Amends the Illinois Health Insurance Portability and Accountability Act. Defines "grandfathered health plan". Provides that, except for grandfathered health plans, a health insurance issuer in the individual, small group, or large group market shall not deny coverage to an individual or employer due to the individual's or employer's failure to pay premiums owed under a prior policy, certificate, or contract of insurance. Specifies that nothing in the provisions concerning past-due premiums prohibits a health insurance issuer from pursuing the collection of past-due premiums from an individual or employer by any other means permitted by law. Effective immediately.
Amends the Illinois Dental Practice Act. Provides that "community health center" means a migrant health center, community health center, health care program for the homeless or for residents of public housing supported under the federal Public Health Service Act, or FQHC, including an FQHC Look-Alike, as designated by the U.S. Department of Health and Human Services, that operates at least one federally designated primary health care delivery site in Illinois. Provides that "physician" means a person licensed under the Medical Practice Act of 1987 to practice medicine in all of its branches and does not include a chiropractic physician. In provisions concerning acts constituting the practice of dental hygiene, provides that a public health dental hygienist may not administer local anesthesia except as provided in the amendatory provisions. Provides that a dental hygienist practicing in a community health center may administer local anesthetics upon the successful completion of a training program approved by the Department and under the general supervision of a dentist as long as the community health center: (i) has adopted written policies and procedures establishing supervision by a dentist or physician at the time the local anesthetics are administered, and (ii) ensures that a dentist or physician is physically present in the clinic at the time the local anesthetics are administered.
Amends the Medical Assistance Article of the Illinois Public Aid Code. Removes provisions requiring the Department of Healthcare and Family Services to: (i) establish benchmarks for hospitals to measure and align payments to reduce potentially preventable hospital readmissions, inpatient complications, and unnecessary emergency room visits; (ii) publish provider-specific historical readmission data and anticipated potentially preventable targets 60 days prior to the start of the program; and (iii) adopt policies and rates of reimbursement for readmission services and other payments.
Amends the Developmental Disability and Mental Disability Services Act. Provides that in one's "own home" means that an adult with a mental disability lives alone; or that an adult with a mental disability is in full-time residence with his or her parents, legal guardian, or other relatives; or that an adult with a mental disability is in full-time residence in a setting not subject to licensure under the Nursing Home Care Act, the Specialized Mental Health Rehabilitation Act of 2013, the ID/DD Community Care Act, the MC/DD Act, or the Child Care Act of 1969 with 5 (rather than 3) or fewer other adults unrelated to the adult with a mental disability who do not provide home-based services to the adult with a mental disability.
Amends the Illinois Insurance Code. Provides that coverage for treatment in a residential treatment center shall include residential coverage for the diagnosis and treatment of substance use disorders. Provides that this coverage shall include unlimited medically necessary treatment for substance use disorder treatment services provided in residential settings. Prohibits the coverage from applying financial requirements or treatment limitations to residential substance use disorder benefits that are more restrictive than the predominant financial requirements and treatment limitations applied to other medical and surgical benefits covered by the policy. Sets forth provisions concerning cost sharing; application of coverage requirements; prior authorization; clinical review; discharge plans; other forms of utilization review; and the criteria for medical necessity determinations.
Amends the Illinois Insurance Code. Provides that any individual or group policy of accident or health insurance that is delivered, extended, renewed, or modified after January 1, 2026 must provide coverage for at least one 6-month supply of each of the following for each infant covered by the policy: an early egg allergen introduction dietary supplement prescribed by a health care practitioner; and an early peanut allergen introduction dietary supplement prescribed by a health care practitioner. Provides that the coverage shall be provided without cost-sharing, except to the extent the cost-sharing limitation would cause a catastrophic plan to fail to be treated as a catastrophic plan under the Patient Protection and Affordable Care Act or would keep a high-deductible health plan from being treated as a high-deductible health plan or to the extent the cost-sharing limitation would disqualify the plan from a health savings account. Amends the State Employees Group Insurance Act of 1971 and the Medical Assistance Article of the Illinois Public Aid Code to require that coverage. Effective immediately.
Amends the Illinois Insurance Code. Provides that a group or individual policy of accident or health insurance that is issued, amended, delivered, or renewed on or after January 1, 2027 shall not charge insured persons a copayment as a method of cost-sharing or include a deductible greater than $1,000. Provides that yearly out-of-pocket expenses for insured persons must be less than or equal to $1,500. 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.
Creates the Holistic Overdose Prevention and Equity Act. Creates the Harm Reduction Program Board, with certain requirements. Provides that the Department of Public Health shall issue grants to harm reduction providers, with certain requirements. Establishes a Chief Harm Reduction Officer within the Department. Provides for a place-based approach to harm reduction pilot program. Provides for local government training and continuing education. Provides that naloxone shall be made readily available to all staff and individuals in prisons and jails, with certain requirements. Provides for medication for opioid use disorder and fentanyl testing. Restricts the use of abstinence-only or sobriety requirements to housing, with certain requirements. Limits home rule powers. Makes findings. Defines terms. Amends the Department of Professional Regulation Law of the Civil Administrative Code of Illinois, the Counties Code, the County Jail Act, the Unified Code of Corrections, the Hospital Licensing Act, and the Overdose Prevention and Harm Reduction Act to make conforming changes.
Amends the Substance Use Disorder Act. Requires the Department of Human Services to establish a mechanism to collect research and data regarding overdose prevention sites (OPSs) and prepare a report for the General Assembly within 12 months after the effective date of the amendatory Act. Provides that the report shall contain information on (1) current research on the effectiveness of an OPS as an overdose prevention strategy; (2) OPS best practices for staffing, placement, and activities; and (3) the benefits and challenges of different OPS models - structures and settings. Requires the Department, in collaboration with people with lived experience, to develop a pilot service, subject to available funding, aimed at saving the lives of people who use substances that shall include the establishment of at least one OPS. Requires the pilot OPSs to offer people, who are most likely to use drugs in public, unobserved, high-risk, and unsanitary locations, a safe space to use pre-obtained substances and connect to community supports or other existing treatment and recovery programs, harm reduction services, and health care. Contains provisions concerning certain principles pilot OPSs must abide by; OPS staffing and location requirements; pilot OPS services; and other matters. Permits the Department to approve an entity to operate a pilot program in one or more jurisdictions. Grants criminal and civil immunity to persons who use pilot OPSs services; pilot OPS staff; and any real property owner upon which the OPS site is located or operates. Contains provisions on public awareness outreach; OPS reporting requirements; home rule exemption; and other matters. Effective immediately.
Amends the Illinois Insurance Code. Provides that any plan of health or accident insurance that provides coverage for prescription drugs and that is issued amended, renewed, or delivered on or after January 1, 2027 must include any amount paid by the insured or paid on behalf of the insured by another person when calculating the insured's overall contribution to any out-of-pocket maximum or other cost-sharing requirement. Provides an exception for a high-deductible health plan to the extent that providing coverage would disqualify that plan from eligibility for a health savings account.
