Rep. Deb Conroy

Filed: 5/23/2020

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 671

2    AMENDMENT NO. ______. Amend Senate Bill 671 by replacing
3everything after the enacting clause with the following:
 
4    "Section 1. Short title. This Act may be cited as the
5Telehealth During the COVID-19 Pandemic Act.
 
6    Section 5. Applicability.
7    (a) This Act applies to policies issued by a health
8insurance issuer as defined in Section 10 of this Act, but does
9not apply to excepted benefits as defined in 45 CFR 146.145(b)
10and 45 CFR 148.220, but does apply to limited scope dental
11benefits, limited scope vision benefits, long-term care
12benefits, coverage only for accidents, and coverage only for
13specified disease or illness.
14    (b) Any policy, contract, or certificate of health
15insurance coverage that does not distinguish between
16in-network and out-of-network providers shall be subject to

 

 

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1this Act as though all providers were in-network.
 
2    Section 10. Definitions. As used in this Act:
3    "Health insurance coverage" has the meaning given to that
4term in Section 5 of the Illinois Health Insurance Portability
5and Accountability Act.
6    "Health insurance issuer" means an insurance company,
7insurance service, or insurance organization, including health
8maintenance organization, that is licensed to engage in the
9business of insurance in a state and that is subject to
10Illinois law that regulates insurance (within the meaning of
11Section 514(b)(2) of the Employee Retirement Income Security
12Act of 1974).
13    "Telehealth services" means the provision of health care,
14psychiatry, mental health treatment, substance use disorder
15treatment, and related services to a patient, regardless of his
16or her location, through electronic or telephonic methods, such
17as telephone (landline or cellular), video technology commonly
18available on smart phones and other devices, and
19videoconferencing, as well as any method within the meaning of
20telehealth services under Section 356z.22 of the Illinois
21Insurance Code.
 
22    Section 15. Coverage for telehealth services during the
23COVID-19 pandemic.
24    (a) In order to protect the public's health, to permit

 

 

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1expedited treatment of health conditions during the COVID-19
2pandemic, and to mitigate its impact upon the residents of the
3State of Illinois, all health insurance issuers regulated by
4the Department of Insurance shall cover the costs of all
5telehealth services rendered by in-network providers to
6deliver any clinically appropriate, medically necessary
7covered services and treatments to insureds, enrollees, and
8members under each policy, contract, or certificate of health
9insurance coverage.
10    (b) Health insurance issuers may establish reasonable
11requirements and parameters for telehealth services, including
12with respect to documentation and recordkeeping, to the extent
13consistent with this Act or any company bulletin issued by the
14Department of Insurance under Executive Order 2020-09. A health
15insurance issuer's requirements and parameters may not be more
16restrictive or less favorable toward providers, insureds,
17enrollees, or members than those contained in the emergency
18rulemaking undertaken by the Department of Healthcare and
19Family Services at 89 Ill. Adm. Code 140.403(e). Health
20insurance issuers shall notify providers of any instructions
21necessary to facilitate billing for telehealth services.
 
22    Section 20. Prior authorization and utilization review
23requirements.
24    (a) In order to ensure that health care is quickly and
25efficiently provided to the public, health insurance issuers

 

 

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1shall not impose upon telehealth services utilization review
2requirements that are unnecessary, duplicative, or unwarranted
3nor impose any treatment limitations that are more stringent
4than the requirements applicable to the same health care
5service when rendered in-person.
6    (b) For telehealth services that relate to COVID-19
7delivered by in-network providers, health insurance issuers
8shall not impose any prior authorization requirements.
 
9    Section 25. Cost-sharing prohibited. Health insurance
10issuers shall not impose any cost-sharing (copayments,
11deductibles, or coinsurance) for telehealth services provided
12by in-network providers. However, in accordance with the
13standards and definitions in 26 U.S.C. 223, if an enrollee in a
14high-deductible health plan has not met the applicable
15deductible under the terms of his or her coverage, the
16requirements of this Section do not require an issuer to pay
17for a charge for telehealth services unless the associated
18health care service for that particular charge is deemed
19preventive care by the United States Department of the
20Treasury. The federal Internal Revenue Service has recognized
21that services for testing, treatment, and any potential
22vaccination for COVID-19 fall within the scope of preventive
23care.
 
24    Section 30. Eligible services. Services eligible under

 

 

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1this Act include services provided by any professional,
2practitioner, clinician, or other provider who is licensed,
3certified, registered, or otherwise authorized to practice in
4the State where the patient receives treatment, subject to the
5provisions of the Telehealth Act for any health care
6professional, as defined in the Telehealth Act, who delivers
7treatment through telehealth to a patient located in this
8State, and substance use disorder professionals and clinicians
9authorized by Illinois law to provide substance use disorder
10services.
 
11    Section 35. Permissible use of non-public facing audio or
12video communication technologies. Notwithstanding the
13requirements of the Mental Health and Developmental
14Disabilities Confidentiality Act, any provider or covered
15entity of any licensure or area of practice subject to this Act
16that uses audio or video communication technology to deliver
17services may use any non-public facing remote communication
18product in accordance with this Act to the extent permitted by
19the U.S. Department of Health and Human Services under the
20federal Health Insurance Portability and Accountability Act of
211996. Providers and covered entities shall, to the extent
22feasible, notify patients that third-party applications
23potentially introduce privacy risks. Providers shall enable
24all available encryption and privacy modes when using such
25applications. A public facing video communication application

 

 

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1may not be used in the provision of telehealth services by
2covered health care providers or covered entities.
 
3    Section 40. Rulemaking authority. The Department of
4Insurance may adopt rules, including emergency rulemaking in
5accordance with the Illinois Administrative Procedure Act, to
6implement the provisions of this Act.
 
7    Section 90. Repeal. This Act is repealed on December 31,
82020.
 
9    Section 95. The Illinois Administrative Procedure Act is
10amended by adding Section 5-45.1 as follows:
 
11    (5 ILCS 100/5-45.1 new)
12    Sec. 5-45.1. Emergency rulemaking. To provide for the
13expeditious and timely implementation of the Telehealth During
14the COVID-19 Pandemic Act, emergency rules may be adopted in
15accordance with Section 5-45 by the respective Department of
16Insurance. The adoption of emergency rules authorized by
17Section 5-45 and this Section is deemed to be necessary for the
18public interest, safety, and welfare.
19    This Section is repealed on January 1, 2026.
 
20    Section 99. Effective date. This Act takes effect upon
21becoming law.".