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.
LRB101 16137 BMS 65504 b
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.)