Full Text of HB3759 102nd General Assembly
HB3759ham001 102ND GENERAL ASSEMBLY | Rep. Ryan Spain Filed: 3/25/2021
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| 1 | | AMENDMENT TO HOUSE BILL 3759
| 2 | | AMENDMENT NO. ______. Amend House Bill 3759 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 Parity 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 | 16 | | his or her location, through electronic or telephonic methods, | 17 | | such as telephone (landline or cellular), video technology | 18 | | commonly 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. | 23 | | (a) All health insurance issuers regulated by the | 24 | | Department of Insurance shall cover the costs of all |
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| 1 | | telehealth services rendered by in-network providers to | 2 | | deliver any clinically appropriate, medically necessary | 3 | | covered services and treatments to insureds, enrollees, and | 4 | | members under each policy, contract, or certificate of health | 5 | | insurance coverage. | 6 | | (b) Health insurance issuers may establish reasonable | 7 | | requirements and parameters for telehealth services, including | 8 | | with respect to documentation and recordkeeping, to the extent | 9 | | consistent with this Act or any company bulletin issued by the | 10 | | Department of Insurance under Executive Order 2020-09. A | 11 | | health insurance issuer's requirements and parameters may not | 12 | | be more restrictive or less favorable toward providers, | 13 | | insureds, enrollees, or members than those contained in the | 14 | | emergency rulemaking undertaken by the Department of | 15 | | Healthcare and Family Services at 89 Ill. Adm. Code | 16 | | 140.403(e). Health insurance issuers shall notify providers of | 17 | | any instructions necessary to facilitate billing for | 18 | | telehealth services. | 19 | | Section 20. Prior authorization and utilization review | 20 | | requirements. | 21 | | (a) In order to ensure that health care is quickly and | 22 | | efficiently provided to the public, health insurance issuers | 23 | | shall not impose upon telehealth services utilization review | 24 | | requirements that are unnecessary, duplicative, or unwarranted | 25 | | nor impose any treatment limitations that are more stringent |
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| 1 | | than the requirements applicable to the same health care | 2 | | service when rendered in-person. | 3 | | (b) For telehealth services that relate to COVID-19 | 4 | | delivered by in-network providers, health insurance issuers | 5 | | shall not impose any prior authorization requirements. | 6 | | Section 25. Eligible services. Services eligible under | 7 | | this Act include services provided by any professional, | 8 | | practitioner, clinician, or other provider who is licensed, | 9 | | certified, registered, or otherwise authorized to practice in | 10 | | the State where the patient receives treatment, subject to the | 11 | | provisions of the Telehealth Act for any health care | 12 | | professional, as defined in the Telehealth Act, who delivers | 13 | | treatment through telehealth to a patient located in this | 14 | | State, and substance use disorder professionals and clinicians | 15 | | authorized by Illinois law to provide substance use disorder | 16 | | services. | 17 | | Section 30. Permissible use of non-public facing audio or | 18 | | video communication technologies. Notwithstanding the | 19 | | requirements of the Mental Health and Developmental | 20 | | Disabilities Confidentiality Act, any provider or covered | 21 | | entity of any licensure or area of practice subject to this Act | 22 | | that uses audio or video communication technology to deliver | 23 | | services may use any non-public facing remote communication | 24 | | product in accordance with this Act to the extent permitted by |
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| 1 | | the U.S. Department of Health and Human Services under the | 2 | | federal Health Insurance Portability and Accountability Act of | 3 | | 1996. Providers and covered entities shall, to the extent | 4 | | feasible, notify patients that third-party applications | 5 | | potentially introduce privacy risks. Providers shall enable | 6 | | all available encryption and privacy modes when using such | 7 | | applications. A public facing video communication application | 8 | | may not be used in the provision of telehealth services by | 9 | | covered health care providers or covered entities. | 10 | | Section 35. Rulemaking authority. The Department of | 11 | | Insurance may adopt rules to implement the provisions of this | 12 | | Act.
| 13 | | Section 99. Effective date. This Act takes effect upon | 14 | | becoming law.".
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