Full Text of SB0671 101st General Assembly
SB0671ham002 101ST GENERAL ASSEMBLY | 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 | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 1. Short title. This Act may be cited as the | 5 | | Telehealth During the COVID-19 Pandemic Act. | 6 | | Section 5. Applicability. | 7 | | (a) This Act applies to policies issued by a health | 8 | | insurance issuer as defined in Section 10 of this Act, but does | 9 | | not apply to excepted benefits as defined in 45 CFR 146.145(b) | 10 | | and 45 CFR 148.220, but does apply to limited scope dental | 11 | | benefits, limited scope vision benefits, long-term care | 12 | | benefits, coverage only for accidents, and coverage only for | 13 | | specified disease or illness. | 14 | | (b) Any policy, contract, or certificate of health | 15 | | insurance coverage that does not distinguish between | 16 | | in-network and out-of-network providers shall be subject to |
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| 1 | | this 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 | 4 | | term in Section 5 of the Illinois Health Insurance Portability | 5 | | and Accountability Act. | 6 | | "Health insurance issuer" means an insurance company, | 7 | | insurance service, or insurance organization, including health | 8 | | maintenance organization, that is licensed to engage in the | 9 | | business of insurance in a state and that is subject to | 10 | | Illinois law that regulates insurance (within the meaning of | 11 | | Section 514(b)(2) of the Employee Retirement Income Security | 12 | | Act of 1974). | 13 | | "Telehealth services" means the provision of health care, | 14 | | psychiatry, mental health treatment, substance use disorder | 15 | | treatment, and related services to a patient, regardless of his | 16 | | or her location, through electronic or telephonic methods, such | 17 | | as telephone (landline or cellular), video technology commonly | 18 | | available on smart phones and other devices, and | 19 | | videoconferencing, as well as any method within the meaning of | 20 | | telehealth services under Section 356z.22 of the Illinois | 21 | | Insurance Code. | 22 | | Section 15. Coverage for telehealth services during the | 23 | | COVID-19 pandemic. | 24 | | (a) In order to protect the public's health, to permit |
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| 1 | | expedited treatment of health conditions during the COVID-19 | 2 | | pandemic, and to mitigate its impact upon the residents of the | 3 | | State of Illinois, all health insurance issuers regulated by | 4 | | the Department of Insurance shall cover the costs of all | 5 | | telehealth services rendered by in-network providers to | 6 | | deliver any clinically appropriate, medically necessary | 7 | | covered services and treatments to insureds, enrollees, and | 8 | | members under each policy, contract, or certificate of health | 9 | | insurance coverage. | 10 | | (b) Health insurance issuers may establish reasonable | 11 | | requirements and parameters for telehealth services, including | 12 | | with respect to documentation and recordkeeping, to the extent | 13 | | consistent with this Act or any company bulletin issued by the | 14 | | Department of Insurance under Executive Order 2020-09. A health | 15 | | insurance issuer's requirements and parameters may not be more | 16 | | restrictive or less favorable toward providers, insureds, | 17 | | enrollees, or members than those contained in the emergency | 18 | | rulemaking undertaken by the Department of Healthcare and | 19 | | Family Services at 89 Ill. Adm. Code 140.403(e). Health | 20 | | insurance issuers shall notify providers of any instructions | 21 | | necessary to facilitate billing for telehealth services. | 22 | | Section 20. Prior authorization and utilization review | 23 | | requirements. | 24 | | (a) In order to ensure that health care is quickly and | 25 | | efficiently provided to the public, health insurance issuers |
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| 1 | | shall not impose upon telehealth services utilization review | 2 | | requirements that are unnecessary, duplicative, or unwarranted | 3 | | nor impose any treatment limitations that are more stringent | 4 | | than the requirements applicable to the same health care | 5 | | service when rendered in-person. | 6 | | (b) For telehealth services that relate to COVID-19 | 7 | | delivered by in-network providers, health insurance issuers | 8 | | shall not impose any prior authorization requirements. | 9 | | Section 25. Cost-sharing prohibited. Health insurance | 10 | | issuers shall not impose any cost-sharing (copayments, | 11 | | deductibles, or coinsurance) for telehealth services provided | 12 | | by in-network providers. However, in accordance with the | 13 | | standards and definitions in 26 U.S.C. 223, if an enrollee in a | 14 | | high-deductible health plan has not met the applicable | 15 | | deductible under the terms of his or her coverage, the | 16 | | requirements of this Section do not require an issuer to pay | 17 | | for a charge for telehealth services unless the associated | 18 | | health care service for that particular charge is deemed | 19 | | preventive care by the United States Department of the | 20 | | Treasury. The federal Internal Revenue Service has recognized | 21 | | that services for testing, treatment, and any potential | 22 | | vaccination for COVID-19 fall within the scope of preventive | 23 | | care. | 24 | | Section 30. Eligible services. Services eligible under |
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| 1 | | this Act include services provided by any professional, | 2 | | practitioner, clinician, or other provider who is licensed, | 3 | | certified, registered, or otherwise authorized to practice in | 4 | | the State where the patient receives treatment, subject to the | 5 | | provisions of the Telehealth Act for any health care | 6 | | professional, as defined in the Telehealth Act, who delivers | 7 | | treatment through telehealth to a patient located in this | 8 | | State, and substance use disorder professionals and clinicians | 9 | | authorized by Illinois law to provide substance use disorder | 10 | | services. | 11 | | Section 35. Permissible use of non-public facing audio or | 12 | | video communication technologies. Notwithstanding the | 13 | | requirements of the Mental Health and Developmental | 14 | | Disabilities Confidentiality Act, any provider or covered | 15 | | entity of any licensure or area of practice subject to this Act | 16 | | that uses audio or video communication technology to deliver | 17 | | services may use any non-public facing remote communication | 18 | | product in accordance with this Act to the extent permitted by | 19 | | the U.S. Department of Health and Human Services under the | 20 | | federal Health Insurance Portability and Accountability Act of | 21 | | 1996. Providers and covered entities shall, to the extent | 22 | | feasible, notify patients that third-party applications | 23 | | potentially introduce privacy risks. Providers shall enable | 24 | | all available encryption and privacy modes when using such | 25 | | applications. A public facing video communication application |
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| 1 | | may not be used in the provision of telehealth services by | 2 | | covered health care providers or covered entities. | 3 | | Section 40. Rulemaking authority. The Department of | 4 | | Insurance may adopt rules, including emergency rulemaking in | 5 | | accordance with the Illinois Administrative Procedure Act, to | 6 | | implement the provisions of this Act. | 7 | | Section 90. Repeal. This Act is repealed on December 31, | 8 | | 2020.
| 9 | | Section 95. The Illinois Administrative Procedure Act is | 10 | | amended 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 | 13 | | expeditious and timely
implementation of the Telehealth During | 14 | | the COVID-19 Pandemic Act, emergency rules may be adopted in
| 15 | | accordance with Section 5-45 by the respective Department of | 16 | | Insurance. The adoption of emergency rules authorized
by | 17 | | Section 5-45 and this Section is deemed to be necessary for
the | 18 | | public interest, safety, and welfare. | 19 | | This Section is repealed on January 1, 2026. | 20 | | Section 99. Effective date. This Act takes effect upon | 21 | | becoming law.".
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