Healthcare Council Update

Aaron Winters | Executive Director, Healthcare Council | 847-334-6411

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Good morning, Healthcare Council. The election is just under 71 days away. Congress has gone on recess with no agreement on the most recent relief package and the Trump administration continues to pump out health care executive orders, including a renewed election-year focus on drug prices (this week is the so-called deadline for pharmaceutical manufacturers to offer "concessions"). More than 175,000 Illinois residents may have recently lost health insurance. And as of Friday, 20 Illinois counties are at a "warning" level for increasing COVID cases. But despite all the bad news out there, there are great stories about Illinois healthcare providers and researchers happening every day, including the new emergency use authorization for the University of Illinois' saliva COVID test. On to the update!

Telehealth Conversations Restarting

Following a flurry of activity concerning telehealth last May with no final package passed, legislative conversations will resume this week concerning telehealth. You may recall there was an effort spearheaded by providers to codify Gov. Pritzker's Executive Order concerning payment parity for telehealth services and in-person visits in the waning days of the Spring legislative session. The Chamber has the dual goals of expanding telehealth services and preserving the affordability of healthcare for all Illinois employers. We will continue to keep you all updated as talks progress.

Chamber Presents Mental Health Coding Working Group Path Forward

Last week the Healthcare Council presented a potential path forward regarding industry compliance with the recently passed health insurance mandate for first episode psychosis. As part of PA 101-0461 (which mandates coverage of three treatment models - first episode psychosis, ACT and CST), there is a requirement that the Department of Insurance convene a work group to determine a coding solution that allows for bundled treatment models to be coded and paid for as a bundle of services, similar to intensive outpatient treatment where multiple services are covered under one billing code or a bundled set of billing codes discussed in 215 ILCS 5/356z.33. Working with insurers, the Chamber helped identify several potential billing codes to use while advocates set up a permanent code for first episode services (the service is not currently covered anywhere in the U.S. by commercial services, posing a logistical problem for reimbursements.) If your organization would like to know more about the ongoing discussions, feel free to reach out and we can bring you up to speed.

Mental Health Parity Working Group Continues

The Chamber continues to participate in the Department of Insurance and Healthcare and Family Services working group to develop a reporting form for non-quantitative treatment limitations for behavioral health. Both Medicaid managed care plans and commercial insurers have presented options to comply with the statute. Advocate groups are currently developing their own set of augmentations to the draft templates. The next meeting is scheduled for Sept. 25.

JCAR Update

Last Friday, several healthcare-related rules were posted in the Illinois Register.

DPH adopted an emergency amendment to Control of Communicable Diseases Code (77 IAC 690; 44 Ill Reg 13807) effective 8/7/20 for a maximum of 150 days regarding JCAR's recent mask enforcement action for organizations and businesses.

HFS proposed an amendment to Specialized Health Care Delivery Systems (89 IAC 146; 44 Ill Reg 13629) implementing PA 101-10, which establishes new reimbursement rates for children's community-based health care centers. Services provided by these centers will be reimbursed at the maximum allowable rate on the HFS fee schedule for these centers (currently, $683 per day or $17 per hour).

Illinois Chamber Annual Meeting Sponsorship Opportunities

The Illinois Chamber's Annual Meeting set for September 24th from 11:00 am to 1:00 pm central time will be virtual this year. The agenda includes an hour devoted to an "All Council Networking Time" and a discussion of Economic Development in Distressed Communities" featuring Charles Evans, President of the Federal Reserve Bank of Chicago, and Timothy Crane, president of Wintrust Financial Corp. Susana Meza, Vice-President of Community Affairs of Wintrust will be the program's moderator.