Illinois Moves to Expand Telehealth Coverage, With Limited Payment Parity

June 03, 2021 - Illinois lawmakers have passed legislation that expands telehealth access and coverage in the state, including establishing payment parity for behavioral health and substance abuse services and creating a panel to study payment parity for all telehealth services.

HB 3308, which is now headed to Governor Jay Pritzker’s desk, makes permanent several emergency actions taken during the height of the coronavirus pandemic to boost connected health. Among other things, it eliminates geographical barriers to telehealth delivery, sets limits on patient cost-sharing, expands the use of remote patient monitoring, asynchronous telehealth and audio-only telehealth services, and expands the list of healthcare providers allowed to use telehealth to include substance use disorder professional and those providing early intervention services for children.

“There’s been a lot of terrible things that have happened in the past year with the pandemic, but one of the good things that’s come out of it has really been this test case that we have had in regards to telemedicine in a variety of ways,” State Senator Dan McConchie said on the Senate floor shortly before the bills was passed last weekend. “I’m very excited about what kinds of opportunities this is going to open up.” 

The bill offers a compromise to the contentious reimbursement issue. Many telehealth advocates had lobbied to mandate coverage of all telehealth services at the same rate as in-person services, and had thrown their support behind another bill that called for payment parity. Opponents, meanwhile, have argued that payers should be able to negotiate their own reimbursement rates for specific services with providers.

This bill establishes parity for telehealth services that address the growing numbers of people who need mental health treatment, including those dealing with substance abuse. Virtual care platforms and mHealth tools can help providers reach more people in need of help, creating programs that reach people when and where they want help rather than requiring them to come to a clinic or office for treatment.

Separately, the bill calls for the creation of a 14-member telehealth payment parity task force within 90 days of passage. The task force would “review existing plans and policies issued, delivered, and offered in this state with respect to coverage and reimbursement for telehealth services, relevant data on payment parity for telehealth services, and payment parity statutes in other states and provide recommendations on the economic feasibility and cost effectiveness of requiring payment parity for healthcare services provided via telehealth, including recommendations for possible legislation.”

The task force would deliver its recommendations to the governor and general assembly by the end of this year and be dissolved at the beginning of 2023.