101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
SB3541

 

Introduced 2/14/2020, by Sen. Andy Manar

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-5.25

    Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to, at a minimum, reimburse crisis intervention services, crisis stabilization services, and mobile crisis response services delivered via telehealth at the approved on-site and off-site Place of Service Codes listed in the Department's Community-Based Behavioral Services Provider Handbook published on October 19, 2018. Effective immediately.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

SB3541LRB101 18185 KTG 67627 b

1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Public Aid Code is amended by
5changing Section 5-5.25 as follows:
 
6    (305 ILCS 5/5-5.25)
7    Sec. 5-5.25. Access to behavioral health and medical
8services.
9    (a) The General Assembly finds that providing access to
10behavioral health and medical services in a timely manner will
11improve the quality of life for persons suffering from illness
12and will contain health care costs by avoiding the need for
13more costly inpatient hospitalization.
14    (b) The Department of Healthcare and Family Services shall
15reimburse psychiatrists, federally qualified health centers as
16defined in Section 1905(l)(2)(B) of the federal Social Security
17Act, clinical psychologists, clinical social workers, advanced
18practice registered nurses certified in psychiatric and mental
19health nursing, and mental health professionals and clinicians
20authorized by Illinois law to provide behavioral health
21services to recipients via telehealth. The Department, by rule,
22shall establish: (i) criteria for such services to be
23reimbursed, including appropriate facilities and equipment to

 

 

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1be used at both sites and requirements for a physician or other
2licensed health care professional to be present at the site
3where the patient is located; however, the Department shall not
4require that a physician or other licensed health care
5professional be physically present in the same room as the
6patient for the entire time during which the patient is
7receiving telehealth services; and (ii) a method to reimburse
8providers for mental health services provided by telehealth. At
9a minimum, the Department shall reimburse Crisis Intervention
10Services (HCPC: H2011), Crisis Stabilization Services (HCPC:
11T1019), and Mobile Crisis Response Services (HCPC: S9484)
12delivered via telehealth at the approved on-site and off-site
13Place of Service Codes listed in Table 4, on page 21 of the
14Department's Community-Based Behavioral Services Provider
15Handbook published on October 19, 2018.
16    (c) The Department shall reimburse any Medicaid certified
17eligible facility or provider organization that acts as the
18location of the patient at the time a telehealth service is
19rendered, including substance abuse centers licensed by the
20Department of Human Services' Division of Alcoholism and
21Substance Abuse.
22    (d) On and after July 1, 2012, the Department shall reduce
23any rate of reimbursement for services or other payments or
24alter any methodologies authorized by this Code to reduce any
25rate of reimbursement for services or other payments in
26accordance with Section 5-5e.

 

 

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1(Source: P.A. 100-385, eff. 1-1-18; 100-790, eff. 8-10-18;
2100-1019, eff. 1-1-19; 101-81, eff. 7-12-19.)
 
3    Section 99. Effective date. This Act takes effect upon
4becoming law.