Telehealth

House Bill 3308

  • AMITA Health has been designing and implementing innovative telehealth programs for 15 years, focusing on improving patient access to care, improving the quality of care, and scaling resources across the health system.
  • Telehealth allows AMITA Health to continue providing the highest quality of health care to everyone in the communities we serve, including medically underserved areas, rural areas and areas where accessibility to specialty care is needed. Telehealth is also cost-efficient.
  • The COVID-19 pandemic and existing socio-economic and racial disparities highlight the urgent need for changes to be made to address health equity, particularly in communities where health outcomes follow racial and socioeconomic lines.

AMITA Health advocated for legislation that would codify the Governor’s pandemic related Executive Orders to ensure permanence in telehealth coverage and payment parity. HB 3308 (Jones/Harris), telehealth legislation, is the result of months of extensive negotiations and efforts in partnership with the Coalition to Protect Telehealth. HB 3308 provision apply to commercial insurance, see Medicaid note below, and include:

  • Reimbursement Parity: on the same basis, manner and rate that apply to in-person services.
  • Does not preclude insurers and providers from voluntarily negotiating alternate reimbursement rates for telehealth services, as long as any agreed upon rates account for ongoing provider investments in telehealth platforms;
  • Includes a 5-year sunset clause for reimbursement of physical health services
  • Requires the Department of Insurance and the Department of Public Health to commission a study on the efficacy of the coverage and reimbursement parity mandates before the sunset date.
  • Coverage Parity Mandate: Insurers must cover clinically appropriate, medically necessary telehealth services (real-time audio or audio/video interactions), e-visits (patient portal communications) and virtual check-ins (5-10-minute “live” conversations to prevent an in-person visit) in the same manner as any other benefits covered under the policy.
  • Patient and Provider Protections: Specifically, insurers are prohibited from:
    • Requiring in-person contact occur between a healthcare professional and a patient prior to the provision of a telehealth service;
    • Requiring patients or providers to demonstrate or document a hardship or access barrier to an in-person consultation;
    • Requiring telehealth services when a provider has determined it not appropriate or when a patient chooses an in-person
    • Creating originating or distance site restrictions;
    • Requiring patients to use a separate panel of health care professionals or facilities for telehealth services;
    • Imposing deductibles, copayments/co-insurance, or other cost-sharing that exceed those required for in-person services.

Medicaid Provisions

  • The Department of Healthcare and Family Services (HFS) has committed to the continuation of existing Medicaid telehealth coverage and reimbursement requirements, which provide for coverage and payment parity, after the COVID-19 public health emergency ends. HFS also committed to meeting with stakeholders to consider whether any Medicaid coverage or reimbursement provisions should be codified in state statute.

AMITA Health supported HB 3308 as amended. The bill passed both Chambers and currently sits on the Governors desk for further action. The bill is effective upon becoming law.

Telehealth and COVID-19

  • The COVID 19 crisis dramatically increased the need for telehealth services across the country and at AMITA Health.
  • The federal CARES Act included various provisions aimed at boosting telehealth access and use across federal health programs and President Trump’s Executive Order declaring COVID-19 a national public health emergency included several telehealth provisions.
  • On March 19, 2020, Governor Pritzker issued an Executive Order that:
    • required that all insurers must cover telehealth service,
    • expanded the permitted telehealth devices to include telephones, including video technology available on smart phones and
    • expanded the professions authorized to provide telehealth services
  • In response, AMITA Health rapidly implemented innovative telehealth programs in acute care settings and for primary care physicians. The Executive Order and Virtual Care Program have allowed for a dramatic increase in telehealth in Illinois.
  • While the Governor has extended his Executive Orders, they are not permanent.

Telehealth at AMITA

  • AMITA Health has been a leader in developing and providing telehealth services since 2005, and is currently utilizing proven systems to provide telemedicine in several critical areas of need, including:
    • providing psychiatry and behavioral health services.
    • monitoring patients in intensive care units (Tele-ICU).
    • minimizing the damage caused by strokes (Telestroke).
    • coordinating care teams as patients are discharged (Warm Nursing Handoff).
    • preventing falls and providing support for hospitalized patients (Remote sitter) and at-risk individuals (Lifeline).

Why does it matter?

  • Increased access to telemedicine beyond the COVID-19 pandemic will allow for:
    • More options for patients to seek preventive care and chronic disease management
    • Lower costs for patients
    • Extension of care to traditionally underserved communities
    • Access to specialty care that may otherwise be delayed
  • Hospitals and providers will not be able to revert-back to the original state of healthcare delivery following the pandemic. Providers need to be able to reach their patients in a variety of ways to facilitate the effective delivery of healthcare. Current telehealth laws in Illinois restrict hospitals from utilizing telehealth at its full potential.
  • By lowering costs for patients and increasing access to care via telehealth, Illinois can achieve better health outcomes and overcome barriers to care such as:
    • Reduce time missed from work
    • Elimination of transportation costs
    • Childcare issues
    • Personal health and safety considerations

What is the AMITA Health perspective?

  • Codify Governor Pritzker’s Executive Orders on Telehealth and Virtual Care.
    • We thank members of the General Assembly for passing HB 3308, including sponsors: Reps Conroy and Jones and Senators Hunter and Harris and respectfully urge the Governor to sign House Bill 3308 into law.
  • Extend Federal Flexibilities beyond the public health emergency (PHE). Congress should pass legislation to make the flexibilities provided during the PHE permanent, including but not limited to:
    • Elimination of originating and distant site requirements
    • Coverage of additional telehealth services, including occupational therapy, physical therapy, speech therapy, mental and behavioral health, and dentistry
    • Access to and coverage of telehealth visits on more platforms, in particular telephone visits (without video).
    • Reimbursement parity for telehealth services as if it were a traditional in-person visit.
  • Allowances for clinicians to practice at the top of their license and across state lines.
  • Reimbursement parity for telehealth services as if it were a traditional in-person visit.

External Resources

Information from third-party organizations that can be resources for you to continue to learn about the issues at hand.

National Journal COVID Telehealth powerpoint

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National Journal State of Telehealth Legislation

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