Appropriations: Health and Human Services

Urges the Illinois Department of Healthcare and Family Services (HFS) to ensure that pharmacies participating in Medicaid managed care networks are reimbursed for covered outpatient prescription drugs at a rate no less than the reimbursement that would be paid under the Illinois Medicaid fee-for-service pharmacy program. Urges HFS to implement such reimbursement parity through Medicaid managed care organization contracts and pharmacy benefit manager agreements. Urges HFS to monitor and report to the General Assembly on the impact of reimbursement parity on pharmacy network participation, patient access to medications, and pharmacy closures within the State. Encourages HFS to evaluate the effect of reimbursement parity on pharmacy deserts, rural health access, and Medicaid beneficiary access to pharmacist-provided patient care services.

Amends the Administration Article of the Illinois Public Aid Code. Provides that subject to federal approval if required, a household that includes one or more veterans or members of the armed forces shall be considered categorically eligible for Supplemental Nutrition Assistance Program benefits if the gross income of such a household is at or below 200% of the nonfarm income poverty guidelines.

Creates the Psychiatric Residential Treatment Facilities (PRTF) Act. Requires the Department of Healthcare and Family Services to establish an Illinois Psychiatric Residential Treatment Facilities (PRTF) program that is family-driven, youth-guided, and trauma-informed, and includes youth and family involvement in all aspects of care planning. Requires the Department to submit a State Plan Amendment, by January 1, 2026, to the Centers for Medicare and Medicaid Services to establish coverage of federally authorized, medically necessary inpatient psychiatric services delivered by a certified PRTF to medical assistance beneficiaries under 21 years of age. Provides that the Department shall adopt rules to implement the PRTF program that at a minimum shall include: (i) certification and participation requirements for PRTF providers in compliance with all applicable federal laws, regulations, requirements, and policies; (ii) monitoring and oversight of PRTF services; (iii) a limit on allowable beds at any one PRTF, not to exceed 40 total beds; and other matters. Requires the Department to establish, and update as needed, a methodology for completing a statewide PRTF capacity analysis for the purposes of identifying capacity needs for PRTF services under the Illinois Medical Assistance Program. Requires the Department to establish a PRTF Advisory Committee responsible for reviewing and providing guidance on the Department's policies and implementations of the PRTF program. Requires the Department to publish on its website counts of reported emergency safety interventions and serious occurrences by State fiscal year and quarter. Makes conforming changes to the Specialized Mental Health Rehabilitation Act of 2013, the Child Care Act of 1969, and other various Acts. Effective immediately.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the medical assistance program shall be subject to provisions of the Illinois Insurance Code concerning telehealth services. Makes a conforming change in the Illinois Insurance Code.

Amends the Cancer Clinical Trial Participation Program Act. Changes the short title of the Act to the Clinical Trial Participation Program Act. Throughout the Act, replaces references to "cancer clinical trial" with references to "clinical trial" and makes conforming changes. Provides that "clinical trial" includes a voluntary research study conducted on people and designed to answer specific questions about the safety or effectiveness of a drug, vaccine, therapy, medical device, medical diagnostic, or new way of using an existing treatment to treat or diagnose a condition. Defines "condition". Makes other changes. Effective immediately.