Healthcare

Amends the Hospital Licensing Act. Provides that, upon request by a patient, a hospital must transfer the patient to the requested health care facility, regardless of whether the facility is part of the hospital's health care network. Effective immediately.

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 Hospital Licensing Act. Provides that a hospital that operates an emergency department shall not use health care kiosks in the hospital's emergency department to assess or determine a patient's medical state, to determine the priority level of a patient's injuries or illness, or to otherwise triage patients. Provides that health care kiosks may be used for data entry of a patient's personal identifying information and billing information in place of paper forms. Amends the University of Illinois Hospital Act to set forth conforming requirements for a University of Illinois Hospital emergency department. Effective January 1, 2027.

Amends the Pharmacy Practice Act. Defines "retail pharmacy". Provides that a retail pharmacy that, on average, receives 150 or more prescription drug orders during its operating hours must satisfy one of the following requirements during all times that the pharmacy remains open for the transaction of business: (1) a pharmacist is present at the location and working in his or her capacity as a pharmacist, or (2) a registered pharmacy technician, registered certified pharmacy technician, student pharmacist, or other supportive staff that is authorized to sell prescriptions is present at the location and working in that capacity pursuant to provisions concerning pharmacy working conditions.

Creates the Health Care Availability and Access Board Act. Establishes the Health Care Availability and Access Board to protect State residents, State and local governments, commercial health plans, health care providers, pharmacies licensed in the State, and other stakeholders within the health care system from the high costs of prescription drug products. Contains provisions concerning Board membership and terms; staff for the Board; Board meetings; circumstances under which Board members must recuse themselves; and other matters. Provides that the Board shall perform the following actions in open session: (i) deliberations on whether to subject a prescription drug product to a cost review; and (ii) any vote on whether to impose an upper payment limit on purchases, payments, and payor reimbursements of prescription drug products in the State. Permits the Board to adopt rules to implement the Act and to enter into a contract with a qualified, independent third party for any service necessary to carry out the powers and duties of the Board. Creates the Health Care Availability and Access Stakeholder Council to provide stakeholder input to assist the Board in making decisions as required by the Act. Contains provisions concerning Council membership, member terms, and other matters. Provides that the Board shall adopt the federal Medicare Maximum Fair Price as the upper payment limit for a prescription drug product intended for use by individuals in the State. Prohibits the Board from creating an upper payment limit that is different from the Medicare Maximum Fair Price for the prescription drug product that has a Medicare Maximum Fair Price. Requires the Board to implement an upper payment limit that is the same as the Medicare Maximum Fair Price no sooner than the Medicare implementation date. Provides that Medicare Part C and D plans are not required to reimburse at the upper payment limit. Provides that the Attorney General may enforce the Act and may pursue any available remedy under State law when enforcing the Act. Effective 180 days after becoming law.

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 Ban on Harmful Supplements for Minors Act. Prohibits the sale of diet pills or dietary supplements for weight loss or muscle building to any person under 18 years of age, unless that individual has a prescription. Provides for responsibilities of retail establishments. Provides for responsibilities of delivery sellers. Provides that the Attorney General may apply for a special proceeding to issue an injunction upon notice to the defendant of not less than 5 days, with certain requirements. Provides that any person who violates any provision of this Act is liable for a civil penalty of up to $1,000 per violation. Provides for an affirmative defense based upon compliance with the Act, with certain requirements. Provides for rulemaking by the Attorney General or the Department of Public Health to determine additional dietary supplements or drugs that are subject to the Act. Provides that the Department of Public Health may adopt other rules as necessary to implement this Act. Defines terms.

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.