5changing Section 356z.22 as follows:

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 
10provider rendering the telehealth service is located.
11 "Interactive telecommunications system" means an audio and 
12video system permitting 2-way, live interactive communication 
13between the patient and the distant site health care provider.
14 "Telehealth services" means the delivery of covered health 
15care services by way of an interactive telecommunications 
16system.
17 (b) If an individual or group policy of accident or health 
18insurance provides coverage for telehealth services, then it 
19must 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 
16health insurance provides coverage for telehealth services, it 
17must provide coverage for licensed dietitian nutritionists and 
18certified diabetes educators who counsel senior diabetes 
19patients in the senior diabetes patients' homes to remove the 
20hurdle of transportation for senior diabetes patients to 
21receive treatment. 
22 (b-10) If an individual or group policy of accident or 
23health insurance provides coverage for telehealth services, it 
24must provide coverage for telehealth services used to treat a 
25mental, emotional, nervous, or substance use disorder or 
26condition as defined in paragraph (4) of subsection (a) of 
 
 
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1Section 370c. 
2 (c) Nothing in this Section shall be deemed as precluding a 
3health insurer from providing benefits for other services, 
4including, but not limited to, remote monitoring services, 
5other monitoring services, or oral communications otherwise 
6covered under the policy. 

7(Source: P.A. 100-1009, eff. 1-1-19.)