102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB2591

 

Introduced 2/19/2021, by Rep. Deb Conroy

 

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 reimburse physicians, community mental health centers, and substance abuse centers that provide primary care and behavioral health services to medical assistance recipients via telehealth, including medical evaluations for individuals residing in facilities licensed under the ID/DD Community Care Act and in community-integrated living arrangements. Requires the Department to establish, by rule, a method to reimburse providers for medical and behavioral health services (rather than mental health services) provided by telehealth. Requires the Department to reimburse any community mental health center, facility licensed under the ID/DD Community Care Act, and community-integrated living arrangement that acts as the location of the patient at the time a telehealth service is rendered.


LRB102 14297 KTG 19649 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB2591LRB102 14297 KTG 19649 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 and
11in the most appropriate setting will improve the quality of
12life for persons suffering from illness, will reduce the
13spread of infectious diseases to the general public, and will
14contain health care costs by avoiding the need for unnecessary
15visits to the emergency room and more costly inpatient
16hospitalization.
17    (b) The Department of Healthcare and Family Services shall
18reimburse physicians, psychiatrists, community mental health
19centers, substance abuse centers, federally qualified health
20centers as defined in Section 1905(l)(2)(B) of the federal
21Social Security Act, clinical psychologists, clinical social
22workers, advanced practice registered nurses certified in
23psychiatric and mental health nursing, and mental health

 

 

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1professionals and clinicians authorized by Illinois law to
2provide primary care and behavioral health services to
3recipients via telehealth, including medical evaluations for
4individuals residing in facilities licensed under the ID/DD
5Community Care Act and in community-integrated living
6arrangements as defined in the Community-Integrated Living
7Arrangements Licensure and Certification Act. The Department,
8by rule, shall establish: (i) criteria for such services to be
9reimbursed, including appropriate facilities and equipment to
10be used at both sites and requirements for a physician or other
11licensed health care professional to be present at the site
12where the patient is located; however, the Department shall
13not require that a physician or other licensed health care
14professional be physically present in the same room as the
15patient for the entire time during which the patient is
16receiving telehealth services; and (ii) a method to reimburse
17providers for medical and behavioral health services mental
18health services provided by telehealth.
19    (c) The Department shall reimburse any Medicaid certified
20eligible facility or provider organization that acts as the
21location of the patient at the time a telehealth service is
22rendered, including community mental health centers certified
23by the Department of Human Services' Division of Mental
24Health, substance abuse centers licensed by the Department of
25Human Services' Division of Alcoholism and Substance Abuse,
26facilities licensed under the ID/DD Community Care Act, and

 

 

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1community-integrated living arrangements as defined in the
2Community-Integrated Living Arrangements Licensure and
3Certification Act.
4    (d) On and after July 1, 2012, the Department shall reduce
5any rate of reimbursement for services or other payments or
6alter any methodologies authorized by this Code to reduce any
7rate of reimbursement for services or other payments in
8accordance with Section 5-5e.
9(Source: P.A. 100-385, eff. 1-1-18; 100-790, eff. 8-10-18;
10100-1019, eff. 1-1-19; 101-81, eff. 7-12-19.)