Summer 2021 | Issue 47
Legislative Update: Mental Health Policy Takes Central Stage in Springfield
By: Mark Peysakhovich
IPS Legislative Consultant
As the mental health impacts of the pandemic continue to reverberate, society’s very perception of the concept of “mental health” is evolving in real time. Over a period of a month, it became ok to not be ok. Friends began to confide in each other about mental health challenges that had previously been unmentionable. Mental health struggles that had been too personal or embarrassing or painful to discuss before, came up in social media posts. As people came forward and asked for help, the challenges of Illinois’ tattered patchwork of mental health services came into stark focus.
When the magnitude of the problem became clear, state officials realized that major reforms and investments in mental health had to be made. While much remains to be done, the recent session of the Illinois General Assembly resulted in an unprecedented list of legislation passed to make Illinois’ mental health services more accessible, more effective, and more humane. The scope of relevant legislation passed this session touched on broad swaths of state policy, covering areas such as education, insurance, emergency medical services, criminal justice reform, Medicaid, law enforcement, housing and social services, drug treatment as well as the state budget. The legislative advancements included fixes to several critically urgent long-term problems that have frustrated patients and psychiatrists for a long time, including:
Telehealth services have provided a much-needed link – a lifeline – during the pandemic. Tele-mental health services proved to be particularly popular and effective. For psychiatrists, it is a force multiplier, enabling them to serve patients anywhere. With a unanimous vote of both Houses, the legislature sent House Bill 3308, as amended, to the Governor’s desk for his signature. Notably, this legislation actually makes the mental health requirements permanent while other coverage mandates sunset in a few years. We are grateful to the legislation’s lead sponsors, state Rep. Thaddeus Jones and state Senator Napoleon Harris as well as many other legislative champions for making sure tele-mental health is here to stay! Here are some of the bill’s main provisions:
- 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 professionals.
Mental health and addiction parity took a huge step in Illinois when both Houses of the General Assembly sent House Bill 2595 to the Governor’s desk for his signature with a unanimous vote. This bill will increase access to care and ensure that health plans in Illinois equitably cover mental health and addiction treatment. Provisions in the law require coverage for, “the medically necessary treatment of mental, emotional, nervous, or substance use disorders or conditions consistent with” relevant parity requirements. If enacted, this law will allow doctors and scientists to determine what constitutes “medical necessity” rather than leaving it up to insurance company lawyers and accountants to make life and death decisions. This legislation’s success depended on a lot of time, work, diplomacy, and expertise from state Rep. Deb Conroy and state Sen. Laura Fine, who are the legislature’s champions and thought leaders on mental health issues.
The Prior Authorization Reform Act, House Bill 711, which also unanimously passed both Houses of the Illinois General Assembly, was another major positive step towards better access to care and better health outcomes for patients. As psychiatrists know only too well, authorization policies require physicians to seek approval from insurers, oftentimes through separate utilization review entities, to ensure that the care they recommend for their patients will be covered. Such requirements can delay necessary care, and sometimes prevent patients from accessing care at all. The number and type of services subject to prior authorization requirements have been steadily increasing, to the point of overuse and misuse that results in harm to Illinois patients. If signed into law by the Governor, this measure will establish much needed guardrails to ensure that patient care is not disrupted or delayed by inappropriate, excessive, or confusing prior authorization policies. The bill establishes requirements for transparency, clinical validity, and responsiveness by insurers or their designees when implementing prior authorization programs. We are grateful for the leadership of legislative sponsors, House Majority Leader Greg Harris and state Sen. Linda Holmes, for getting this difficult task done!
While this was an unprecedented legislative session for mental health in Illinois, there are a number of issues that remain unfinished. One particular ongoing concern for IPS is pending legislation that would dangerously expand psychologists’ authority to prescribe to kids and seniors. We look forward to telling you more about this and some of the other major legislative developments in future articles.
***FOR NOW, HERE’S WHAT YOU CAN DO TO MAKE SURE THESE MAJOR BILLS GET ACROSS THE FINISH LINE: Go to Governor Pritzker’s online Issue Feedback Form and leave a brief note asking the Governor to “Please sign House Bills 711, 2595 and 3308 into law as soon as possible.”
Many thanks to all of the IPS members who take time to advocate for important issues! Your voice is heard in Springfield!