Healthcare (Children's Health)

Amends the Sexual Assault Survivors Emergency Treatment Act. Defines "acute sexual assault" as a sexual assault that has recently occurred within a specified time. Replaces various references to "sexual assault" with "acute sexual assault". Deletes the definition of "prepubescent sexual assault survivor". Changes provisions regarding hospitals located in counties with a population of less than 1,000,000 and within a 20-mile radius of a 4-year public university with respect to a sexual assault treatment plan approved by the Department of Public Health. Makes changes in various provisions concerning plans of correction and penalties for hospitals that commit specified violations of the Act. In provisions regarding requirements for medical forensic services, provides that the provisions of the Act are not intended to prohibit a qualified medical provider from offering an Illinois Sexual Assault Evidence Collection Kit to a sexual assault survivor who presents at a treatment hospital or approved pediatric health care facility with a nonacute complaint of sexual assault if there is a compelling reason for evidence collection, or upon the request of the survivor. In provisions regarding the prohibition on billing sexual assault survivors directly for certain services, changes references to the Office of the Attorney General to references to the Department of Healthcare and Family Services.

Appropriates $2 from the General Revenue Fund to the Illinois Comprehensive Health Insurance Plan Board for its FY26 ordinary and contingent expenses. Effective July 1, 2025.

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.

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.

Creates the Accountability in Psychotropic Drug Prescriptions for Children Under Medicaid Act. Requires medical care providers prescribing psychotropic drugs to children under the State's Medicaid program to provide FDA Medication Guides to parents or legal guardians before issuing a prescription. Provides that the Medication Guides must be printed and reviewed with the parent or legal guardian, explaining (1) FDA-identified risks of the medication, including pediatric-specific warnings and (2) signs of potential side effects and adverse drug reactions detailed in the Medication Guide. Provides that written informed consent must be obtained from the parent or legal guardian before prescribing a psychotropic drug. Requires the Department of Healthcare and Family Services to, within 12 months after the effective date of the Act, develop and maintain a secure online reporting system for adverse drug reactions related to psychotropic drugs prescribed to children and adolescents. Contains provisions on adverse drug reaction reporting requirements; legislative oversight and reviews of adverse drug reaction reports related to psychotropic drugs; penalties for medical care providers who fail to comply with medication guide distribution; transparency and accountability reporting requirements for the Department of Healthcare and Family Services; and other matters. Amends the State Finance Act. Creates the Medicaid Oversight and Safety Measures Fund.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that, beginning January 1, 2026, providers offering pediatric primary care shall be reimbursed at a rate that is no lower than 100% of the Medicare program's rates for preventative and screening services.

Amends the State Employees Group Insurance Act of 1971. Prohibits the State from applying for any federal waiver that would reduce or eliminate any protection or coverage required under the Patient Protection and Affordable Care Act (Affordable Care Act) that was in effect on January 1, 2017, including, but not limited to, any protection for persons with preexisting conditions and coverage for services identified as essential health benefits under the Affordable Care Act. Provides that the State or an agency of the executive branch may apply for such a waiver only if granted authorization by the General Assembly through joint resolution. Amends the Illinois Insurance Code. Prohibits the State from applying for any federal waiver that would permit an individual or group health insurance plan to reduce or eliminate any protection or coverage required under the Affordable Care Act that was in effect on January 1, 2017, including, but not limited to, any protection for persons with preexisting conditions and coverage for services identified as essential health benefits under the Affordable Care Act. Provides that the State or an agency of the executive branch may apply for such a waiver only if granted authorization by the General Assembly through joint resolution. Amends the Illinois Public Aid Code. Prohibits the State or an agency of the executive branch from applying for any federal Medicaid waiver that would result in more restrictive standards, methodologies, procedures, or other requirements than those that were in effect in Illinois as of January 1, 2017 for the Medical Assistance Program, the Children's Health Insurance Program, or any other medical assistance program in Illinois operating under any existing federal waiver authorized by specified provisions of the Social Security Act. Provides that the State or an agency of the executive branch may apply for such a waiver only if granted authorization by the General Assembly through joint resolution. Effective immediately.

States that the new Department of Early Childhood and its planning process should prioritize appropriate attention to the facilities needs of our State's mixed-delivery system of early care and education. Additionally states that the State should move expeditiously to award its remaining Early Childhood Construction Grant monies to qualified applicants, to assist providers of critical birth-to-five programs in meeting their growing building-and-repair demands. Finally states that the State should also move as quickly as feasible to replenish Early Childhood Construction Grant resources to help Illinois achieve the long-term vision of the bipartisan Funding Commission for making services "simpler, better, fairer" for young children, their families, and communities statewide.

Urges the implementation of interventions to support vaccine uptake and reduce disparities in vaccine coverage among children. Urges the Illinois Department of Health, the Illinois State Board of Education, and the Illinois Department of Healthcare and Family Services to work with pediatricians, clinicians, families, and other stakeholders to ensure infants and children are vaccinated on time and students begin school fully vaccinated. Urges the Illinois Department of Health, the Illinois State Board of Education, and the Illinois Department of Healthcare and Family Services to continue to invest in immunization initiatives and infrastructure to ensure timely reporting of vaccine coverage to ensure children are protected from vaccine-preventable illness in public and private schools, child care facilities, and pre-kindergarten programs and beyond.

Urges the implementation of interventions to support vaccine uptake and reduce disparities in vaccine coverage among children. Urges the Illinois Department of Health, the Illinois State Board of Education, and the Illinois Department of Healthcare and Family Services to work with pediatricians, clinicians, families, and other stakeholders to ensure infants and children are vaccinated on time and students begin school fully vaccinated. Urges the Illinois Department of Health, the Illinois State Board of Education, and the Illinois Department of Healthcare and Family Services to continue to invest in immunization initiatives and infrastructure to ensure timely reporting of vaccine coverage to ensure children are protected from vaccine-preventable illness in public and private schools, child care facilities, and pre-kindergarten programs and beyond.