Part 1: How Does the New Telemedicine Law Impact Health Insurance Coverage?
September 17, 2021
What physicians need to know
On July 21, 2021, Governor Pritzker 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 cover health insurance coverage for telemedicine.
Before the new telemedicine law: Health insurers regulated by the Illinois Department of Insurance were not required to provide coverage for telemedicine services.
How the new law helps: All state-regulated health insurance plans are now required to cover all clinically appropriate, medically necessary services delivered via telemedicine by in-network health professionals.
- There are no geographic parameters or restrictions on where plan enrollees must be located to be eligible to receive telemedicine coverage.
- Plans cannot establish originating site requirements, such as requiring patients to visit a specific clinical location or requiring a clinician to be present with the patient.
Applicable plans will commonly be those health insurance plans purchased through the health insurance marketplace (for example, Get Covered Illinois) or individually through health insurers or insurance brokers.
For a comprehensive overview of the new telemedicine legislation, access ISMS’ new Issue Brief, Telemedicine in Illinois: Emergency Measures Made Permanent.
If you have questions, please contact ISMS Senior Vice President of State Legislative Affairs Erin O’Brien by email.