Healthcare

Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed after the effective date of the amendatory Act shall provide coverage for hippotherapy and other forms of therapeutic riding. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, and the Health Maintenance Organization Act.

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, 2026 shall provide coverage for the cost of a karyotype test or related hormone testing to diagnose Klinefelter syndrome. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code to require coverage under those provisions.

Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Provides that the Department of Public Health is vested with the duty and responsibility for oversight and training connected with the use of the Department of Public Health Uniform POLST form at all hospitals, healthcare facilities, and other facilities and providers that use the Department of Public Health Uniform POLST form. Provides that the Department of Public Health shall develop, in consultation with stakeholders determined by the Director of Public Health, training resources to support informed decisions and accurate completion of the Department of Public Health Uniform POLST form. Provides that the Department of Public Health shall establish a simple, efficient, and effective process to ensure oversight of and accountability for training to support informed decisions and accurate completion of the Department of Public Health Uniform POLST form at all hospitals, healthcare facilities, and other facilities and providers that use the Department of Public Health Uniform POLST form. Provides that, in consultation with various organizations, the Department of Public Health shall adopt rules implementing these policies no later than 2 years after the effective date of this amendatory Act. Provides that the Department of Public Health, in connection with implementing these policies, may also consult with the Office of the Secretary of State with respect to the Advance Directive Registry established by the Secretary of State.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Repeals provisions that require: (i) the Department of Healthcare and Family Services to consult with stakeholders and General Assembly members for input on a plan to develop enhanced Medicaid rates for substance use disorder treatment and mental health treatment in underserved communities; and (ii) the Department of Healthcare and Family Services and the Department of Human Services to collaborate to review coverage and billing requirements for substance use prevention and recovery and mental health services with the goal of identifying disparities and streamlining coverage and billing requirements to reduce the administrative burden for providers and medical assistance beneficiaries. Effective January 1, 2026.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires hospitals and birthing centers to adopt and maintain written policies and procedures authorizing a patient enrolled in the medical assistance program to select an Illinois Medicaid certified and enrolled doula of the patient's choice to accompany the patient within the facility's premises for the purposes of providing support before, during, and after labor and childbirth, and during the patient's entire postpartum stay. Provides that the doula shall be considered part of the patient's care team and shall not be counted as a support person or against any guest quota. Requires hospitals and birthing centers to provide a written copy of their policies and procedures to maternity patients, the facilities' maternity health care providers, and any other person at the patient's request. Requires publication of the written policies on each facility's website. Contains provisions concerning hospital and birthing center liaisons and doulas certification acknowledgment requirements. Permits the Department of Healthcare and Family Services and the Department of Public Health to establish standing recommendations to meet Centers for Medicare and Medicaid Services requirements and ensure access to preventive services, including Medicaid-covered maternal and reproductive health supports and services.

Creates the Artificial Intelligence Systems Use in Health Insurance Act. Provides that the Department of Insurance's regulatory oversight of insurers includes oversight of an insurer's use of AI systems to make or support adverse determinations that affect consumers. Provides that any insurer authorized to operate in the State is subject to review by the Department in an investigation or market conduct action regarding the development, implementation, and use of AI systems or predictive models and the outcomes from the use of those AI systems or predictive models. Provides that an insurer authorized to do business in Illinois shall not issue an adverse consumer outcome with regard to the denial, reduction, or termination of insurance plans or benefits that result solely from the use or application of any AI system or predictive model. Provides that any decision-making process for the denial, reduction, or termination of insurance plans or benefits that results from the use of AI systems or predictive models shall be meaningfully reviewed, in accordance with review procedures determined by Department rules, by an individual with authority to override the AI systems and determinations. Authorizes the Department to adopt emergency rules to implement the Act and to adopt rules concerning standards for full and fair disclosure of an insurer's use of AI systems. Makes a conforming change in the Illinois Administrative Procedure Act.

Amends the Children and Family Services Act. Provides that all youth in care shall be assigned a mental health provider to manage their mental health care needs. Requires a youth's mental health provider to visit the youth and conduct a well-being assessment within 30 days after the youth is removed from his or her home and placed in the temporary custody or guardianship of the Department of Children and Family Services. Provides that additional follow-up visits and well-being checks shall be scheduled and conducted until the youth is no longer under the custody or guardianship of the Department. Provides that any mental health care services provided to the youth shall be in addition to any care or services the youth receives from his or her primary care provider. Grants the Department rulemaking authority.

Urges the State to increase reimbursement rates, state grants and contracts, and the minimum overhead allowance to meet the rising costs of providing essential human services in Illinois and supporting the workers who deliver those services.

Expresses opposition to the Trump healthcare cuts, which fundamentally undermine the basic dignity and financial security of working families across the country. Calls upon the United States Senate to immediately table the Trump healthcare cuts bill and instead pursue reforms such as the Illinois' Healthcare Protection Act to make healthcare more accessible and more affordable.

Amends the Managed Care Reform and Patient Rights Act. Provides that any intergovernmental joint self-insurance pool providing health benefits under a specified provision of the Intergovernmental Cooperation Act shall not be included under the definition of "health care plan". Effective immediately.