Healthcare

Amends the Illinois Insurance Code. Prohibits an insurer, dental service plan corporation, professional service corporation, insurance network leasing company, or any other company or its contracted vendor that amends, delivers, issues, or renews an individual or group policy of accident and health insurance on or after the effective date of the amendatory Act from requiring a dental care provider to only accept payment from a credit card or electronic funds transfer, in addition to the existing prohibition on incurred fees to access and obtain payment or reimbursement for services provided. Provides that any insurer, dental service plan corporation, professional service corporation, insurance network leasing company, or any other company or its contracted vendor that amends, delivers, issues, or renews an individual or group policy of accident and health insurance may initiate or change payment methodology to a dental care provider using electronic funds transfer payments, including virtual credit card payments, if the specified conditions are met. Sets forth provisions concerning claim payment methodologies and fees for transmitting payments. Provides that the specified dental coverage reimbursement provisions shall not be waived by contract. Effective January 1, 2027.

Amends the Nursing Home Care Act and the Assisted Living and Shared Housing Act. Requires the Department of Public Health to hold semiannual joint training sessions for surveyors, nursing home providers, and assisted living establishment providers. Provides that the Department shall include the State long-term care ombudsman, or the State long-term care ombudsman's designee, and representatives of each nursing home provider association and assisted living provider association in the State in the planning process to create the topics and content of the joint training sessions as well as the coordination and presentations for the joint training sessions. Provides that, at least annually, a joint training session shall include, but not be limited to, regional citation patterns relating to complaints, standards, and outcomes in the nursing home and assisted living survey process. Requires the Department to develop standardized training for establishments to prevent common citations in the assisted living survey process.

Amends the Illinois Insurance Code. Establishes reimbursement rates for mental health and substance use disorder treatment services for all group or individual policies of accident and health insurance or managed care plans that are amended, delivered, issued, or renewed on or after January 1, 2027 or for any contracted third party administering the behavioral health benefits for the insurer. Requires a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2026 or any contracted third party administering the behavioral health benefits for the insurer to cover certain medically necessary mental health and substance use disorder treatment services. Provides that, if the Department of Insurance determines that an insurer or a contracted third party administering the behavioral health benefits for the insurer has violated a provision concerning mental health and substance use parity, the Department shall by order assess a civil penalty of $1,000 for each violation. Excludes certain health care plans serving Medicaid populations who are enrolled under the Illinois Public Aid Code or under the Children's Health Insurance Program Act from provisions concerning mental health and substance use parity. Requires the Department to review the impact of the proposed mental health and substance abuse mandate on network adequacy for mental health and substance use disorder treatment and access to affordable mental health and substance use care. Permits the Department to examine out-of-network utilization and out-of-pocket costs for insureds for mental health and substance use treatment and services for all plans to compare with in-network utilization. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, and the School Code to require coverage under those provisions. Effective immediately.

This bill nominates Anusha Thotakura to serve as a member of the Illinois Health Benefits Exchange Advisory Committee. If approved, Ms. Thotakura would join the committee responsible for advising on health benefits exchange matters in Illinois.

Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2027 that provides coverage for: habilitative services shall provide coverage for habilitative speech therapy as a treatment for stuttering, regardless of whether the stuttering is classified as developmental; rehabilitative services shall provide coverage for rehabilitative speech therapy as a treatment for stuttering; or habilitative services and rehabilitative services shall provide coverage for habilitative speech therapy as a treatment for stuttering, regardless of whether the stuttering is classified as developmental, and shall provide coverage for rehabilitative speech therapy as a treatment for stuttering. Sets forth requirements and limitations for the coverage. 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. Amends the State Mandates Act to require implementation without reimbursement. Effective January 1, 2027.

Amends the Public Higher Education Act. Provides that, beginning with the 2025-2026 school year, each public institution of higher education with student health services shall provide enrolled students with access to health care professionals authorized under State law to prescribe contraception. Provides that, beginning with the 2025-2026 school year, if the public institution of higher education's student health services includes a pharmacy, the pharmacy on campus shall dispense contraception to enrolled students who wish to fill their prescriptions at the university pharmacy. Provides that, beginning with the 2025-2026 school year, each public institution of higher education with student health services shall provide enrolled students with access to health care professionals authorized under State law to prescribe medication abortion. Provides that a public institution of higher education that dispenses medication abortion from the university pharmacy shall enter into a referral agreement with a tertiary care facility with obstetrics and gynecological services in the event of complication from medication abortion or suspected complicated pregnancy prior to dispensing medication abortion. Requires each public institution of higher education to report annually to the Board of Higher Education that policies under the provisions have been adopted. Requires the Board to post to its website annually each public institution of higher education's compliance with the policies under the provisions. Effective immediately.

Amends the Mental Health Early Action on Campus Act. Provides that the expert panel designated by the board of trustees to develop and implement policies and procedures shall be comprised of at least 2 administrators, 2 members of faculty, and one mental health professional. Requires each public college or university to provide at least 3 on-site licensed clinical professional counselors or licensed clinical social workers.

Amends the Clinical Psychologist Licensing Act, the Clinical Social Work and Social Work Practice Act, the Marriage and Family Therapy Licensing Act, the Music Therapy Licensing and Practice Act, and the Professional Counselor and Clinical Professional Counselor Licensing and Practice Act. Allows an applicant for licensure under those Acts to temporarily practice under supervision while the applicant's application for licensure is pending under specified circumstances. Removes good moral character standards as qualification requirements for the licensing of social workers and music therapists. Creates procedures for placing a license on inactive status for social workers and professional counselors. Provides that the Department of Financial and Professional Regulation must allow reasonable exam accommodations for licensed marriage and family therapists and clinical psychologists whose primary language is not English if a test in the therapist's or psychologist's primary language is not available.

Amends the Managed Care Reform and Patient Rights Act. Provides that a health care plan shall provide annually to enrollees and prospective enrollees, upon request, a statement of all basic health care services and all specific benefits and services mandated to be provided to enrollees by State law or administrative rule, highlighting any newly enacted State law or administrative rule. Provides that this requirement can be fulfilled by providing enrollees the most up-to-date accident and health checklist submitted to the Department of Insurance, reflecting statutory health care coverage compliance by the health care plan. Requires the Office of Consumer Health Insurance to post in a prominent location on the Department's publicly accessible website an annual report on the development and implementation of federal, State, and local laws, regulations, and other governmental policies and actions that pertain to the adequacy of health care plans, facilities, and services in the State and summary of all State health insurance benefit related legislation enacted in the prior calendar year that includes, at minimum, a link to the Public Act, the statutory citation, the subject, a brief summary, and the effective date. Amends the Uniform Health Care Services Benefit Information Card Act. Adds a health benefit plan offering dental coverage to the list of plans required to issue a health care benefit information card. Specifies health care benefit information cards may be electronic or physical. Requires uniform health care benefit information to display on the back of the card a statement indicating whether the plan is self-insured or fully funded and if the plan is subject to regulation by the Department of Insurance. Makes other changes.

Creates the Hospitals and Homelessness Support Act. Requires the Office to Prevent and End Homelessness within the Department of Human Services to maintain on its publicly accessible website information on how a hospital or healthcare system may connect a patient experiencing homelessness or otherwise in a vulnerable housing situation with shelter and homeless support services for each continuum of care in the State. Requires the Department to ensure that the information required includes, for each continuum of care, any phone number, email address, physical address, primary agencies, or any other information that may be necessary for a person in that continuum of care territory to begin accessing shelter or other homelessness services. Requires the Department to include, where possible, a specific phone number that a hospital or health care facility may call and specific language to use. Requires the Department to also include on its website a way for the hospital or healthcare system to determine which continuum of care applies based on the physical location of the hospital or healthcare system. Requires other information, all of which must be added to the Department's website by October 31, 2025. Contains provisions concerning annual audits.