Telehealth contributes to comprehensive primary care with research showing that patients who have regular access to their primary care physician have lower overall health care costs and improved health outcomes.
Over the next year, it will be important for physicians to tracking insurers' compliance with payment parity as well as the ways telehealth have helped medical practices such as continuity of care.
In 2020, Illinois implemented COVID-19 related regulations requiring that telehealth be covered by insurers no less restrictively than an in-person visit and prohibiting consumer cost-sharing for telehealth services. In 2021, the Illinois legislature codified several aspects of telehealth into law, which was supported by the Coalition to Protect Telehealth with the Illinois Academy of Family Physicians as a coalition member, see also IAFP 2021 Survey Results.
Public Act 102-104 established the following telehealth protections:
Bars insurers from requiring patients to prove a hardship or access barrier in order to receive healthcare services through telehealth.
Prohibits geographic or facility restrictions on telehealth services, allowing patients to be treated via telehealth in their home.
Protects patient preference by establishing that a patient cannot be required to use telehealth services.
Ensures patients will not be required to use a separate panel of providers or professionals to receive telehealth services.
Aligns telehealth practice with privacy laws for in-person practice, while giving healthcare professionals the latitude to determine the appropriateness of specific sites and technology platforms for telehealth services.
Aligns telehealth coverage and payment with in-person care, making appropriate patient access to care the priority and removing harmful barriers that shift costs to the patient and healthcare professional.
While Public Act 102-104 recognized telehealth as a modality for delivering otherwise in-person healthcare services, there will still be more work necessary to (1) justify telehealth costs for those seeking payment parity from private carriers and (2) preserve Medicaid telehealth payment parity beyond the current pandemic related administrative rules.
215 ILCS 5/356z.22(d)(new): recognizes telehealth payment parity as a concept for private carriers through December 2027 (note: mental health and substance abuse services are not subject to the sunset);
215 ILCS 5/356z.22(e)(new): authorizes a study on the effectiveness of telehealth, subject to appropriation, and by January 2027;
215 ILCS 5/356z.22(f)(new): subjects telehealth payment parity to conditions that provide for negotiated rates and cost justifications