Bill Text: IL SB2684 | 2023-2024 | 103rd General Assembly | Introduced

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Bill Title: Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to adopt rules permitting reimbursement under the fee-for-service and managed care medical assistance programs for remote ultrasound procedures and remote fetal nonstress tests, utilizing established Current Procedural Terminology codes, as published by the American Medical Association, for these procedures when the patient is in a residence or other off-site location from the patient's provider and the same standard of care is met as would be present during an in-person visit. Provides that remote ultrasounds and remote fetal nonstress tests are only eligible for reimbursement when the provider uses digital technology that meets certain criteria. Provides which fetal nonstress test requires a place of service modifier for at-home monitoring in order to qualify for reimbursement. Requires the Department to issue guidance to implement the provisions of the amendatory Act.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Introduced) 2024-04-10 - Added as Co-Sponsor Sen. Emil Jones, III [SB2684 Detail]

Download: Illinois-2023-SB2684-Introduced.html

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103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB2684 Introduced 1/10/2024, by Sen. Laura M. Murphy SYNOPSIS AS INTRODUCED:
305 ILCS 5/5-5.24a new
Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to adopt rules permitting reimbursement under the fee-for-service and managed care medical assistance programs for remote ultrasound procedures and remote fetal nonstress tests, utilizing established Current Procedural Terminology codes, as published by the American Medical Association, for these procedures when the patient is in a residence or other off-site location from the patient's provider and the same standard of care is met as would be present during an in-person visit. Provides that remote ultrasounds and remote fetal nonstress tests are only eligible for reimbursement when the provider uses digital technology that meets certain criteria. Provides which fetal nonstress test requires a place of service modifier for at-home monitoring in order to qualify for reimbursement. Requires the Department to issue guidance to implement the provisions of the amendatory Act.
LRB103 35787 KTG 65870 b
A BILL FOR
SB2684 LRB103 35787 KTG 65870 b
AN ACT concerning public aid.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Illinois Public Aid Code is amended by
adding Section 5-5.24a as follows:
(305 ILCS 5/5-5.24a new)
Sec. 5-5.24a. Remote ultrasounds and remote fetal
nonstress tests; reimbursement.
(a) As used in this Section, "CPT code" means the medical
billing code set contained in the most recent version of the
Current Procedural Terminology code book published by the
American Medical Association.
(b) The Department shall adopt rules permitting
reimbursement under the fee-for-service and managed care
medical assistance programs for remote ultrasound procedures
and remote fetal nonstress tests, utilizing established CPT
codes for these procedures, when the patient is in a residence
or other off-site location from the patient's provider and the
same standard of care is met as would be present during an
in-person visit.
(c) Remote ultrasounds and remote fetal nonstress tests
are only eligible for reimbursement when the provider uses
digital technology:

SB2684 - 2 - LRB103 35787 KTG 65870 b