Healthcare

Amends the Illinois Vehicle Code. Allows a decal to be issued for sickle cell anemia awareness. Provides that a $25 fee for original issuance shall be paid with $10 to the Sickle Cell Anemia License Fund and $15 to the Secretary of State Special License Plate Fund. Provides that a $25 fee for renewal shall be paid with $23 to the Sickle Cell Anemia License Fund and $2 to the Secretary of State Special License Plate Fund. Creates the Sickle Cell Anemia License Fund, from which all money shall be paid as grants to the Sickle Cell Disease Association of Illinois. Makes a conforming change in the State Finance Act.

Amends the Emergency Medical Services (EMS) Systems Act. Provides that the Department of Public Health shall allow for an alternative rural staffing model for vehicle service providers that serve a rural or semi-rural population of 10,000 or fewer inhabitants and exclusively use volunteers, paid-on-call, or part-time employees, or a combination thereof (now, the use of part-time employees is not an option). Effective immediately.

Amends the Emergency Medical Services (EMS) Systems Act. Makes changes to defined terms. Replaces references to Primary Stroke Centers with Stroke Centers. Provides that a hospital that no longer meets nationally recognized, evidence-based standards for Stroke Centers, loses its Stroke Center certification, or has any change to its designation level shall notify the Department of Public Health and the Regional EMS Advisory Committee within 5 business days. Requires the Department to consult with the State Stroke Advisory Subcommittee for the adoption or deletion of approved stroke designation levels. Provides that the approved stroke designation levels shall coincide with the stroke designation levels recognized by Department-approved certifying bodies. Requires the Department to establish reporting requirements for designated Stroke Centers to capture information using new or existing electronic reporting tools for statewide data collection and certification purposes. Removes provisions concerning previous Stroke Center designations. Makes other changes.

Amends the Illinois Insurance Code. In provisions concerning biomarker testing: makes changes to defined terms; requires applicable health insurers, nonprofit health service plans, and health maintenance organizations to update and make publicly available medical policies and coverage guidelines within 90 days after the effective date of the amendatory Act; provides that, if a health insurer or nonprofit health service plan denies a claim for coverage of testing that is supported by any specified evidence, the insurer or nonprofit health service plan shall provide to the requesting entity specific written justification explaining in detail why the claim for coverage was denied as it pertains to the individual for whom the test was ordered; sets forth provisions concerning utilization review and prior authorization; provides that the Department of Insurance may conduct periodic audits and reviews to ensure entity compliance; and makes other changes.

Amends the Community Services Act. Adds community day services to the list of service categories covered under the Act. Defines "community day services" to mean a Home and Community-Based Waiver day program that is certified by the Department of Human Services and provides assistance with gaining, maintaining, or improving skills and functioning to individuals with developmental disabilities. Makes conforming changes to the Mental Health and Developmental Disabilities Administrative Act.

Amends the Illinois Administrative Procedure Act. Provides that, for any law implementing the federal Patient Protection and Affordable Care Act, the Department of Insurance may adopt rules that include incorporations by reference of federal rules and regulations without identifying the incorporated matter by date and without including a statement that the incorporation does not include later amendments. Amends the Illinois Insurance Code. Makes changes concerning the assignment or transfer of property and casualty policies; formatting requirements for the insurance company supplier diversity report; and insurance coverage for dependent parents. Provides that the Director of Insurance shall maintain as confidential any records or information received from the National Association of Insurance Commissioners or other state, federal, and international regulatory agencies (instead of insurance regulatory officials of other states) that are confidential in that other jurisdiction. Provides that the Department may waive registration and course certification fees if the pre-licensing or continuing education course is provided by a government entity free of charge. Amends the Network Adequacy and Transparency Act. In applicability provisions, removes language concerning exemptions for short-term, limited-duration health insurance coverage with a network plan. Repeals the Health Care Purchasing Group Act. Effective immediately.

Amends the Medical Practice Act of 1987. In provisions concerning an exception to the prohibition on fee splitting for billing, administrative preparation, or collection services, requires any charges for multiple in-network services during the same appointment, including, but not limited to, an office visit that was added to a physical exam, to be disclosed to the patient during the appointment.

Amends the Illinois Insurance Code. In provisions concerning the payment of nonparticipating ground ambulance service providers, makes changes to defined term, removes jurisdictional provisions, and provides that, for nonparticipating ground ambulance service providers owned and operated by (instead of subject to) a unit of local government, a rate shall be paid that is equal to the rate established or approved by the governing body of the unit of local government providing the ground ambulance service. Establishes a rate of pay for nonparticipating ground ambulance service providers that are not owned and operated by (instead of subject to the jurisdiction of) a unit of local government. Amends the Health Maintenance Organization Act. Replaces provisions concerning coverage for emergency transportation by ambulance with provisions concerning coverage for ground ambulance service.

Amends the Pharmacy Practice Act. Provides that a pharmacist who is exercising his or her professional judgment may add missing non-pharmaceutical devices or durable medical equipment that aid in the appropriate clinical usage of a medication or in achieving a positive therapeutic outcome to a prescription. Provides that a pharmacist may complete missing information on a prescription if there is evidence to support the change. Requires any adaptations to a prescription to be documented in the patient's record. In provisions concerning the distribution of a prescription drug for less than its fair market value, provides that it shall be unlawful to require a pharmacist or pharmacy to dispense a prescription drug for less than its fair market value, including the cost of dispensing. Provides that a payor that reimburses a pharmacy for less than fair market value, including the cost of dispensing, shall not be able to include the pharmacy toward any network adequacy requirements and shall not be deemed in compliance with any willing provider provisions.

Creates the Kidney Disease Treatment Delegation Act. Provides that, notwithstanding any provision of the Nurse Practice Act or any rule of the Department of Financial and Professional Regulation to the contrary, delegation, including, but not limited to, delegation of the performance of central venous catheter procedures in a kidney disease treatment center, shall only be allowed if the individual receiving delegation is a licensed practical nurse who has obtained the proper training, education, and experience or a certified dialysis technician who currently holds, or is in the process of acquiring, the necessary experience to apply for and obtain certification as a certified clinical hemodialysis technician by the Nephrology Nursing Certification Commission or a Certified Hemodialysis Technologist/Technician by the Board of Nephrology Examiners Nursing and Technology. Sets forth additional provisions concerning delegation of duties in a kidney disease treatment center. Provides that the Department is authorized to adopt rules for the administration and enforcement of the Act, and the rules may define standards and criteria for the necessary training, education, and experience for licensed practical nurses to obtain before receiving delegation under the Act. Amends the Nurse Practice Act. Provides that a violation of the Kidney Disease Treatment Delegation Act is grounds for disciplinary action. Effective immediately.