Summary as Introduced
Provides that the Act may be referred to as the Mental Health Equity Access and Prevention Act. Amends the Department of Public Health Powers and Duties Law. Provides that subject to appropriation, the Department of Public Health shall undertake a public educational campaign to bring broad public awareness to communities across the State on the importance of mental health and wellness. Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2025 shall cover all medically necessary out-of-network mental health visits, treatment, and services provided by a mental health provider or facility. Provides that 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 2 annual mental health prevention and wellness visits for children and for adults. Provides that 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 not require the diagnosis of a mental, emotional, or nervous disorder or condition to establish medical necessity for mental health care, services, or treatment. Provides that the Department of Insurance shall contract with an independent third party with expertise in analyzing commercial insurance premiums and costs to perform an independent analysis of the impact of the coverage of services pursuant to the provisions has had on insurance premiums. Provides that the Department shall adopt any rules necessary to implement the provisions by no later than October 31, 2024. Makes other changes. Effective immediately.
Staff Analysis
Provides that the Act may be referred to as the Mental Health Equity Access and Prevention Act. Amends the Department of Public Health Powers and Duties Law. Provides that subject to appropriation, the Department of Public Health shall undertake a public educational campaign to bring broad public awareness to communities across the State on the importance of mental health and wellness. Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2025 shall cover all medically necessary out-of-network mental health visits, treatment, and services provided by a mental health provider or facility. Provides that 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 2 annual mental health prevention and wellness visits for children and for adults. Provides that 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 not require the diagnosis of a mental, emotional, or nervous disorder or condition to establish medical necessity for mental health care, services, or treatment. Provides that the Department of Insurance shall contract with an independent third party with expertise in analyzing commercial insurance premiums and costs to perform an independent analysis of the impact of the coverage of services pursuant to the provisions has had on insurance premiums. Provides that the Department shall adopt any rules necessary to implement the provisions by no later than October 31, 2024. Makes other changes. Effective immediately.
House Amendment 2: Replaces everything after the enacting clause. Reinserts the provisions of the introduced bill with the following changes. Creates the Mental Health and Wellness Act (rather than the Mental Health Equity Access and Prevention Act). In provisions concerning coverage of no-cost mental health prevention and wellness visits, provides that a mental health prevention and wellness visit shall be in addition to an annual physical examination. Provides that the Department of Insurance shall update current procedural terminology codes through adoption of rules if the codes listed in the provisions are altered, amended, changed, deleted, or supplemented. Provides that a mental health prevention and wellness visit may be incorporated into and reimbursed within any type of integrated primary care service delivery method. Provides that the Department shall adopt any rules necessary to implement the provisions by no later than October 31, 2024 (rather than 2023). Removes provisions concerning coverage of out-of-network mental health care, provisions concerning coverage of medically necessary mental health care for individuals not diagnosed with a mental health disorder, and provisions concerning analysis of mental health care coverage on insurance premiums. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code and the School Code. Makes other changes. Effective immediately.