HB2847 EngrossedLRB103 26943 BMS 53308 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 1. References to Act; purpose.
5    (a) References to Act. This Act may be referred to as the
6Mental Health and Wellness Act.
7    (b) Purpose. This Act is intended to address Illinois'
8skyrocketing mental health needs for children, youth, and
9adults following the COVID-19 pandemic by covering preventive
10mental health care.
 
11    Section 5. Findings. The General Assembly finds that:
12        (1) According to a recent U.S. Surgeon General's
13    Advisory on Protecting Youth Mental Health, the proportion
14    of high school students reporting persistent feelings of
15    hopelessness and sadness increased by 40% between 2009 and
16    2019, and rates of depression and anxiety doubled during
17    the COVID-19 pandemic.
18        (2) Death by suicide is alarmingly high, particularly
19    among Black children. Black children under 13 are now
20    nearly twice as likely to die by suicide than White
21    children.
22        (3) According to a bipartisan United States Senate
23    Finance Committee report on Mental Health Care in the

 

 

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1    United States, symptoms for depression and anxiety in
2    adults increased nearly fourfold during the COVID-19
3    pandemic.
 
4    Section 10. The State Employees Group Insurance Act of
51971 is amended by changing Section 6.11 as follows:
 
6    (5 ILCS 375/6.11)
7    (Text of Section before amendment by P.A. 102-768)
8    Sec. 6.11. Required health benefits; Illinois Insurance
9Code requirements. The program of health benefits shall
10provide the post-mastectomy care benefits required to be
11covered by a policy of accident and health insurance under
12Section 356t of the Illinois Insurance Code. The program of
13health benefits shall provide the coverage required under
14Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
15356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
16356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
17356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
18356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
19356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and
20356z.61 of the Illinois Insurance Code. The program of health
21benefits must comply with Sections 155.22a, 155.37, 355b,
22356z.19, 370c, and 370c.1 and Article XXXIIB of the Illinois
23Insurance Code. The Department of Insurance shall enforce the
24requirements of this Section with respect to Sections 370c and

 

 

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1370c.1 of the Illinois Insurance Code; all other requirements
2of this Section shall be enforced by the Department of Central
3Management Services.
4    Rulemaking authority to implement Public Act 95-1045, if
5any, is conditioned on the rules being adopted in accordance
6with all provisions of the Illinois Administrative Procedure
7Act and all rules and procedures of the Joint Committee on
8Administrative Rules; any purported rule not so adopted, for
9whatever reason, is unauthorized.
10(Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
11101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
121-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
13eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
14102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
151-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
16eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
17revised 12-13-22.)
 
18    (Text of Section after amendment by P.A. 102-768)
19    Sec. 6.11. Required health benefits; Illinois Insurance
20Code requirements. The program of health benefits shall
21provide the post-mastectomy care benefits required to be
22covered by a policy of accident and health insurance under
23Section 356t of the Illinois Insurance Code. The program of
24health benefits shall provide the coverage required under
25Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,

 

 

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1356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
2356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
3356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
4356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
5356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59, and
6356z.60, and 356z.61 of the Illinois Insurance Code. The
7program of health benefits must comply with Sections 155.22a,
8155.37, 355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of
9the Illinois Insurance Code. The Department of Insurance shall
10enforce the requirements of this Section with respect to
11Sections 370c and 370c.1 of the Illinois Insurance Code; all
12other requirements of this Section shall be enforced by the
13Department of Central Management Services.
14    Rulemaking authority to implement Public Act 95-1045, if
15any, is conditioned on the rules being adopted in accordance
16with all provisions of the Illinois Administrative Procedure
17Act and all rules and procedures of the Joint Committee on
18Administrative Rules; any purported rule not so adopted, for
19whatever reason, is unauthorized.
20(Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
21101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
221-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
23eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
24102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
251-1-23; 102-768, eff. 1-1-24; 102-804, eff. 1-1-23; 102-813,
26eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff. 1-1-23;

 

 

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1102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
 
2    Section 15. The Department of Public Health Powers and
3Duties Law of the Civil Administrative Code of Illinois is
4amended by adding Section 2310-720 as follows:
 
5    (20 ILCS 2310/2310-720 new)
6    Sec. 2310-720. Public educational effort on mental health
7and wellness. Subject to appropriation, the Department shall
8undertake a public educational campaign to bring broad public
9awareness to communities across this State on the importance
10of mental health and wellness, including the expanded coverage
11of mental health treatment, and consistent with the
12recommendations of the Illinois Children's Mental Health
13Partnership's Children's Mental Health Plan of 2022 and Public
14Act 102-899. The Department shall look to other successful
15public educational campaigns to guide this effort, such as the
16public educational campaign related to Get Covered Illinois.
17Additionally, the Department shall work with the Department of
18Insurance, the Illinois State Board of Education, the
19Department of Human Services, the Department of Healthcare and
20Family Services, the Department of Juvenile Justice, the
21Department of Children and Family Services, and other State
22agencies as necessary to promote consistency in messaging and
23distribution methods between this campaign and other
24concurrent public educational campaigns related to mental

 

 

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1health and mental wellness. Public messaging for this campaign
2shall be simple, be easy to understand, and include culturally
3competent messaging for different communities and regions
4throughout this State.
 
5    Section 20. The Counties Code is amended by changing
6Section 5-1069.3 as follows:
 
7    (55 ILCS 5/5-1069.3)
8    Sec. 5-1069.3. Required health benefits. If a county,
9including a home rule county, is a self-insurer for purposes
10of providing health insurance coverage for its employees, the
11coverage shall include coverage for the post-mastectomy care
12benefits required to be covered by a policy of accident and
13health insurance under Section 356t and the coverage required
14under Sections 356g, 356g.5, 356g.5-1, 356q, 356u, 356w, 356x,
15356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
16356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
17356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, 356z.40,
18356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53,
19356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and 356z.61
20of the Illinois Insurance Code. The coverage shall comply with
21Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
22Insurance Code. The Department of Insurance shall enforce the
23requirements of this Section. The requirement that health
24benefits be covered as provided in this Section is an

 

 

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1exclusive power and function of the State and is a denial and
2limitation under Article VII, Section 6, subsection (h) of the
3Illinois Constitution. A home rule county to which this
4Section applies must comply with every provision of this
5Section.
6    Rulemaking authority to implement Public Act 95-1045, if
7any, is conditioned on the rules being adopted in accordance
8with all provisions of the Illinois Administrative Procedure
9Act and all rules and procedures of the Joint Committee on
10Administrative Rules; any purported rule not so adopted, for
11whatever reason, is unauthorized.
12(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
13101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
141-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
15eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
16102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
171-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
18eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
19102-1117, eff. 1-13-23.)
 
20    Section 25. The Illinois Municipal Code is amended by
21changing Section 10-4-2.3 as follows:
 
22    (65 ILCS 5/10-4-2.3)
23    Sec. 10-4-2.3. Required health benefits. If a
24municipality, including a home rule municipality, is a

 

 

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1self-insurer for purposes of providing health insurance
2coverage for its employees, the coverage shall include
3coverage for the post-mastectomy care benefits required to be
4covered by a policy of accident and health insurance under
5Section 356t and the coverage required under Sections 356g,
6356g.5, 356g.5-1, 356q, 356u, 356w, 356x, 356z.4, 356z.4a,
7356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
8356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
9356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41,
10356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54,
11356z.56, 356z.57, 356z.59, and 356z.60, and 356z.61 of the
12Illinois Insurance Code. The coverage shall comply with
13Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
14Insurance Code. The Department of Insurance shall enforce the
15requirements of this Section. The requirement that health
16benefits be covered as provided in this is an exclusive power
17and function of the State and is a denial and limitation under
18Article VII, Section 6, subsection (h) of the Illinois
19Constitution. A home rule municipality to which this Section
20applies must comply with every provision of this Section.
21    Rulemaking authority to implement Public Act 95-1045, if
22any, is conditioned on the rules being adopted in accordance
23with all provisions of the Illinois Administrative Procedure
24Act and all rules and procedures of the Joint Committee on
25Administrative Rules; any purported rule not so adopted, for
26whatever reason, is unauthorized.

 

 

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1(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
2101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
31-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
4eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
5102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
61-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
7eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
8102-1117, eff. 1-13-23.)
 
9    Section 30. The School Code is amended by changing Section
1010-22.3f as follows:
 
11    (105 ILCS 5/10-22.3f)
12    Sec. 10-22.3f. Required health benefits. Insurance
13protection and benefits for employees shall provide the
14post-mastectomy care benefits required to be covered by a
15policy of accident and health insurance under Section 356t and
16the coverage required under Sections 356g, 356g.5, 356g.5-1,
17356q, 356u, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8,
18356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
19356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
20356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
21356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and
22356z.61 of the Illinois Insurance Code. Insurance policies
23shall comply with Section 356z.19 of the Illinois Insurance
24Code. The coverage shall comply with Sections 155.22a, 355b,

 

 

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1and 370c of the Illinois Insurance Code. The Department of
2Insurance shall enforce the requirements of this Section.
3    Rulemaking authority to implement Public Act 95-1045, if
4any, is conditioned on the rules being adopted in accordance
5with all provisions of the Illinois Administrative Procedure
6Act and all rules and procedures of the Joint Committee on
7Administrative Rules; any purported rule not so adopted, for
8whatever reason, is unauthorized.
9(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
10101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
111-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
12eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff. 1-1-22;
13102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804, eff.
141-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
15eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
 
16    Section 35. The Illinois Insurance Code is amended by
17adding Section 356z.61 as follows:
 
18    (215 ILCS 5/356z.61 new)
19    Sec. 356z.61. Coverage of no-cost mental health prevention
20and wellness visits.
21    (a) A group or individual policy of accident and health
22insurance or managed care plan that is amended, delivered,
23issued, or renewed on or after January 1, 2025 shall provide
24coverage for one annual mental health prevention and wellness

 

 

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1visit for children and for adults.
2    (b) Mental health prevention and wellness visits shall
3include any age-appropriate screening recommended by the
4United States Preventive Services Task Force or by the
5American Academy of Pediatrics' Bright Futures: Guidelines for
6Health Supervision of Infants, Children, and Adolescents for
7purposes of identifying a mental health issue, condition, or
8disorder; discussing mental health symptoms that might be
9present, including symptoms of a previously diagnosed mental
10health condition or disorder; performing an evaluation of
11adverse childhood experiences; and discussing mental health
12and wellness.
13    (c) A mental health prevention and wellness visit shall be
14covered for up to 60 minutes and may be performed by a
15physician licensed to practice medicine in all of its
16branches, a licensed clinical psychologist, a licensed
17clinical social worker, a licensed clinical professional
18counselor, a licensed marriage and family therapist, a
19licensed social worker, or a licensed professional counselor.
20    (d) A policy subject to this Section shall not impose a
21deductible, coinsurance, copayment, or other cost-sharing
22requirement for mental health prevention and wellness visits.
23The cost-sharing prohibition in this subsection (d) does not
24apply to coverage of mental health prevention and wellness
25visits to the extent such coverage would disqualify a
26high-deductible health plan from eligibility for a health

 

 

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1savings account pursuant to Section 223 of the Internal
2Revenue Code.
3    (e) A mental health prevention and wellness visit shall be
4in addition to an annual physical examination and shall not
5replace a well-child visit or a general health or medical
6visit.
7    (f) A mental health prevention and wellness visit shall be
8reimbursed through the following American Medical Association
9current procedural terminology codes and at the same rate that
10current procedural terminology codes are reimbursed for the
11provision of other medical care: 99381-99387 and 99391-99397.
12The Department shall update the current procedural terminology
13codes through adoption of rules if the codes listed in this
14subsection are altered, amended, changed, deleted, or
15supplemented.
16    (g) Reimbursement of any of the current procedural
17terminology codes listed in this Section shall comply with the
18following:
19        (1) reimbursement may be adjusted for payment of
20    claims that are billed by a nonphysician clinician so long
21    as the methodology to determine the adjustments are
22    comparable to and applied no more stringently than the
23    methodology for adjustments made for reimbursement of
24    claims billed by nonphysician clinicians for other medical
25    care, in accordance with 45 CFR 146.136(c)(4); and
26        (2) for a mental health prevention and wellness visit

 

 

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1    and for a service other than a mental health prevention
2    and wellness visit, reimbursement shall not be denied if
3    they occur on the same date by the same provider and the
4    provider is a primary care provider.
5    (h) A mental health prevention and wellness visit may be
6incorporated into and reimbursed within any type of integrated
7primary care service delivery method, including, but not
8limited to, a psychiatric collaborative care model as provided
9for under this Code.
10    (i) The Department shall adopt any rules necessary to
11implement this Section by no later than October 31, 2024.
 
12    Section 95. No acceleration or delay. Where this Act makes
13changes in a statute that is represented in this Act by text
14that is not yet or no longer in effect (for example, a Section
15represented by multiple versions), the use of that text does
16not accelerate or delay the taking effect of (i) the changes
17made by this Act or (ii) provisions derived from any other
18Public Act.
 
19    Section 99. Effective date. This Act takes effect upon
20becoming law.