HSHS applauds Illinois law expanding Medicaid coverage for behavioral telehealth

September 15, 2018

Illinois has passed legislation that will require the state's Medicaid program to reimburse for behavioral health services provided through telehealth connections, and at the same rate that Medicaid reimburses for such services provided in person. The law expands the range of providers eligible for reimbursement. Springfield, Ill.-based Hospital Sisters Health System had advocated the law's passage and applauded its August signing by Gov. Bruce Rauner.

The telehealth legislation was part of a package of five bills aimed at increasing access to mental health and substance abuse treatment.

Illinois health care officials at signing ceremony
Illinois Gov. Bruce Rauner signs legislation that will require the state’s Medicaid program to pay for more telehealth behavioral health services. Illinois health care officials at the Aug. 22 signing ceremony include, at the far right, Dr. Gurpreet Mander. Mander is chief medical officer at HSHS St. John’s Hospital in Springfield, Ill., and executive director of the Illinois Telehealth Network.

Dr. Gurpreet Mander, chief medical officer of HSHS St. John's Hospital in Springfield, said the law, which goes into effect Jan. 1, will expand the use of telehealth for vulnerable populations in need of inpatient and outpatient behavioral health services.

Mander, who also is executive director of the Illinois Telehealth Network, said research has shown that the use of telehealth can greatly expand access to high-quality care while also reducing overall health care spending. Founded by HSHS, the Illinois Telehealth Network is a membership group of 26 Illinois health care organizations committed to growing the use of telehealth to improve access to care for people in rural areas and other underserved groups.

Mander said that while Illinois' Medicaid program has reimbursed for some behavioral telehealth services, it only pays for a limited set of services and then only for those provided by psychiatrists and by select clinicians at federally qualified health centers. In cases in which telehealth behavioral health services were ineligible for Medicaid reimbursement, but beneficial to patient care, health care facilities might absorb the cost.

HSHS, its Illinois Telehealth Network and the Illinois Health and Hospital Association's advocacy for the bill had included educating state lawmakers on the benefits of telehealth and providing demonstrations of the service for them.

Mander said the level of quality is the same for mental health services delivered remotely as for those delivered in person. He said by increasing access to behavioral health services through telehealth platforms, escalation of symptoms can be slowed or halted.

Illinois Lt. Gov. Evelyn Sanguinetti said in a press release announcing the bill's passage that Medicaid clients with behavioral health needs comprise 25 percent of all Medicaid enrollees, but account for 56 percent of all Medicaid spending. She said improving care access is expected to result in fewer emergency room visits, reduced hospital stays and readmissions, lower costs to taxpayers and improved quality of life for people insured under Medicaid.

Medicaid programs in more than 30 states already allow for the reimbursement of behavioral telehealth services, according to information from the Illinois governor's office.

Private payers have been slow to reimburse for telehealth behavioral health, Mander said. Some states have mandated through legislation that private payers reimburse providers for specified telehealth services at the same rate they reimburse for services provided in person. Mander said HSHS is advocating for this state-mandated parity in Illinois and seeks it for all telehealth services.

Already, HSHS is using telehealth for more than 50 inpatient and outpatient applications throughout the health system, many of which are being paid for by public and private payers. Such applications include emergency and inpatient stroke consultations and neonatal intensive care unit services. The system will soon be using telehealth services for intensive care unit monitoring.



Copyright © 2018 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3490.

Copyright © 2018 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.