HB3977 103RD GENERAL ASSEMBLY

LRB103 26962 KTG 53327 b

103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB3977

Introduced 2/21/2023, by Rep. Lindsey LaPointe

SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-47 new

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that for purposes of preventing a potential mental health diagnosis when mental health symptoms are present and to enable early treatment, Therapy and Counseling - Brief Intervention Services (Code H0004 TF TL) shall be covered under the medical assistance program for children under 21, and for adults ages 21 and older, who are otherwise eligible for medical assistance. Provides that completion of an Integrated Assessment and Treatment Planning service shall not be required (given the short duration of services). Provides that, at a minimum, up to 8 clinical sessions not to exceed 90 minutes per session shall be permitted. Provides that such services shall be permitted to be delivered by a licensed practitioner of the healing arts; or a qualified mental health professional or mental health professional under the direction of a licensed practitioner of the healing arts. Sets forth certain billing codes that must be used when billing for therapy and counseling services. Requires the Department of Healthcare and Family Services to apply for federal approval if necessary. Grants the Department rulemaking authority. Effective immediately.

A BILL FOR

AN ACT concerning public aid.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Illinois Public Aid Code is amended by adding Section 5-47 as follows:

(305 ILCS 5/5-47 new)

Sec. 5-47. Mental health prevention services for children and adults. For purposes of preventing a potential mental health diagnosis when mental health symptoms are present and to enable early treatment, Therapy and Counseling - Brief Intervention Services (Code H0004 TF TL) shall be covered under the medical assistance program for children under 21, and for adults ages 21 and older, who are otherwise eligible for medical assistance. Such services shall be deemed to be medically necessary when performed for the immediate amelioration of an individual's presenting clinical issues, meaning a mental health diagnosis is not required for such services. Completion of an Integrated Assessment and Treatment Planning service shall not be required (given the short duration of services). At a minimum, up to 8 clinical sessions not to exceed 90 minutes per session shall be permitted. Such services shall be permitted to be delivered by a licensed practitioner of the healing arts; or a qualified mental health professional or mental health professional under the direction of a licensed practitioner of the healing arts.

(1) Coding. The following credentialed individuals shall bill for therapy and counseling - brief intervention using the following codes:

(A) Licensed practitioners of the healing arts shall bill under Code H0004 TF TL.

(B) Qualified mental health professionals shall bill under Code H0004 HO TL.

(C) Mental health professionals shall bill under Code H0004 HN TL.

(2) Federal approval and rulemaking authority. If the Department of Healthcare and Family Services determines that federal approval is required for implementation of this Section, an application for federal approval shall be filed within 3 months after the effective date of this amendatory Act of the 103rd General Assembly. If the Department determines an administrative rule change is necessary for purposes of this Section, such rule shall be adopted within 6 months after the effective date of this amendatory Act of the 103rd General Assembly or, if necessary, within 6 months after the Department receives federal approval, whichever comes last.

Section 99. Effective date. This Act takes effect upon becoming law.