I hope everyone had a very enjoyable Memorial Day weekend!
Illinois front:
The Chamber will be issuing an end of session report this Friday.
Several bills the Healthcare Council has been tracking passed over the last several days including:
-
HB 33 Insurance Code – Substance Use Treatment – Passed both Houses
- HB 135 Insurance Code – Birth Control – Passed both Houses
- HB 711 Prior Authorization –Passed both Houses
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HB 1745 Prescription Drugs – Passed both Houses
- HB 1779 Biomarker Testing – Passed both Houses
- HB 1955 Holding Company Systems – Passed both Houses
- HB 1957 Ins – Various – Passed both Houses
- HB 2109 Regulation - Tech – Passed both Houses
- HB 2405 Insurance Guaranty Fund – Passed both Houses
- HB 2589 Substance Use Disorder-Opioids – Passed both Houses
- HB 2595 Insurance – Mental Health – Passed both Houses
- HB 3308 Telehealth – Passed both Houses
- HB 3598 Insurance – Chambers of Commerce – Passed both Houses
- HB 3709 Insurance Code – Infertility Coverage – Passed both Houses
- SB 499 Health Care/TMJ Disorders – Passed both Houses
- SB 1753 Surplus Line – Passed both Houses
- SB 1876 Group Life Insurance – Passed both Houses
Telehealth: Key provisions of the Telehealth bill that passed (HB 3308) include:
- Coverage is mandatory (instead of permissive) for clinically appropriate and medically necessary telehealth services.
- Benefits for in-person and telehealth services must be covered at parity (existing provisions are strengthened to further prohibit insurers from placing unnecessary barriers to obtaining coverage for clinically appropriate, medically necessary telehealth services).
- Permanent payment parity for behavioral health with physical health payment parity subject to a 5-year sunset.
- Payment parity provisions are explicit that if the service cannot be billed as an in-person service, then it is not subject to parity. Additionally, provisions allow for negotiation of alternative reimbursement rates.
- Originating site reimbursement is permissive and may be considered (rather than shall) if the site is a facility.
- IDPH and DOI will commission a study on telehealth utilization, impact on access, outcomes, and health equity, as well as cost to be reported out in 2026 (before broad payment parity provisions expire in 2027).
- Medicaid will NOT be included since the coverage and reimbursement provisions for that program are already in permanent regulation.
Prior Authorization: HB 711 passed both Houses.
PBM: SB 2008 did not move in this session.
List of key dates:
We will be scheduling a Healthcare Council Quarterly meeting this summer.
Happy summer everyone!
