Healthcare

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 Medicare-Medicaid Alignment Initiative (MMAI) Nursing Home Residents' Managed Care Rights Law of the Illinois Public Aid Code. Provides that the Article applies to a fully integrated dual eligible special needs plan and any managed care plan for persons who are dually eligible for Medicare and Medicaid. Adds to the definition of "Demonstration Project", a fully integrated dual eligible special needs plan and any managed care plan for persons who are dually eligible for Medicare and Medicaid. Provides that the Department of Healthcare and Family Services shall provide each managed care organization with the quarterly facility-specific nursing component (instead of RUG-IV nursing component) per diem along with any add-ons for enhanced care services, support component per diem, and capital component per diem effective for each nursing home under contract with the managed care organization. Effective immediately.

Amends the Critical Health Problems and Comprehensive Health Education Act of the School Code. Requires the program to include instruction on gambling and gambling disorders. Provides that instruction on gambling and gambling disorders shall include classroom instruction in grades 5 through 12, and include, at a minimum: the nature and addictive potential of gambling; the risks associated with digital gaming mechanics; the identification of gaming disorders and their impact on mental and physical health; and information on how and where to find specialized treatment and resources in the State for gambling disorders. Effective July 1, 2026.

Amends the Behavior Analyst Licensing Act. Adds an occupational therapist to the individuals that the Act does not prohibit from performing or advertising activities that are considered to be the practice of applied behavior analysis under the Act. In provisions concerning unlicensed practice, provides that any member, partner, shareholder, director, officer, holder of any other ownership interest, or agent of a business organization providing behavior analysis services who makes clinical decisions regarding patient care without being licensed or exempt under the Act shall be deemed to have violated the provisions. Repeals a provision concerning license restrictions and limitations. Amends the Professional Service Corporation Act. Adds the practice of applied behavior analysis by persons licensed under the Behavior Analyst Licensing Act to the list of personal services that, when combined, constitute "related professions" and "related professional services". Amends the Professional Limited Liability Company Act. Adds the practice of applied behavior analysis by behavior analysts and assistant behavior analysts licensed under the Behavior Analyst Licensing Act to the list of professional services that may be combined under a single professional limited liability company. Makes other changes. Effective immediately.

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.

Creates the Reproductive Health Records Privacy Act. Requires health information exchanges to implement policies and technical capabilities by July 1, 2027, to segregate medical information related to abortion care, restrict access by out-of-state entities, and limit disclosure. Provides enforcement through private actions and civil actions by the Attorney General, including injunctive relief and civil penalties. Defines terms. Amends the Medical Patient Rights Act to clarify patient privacy rights and allow segregation of abortion-related information in health information exchanges. Provides for severability.

Amends the Unified Code of Corrections. Provides that the Department of Corrections shall create and implement, beginning on January 1, 2027, a pilot program to establish the effectiveness of long-acting injectable medications for substance use disorders for persons committed to its custody who have drug problems. Provides that the pilot program shall require long-acting injectable medications for substance use disorders to be used in at least one Department of Corrections facility. Provides that the Director of Corrections may expand the pilot program to include an additional facility or facilities as he or she deems appropriate. Provides that a minimum of 4,000 administrations of long-acting injectable medications for substance use disorders shall be included in the pilot program. Provides that the Department must report to the General Assembly on the effectiveness of the program on or before January 1, 2028.

Provides that the Act may be referred to as the Illinois Newborn Equity Support Transfer (NEST) Program Act. Amends the Department of Human Services Act. Requires the Department of Human Services to establish and administer, subject to appropriations, the Illinois Newborn Equity Support Transfer (NEST) Program to provide direct cash assistance to eligible participants by July 1, 2026. Defines "participant" to mean any individual who gives birth in Illinois while enrolled in or eligible for Medicaid through Moms and Babies. Permits the Department to adopt any rules necessary to implement the NEST Program. Provides that program participants shall receive a $1,500 lump sum payment in or around the third trimester of pregnancy, prior to delivery; and a $500 monthly cash payment for the first 6 months following delivery. Requires the Department to submit reports to the General Assembly on a biennial basis that summarizes (1) the number of program participants and distribution across the State, (2) outcomes related to maternal and child health, housing stability, and economic security, or other outcomes identified by the Department in collaboration with stakeholders, and (3) recommendations for program improvements or additional populations beyond Medicaid enrollment to include as participants. Provides that cash disbursements made to participants under the NEST Program shall be considered "guaranteed income" as described in the Hospital Uninsured Patient Discount Act for purposes of determining eligibility for assistance under the Illinois Public Aid Code. Effective immediately.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that a safety-net hospital includes a behavioral health safety-net provider that: (i) is licensed or certified by the Department of Human Services, or otherwise authorized under State law, to provide behavioral health or substance use disorder treatment services; (ii) meets specified federal requirements for being designated a disproportionate share hospital, as defined by the Department of Healthcare and Family Services; (iii) accepts admissions 24 hours a day, 7 days a week, with no blackout periods; (iv) accepts patients who only need mental health or substance use disorder treatment; and (v) has a MIUR of at least 40% and a charity percent of at least 4%, or a MIUR of at least 50%.

Amends the Illinois Insurance Code. Contains findings. Requires each health carrier to annually submit completed templates with both plan-level and carrier-level data to the Director of Insurance in the form, manner, and time prescribed by the Director by no later than July 1 of each year for data from the previous calendar year. Provides that data must be sufficient to support independent technical evaluation and to enable meaningful public understanding of access to and coverage for each facility type and specified professional provider type. Requires each health carrier to report, disaggregated by facility type, professional provider type, youth, adult, in-person, and telehealth, the specified data elements. Requires the Director to post, in an easily accessible, consumer-friendly manner, on a public website, all underlying data and data files reported no later than 3 months after receipt. Sets forth provisions concerning certification of health carriers and administration and enforcement of the provisions. Provides that the data submission requirements apply to health benefit plans issued or renewed on or after January 1, 2027. Effective immediately.