|
United States, symptoms for depression and anxiety in |
adults increased nearly fourfold during the COVID-19 |
pandemic.
|
Section 10. The State Employees Group Insurance Act of |
1971 is amended by changing Section 6.11 as follows:
|
(5 ILCS 375/6.11)
|
(Text of Section before amendment by P.A. 102-768) |
Sec. 6.11. Required health benefits; Illinois Insurance |
Code
requirements. The program of health
benefits shall |
provide the post-mastectomy care benefits required to be |
covered
by a policy of accident and health insurance under |
Section 356t of the Illinois
Insurance Code. The program of |
health benefits shall provide the coverage
required under |
Sections 356g, 356g.5, 356g.5-1, 356m, 356q,
356u, 356w, 356x, |
356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, |
356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22, |
356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, |
356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51, |
356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and |
356z.61 of the
Illinois Insurance Code.
The program of health |
benefits must comply with Sections 155.22a, 155.37, 355b, |
356z.19, 370c, and 370c.1 and Article XXXIIB of the
Illinois |
Insurance Code. The Department of Insurance shall enforce the |
requirements of this Section with respect to Sections 370c and |
|
370c.1 of the Illinois Insurance Code; all other requirements |
of this Section shall be enforced by the Department of Central |
Management Services.
|
Rulemaking authority to implement Public Act 95-1045, if |
any, is conditioned on the rules being adopted in accordance |
with all provisions of the Illinois Administrative Procedure |
Act and all rules and procedures of the Joint Committee on |
Administrative Rules; any purported rule not so adopted, for |
whatever reason, is unauthorized. |
(Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20; |
101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff. |
1-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103, |
eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; |
102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. |
1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, |
eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; |
revised 12-13-22.)
|
(Text of Section after amendment by P.A. 102-768) |
Sec. 6.11. Required health benefits; Illinois Insurance |
Code
requirements. The program of health
benefits shall |
provide the post-mastectomy care benefits required to be |
covered
by a policy of accident and health insurance under |
Section 356t of the Illinois
Insurance Code. The program of |
health benefits shall provide the coverage
required under |
Sections 356g, 356g.5, 356g.5-1, 356m, 356q,
356u, 356w, 356x, |
|
356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, |
356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22, |
356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, |
356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51, |
356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59, and |
356z.60, and 356z.61 of the
Illinois Insurance Code.
The |
program of health benefits must comply with Sections 155.22a, |
155.37, 355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of |
the
Illinois Insurance Code. The Department of Insurance shall |
enforce the requirements of this Section with respect to |
Sections 370c and 370c.1 of the Illinois Insurance Code; all |
other requirements of this Section shall be enforced by the |
Department of Central Management Services.
|
Rulemaking authority to implement Public Act 95-1045, if |
any, is conditioned on the rules being adopted in accordance |
with all provisions of the Illinois Administrative Procedure |
Act and all rules and procedures of the Joint Committee on |
Administrative Rules; any purported rule not so adopted, for |
whatever reason, is unauthorized. |
(Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20; |
101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff. |
1-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103, |
eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; |
102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. |
1-1-23; 102-768, eff. 1-1-24; 102-804, eff. 1-1-23; 102-813, |
eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff. 1-1-23; |
|
102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
|
Section 15. The Department of Public Health Powers and |
Duties Law of the
Civil Administrative Code of Illinois is |
amended by adding Section 2310-720 as follows:
|
(20 ILCS 2310/2310-720 new) |
Sec. 2310-720. Public educational effort on mental health |
and wellness. Subject to appropriation, the Department shall |
undertake a public educational campaign to bring broad public |
awareness to communities across this State on the importance |
of mental health and wellness, including the expanded coverage |
of mental health treatment, and consistent with the |
recommendations of the Illinois Children's Mental Health |
Partnership's Children's Mental Health Plan of 2022 and Public |
Act 102-899. The Department shall look to other successful |
public educational campaigns to guide this effort, such as the |
public educational campaign related to Get Covered Illinois. |
Additionally, the Department shall work with the Department of |
Insurance, the Illinois State Board of Education, the |
Department of Human Services, the Department of Healthcare and |
Family Services, the Department of Juvenile Justice, the |
Department of Children and Family Services, and other State |
agencies as necessary to promote consistency in messaging and |
distribution methods between this campaign and other |
concurrent public educational campaigns related to mental |
|
health and mental wellness. Public messaging for this campaign |
shall be simple, be easy to understand, and include culturally |
competent messaging for different communities and regions |
throughout this State.
|
Section 20. The Counties Code is amended by changing |
Section 5-1069.3 as follows:
|
(55 ILCS 5/5-1069.3)
|
Sec. 5-1069.3. Required health benefits. If a county, |
including a home
rule
county, is a self-insurer for purposes |
of providing health insurance coverage
for its employees, the |
coverage shall include coverage for the post-mastectomy
care |
benefits required to be covered by a policy of accident and |
health
insurance under Section 356t and the coverage required |
under Sections 356g, 356g.5, 356g.5-1, 356q, 356u,
356w, 356x, |
356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, |
356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, |
356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, |
356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, |
356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and 356z.61 |
of
the Illinois Insurance Code. The coverage shall comply with |
Sections 155.22a, 355b, 356z.19, and 370c of
the Illinois |
Insurance Code. The Department of Insurance shall enforce the |
requirements of this Section. The requirement that health |
benefits be covered
as provided in this Section is an
|
|
exclusive power and function of the State and is a denial and |
limitation under
Article VII, Section 6, subsection (h) of the |
Illinois Constitution. A home
rule county to which this |
Section applies must comply with every provision of
this |
Section.
|
Rulemaking authority to implement Public Act 95-1045, if |
any, is conditioned on the rules being adopted in accordance |
with all provisions of the Illinois Administrative Procedure |
Act and all rules and procedures of the Joint Committee on |
Administrative Rules; any purported rule not so adopted, for |
whatever reason, is unauthorized. |
(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20; |
101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff. |
1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203, |
eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22; |
102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. |
1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, |
eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; |
102-1117, eff. 1-13-23.)
|
Section 25. The Illinois Municipal Code is amended by |
changing Section 10-4-2.3 as follows:
|
(65 ILCS 5/10-4-2.3)
|
Sec. 10-4-2.3. Required health benefits. If a |
municipality, including a
home rule municipality, is a |
|
self-insurer for purposes of providing health
insurance |
coverage for its employees, the coverage shall include |
coverage for
the post-mastectomy care benefits required to be |
covered by a policy of
accident and health insurance under |
Section 356t and the coverage required
under Sections 356g, |
356g.5, 356g.5-1, 356q, 356u, 356w, 356x, 356z.4, 356z.4a, |
356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, |
356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, |
356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41, |
356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54, |
356z.56, 356z.57, 356z.59, and 356z.60, and 356z.61 of the |
Illinois
Insurance
Code. The coverage shall comply with |
Sections 155.22a, 355b, 356z.19, and 370c of
the Illinois |
Insurance Code. The Department of Insurance shall enforce the |
requirements of this Section. The requirement that health
|
benefits be covered as provided in this is an exclusive power |
and function of
the State and is a denial and limitation under |
Article VII, Section 6,
subsection (h) of the Illinois |
Constitution. A home rule municipality to which
this Section |
applies must comply with every provision of this Section.
|
Rulemaking authority to implement Public Act 95-1045, if |
any, is conditioned on the rules being adopted in accordance |
with all provisions of the Illinois Administrative Procedure |
Act and all rules and procedures of the Joint Committee on |
Administrative Rules; any purported rule not so adopted, for |
whatever reason, is unauthorized. |
|
(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20; |
101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff. |
1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203, |
eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22; |
102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. |
1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, |
eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; |
102-1117, eff. 1-13-23.)
|
Section 30. The School Code is amended by changing Section |
10-22.3f as follows:
|
(105 ILCS 5/10-22.3f)
|
Sec. 10-22.3f. Required health benefits. Insurance |
protection and
benefits
for employees shall provide the |
post-mastectomy care benefits required to be
covered by a |
policy of accident and health insurance under Section 356t and |
the
coverage required under Sections 356g, 356g.5, 356g.5-1, |
356q, 356u, 356w, 356x, 356z.4, 356z.4a,
356z.6, 356z.8, |
356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, |
356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, |
356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51, |
356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and |
356z.61 of
the
Illinois Insurance Code.
Insurance policies |
shall comply with Section 356z.19 of the Illinois Insurance |
Code. The coverage shall comply with Sections 155.22a, 355b, |
|
and 370c of
the Illinois Insurance Code. The Department of |
Insurance shall enforce the requirements of this Section.
|
Rulemaking authority to implement Public Act 95-1045, if |
any, is conditioned on the rules being adopted in accordance |
with all provisions of the Illinois Administrative Procedure |
Act and all rules and procedures of the Joint Committee on |
Administrative Rules; any purported rule not so adopted, for |
whatever reason, is unauthorized. |
(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20; |
101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff. |
1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203, |
eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff. 1-1-22; |
102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804, eff. |
1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, |
eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
|
Section 35. The Illinois Insurance Code is amended by |
adding Section 356z.61 as follows:
|
(215 ILCS 5/356z.61 new) |
Sec. 356z.61. Coverage of no-cost mental health prevention |
and wellness visits. |
(a) A group or individual policy of accident and health |
insurance or managed care plan that is amended, delivered, |
issued, or renewed on or after January 1, 2025 shall provide |
coverage for one annual mental health prevention and wellness |
|
visit for children and for adults. |
(b) Mental health prevention and wellness visits shall |
include any age-appropriate screening recommended by the |
United States Preventive Services Task Force or by the |
American Academy of Pediatrics' Bright Futures: Guidelines for |
Health Supervision of Infants, Children, and Adolescents for |
purposes of identifying a mental health issue, condition, or |
disorder; discussing mental health symptoms that might be |
present, including symptoms of a previously diagnosed mental |
health condition or disorder; performing an evaluation of |
adverse childhood experiences; and discussing mental health |
and wellness. |
(c) A mental health prevention and wellness visit shall be |
covered for up to 60 minutes and may be performed by a |
physician licensed to practice medicine in all of its |
branches, a licensed clinical psychologist, a licensed |
clinical social worker, a licensed clinical professional |
counselor, a licensed marriage and family therapist, a |
licensed social worker, or a licensed professional counselor. |
(d) A policy subject to this Section shall not impose a |
deductible, coinsurance, copayment, or other cost-sharing |
requirement for mental health prevention and wellness visits. |
The cost-sharing prohibition in this subsection (d) does not |
apply to coverage of mental health prevention and wellness |
visits to the extent such coverage would disqualify a |
high-deductible health plan from eligibility for a health |
|
savings account pursuant to Section 223 of the Internal |
Revenue Code. |
(e) A mental health prevention and wellness visit shall be |
in addition to an annual physical examination and shall not |
replace a well-child visit or a
general health or medical |
visit. |
(f) A mental health prevention and wellness visit shall be |
reimbursed through the following American Medical Association |
current procedural terminology codes and at the same rate that |
current procedural terminology codes are reimbursed for the |
provision of other medical care: 99381-99387 and 99391-99397. |
The Department shall update the current procedural terminology |
codes through adoption of rules if the codes listed in this |
subsection are altered, amended, changed, deleted, or |
supplemented. |
(g) Reimbursement of any of the current procedural |
terminology codes listed in this Section shall comply with the |
following: |
(1) reimbursement may be adjusted for payment of |
claims that are billed by a nonphysician clinician so long |
as the methodology to determine the adjustments are |
comparable to and applied no more stringently than the |
methodology for adjustments made for reimbursement of |
claims billed by nonphysician clinicians for other medical |
care, in accordance with 45 CFR 146.136(c)(4); and |
(2) for a mental health prevention and wellness visit |
|
and for a service other than a mental health prevention |
and wellness visit, reimbursement shall not be denied if |
they occur on the same date by the same provider and the |
provider is a primary care provider. |
(h) A mental health prevention and wellness visit may be |
incorporated into and reimbursed within any type of integrated |
primary care service delivery method, including, but not |
limited to, a psychiatric collaborative care model as provided |
for under this Code. |
(i) The Department shall adopt any rules necessary to |
implement this Section by no later than October 31, 2024.
|
Section 95. No acceleration or delay. Where this Act makes |
changes in a statute that is represented in this Act by text |
that is not yet or no longer in effect (for example, a Section |
represented by multiple versions), the use of that text does |
not accelerate or delay the taking effect of (i) the changes |
made by this Act or (ii) provisions derived from any other |
Public Act.
|
Section 99. Effective date. This Act takes effect upon |
becoming law.
|