Part 4: How Does the New Telemedicine Law Address Coverage for Telemedicine Services?

October 15, 2021

What physicians need to know

Governor Pritzker recently signed House Bill 3308  into law, expanding access to telemedicine services for patients in Illinois. The new law makes permanent many of the emergency telemedicine rules that were authorized during COVID-19.

Physician Advocate is taking a deep dive into the various components of this important ISMS-backed legislation. This week’s installment will highlight coverage for telemedicine services

Before the new telemedicine law: Health insurers generally were not prohibited from implementing separate conditions of coverage for telemedicine services. As the use of telemedicine technologies expanded, health plans were increasingly placing requirements or restrictions on when and whether patients could choose a telemedicine visit, and which physicians in the network would be able to provide telemedicine services.

How the new law helps: Health insurers are now prohibited from imposing certain restrictions on the use of telemedicine, or creating separate rules for the coverage of telemedicine services.

The new law clarifies that health insurers are not allowed  to:

  • Require in-person contact between a healthcare professional and a patient before a telehealth service
  • Require proof or documentation of a hardship or access barrier to in-person care
  • Require the use of telehealth services when a patient chooses an in-person consultation
  • Require patients to use telehealth services, e-visits or virtual check-ins or to use a separate panel of healthcare professionals or facilities to receive these services

For a comprehensive overview of the new telemedicine legislation, access ISMS’ new Issue Briefs:

Telemedicine in Illinois: Emergency Measures Made Permanent 

Telemedicine FAQs 

If you missed the previous installments in this series, access:

Part 1: Health Insurance Coverage 
Part 2: Medical Visits Conducted Over the Telephone
Part 3: Equal Payment for Telemedicine and In-Person Visits

If you have questions, please contact ISMS Senior Vice President of State Legislative Affairs Erin O’Brien by email.
Share this article:

Cookie Consent

Cookies are required for some functionality on our site. View our privacy policy for more information.