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 Occupational Therapy Practice Act. Requires a licensed occupational therapist or licensed occupational therapy assistant who intends to provide services for individuals, groups, and populations concerning occupational therapy needs without a referral to do so within the licensee's scope of practice. Provides that a referral is not required for the purpose of providing consultations, habilitation services, screenings, education, wellness services, preventions services, environmental assessments, and work-related ergonomic services. Provides that, except for occupational therapy services within the licensee's scope of practice at the time of evaluation and services provided pursuant to provisions concerning when referrals are not required, an occupational therapist shall refer a patient to the patient's treating health care professional of record, or to a health care professional of the patient's choosing if there is no health care professional of record, if the patient meets certain criteria. Provides that an occupational therapist shall refer a patient to the patient's treating health care professional of record, or to a health care professional of the patient's choosing if there is no health care professional of record if the patient does not demonstrate measurable or function improvement after 10 visits (rather than after 10 visits or 15 business days, whichever occurs first).
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 Department of Human Services Act. Requires the Department of Human Services to revise all Department forms and billing codes to remove the term "mental retardation" and replace it with "intellectual disability".
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.
Amends the Nurse Practice Act. Makes changes to the requirements for a registered professional nursing education program in provisions concerning the establishment of a new program, program policies, faculty members, training and development, the program's curriculum, the program's use of simulation, the accreditation process, approval by the Board of Nursing, and the program closure process. Makes a conforming change. Provides that the Department of Financial and Professional Regulation may, without hearing, rescind the license of any person who obtain a license after completing a program or obtaining credit from a program that does not meet the requirements of the provisions regarding registered professional nursing education programs. In provisions concerning nursing licensure by examination, removes the provision regarding the good standing period for professional nursing programs on probationary status.
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 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 incidence of suicide attempts related to gambling disorders or gambling issues. Requires the Department to select the 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 disorders; and to perform other actions. Allows the Department to award grants to create or support local gambling prevention, recognition, and response projects. Makes other changes.
Amends the Illinois Insurance Code. In a provision concerning coverage of certain cancer screenings, adds having a high level of CA-125, as indicated by a blood test screening, to the definition of "at risk for ovarian cancer". Provides that "surveillance tests for ovarian cancer" means all medically viable methods for the detection and diagnosis of ovarian cancer, including, but not limited to, ultrasounds, magnetic resonance imagings (MRIs), x-rays, computed tomography (CT) scans, and CA-125 blood test screenings (instead of an annual screening using (i) CA-125 serum tumor marker testing, (ii) transvaginal ultrasound, (iii) pelvic examination). Effective January 1, 2028.
