Illinois Coalition Backs Telehealth Bill Supporting Payment Parity Beyond COVID-19 Pandemic

Epstein Becker & Green

Epstein Becker & Green

The Illinois Coalition to Protect Telehealth, a coalition of more than thirty Illinois healthcare providers and patient advocates, announced its support for a bill that would, among other things, establish payment parity for telehealth services and permanently eliminate geographic and facility restrictions beyond the COVID-19 pandemic. Like many states, Illinois issued an executive order at the outset of the pandemic temporarily lifting longstanding barriers to consumer access to telehealth via commercial health plans and Medicaid.[1]  The executive order expanded the definition of telehealth services, loosened geographical restrictions on physician licensing requirements, and barred private insurers from charging copays and deductibles for in-network telehealth visits.

Now, House Bill 3498 seeks to make permanent some of those temporary waivers by aligning coverage and reimbursement for telehealth services with in-person care. If enacted, it would also establish that patients could no longer be required to use an exclusive panel of providers or professionals to receive telehealth services, nor would they be required to prove a hardship or access barrier in order to receive those services.  The bill does not include a provision that would permanently allow out-of-state physicians or health care providers to provide services in the state beyond the pandemic.[2]

In the Coalition’s announcement of support for this bill, it states that the use of telehealth over the last year has shown an increased adherence to patient care plans and improved chronic disease management.  “In recent surveys, over 70% of Illinois hospital respondents and 78% of community-based behavioral healthcare respondents reported that telehealth has helped drive a reduction in the rates at which patients missed appointments. Surveys of Illinois physicians, community health centers, and specialized mental health and substance use disorder treatment providers have also revealed similar dramatic reductions in missed appointments.”

The announcement also notes that, even with in-person care resuming, patients are still using telehealth at a persistent and significant level, suggesting that flexible access to virtual care should be maintained permanently.

Prior to the COVID-19 public health emergency, thirty-six states had telehealth parity laws and sixteen states had parity coverage for commercial health plans.  Illinois had neither.  If enacted, this legislation would greatly increase consumer access to telehealth services.  The prohibition requiring patients to use a separate panel of providers to receive those services could potentially serve as an impediment to nationwide network contracting.

House Bill 3498 is currently being reviewed by the state’s House of Representatives.  As of March 18, 2021, the bill has thirty-five co-sponsors and has been assigned to the Health Care Availability and Accessibility Committee.[3]  We will continue to monitor and report on any updates to the status of the bill.

[1] March 19, 2020 executive order

[2] A March 23, 2020 executive order established that out-of-state physicians, nurses, and certain other health care providers may practice in Illinois if they are licensed in another state, are in good standing with that license, and apply for a temporary practice permit. The temporary practice permit application states that such permit will be valid until May 31, 2021.

[3] Bill status

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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