Illinois General Assembly - Bill Status for EO2009

Contains a preamble concerning Coronavirus Disease 2019 (COVID-19), the Gubernatorial Disaster Proclamation declaring all counties in the State of Illinois as a disaster area on March 9, 2020, and other matters. Pursuant to the Illinois Emergency Management Agency Act, orders the following: (1) defines terms; (2) for the duration of the Gubernatorial Disaster Proclamation, health insurance issuers regulated by the Department of Insurance are required to cover the costs of telehealth services rendered by in-network providers to deliver clinically appropriate, medically necessary covered services and treatments to insureds, enrollees, and members under a policy, contract, or certificate of health insurance coverage; issuers may establish reasonable requirements and parameters for telehealth services consistent with this Executive Order or a company bulletin issued by the Department of Insurance under this Executive Order; an issuer's requirements and parameters may not be more restrictive or less favorable toward providers, insureds, enrollees, or members than those contained in a specified emergency rulemaking; issuers shall notify providers of instructions necessary to facilitate billing for telehealth services; (3) health insurance issuers shall not impose unnecessary, duplicative, or unwarranted utilization review requirements upon telehealth services nor impose treatment limitations more stringent than the requirements applicable to the same health care service when rendered in person; for telehealth services delivered by in-network providers that relate to COVID-19, health insurance issuers shall not impose prior authorization requirements; (4) health insurance issuers shall not impose copayments, deductibles, or coinsurance for telehealth services by in-network providers, but if an enrollee in a high-deductible health plan has not met the applicable deductible, an issuer is not required to pay for a charge for telehealth services unless the associated health care service for that charge is deemed preventive care by the U.S. Treasury; (5) telehealth services subject to this Executive Order may be provided by specified health care providers authorized to practice in Illinois, regardless of whether the in-network provider was originally established before the COVID-19 pandemic in a designated telehealth network for the policy, contract, or certificate of health insurance coverage; existing insurance law requirements regarding coverage of treatments based on licensure apply; (6) this Executive Order does not apply to "excepted benefits" as defined by specified regulations but does apply to limited scope dental benefits, limited scope vision benefits, long-term care benefits, coverage only for accidents, or coverage only for specified disease or illness; this Executive Order applies to short-term, limited-duration health insurance coverage, fully insured student health insurance coverage, and fully insured association health plans except with respect to excepted benefits as provided above; a policy, contract, or certificate of health insurance coverage that does not distinguish between in-network and out-of-network providers is subject to this Executive Order as though all providers are in-network; (7) the Department of Insurance may provide additional guidance and implement rules consistent with this Executive Order; (8) for the duration of the Gubernatorial Disaster Proclamation, specified statutory limitations under the Mental Health and Developmental Disabilities Confidentiality Act are suspended for the provision of telehealth services to mental health and developmental disability patients; (9) a covered health care provider or covered entity subject to the requirements of the Mental Health and Developmental Disabilities Confidentiality Act that uses audio or video communication technology to provide telehealth services to mental health and developmental disability patients may use a non-public facing remote communication product in accordance with this Executive Order for the duration of the Gubernatorial Disaster Proclamation; (10) for the duration of the Gubernatorial Disaster Proclamation, specified requirements of the Medical Practice Act of 1987 for reinstatement of a license are suspended for certain licensees.

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