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.


LRB100 19674 SMS 34948 b

 

 

A BILL FOR

 

HB5473LRB100 19674 SMS 34948 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Insurance Code is amended by
5changing Section 356z.22 as follows:
 
6    (215 ILCS 5/356z.22)
7    Sec. 356z.22. Coverage for telehealth services.
8    (a) For purposes of this Section:
9    "Distant site" means the location at which the health care
10provider rendering the telehealth service is located.
11    "Family caregiver" means a relative, partner, friend, or
12neighbor who has a significant relationship with the patient
13and administers or assists the patient with activities of daily
14living, instrumental activities of daily living, or other
15medical or nursing tasks for the quality and welfare of that
16patient.
17    "Interactive telecommunications system" means an audio and
18video system permitting 2-way, live interactive communication
19between the patient and the distant site health care provider.
20    "Telehealth services" means the delivery of covered health
21care services by way of an interactive telecommunications
22system.
23    (b) If an individual or group policy of accident or health

 

 

HB5473- 2 -LRB100 19674 SMS 34948 b

1insurance provides coverage for telehealth services, then it
2must comply with the following:
3        (1) An individual or group policy of accident or health
4    insurance providing telehealth services may not:
5            (A) require that in-person contact occur between a
6        health care provider and a patient;
7            (B) require the health care provider to document a
8        barrier to an in-person consultation for coverage of
9        services to be provided through telehealth;
10            (C) require the use of telehealth when the health
11        care provider has determined that it is not
12        appropriate; or
13            (D) require the use of telehealth when a patient
14        chooses an in-person consultation.
15        (2) Deductibles, copayments, or coinsurance applicable
16    to services provided through telehealth shall not exceed
17    the deductibles, copayments, or coinsurance required by
18    the individual or group policy of accident or health
19    insurance for the same services provided through in-person
20    consultation.
21        (3) All health care provider access information or
22    provider directories, whether in electronic format or,
23    upon request, in print format, shall, at a minimum,
24    include:
25            (A) whether the provider offers the use of
26        telehealth or telemedicine to deliver services;

 

 

HB5473- 3 -LRB100 19674 SMS 34948 b

1            (B) what modality the provider uses and what
2        services through telehealth or telemedicine are
3        provided; and
4            (C) whether the provider has the ability and
5        willingness to include in a telehealth or telemedicine
6        encounter a family caregiver who is in a separate
7        location than the patient, if the patient wishes and
8        provides his or her consent.
9    (c) Nothing in this Section shall be deemed as precluding a
10health insurer from providing benefits for other services,
11including, but not limited to, remote monitoring services,
12other monitoring services, or oral communications otherwise
13covered under the policy.
14(Source: P.A. 98-1091, eff. 1-1-15.)
 
15    Section 10. The Telehealth Act is amended by changing
16Section 5 and by adding Section 20 as follows:
 
17    (225 ILCS 150/5)
18    Sec. 5. Definitions. As used in this Act:
19    "Family caregiver" means a relative, partner, friend, or
20neighbor who has a significant relationship with the patient
21and administers or assists the patient with activities of daily
22living, instrumental activities of daily living, or other
23medical or nursing tasks for the quality and welfare of that
24patient.

 

 

HB5473- 4 -LRB100 19674 SMS 34948 b

1    "Health care professional" includes physicians, physician
2assistants, optometrists, advanced practice registered nurses,
3clinical psychologists licensed in Illinois, and mental health
4professionals and clinicians authorized by Illinois law to
5provide mental health services.
6    "Telehealth" means the evaluation, diagnosis, or
7interpretation of electronically transmitted patient-specific
8data between a remote location and a licensed health care
9professional that generates interaction or treatment
10recommendations. "Telehealth" includes telemedicine and the
11delivery of health care services provided by way of an
12interactive telecommunications system, as defined in
13subsection (a) of Section 356z.22 of the Illinois Insurance
14Code.
15(Source: P.A. 100-317, eff. 1-1-18; revised 1-24-18.)
 
16    (225 ILCS 150/20 new)
17    Sec. 20. Health care professional directories. An
18insurance company or health plan that provides health care
19professional or provider directories, whether in electronic
20format or, upon request, in print format, shall, at a minimum,
21include:
22        (1) whether the provider offers the use of telehealth
23    to deliver services;
24        (2) what modality the provider uses and what services
25    through telehealth are provided; and

 

 

HB5473- 5 -LRB100 19674 SMS 34948 b

1        (3) whether the provider has the ability and
2    willingness to include in a telehealth encounter a family
3    caregiver who is in a separate location than the patient,
4    if the patient wishes and provides his or her consent.
 
5    Section 99. Effective date. This Act takes effect upon
6becoming law.