HB2498 103RD GENERAL ASSEMBLY

LRB103 26798 BMS 53161 b

103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB2498

Introduced 2/15/2023___________, by

SYNOPSIS AS INTRODUCED:

215 ILCS 5/370c.3 new

Amends the Illinois Insurance Code. Creates the Eating Disorder Treatment Parity Task Force within the Department of Insurance to review reimbursement to eating disorder treatment providers in Illinois as well as out-of-state providers of similar services. Provides for the membership of the Task Force. Provides that the Task Force shall elect a chairperson from its membership and shall have the authority to determine its meeting schedule, hearing schedule, and agendas. Provides that appointments shall be made within 60 days after the effective date of the amendatory Act. Provides that the Task Force shall review insurance plans and rates and provide recommendations for rules, and the findings, recommendations, and other information determined by the Task Force to be relevant shall be made available on the Department's website. Provides that the Task Force shall submit findings and recommendations to the Director of Insurance, the Governor, and the General Assembly by December 31, 2023. Provides for repeal of the provisions on January 1, 2025. 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 adding Section 370c.3 as follows:

(215 ILCS 5/370c.3 new)

Sec. 370c.3. Eating Disorder Treatment Parity Task Force.

(a) The General Assembly finds that there is a mental health crisis in Illinois regarding access to care for people experiencing eating disorders. At least 1,600,000 people suffer from an eating disorder in Illinois, and eating disorders have the highest mortality rate of any mental illness. The Academy for Eating Disorders estimates that 10,200 deaths occurred in the U.S. between 2018 and 2019 and that the disease is more than 2 times more likely to occur in females than males. This crisis has a much more significant affect on young people between the ages of 15 and 24 with anorexia nervosa, who have 10 times the risk of dying compared to their same-aged peers. The General Assembly also finds that the current COVID-19 pandemic has dramatically increased the demand for residential treatment of eating disorders to support those experiencing additional anxiety and depression and cannot cope at home.

The General Assembly further finds that access to eating disorder treatment in Illinois may be restricted due to insurance companies providing low reimbursement rates to Illinois-based providers as compared to those in other states. The lower reimbursement rates may be contributing to the low number of providers available to treat persons suffering from these disorders in Illinois.

(b) As used in this Section, "eating disorder" includes anorexia nervosa, bulimia nervosa, binge eating disorder, other specified feeding or eating disorder, atypical anorexia nervosa, and avoidant/restrictive food intake disorder as set forth in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

(c) The Eating Disorder Treatment Parity Task Force is created within the Department to review reimbursement to eating disorder treatment providers in Illinois as well as out-of-state providers of similar services. The Task Force shall work cooperatively with the insurance industry, community organizations, businesses, business coalitions, and advocacy groups to identify the high costs of medical complications, disability, and loss of life associated with eating disorders and to determine whether disparities in insurance reimbursement is limiting access to a full range of evidence-based treatment providers in the State of Illinois.

(d) The Task Force shall be comprised of the following members:

(1) 2 experts in the eating disorder treatment field appointed by the Governor;

(2) 2 consumers of mental health insurance appointed by the Governor who have experienced or are experiencing an eating disorder directly or as family members of eating disorder patients;

(3) 2 members of the General Assembly appointed by the Speaker of the House of Representatives;

(4) 2 members of the General Assembly appointed by the President of the Senate;

(5) 2 members of the General Assembly appointed by the Minority Leader of the House of Representatives; and

(6) 2 members of the General Assembly appointed by the Minority Leader of the Senate.

Members shall be adults and residents of Illinois.

(e) The Task Force shall elect a chairperson from its membership and shall have the authority to determine its meeting schedule, hearing schedule, and agendas.

(f) Appointments shall be made within 60 days after the effective date of this amendatory Act of the 103rd General Assembly.

(g) Members shall serve without compensation.

(h) The Task Force shall:

(1) review existing plans and policies for individual and group health insurance issued, delivered, and offered in Illinois that cover treatment of eating disorders;

(2) review and compare commercial insurance rates paid for health insurance plan members receiving eating disorder treatment in network with Illinois-based providers to rates paid to out-of-state, out-of-network providers for the same level of care;

(3) provide recommendations for rules to provide a process for the Department to receive and investigate complaints from consumers and treatment providers who have been wrongfully denied coverage or fair compensation by health care insurers;

(4) provide recommendations for rules designed to increase access for needed treatments for eating disorders; these recommendations may include providing incentives to providers of such treatments as well as rate methodologies for third-party insurers; and

(5) provide recommendations for rules to ensure compliance with such rules adopted pursuant to this Section, which may include fines, license sanctions, or other enforcement remedies that may be appropriate as determined by the Task Force.

(i) The findings, recommendations, and other information determined by the Task Force to be relevant shall be made available on the Department's website.

(j) The Task Force shall submit findings and recommendations to the Director, the Governor, and the General Assembly by December 31, 2023.

(k) This Section is repealed on January 1, 2025.

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