101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB4133

 

Introduced 1/22/2020, by Rep. Keith R. Wheeler

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-5.25

    Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services shall reimburse epilepsy specialists, as defined by the Department by rule, who are authorized by Illinois law to provide epilepsy treatment services to persons with epilepsy or related disorders via telehealth. Provides that the Department shall establish, by rule, a method to reimburse providers for epilepsy treatment services provided by telehealth. Effective immediately.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Public Aid Code is amended by
5changing Section 5-5.25 as follows:
 
6    (305 ILCS 5/5-5.25)
7    Sec. 5-5.25. Access to behavioral health, and medical, and
8epilepsy treatment services.
9    (a) The General Assembly finds that providing access to
10behavioral health, and medical, and epilepsy treatment
11services in a timely manner will improve the quality of life
12for persons suffering from illness and will contain health care
13costs by avoiding the need for more costly inpatient
14hospitalization.
15    (b) The Department of Healthcare and Family Services shall
16reimburse psychiatrists, federally qualified health centers as
17defined in Section 1905(l)(2)(B) of the federal Social Security
18Act, clinical psychologists, clinical social workers, advanced
19practice registered nurses certified in psychiatric and mental
20health nursing, and mental health professionals and clinicians
21authorized by Illinois law to provide behavioral health
22services to recipients via telehealth. The Department shall
23reimburse epilepsy specialists, as defined by the Department by

 

 

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1rule, who are authorized by Illinois law to provide epilepsy
2treatment services to persons with epilepsy or related
3disorders via telehealth. The Department, by rule, shall
4establish: (i) criteria for such services to be reimbursed,
5including appropriate facilities and equipment to be used at
6both sites and requirements for a physician or other licensed
7health care professional to be present at the site where the
8patient is located; however, the Department shall not require
9that a physician or other licensed health care professional be
10physically present in the same room as the patient for the
11entire time during which the patient is receiving telehealth
12services; and (ii) a method to reimburse providers for mental
13health services provided by telehealth; and (iii) a method to
14reimburse providers for epilepsy treatment services provided
15by telehealth.
16    (c) The Department shall reimburse any Medicaid certified
17eligible facility or provider organization that acts as the
18location of the patient at the time a telehealth service is
19rendered, including substance abuse centers licensed by the
20Department of Human Services' Division of Alcoholism and
21Substance Abuse.
22    (d) On and after July 1, 2012, the Department shall reduce
23any rate of reimbursement for services or other payments or
24alter any methodologies authorized by this Code to reduce any
25rate of reimbursement for services or other payments in
26accordance with Section 5-5e.

 

 

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1(Source: P.A. 100-385, eff. 1-1-18; 100-790, eff. 8-10-18;
2100-1019, eff. 1-1-19; 101-81, eff. 7-12-19.)
 
3    Section 99. Effective date. This Act takes effect upon
4becoming law.