HB4483 102ND GENERAL ASSEMBLY

LRB102 22103 BMS 31231 b

102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB4483

Introduced 1/21/2022, by Rep. Stephanie A. Kifowit

SYNOPSIS AS INTRODUCED:

215 ILCS 5/356z.53 new

Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance that is amended, delivered, issued, or renewed on or after January 1, 2023 shall for each plan year provide coverage for and shall not impose any cost-sharing requirements for 3 primary care visits and 3 behavioral health care visits. Provides that a health insurer shall ensure that the treatment limitations applicable to the health care visits are no more restrictive than the treatment limitations applied to any other primary care visit or behavioral health care visit covered by the plan or coverage and that there are no separate treatment limitations that are applicable only with respect to the covered visits, and that the reimbursement rates under the plan or coverage for the covered visits are the same as the rates for any other primary care visit or behavioral health care visit covered by the plan or coverage.

A BILL FOR

AN ACT concerning regulation.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Illinois Insurance Code is amended by adding Section 356z.53 as follows:

(215 ILCS 5/356z.53 new)

Sec. 356z.53. Health care visits; cost sharing.

(a) A group or individual policy of accident and health insurance that is amended, delivered, issued, or renewed on or after January 1, 2023 shall for each plan year provide coverage for and shall not impose any cost-sharing requirements for:

(1) 3 primary care visits; and

(2) 3 behavioral health care visits.

(b) A health insurer shall ensure that:

(1) the treatment limitations applicable to the health care visits described in subsection (a) are no more restrictive than the treatment limitations applied to any other primary care visit or behavioral health care visit covered by the plan or coverage and that there are no separate treatment limitations that are applicable only with respect to the health care visits described in subsection (a); and

(2) the reimbursement rates under the plan or the coverage for the health care visits described in subsection (a) are the same as the rates for any other primary care visit or behavioral health care visit covered by the plan or coverage.