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.


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A BILL FOR

 

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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
5adding Section 370c.3 as follows:
 
6    (215 ILCS 5/370c.3 new)
7    Sec. 370c.3. Eating Disorder Treatment Parity Task Force.
8    (a) The General Assembly finds that there is a mental
9health crisis in Illinois regarding access to care for people
10experiencing eating disorders. At least 1,600,000 people
11suffer from an eating disorder in Illinois, and eating
12disorders have the highest mortality rate of any mental
13illness. The Academy for Eating Disorders estimates that
1410,200 deaths occurred in the U.S. between 2018 and 2019 and
15that the disease is more than 2 times more likely to occur in
16females than males. This crisis has a much more significant
17affect on young people between the ages of 15 and 24 with
18anorexia nervosa, who have 10 times the risk of dying compared
19to their same-aged peers. The General Assembly also finds that
20the current COVID-19 pandemic has dramatically increased the
21demand for residential treatment of eating disorders to
22support those experiencing additional anxiety and depression
23and cannot cope at home.

 

 

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1    The General Assembly further finds that access to eating
2disorder treatment in Illinois may be restricted due to
3insurance companies providing low reimbursement rates to
4Illinois-based providers as compared to those in other states.
5The lower reimbursement rates may be contributing to the low
6number of providers available to treat persons suffering from
7these disorders in Illinois.
8    (b) As used in this Section, "eating disorder" includes
9anorexia nervosa, bulimia nervosa, binge eating disorder,
10other specified feeding or eating disorder, atypical anorexia
11nervosa, and avoidant/restrictive food intake disorder as set
12forth in the Diagnostic and Statistical Manual of Mental
13Disorders, Fifth Edition (DSM-5).
14    (c) The Eating Disorder Treatment Parity Task Force is
15created within the Department to review reimbursement to
16eating disorder treatment providers in Illinois as well as
17out-of-state providers of similar services. The Task Force
18shall work cooperatively with the insurance industry,
19community organizations, businesses, business coalitions, and
20advocacy groups to identify the high costs of medical
21complications, disability, and loss of life associated with
22eating disorders and to determine whether disparities in
23insurance reimbursement is limiting access to a full range of
24evidence-based treatment providers in the State of Illinois.
25    (d) The Task Force shall be comprised of the following
26members:

 

 

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1        (1) 2 experts in the eating disorder treatment field
2    appointed by the Governor;
3        (2) 2 consumers of mental health insurance appointed
4    by the Governor who have experienced or are experiencing
5    an eating disorder directly or as family members of eating
6    disorder patients;
7        (3) 2 members of the General Assembly appointed by the
8    Speaker of the House of Representatives;
9        (4) 2 members of the General Assembly appointed by the
10    President of the Senate;
11        (5) 2 members of the General Assembly appointed by the
12    Minority Leader of the House of Representatives; and
13        (6) 2 members of the General Assembly appointed by the
14    Minority Leader of the Senate.
15    Members shall be adults and residents of Illinois.
16    (e) The Task Force shall elect a chairperson from its
17membership and shall have the authority to determine its
18meeting schedule, hearing schedule, and agendas.
19    (f) Appointments shall be made within 60 days after the
20effective date of this amendatory Act of the 103rd General
21Assembly.
22    (g) Members shall serve without compensation.
23    (h) The Task Force shall:
24        (1) review existing plans and policies for individual
25    and group health insurance issued, delivered, and offered
26    in Illinois that cover treatment of eating disorders;

 

 

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1        (2) review and compare commercial insurance rates paid
2    for health insurance plan members receiving eating
3    disorder treatment in network with Illinois-based
4    providers to rates paid to out-of-state, out-of-network
5    providers for the same level of care;
6        (3) provide recommendations for rules to provide a
7    process for the Department to receive and investigate
8    complaints from consumers and treatment providers who have
9    been wrongfully denied coverage or fair compensation by
10    health care insurers;
11        (4) provide recommendations for rules designed to
12    increase access for needed treatments for eating
13    disorders; these recommendations may include providing
14    incentives to providers of such treatments as well as rate
15    methodologies for third-party insurers; and
16        (5) provide recommendations for rules to ensure
17    compliance with such rules adopted pursuant to this
18    Section, which may include fines, license sanctions, or
19    other enforcement remedies that may be appropriate as
20    determined by the Task Force.
21    (i) The findings, recommendations, and other information
22determined by the Task Force to be relevant shall be made
23available on the Department's website.
24    (j) The Task Force shall submit findings and
25recommendations to the Director, the Governor, and the General
26Assembly by December 31, 2023.

 

 

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1    (k) This Section is repealed on January 1, 2025.
 
2    Section 99. Effective date. This Act takes effect upon
3becoming law.