Rep. Ryan Spain

Filed: 3/25/2021





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2    AMENDMENT NO. ______. Amend House Bill 3759 by replacing
3everything after the enacting clause with the following:
4    "Section 1. Short title. This Act may be cited as the
5Telehealth Parity 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
16his or her location, through electronic or telephonic methods,
17such as telephone (landline or cellular), video technology
18commonly available 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.
23    (a) All health insurance issuers regulated by the
24Department of Insurance shall cover the costs of all



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1telehealth services rendered by in-network providers to
2deliver any clinically appropriate, medically necessary
3covered services and treatments to insureds, enrollees, and
4members under each policy, contract, or certificate of health
5insurance coverage.
6    (b) Health insurance issuers may establish reasonable
7requirements and parameters for telehealth services, including
8with respect to documentation and recordkeeping, to the extent
9consistent with this Act or any company bulletin issued by the
10Department of Insurance under Executive Order 2020-09. A
11health insurance issuer's requirements and parameters may not
12be more restrictive or less favorable toward providers,
13insureds, enrollees, or members than those contained in the
14emergency rulemaking undertaken by the Department of
15Healthcare and Family Services at 89 Ill. Adm. Code
16140.403(e). Health insurance issuers shall notify providers of
17any instructions necessary to facilitate billing for
18telehealth services.
19    Section 20. Prior authorization and utilization review
21    (a) In order to ensure that health care is quickly and
22efficiently provided to the public, health insurance issuers
23shall not impose upon telehealth services utilization review
24requirements that are unnecessary, duplicative, or unwarranted
25nor impose any treatment limitations that are more stringent



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1than the requirements applicable to the same health care
2service when rendered in-person.
3    (b) For telehealth services that relate to COVID-19
4delivered by in-network providers, health insurance issuers
5shall not impose any prior authorization requirements.
6    Section 25. Eligible services. Services eligible under
7this Act include services provided by any professional,
8practitioner, clinician, or other provider who is licensed,
9certified, registered, or otherwise authorized to practice in
10the State where the patient receives treatment, subject to the
11provisions of the Telehealth Act for any health care
12professional, as defined in the Telehealth Act, who delivers
13treatment through telehealth to a patient located in this
14State, and substance use disorder professionals and clinicians
15authorized by Illinois law to provide substance use disorder
17    Section 30. Permissible use of non-public facing audio or
18video communication technologies. Notwithstanding the
19requirements of the Mental Health and Developmental
20Disabilities Confidentiality Act, any provider or covered
21entity of any licensure or area of practice subject to this Act
22that uses audio or video communication technology to deliver
23services may use any non-public facing remote communication
24product in accordance with this Act to the extent permitted by



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1the U.S. Department of Health and Human Services under the
2federal Health Insurance Portability and Accountability Act of
31996. Providers and covered entities shall, to the extent
4feasible, notify patients that third-party applications
5potentially introduce privacy risks. Providers shall enable
6all available encryption and privacy modes when using such
7applications. A public facing video communication application
8may not be used in the provision of telehealth services by
9covered health care providers or covered entities.
10    Section 35. Rulemaking authority. The Department of
11Insurance may adopt rules to implement the provisions of this
13    Section 99. Effective date. This Act takes effect upon
14becoming law.".