Illinois licensing laws do not directly address telehealth counseling. All regular laws apply to telehealth.
Only three states — California, Kentucky and Vermont — have
instituted specific licensing guidelines use of
telehealth. Most states continue to follow policies devised long before
technology allowed provider and client to interact from separate states.
Limited Federal Guidance on Coverage and Reimbursement: Despite Medicaid’s fewer restrictions on telehealth coverage as compared to its Medicare counterpart, there is limited federal guidance or information regarding the implementation of telehealth services in state Medicaid programs or coverage parameters for states choosing to offer such services. Health care practitioners who treat Medicaid populations are at risk for steep penalties for noncompliance, including fines and the potential loss of their professional licenses.
Lack of Meaningful Coverage by Third-Party Payors: A range of public and private payors do not provide meaningful coverage andreimbursement requirements for telehealth services.
A recent MedPAC survey noted that coverage of telehealth services continues to vary widely across commercial health plans, with most covering only one or two types of telehealth-based services.
According to MedPAC, most commercial health plans have had little incentive to offer telehealth services because there has been scant evidence of reduced costs or improved outcomes associated with telehealth services.
While telehealth parity laws are currently in effect in 39 states and the District of Columbia and are intended to ensure the same coverage of (and in some cases, reimbursement for) telehealth services, there is more work ahead to achieve comprehensive coverage and access. States must continue to enact new parity laws or expand existing ones. There are already plans for progress in 2019—for example:
Arizona will expand its existing parity law to include coverage of SUD treatment services provided through telehealth.
Kentucky legislation will go into effect on July 1, 2019, that requires commercial health plans to reimburse psychologists, therapists, and other non-physician providers for telehealth visits.
States including Alaska, Michigan, and Utah are amending their parity laws to expand or modify their applicability to additional specialties or types of providers.
Governor J. B. Pritzker Issues Critical Telehealth Executive Order
March 19, 2020
We are very pleased to announce that, in response to our request and proposal, Governor JB Pritzker has just issued an importantExecutive Orderthat requires all health insurance issuers regulated by the Department of Insurance to cover telehealth services. The Order applies to provisions of mental health & substance use disorder treatment and general healthcare. The technology authorized to be utilized goes beyond traditional telehealth methods to include:
These methods do not have to meet the HIPAA standards per the Waiver issued by the federal Office of Civil Rights.
The services may be provided by any in-network physician, APRNs, psychologists, clinical social workers, other mental health providers, and other substance use disorder treatment providers who are licensed, registered, certified and/or authorized to practice.
The health insurance issuers shall NOT impose utilization review requirements that are unnecessary OR impose any treatment limitations that are more stringent than the requirement imposed upon in-person care. There are also NO PRIOR AUTHORIZATION requirements allowed to be imposed for in-network providers. Finally, no cost sharing requirements may be imposed upon patients under this order.
We thank Governor Pritzker and the Illinois Department of Insurance for their swift response to our request. Further, many thanks to IABH Legal CounselJud DeLossfor developing a draft Executive Order that we shared with the Governor's Office - a majority of what he drafted is included in the final order! We are pleased to see such a swift and positive response to our request and grateful for the Governor's continued leadership during this critical time.