HB5473 100TH GENERAL ASSEMBLY

LRB100 19674 SMS 34948 b

100TH GENERAL ASSEMBLY
State of Illinois
2017 and 2018
HB5473

Introduced , by Rep. Anna Moeller

SYNOPSIS AS INTRODUCED:

215 ILCS 5/356z.22
225 ILCS 150/5
225 ILCS 150/20 new

Amends the Illinois Insurance Code. In provisions concerning if an individual or group policy of accident or health insurance coverage for telehealth services, provides that all health care provider access information of provider directories shall include: whether the provider offers the use of telehealth or telemedicine to deliver services; what modalities the provider uses and what services through telehealth or telemedicine are provided; and whether the provider has the ability and willingness to include in a telehealth or telemedicine encounter a family caregiver who is in a separate location than the patient, if the patient wishes and provides consent. Amends the Telehealth Act. Provides that an insurance company or health plan that provides health care professional or provider directories shall include: whether the provider offers the use of telehealth to deliver services; what modalities the provider uses and what services through telehealth or telemedicine are provided; and whether the provider has the ability and willingness to include in a telehealth encounter a family caregiver who is in a separate location than the patient, if the patient wishes and provides consent. Effective immediately.

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 changing Section 356z.22 as follows:

(215 ILCS 5/356z.22)

Sec. 356z.22. Coverage for telehealth services.

(a) For purposes of this Section:

"Distant site" means the location at which the health care provider rendering the telehealth service is located.

"Family caregiver" means a relative, partner, friend, or neighbor who has a significant relationship with the patient and administers or assists the patient with activities of daily living, instrumental activities of daily living, or other medical or nursing tasks for the quality and welfare of that patient.

"Interactive telecommunications system" means an audio and video system permitting 2-way, live interactive communication between the patient and the distant site health care provider.

"Telehealth services" means the delivery of covered health care services by way of an interactive telecommunications system.

(b) If an individual or group policy of accident or health insurance provides coverage for telehealth services, then it must comply with the following:

(1) An individual or group policy of accident or health insurance providing telehealth services may not:

(A) require that in-person contact occur between a health care provider and a patient;

(B) require the health care provider to document a barrier to an in-person consultation for coverage of services to be provided through telehealth;

(C) require the use of telehealth when the health care provider has determined that it is not appropriate; or

(D) require the use of telehealth when a patient chooses an in-person consultation.

(2) Deductibles, copayments, or coinsurance applicable to services provided through telehealth shall not exceed the deductibles, copayments, or coinsurance required by the individual or group policy of accident or health insurance for the same services provided through in-person consultation.

(3) All health care provider access information or provider directories, whether in electronic format or, upon request, in print format, shall, at a minimum, include:

(A) whether the provider offers the use of telehealth or telemedicine to deliver services;

(B) what modality the provider uses and what services through telehealth or telemedicine are provided; and

(C) whether the provider has the ability and willingness to include in a telehealth or telemedicine encounter a family caregiver who is in a separate location than the patient, if the patient wishes and provides his or her consent.

(c) Nothing in this Section shall be deemed as precluding a health insurer from providing benefits for other services, including, but not limited to, remote monitoring services, other monitoring services, or oral communications otherwise covered under the policy.

(Source: P.A. 98-1091, eff. 1-1-15.)

Section 10. The Telehealth Act is amended by changing Section 5 and by adding Section 20 as follows:

(225 ILCS 150/5)

Sec. 5. Definitions. As used in this Act:

"Family caregiver" means a relative, partner, friend, or neighbor who has a significant relationship with the patient and administers or assists the patient with activities of daily living, instrumental activities of daily living, or other medical or nursing tasks for the quality and welfare of that patient.

"Health care professional" includes physicians, physician assistants, optometrists, advanced practice registered nurses, clinical psychologists licensed in Illinois, and mental health professionals and clinicians authorized by Illinois law to provide mental health services.

"Telehealth" means the evaluation, diagnosis, or interpretation of electronically transmitted patient-specific data between a remote location and a licensed health care professional that generates interaction or treatment recommendations. "Telehealth" includes telemedicine and the delivery of health care services provided by way of an interactive telecommunications system, as defined in subsection (a) of Section 356z.22 of the Illinois Insurance Code.

(Source: P.A. 100-317, eff. 1-1-18; revised 1-24-18.)

(225 ILCS 150/20 new)

Sec. 20. Health care professional directories. An insurance company or health plan that provides health care professional or provider directories, whether in electronic format or, upon request, in print format, shall, at a minimum, include:

(1) whether the provider offers the use of telehealth to deliver services;

(2) what modality the provider uses and what services through telehealth are provided; and

(3) whether the provider has the ability and willingness to include in a telehealth encounter a family caregiver who is in a separate location than the patient, if the patient wishes and provides his or her consent.

Section 99. Effective date. This Act takes effect upon becoming law.