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Analysis

Illinois Lawmakers Pressed to Protect Telehealth

By John Commins  
   September 30, 2020

Stakeholders say legislation to support coverage parity is needed for continued post-pandemic access to telehealth services.

A coalition of Illinois healthcare providers and patient advocates want the state's general assembly to make permanent the temporary regulatory "flexibilities" that were authorized for telehealth services during the COVID-19 pandemic. 

In a letter this week to every member of the Illinois General Assembly, the Coalition to Protect of Telehealth praised Gov. J.B. Pritzker and the state's Department of Healthcare and Family Services for a March 19 executive order that "temporarily lifted longstanding barriers to service access via telehealth for commercial health plans and Medicaid."

Among other things, the executive order expanded the definition of telehealth services and access points for consumers, loosed restrictions on physician licensing, and barred private insurers from charging copays and deductibles for in-network telehealth visits.

"In response," the stakeholders wrote, "healthcare providers rapidly invested in new technology, adjusted clinical workflows and educated staff, patients, and clinicians on telehealth delivery."

However, unless state lawmakers make the executive order permanent, the coalition wrote that "providers and professionals will not have the certainty they need to continue to invest in and utilize new care delivery tools, and Illinois residents will abruptly lose access to the telehealth services they have relied on during the pandemic."

Thirty-six states had coverage parity policies in place before the pandemic, and 16 states payment parity for commercial health plans. Illinois requires neither.

For Medicaid, 21 states have coverage parity policies and 28 states had payment parity. Illinois offers limited Medicaid coverage for telehealth services and has no laws that direct the Medicaid program to treat telehealth and in-person services the same.

A federal report this summer found that 47% of Medicare fee-for-service primary care visits in Illinois were provided via telehealth in April, compared with an average of less than 1% before the COVID-19 public health emergency.

Medicare Advantage plans reported that telehealth use among beneficiaries rose by 52% this spring, and that 91% of seniors reported a favorable experience with telehealth. As in-person visits have since resumed, and while telehealth use has tapered somewhat, it still accounted for 20% of all visits by the start of June.

The stakeholders also laid out for lawmakers a 10-point plan that they said should be model telehealth reform legislation that would guarantee coverage and payment parity with in-patient services. 

The Coalition to Protect Our Telehealth includes: AARP Illinois; American Nurses Association-Illinois; Association of Community Mental Health Authorities of Illinois; Health Care Council of Illinois; Illinois Association for Behavioral Health; Illinois Critical Access Hospital Network; Illinois Health and Hospital Association; Illinois Health Care Association; Illinois Occupational Therapy Association; Illinois Primary Health Care Association; Illinois Psychiatric Society; Illinois Society of Advanced Practice Nursing; Illinois State Medical Society; The Kennedy Forum; and LeadingAge.

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.


KEY TAKEAWAYS

In a letter this month to every member of the Illinois General Assembly, the Coalition to Protect of Telehealth praised an executive order that "temporarily lifted longstanding barriers to service access via telehealth for commercial health plans and Medicaid."

The executive order expanded the definition of telehealth services and access points for consumers, loosed restrictions on physician licensing, and barred private insurers from charging copays and deductibles for in-network telehealth visits.

Unless lawmakers make the order permanent, the coalition wrote that "providers and professionals will not have the certainty they need to continue to invest in and utilize new care delivery tools, and Illinois residents will abruptly lose access to the telehealth services they have relied on during the pandemic."


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