Page 43 50 State Telemedicine Gaps Analysis Coverage and Reimbursement

50 State Telemedicine Gaps Analysis: Coverage & Reimbursement

Telemedicine in

Illinois

PARITY:
Private Insurance F  Bordered by KY and MO which have
Medicaid 75-77 C private insurance parity laws. No
State Employee Health Plan F telemedicine parity law.
MEDICAID SERVICE  In 2014, a law enacted that prohibits
COVERAGE & CONDITIONS individual and group accident and health
OF PAYMENT: insurance plans, who choose to cover
Patient Setting F telemedicine, from requiring in-person
contact. In 2015, SB 452 was
Eligible Technologies C introduced to achieve full parity, and HB
Distance or Geography A 76 to include telehealth in the mental
Restrictions health parity law. 71-72
Eligible Providers F
Physician-provided Services B Medicaid

Mental/behavioral Health B  The agency imposes restrictions on
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Services covered services, patient settings, and
Rehabilitation F distant site providers but includes
Home Health F coverage for services provided by local
Informed Consent A education agencies (schools) and a
podiatrist.
Telepresenter C  Store-and-forward allowed for
INNOVATIVE PAYMENT dermatologic purposes.
OR SERVICE DELIVERY  Telepresenter required.
MODELS:  IL Department of Aging is authorized to
State-wide Network fund older adult services such as home
Medicaid Managed Care telemedicine monitoring devices.
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Medicare-Medicaid Dual  In 2014, IL submitted a CMS §1115
Eligibles waiver proposal which includes the
Health Home development of a statewide specialty
HCBS Waiver telemedicine network. The application
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Corrections is still pending.
Other ✔

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American Telemedicine Association
2015