Amends the Substance Use Disorder Act. Expands the Act to include counseling, referral, and other supportive services for persons with gambling disorders. Requires the Department of Human Services to collaborate with the State Board of Education in the development of instructional resources for substance use or gambling disorder prevention and awareness that may be used by school districts. Permits the Department to cooperate with institutions of higher education in the development of programs on substance use and gambling disorders. Requires the Department to establish a toll-free hotline and website that provides crisis counseling and referral services for families experiencing difficulty related to a gambling disorder. Requires the Department to promote public awareness regarding the impact of gambling disorders on individuals, families, and communities. Makes other changes.
Amends the Assisted Living and Shared Housing Act. In provisions concerning assessment and service plan requirements, provides that a comprehensive assessment shall be completed by a physician, a physician assistant, or an advanced practice registered nurse (instead of only a physician). In provisions concerning Alzheimer and dementia programs, provides that an assessment must be approved by a resident's physician, physician assistant, or advanced practice registered nurse (instead of only a physician) and shall occur prior to acceptance for residency, annually, and at such time that a change in the resident's condition is identified by a family member, staff of the establishment, or the resident's physician, physician assistant, or advanced practice registered nurse (instead of only a physician).
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 for eye medication under the provisions of those Acts pursuant to the Topical Eye Medication Prescription Act.
Amends the Counties Code and the Illinois Municipal Code. Provides that county medical examiners and coroners are first responders for the purposes of provisions requiring a county to provide health insurance coverage for its employees who are first responders without imposing a deductible, coinsurance, copayment, or any other cost-sharing requirement.
Amends the Rehabilitation of Persons with Disabilities Act. Requires direct service workers employed by the Department of Human Services, or an agency contracted with the Department, to provide services under the Home Services Program to complete at least 2 hours of dementia training at the start of their employment and annually thereafter. Requires the training to cover subjects concerning Alzheimer's disease and dementia, safety risks, and communication and behavior. Requires the Department to provide contractors with dementia training curriculum on the required subjects. Provides that any other laws or rules that impose more rigorous dementia training for direct service workers under the Home Services Program shall apply. Exempts from the training requirements direct service workers who provide proof that they obtained equivalent dementia training in compliance with another law or rule. For personal assistants covered by a collective bargaining agreement, requires the Department to establish, in consultation with the joint training committee created under the collective bargaining agreement, different parameters and specific topics for curriculum covering dementia training.
Amends the School Code. Allows a school district, public school, charter school, or nonpublic school to authorize a school nurse or trained personnel to: (1) provide undesignated ready-to-use glucagon to authorized personnel to administer ready-to-use glucagon to a student that meets the student's prescription on file; (2) administer undesignated ready-to-use glucagon that meets the prescription on file to any student who has a plan that authorizes the use of ready-to-use glucagon; and (3) administer undesignated ready-to-use glucagon to any person that the school nurse or trained personnel believes in good faith is having a severe hypoglycemia emergency. Makes conforming changes regarding liability, where and when the undesignated ready-to-use glucagon may be administered, supply maintenance, notification of administration to the student's parent or guardian or emergency contact, training, and reports of administration to the State Board of Education, General Assembly, and Department of Public Health.
Amends the Illinois Insurance Code. Provides that every insurer that amends, delivers, issues, or renews a group or individual policy or certificate of disability insurance or disability income insurance shall ensure parity for the payment of mental, emotional, nervous, or substance use disorders or conditions. Changes the definition of "treatment limitation" to include benefit payments under disability insurance or disability income insurance.
Amends the Limited Health Service Organization Act. Makes changes to defined terms. In provisions concerning the offering of a point-of-sale contract by a limited health service organization (LHSO), removes a provision requiring the LHSO to include an annual maximum benefit allowance not to exceed $2,500 per year that is separate from any limits or allowances applied to in-plan services. Provides that, if an LHSO expends in any calendar quarter more than 20% of its total limited health services expenditures for all its members for out-of-plan covered services, then specified limitations shall not apply subject to the LHSO minimum capital and surplus requirements applicable to a life, accident, and health insurance company. Makes other changes.
Amends the Illinois Speech-Language Pathology and Audiology Practice Act. Allows a speech-language pathologist to diagnose autism spectrum disorders if: (1) the child is under 3 years of age; and (2) the speech-language pathologist is trained in autism diagnostic evaluation methods as part of the curriculum of an approved program, through worksite training, or through continuing education. Provides that if a diagnosis requires a plan of care that includes elements that are outside the scope of practice of a speech-language pathologist, the speech-language pathologist must refer the patient to the appropriate medical personnel for further evaluation or management. Makes conforming changes in the Medical Assistance Article of the Illinois Public Aid Code, and provisions of the Illinois Insurance Code concerning autism spectrum disorders. Effective July 1, 2027.
Creates the Transparency in Downcoding Act. Provides that the Act applies to certain policies of health insurance amended, delivered, issued, or renewed on or after the effective date of the Act, except for employee or employer self-insured health benefit plans under the federal Employee Retirement Income Security Act of 1974 and health care provided pursuant to the Workers' Compensation Act or the Workers' Occupational Diseases Act. Prohibits a health insurance issuer from using an automated process, system, or tool to downcode a claim; from downcoding a claim based solely on the reported diagnosis codes; and from using downcoding practices in a targeted or discriminatory manner against physicians who routinely treat patients with complex or chronic conditions. Requires downcoding decisions to be made by a physician licensed to practice medicine in all its branches in any United States jurisdiction and of the same or similar specialty as a physician who typically manages the medical condition or disease. Sets forth provisions concerning notification requirements for downcoded claims; the appeal process for downcoded claims; enforcement by the Department of Insurance; and penalties. Provides that any pattern or practice of discriminatory downcoding identified by the Director of Insurance or another regulatory authority shall be subject to enforcement actions, including fines, restitution, or suspension of the health insurance issuer's license in this State. Effective immediately.
