Public Act 103-0535
Public Act 0535 103RD GENERAL ASSEMBLY
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Public Act 103-0535
| | HB2847 Enrolled | LRB103 26943 BMS 53308 b |
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| AN ACT concerning regulation.
| Be it enacted by the People of the State of Illinois,
| represented in the General Assembly:
| Section 1. References to Act; purpose. | (a) References to Act. This Act may be referred to as the | Mental Health and Wellness Act. | (b) Purpose. This Act is intended to address Illinois' | skyrocketing mental health
needs for children, youth, and | adults following the COVID-19 pandemic by covering preventive
| mental health care.
| Section 5. Findings. The General Assembly finds that: | (1) According to a recent U.S. Surgeon General's | Advisory on Protecting Youth Mental Health, the proportion | of high school students reporting persistent feelings of | hopelessness and
sadness increased by 40% between 2009 and | 2019, and rates of depression and anxiety
doubled during | the COVID-19 pandemic. | (2) Death by suicide is alarmingly high, particularly | among Black children. Black children
under 13 are now | nearly twice as likely to die by suicide than White | children. | (3) According to a bipartisan United States Senate | Finance Committee report on Mental Health Care in the |
| United States, symptoms for depression and anxiety in | adults increased nearly fourfold during the COVID-19 | pandemic.
| Section 10. The State Employees Group Insurance Act of | 1971 is amended by changing Section 6.11 as follows:
| (5 ILCS 375/6.11)
| (Text of Section before amendment by P.A. 102-768) | Sec. 6.11. Required health benefits; Illinois Insurance | Code
requirements. The program of health
benefits shall | provide the post-mastectomy care benefits required to be | covered
by a policy of accident and health insurance under | Section 356t of the Illinois
Insurance Code. The program of | health benefits shall provide the coverage
required under | Sections 356g, 356g.5, 356g.5-1, 356m, 356q,
356u, 356w, 356x, | 356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, | 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22, | 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, | 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51, | 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and | 356z.61 of the
Illinois Insurance Code.
The program of health | benefits must comply with Sections 155.22a, 155.37, 355b, | 356z.19, 370c, and 370c.1 and Article XXXIIB of the
Illinois | Insurance Code. The Department of Insurance shall enforce the | requirements of this Section with respect to Sections 370c and |
| 370c.1 of the Illinois Insurance Code; all other requirements | of this Section shall be enforced by the Department of Central | Management Services.
| Rulemaking authority to implement Public Act 95-1045, if | any, is conditioned on the rules being adopted in accordance | with all provisions of the Illinois Administrative Procedure | Act and all rules and procedures of the Joint Committee on | Administrative Rules; any purported rule not so adopted, for | whatever reason, is unauthorized. | (Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20; | 101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff. | 1-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103, | eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; | 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. | 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, | eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; | revised 12-13-22.)
| (Text of Section after amendment by P.A. 102-768) | Sec. 6.11. Required health benefits; Illinois Insurance | Code
requirements. The program of health
benefits shall | provide the post-mastectomy care benefits required to be | covered
by a policy of accident and health insurance under | Section 356t of the Illinois
Insurance Code. The program of | health benefits shall provide the coverage
required under | Sections 356g, 356g.5, 356g.5-1, 356m, 356q,
356u, 356w, 356x, |
| 356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, | 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22, | 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, | 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51, | 356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59, and | 356z.60, and 356z.61 of the
Illinois Insurance Code.
The | program of health benefits must comply with Sections 155.22a, | 155.37, 355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of | the
Illinois Insurance Code. The Department of Insurance shall | enforce the requirements of this Section with respect to | Sections 370c and 370c.1 of the Illinois Insurance Code; all | other requirements of this Section shall be enforced by the | Department of Central Management Services.
| Rulemaking authority to implement Public Act 95-1045, if | any, is conditioned on the rules being adopted in accordance | with all provisions of the Illinois Administrative Procedure | Act and all rules and procedures of the Joint Committee on | Administrative Rules; any purported rule not so adopted, for | whatever reason, is unauthorized. | (Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20; | 101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff. | 1-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103, | eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; | 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. | 1-1-23; 102-768, eff. 1-1-24; 102-804, eff. 1-1-23; 102-813, | eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff. 1-1-23; |
| 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
| Section 15. The Department of Public Health Powers and | Duties Law of the
Civil Administrative Code of Illinois is | amended by adding Section 2310-720 as follows:
| (20 ILCS 2310/2310-720 new) | Sec. 2310-720. Public educational effort on mental health | and wellness. Subject to appropriation, the Department shall | undertake a public educational campaign to bring broad public | awareness to communities across this State on the importance | of mental health and wellness, including the expanded coverage | of mental health treatment, and consistent with the | recommendations of the Illinois Children's Mental Health | Partnership's Children's Mental Health Plan of 2022 and Public | Act 102-899. The Department shall look to other successful | public educational campaigns to guide this effort, such as the | public educational campaign related to Get Covered Illinois. | Additionally, the Department shall work with the Department of | Insurance, the Illinois State Board of Education, the | Department of Human Services, the Department of Healthcare and | Family Services, the Department of Juvenile Justice, the | Department of Children and Family Services, and other State | agencies as necessary to promote consistency in messaging and | distribution methods between this campaign and other | concurrent public educational campaigns related to mental |
| health and mental wellness. Public messaging for this campaign | shall be simple, be easy to understand, and include culturally | competent messaging for different communities and regions | throughout this State.
| Section 20. The Counties Code is amended by changing | Section 5-1069.3 as follows:
| (55 ILCS 5/5-1069.3)
| Sec. 5-1069.3. Required health benefits. If a county, | including a home
rule
county, is a self-insurer for purposes | of providing health insurance coverage
for its employees, the | coverage shall include coverage for the post-mastectomy
care | benefits required to be covered by a policy of accident and | health
insurance under Section 356t and the coverage required | under Sections 356g, 356g.5, 356g.5-1, 356q, 356u,
356w, 356x, | 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, | 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, | 356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, | 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, | 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and 356z.61 | of
the Illinois Insurance Code. The coverage shall comply with | Sections 155.22a, 355b, 356z.19, and 370c of
the Illinois | Insurance Code. The Department of Insurance shall enforce the | requirements of this Section. The requirement that health | benefits be covered
as provided in this Section is an
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| exclusive power and function of the State and is a denial and | limitation under
Article VII, Section 6, subsection (h) of the | Illinois Constitution. A home
rule county to which this | Section applies must comply with every provision of
this | Section.
| Rulemaking authority to implement Public Act 95-1045, if | any, is conditioned on the rules being adopted in accordance | with all provisions of the Illinois Administrative Procedure | Act and all rules and procedures of the Joint Committee on | Administrative Rules; any purported rule not so adopted, for | whatever reason, is unauthorized. | (Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20; | 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff. | 1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203, | eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22; | 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. | 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, | eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; | 102-1117, eff. 1-13-23.)
| Section 25. The Illinois Municipal Code is amended by | changing Section 10-4-2.3 as follows:
| (65 ILCS 5/10-4-2.3)
| Sec. 10-4-2.3. Required health benefits. If a | municipality, including a
home rule municipality, is a |
| self-insurer for purposes of providing health
insurance | coverage for its employees, the coverage shall include | coverage for
the post-mastectomy care benefits required to be | covered by a policy of
accident and health insurance under | Section 356t and the coverage required
under Sections 356g, | 356g.5, 356g.5-1, 356q, 356u, 356w, 356x, 356z.4, 356z.4a, | 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, | 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, | 356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41, | 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54, | 356z.56, 356z.57, 356z.59, and 356z.60, and 356z.61 of the | Illinois
Insurance
Code. The coverage shall comply with | Sections 155.22a, 355b, 356z.19, and 370c of
the Illinois | Insurance Code. The Department of Insurance shall enforce the | requirements of this Section. The requirement that health
| benefits be covered as provided in this is an exclusive power | and function of
the State and is a denial and limitation under | Article VII, Section 6,
subsection (h) of the Illinois | Constitution. A home rule municipality to which
this Section | applies must comply with every provision of this Section.
| Rulemaking authority to implement Public Act 95-1045, if | any, is conditioned on the rules being adopted in accordance | with all provisions of the Illinois Administrative Procedure | Act and all rules and procedures of the Joint Committee on | Administrative Rules; any purported rule not so adopted, for | whatever reason, is unauthorized. |
| (Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20; | 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff. | 1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203, | eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22; | 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. | 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, | eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; | 102-1117, eff. 1-13-23.)
| Section 30. The School Code is amended by changing Section | 10-22.3f as follows:
| (105 ILCS 5/10-22.3f)
| Sec. 10-22.3f. Required health benefits. Insurance | protection and
benefits
for employees shall provide the | post-mastectomy care benefits required to be
covered by a | policy of accident and health insurance under Section 356t and | the
coverage required under Sections 356g, 356g.5, 356g.5-1, | 356q, 356u, 356w, 356x, 356z.4, 356z.4a,
356z.6, 356z.8, | 356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, | 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, | 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51, | 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and | 356z.61 of
the
Illinois Insurance Code.
Insurance policies | shall comply with Section 356z.19 of the Illinois Insurance | Code. The coverage shall comply with Sections 155.22a, 355b, |
| and 370c of
the Illinois Insurance Code. The Department of | Insurance shall enforce the requirements of this Section.
| Rulemaking authority to implement Public Act 95-1045, if | any, is conditioned on the rules being adopted in accordance | with all provisions of the Illinois Administrative Procedure | Act and all rules and procedures of the Joint Committee on | Administrative Rules; any purported rule not so adopted, for | whatever reason, is unauthorized. | (Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20; | 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff. | 1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203, | eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff. 1-1-22; | 102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804, eff. | 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, | eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
| Section 35. The Illinois Insurance Code is amended by | adding Section 356z.61 as follows:
| (215 ILCS 5/356z.61 new) | Sec. 356z.61. Coverage of no-cost mental health prevention | and wellness visits. | (a) A group or individual policy of accident and health | insurance or managed care plan that is amended, delivered, | issued, or renewed on or after January 1, 2025 shall provide | coverage for one annual mental health prevention and wellness |
| visit for children and for adults. | (b) Mental health prevention and wellness visits shall | include any age-appropriate screening recommended by the | United States Preventive Services Task Force or by the | American Academy of Pediatrics' Bright Futures: Guidelines for | Health Supervision of Infants, Children, and Adolescents for | purposes of identifying a mental health issue, condition, or | disorder; discussing mental health symptoms that might be | present, including symptoms of a previously diagnosed mental | health condition or disorder; performing an evaluation of | adverse childhood experiences; and discussing mental health | and wellness. | (c) A mental health prevention and wellness visit shall be | covered for up to 60 minutes and may be performed by a | physician licensed to practice medicine in all of its | branches, a licensed clinical psychologist, a licensed | clinical social worker, a licensed clinical professional | counselor, a licensed marriage and family therapist, a | licensed social worker, or a licensed professional counselor. | (d) A policy subject to this Section shall not impose a | deductible, coinsurance, copayment, or other cost-sharing | requirement for mental health prevention and wellness visits. | The cost-sharing prohibition in this subsection (d) does not | apply to coverage of mental health prevention and wellness | visits to the extent such coverage would disqualify a | high-deductible health plan from eligibility for a health |
| savings account pursuant to Section 223 of the Internal | Revenue Code. | (e) A mental health prevention and wellness visit shall be | in addition to an annual physical examination and shall not | replace a well-child visit or a
general health or medical | visit. | (f) A mental health prevention and wellness visit shall be | reimbursed through the following American Medical Association | current procedural terminology codes and at the same rate that | current procedural terminology codes are reimbursed for the | provision of other medical care: 99381-99387 and 99391-99397. | The Department shall update the current procedural terminology | codes through adoption of rules if the codes listed in this | subsection are altered, amended, changed, deleted, or | supplemented. | (g) Reimbursement of any of the current procedural | terminology codes listed in this Section shall comply with the | following: | (1) reimbursement may be adjusted for payment of | claims that are billed by a nonphysician clinician so long | as the methodology to determine the adjustments are | comparable to and applied no more stringently than the | methodology for adjustments made for reimbursement of | claims billed by nonphysician clinicians for other medical | care, in accordance with 45 CFR 146.136(c)(4); and | (2) for a mental health prevention and wellness visit |
| and for a service other than a mental health prevention | and wellness visit, reimbursement shall not be denied if | they occur on the same date by the same provider and the | provider is a primary care provider. | (h) A mental health prevention and wellness visit may be | incorporated into and reimbursed within any type of integrated | primary care service delivery method, including, but not | limited to, a psychiatric collaborative care model as provided | for under this Code. | (i) The Department shall adopt any rules necessary to | implement this Section by no later than October 31, 2024.
| Section 95. No acceleration or delay. Where this Act makes | changes in a statute that is represented in this Act by text | that is not yet or no longer in effect (for example, a Section | represented by multiple versions), the use of that text does | not accelerate or delay the taking effect of (i) the changes | made by this Act or (ii) provisions derived from any other | Public Act.
| Section 99. Effective date. This Act takes effect upon | becoming law.
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Effective Date: 8/11/2023
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