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HB4968 • 2026
PUBLIC AID-TELEHEALTH SERVICES
This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.
Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.
PUBLIC AID-TELEHEALTH SERVICES
Rule 19(a) / Re-referred to Rules Committee
To Appropriations-Medicaid Subcommittee
Assigned to Appropriations-Health and Human Services Committee
First Reading
Referred to Rules Committee
Filed with the Clerk by Rep. Laura Faver Dias
PUBLIC AID-TELEHEALTH SERVICES
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Full Text of HB4968 Home Legislation Full Text HB4968 - 104th General Assembly Bill Status Full Text Votes Witness Slips Select Menu Bill Status Full Text Votes Witness Slips Printer Friendly Version Introduced Printer Friendly Version Introduced Open PDF 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB4968 Introduced , by Rep. Laura Faver Dias SYNOPSIS AS INTRODUCED: 305 ILCS 5/5-50a new Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services shall provide coverage under the medical assistance program for intensive outpatient services delivered via telehealth when the services: (1) are otherwise covered when provided in person; (2) are medically necessary; (3) are delivered by a provider enrolled in the medical assistance program and acting within the scope of the provider's license, certification, or authorization under State law; and (4) comply with all applicable federal and State telehealth requirements. Provides that intensive outpatient services provided via telehealth shall be subject to the same coverage requirements, utilization management, and reimbursement methodologies as intensive outpatient services provided in person. Sets forth standards for telehealth delivery of intensive outpatient services. Provides that implementation of the provisions is subject to any required federal approval. Effective immediately. LRB104 19589 KTG 33037 b A BILL FOR HB4968 LRB104 19589 KTG 33037 b 1 AN ACT concerning public aid. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 5. The Illinois Public Aid Code is amended by 5 adding Section 5-50a as follows: 6 (305 ILCS 5/5-50a new) 7 Sec. 5-50a. Telehealth delivery of intensive outpatient 8 services. 9 (a) Purpose. To ensure access to medically necessary 10 behavioral health treatment, the medical assistance program 11 shall authorize intensive outpatient services to be provided 12 via telehealth in a manner consistent with existing telehealth 13 coverage under this Code. 14 (b) Definitions. As used in this Section: 15 "Intensive outpatient services" means a structured 16 behavioral health treatment service, delivered at a minimum 3 17 times per week for 9 hours or more, that is more intensive than 18 standard outpatient services and less intensive than partial 19 hospitalization, delivered pursuant to an individualized 20 treatment plan and consistent with Department-established 21 criteria and generally accepted standards of care. 22 "Telehealth" has the meaning given to the term "telehealth 23 services" in Section 5 of the Telehealth Act. HB4968 - 2 - LRB104 19589 KTG 33037 b 1 "Telehealth" includes the delivery of health care services 2 using interactive telecommunications systems, including 3 synchronous audio and video, that allow real-time 4 communication between a patient and a provider. 5 (c) Coverage. Notwithstanding any other provision of law, 6 the Department shall provide coverage under the medical 7 assistance program for intensive outpatient services delivered 8 via telehealth when the services: 9 (1) are otherwise covered when provided in person; 10 (2) are medically necessary; 11 (3) are delivered by a provider enrolled in the 12 medical assistance program and acting within the scope of 13 the provider's license, certification, or authorization 14 under State law; and 15 (4) comply with all applicable federal and State 16 telehealth requirements. 17 (d) Parity. Intensive outpatient services provided via 18 telehealth service under this Section shall be subject to the 19 same coverage requirements, utilization management, and 20 reimbursement methodologies as intensive outpatient services 21 provided in person, in accordance with Section 5-5.25 and 22 Department rules. 23 (e) Standards and safeguards. Telehealth delivery of 24 intensive outpatient services shall: 25 (1) meet the same standards of care as in-person 26 services; HB4968 - 3 - LRB104 19589 KTG 33037 b 1 (2) include informed consent for the use of 2 telehealth, as required by Department rule; 3 (3) ensure compliance with State and federal privacy 4 and confidentiality laws; 5 (4) include protocols for emergency response, 6 continuity of care, and referral to in-person services 7 when clinically appropriate; and 8 (5) not require any in-person elements or services. 9 (f) Rulemaking authority. The Department may adopt rules 10 consistent with Section 5-5.25 that are necessary to implement 11 this Section, including rules governing clinical eligibility, 12 documentation, quality assurance, and program integrity. 13 (g) Federal approval. Implementation of this Section is 14 subject to any required federal approval. 15 Section 99. Effective date. This Act takes effect upon 16 becoming law. 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