Healthcare

Amends the Medicaid Technical Assistance Act. Requires the Medicaid Technical Assistance Center to collaborate with public and private partners throughout the State to identify, establish, and maintain best practices necessary for health providers to ensure their capacity to participate in the Illinois Medical Assistance Program (rather than ensure their capacity to participate in HealthChoice Illinois or YouthCare). Requires the Medicaid Technical Assistance Center to promote equitable delivery systems, remaining committed to the principle that all Medicaid recipients have accessible and equitable physical and mental health care services. Removes provisions concerning the Medicaid Technical Assistance Center's administration of network adequacy reports, and instead requires the Medicaid Technical Assistance Center to administer a network recruitment plan. Provides that by using reports and data provided by the Department of Healthcare and Family Services’ External Quality Review Organization on network adequacy, provider service deserts, and health care disparities by race and ethnicity, the Medicaid Technical Assistance Center shall propose for Department review and approval an annual plan for recruiting providers to participate in the Illinois Medical Assistance Program and report on outcomes of its recruitment efforts to the Department for continuous improvement. Repeals a provision requiring the Department to maximize federal financial participation for any moneys appropriated to the Department for the Medicaid Technical Assistance Center and to deposit all federal financial participation funds into the Medicaid Technical Assistance Center Fund. Repeals a provision creating the Medicaid Technical Assistance Center Fund. Amends the State Finance Act. Provides for the dissolution of the Medicaid Technical Assistance Center Fund on July 1, 2026, or as soon thereafter as practical, after the transfer of all remaining funds into the Healthcare Provider Relief Fund. Effective July 1, 2026.

Amends the Mental Health and Developmental Disabilities Administrative Act. Provides that notwithstanding any other law or rule to the contrary, a State-operated developmental center funded, certified, or licensed by the Department of Human Services shall readmit, upon request, any former resident who transferred to and currently receives services at a licensed community-integrated living arrangement, if the former resident consents or if the former resident has a guardian with placement authority and that guardian consents based on a determination that the former resident's medical needs cannot be met by the program of services administered by the community-integrated living arrangement. Effective immediately.

Amends the Illinois Insurance Code. In a provision requiring policies of group accident and health insurance to provide coverage for certain examination and testing services provided to a victim of specified criminal offenses, prohibits the policy from imposing a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage provided, except to the extent that the coverage would disqualify a high-deductible health plan from eligibility for a health savings account under the Internal Revenue Code. Effective January 1, 2026.

Amends the Nursing Home Care Act and the Assisted Living and Shared Housing Act. Requires the Department of Public Health to hold semiannual joint training sessions for surveyors, nursing home providers, and assisted living establishment providers. Provides that the Department shall include the State long-term care ombudsman, or the State long-term care ombudsman's designee, and representatives of each nursing home provider association and assisted living provider association in the State in the planning process to create the topics and content of the joint training sessions as well as the coordination and presentations for the joint training sessions. Provides that, at least annually, a joint training session shall include, but not be limited to, regional citation patterns relating to complaints, standards, and outcomes in the nursing home and assisted living survey process. Requires the Department to develop standardized training for establishments to prevent common citations in the assisted living survey process.

Urges the Illinois Department of Human Services and the Pritzker Administration to delay cuts to Direct Service Professional (DSP) service hours set to begin January 1,2026, until such time as the State is prepared to implement the "Zero Hour" Staffing Model, to protect the services depended on by individuals with intellectual and developmental disabilities (I/DD).

Amends the Substance Use Disorder Act. In provisions requiring the Department of Human Services to establish a public education program regarding gambling disorders, requires the program to (i) promote public awareness to create a gambling informed State regarding the impact of gambling disorders on individuals, families, and communities and the stigma that surrounds gambling disorders and (ii) use screening, crisis intervention, treatment, public awareness, prevention, in-service training, and other innovative means to decrease the incidents of suicide attempts related to a gambling disorder or gambling issues. Requires the Department to determine a statement regarding obtaining assistance with a gambling disorder, which each licensed gambling establishment owner shall post and each master sports wagering licensee shall include on the master sports wagering licensee's portal, Internet website, or computer or mobile application. Permits the Department: to provide advice to State and local officials on gambling disorders; to support gambling disorder prevention, recognition, treatment, and recovery projects; to collaborate with other community-based organizations, substance use disorder treatment centers, or other health care providers engaged in treating individuals who are experiencing gambling disorder; and to perform other actions. Permits the Department to award grants to create or support local gambling prevention, recognition, and response projects. Makes other changes.

Amends the Mental Health Early Action on Campus Act. Provides that the expert panel designated by the board of trustees to develop and implement policies and procedures shall be comprised of at least 2 administrators, 2 members of faculty, and one mental health professional. Requires each public college or university to provide at least 3 on-site licensed clinical professional counselors or licensed clinical social workers.

Amends the Managed Care Reform and Patient Rights Act. Provides that a health care plan shall provide annually to enrollees and prospective enrollees, upon request, a statement of all basic health care services and all specific benefits and services mandated to be provided to enrollees by State law or administrative rule, highlighting any newly enacted State law or administrative rule. Provides that this requirement can be fulfilled by providing enrollees the most up-to-date accident and health checklist submitted to the Department of Insurance, reflecting statutory health care coverage compliance by the health care plan. Requires the Office of Consumer Health Insurance to post in a prominent location on the Department's publicly accessible website an annual report on the development and implementation of federal, State, and local laws, regulations, and other governmental policies and actions that pertain to the adequacy of health care plans, facilities, and services in the State and summary of all State health insurance benefit related legislation enacted in the prior calendar year that includes, at minimum, a link to the Public Act, the statutory citation, the subject, a brief summary, and the effective date. Amends the Uniform Health Care Services Benefit Information Card Act. Adds a health benefit plan offering dental coverage to the list of plans required to issue a health care benefit information card. Specifies health care benefit information cards may be electronic or physical. Requires uniform health care benefit information to display on the back of the card a statement indicating whether the plan is self-insured or fully funded and if the plan is subject to regulation by the Department of Insurance. Makes other changes.

Creates the Hospitals and Homelessness Support Act. Requires the Office to Prevent and End Homelessness within the Department of Human Services to maintain on its publicly accessible website information on how a hospital or healthcare system may connect a patient experiencing homelessness or otherwise in a vulnerable housing situation with shelter and homeless support services for each continuum of care in the State. Requires the Department to ensure that the information required includes, for each continuum of care, any phone number, email address, physical address, primary agencies, or any other information that may be necessary for a person in that continuum of care territory to begin accessing shelter or other homelessness services. Requires the Department to include, where possible, a specific phone number that a hospital or health care facility may call and specific language to use. Requires the Department to also include on its website a way for the hospital or healthcare system to determine which continuum of care applies based on the physical location of the hospital or healthcare system. Requires other information, all of which must be added to the Department's website by October 31, 2025. Contains provisions concerning annual audits.

Amends the Assisted Living and Shared Housing Act. Makes changes to assessments for admission to establishments and service plan requirements. Requires an establishment to notify the resident and the resident's representative when there is a significant change in the resident's condition that affects the establishment's ability to meet the resident's needs. Prohibits an establishment from terminating or reducing any service without the consent of the resident or the resident's representative for the purpose of making it more difficult or impossible for the resident to remain in the establishment. Adds new requirements for establishments and the Department of Public Health regarding the involuntary termination of residency. Provides that a resident has the right to not be unlawfully transferred or discharged. Makes other changes. Amends the Nursing Home Care Act. Prohibits a resident from being transferred or discharged in violation of the Act. Provides that a resident has the right not to be unlawfully transferred or discharged. Provides for the assessment of a $2,500 fine for a facility that fails to comply with an order to readmit a resident who wishes to return to the facility and is appropriate for that level of care and services provided. Requires a facility that complies with an order to readmit a resident that has been deemed to have been unlawfully discharged to notify the Department within 10 business days after the resident has been readmitted to the facility. Provides that a facility may involuntarily transfer or discharge a resident because the facility is unable to meet the medical needs of the resident, as documented in the resident's clinical record by the resident's physician. Provides that the Department maintains jurisdiction over the transfer or discharge irrespective of the timing of the notice and discharge. Provides that if the Department determines that a transfer or discharge is not authorized, then the Department shall issue a written decision stating that the transfer or discharge is denied. Makes other changes. Effective immediately.