Healthcare (Medical Licensing)

Creates the Occupational Therapy Licensure Compact Act. Provides that the State of Illinois ratifies and approves the Occupational Therapy Licensure Compact. Provides that the purpose of the Compact is to facilitate interstate practice of Occupational Therapy with the goal of improving public access to Occupational Therapy services, and states that the Compact preserves the regulatory authority of states to protect public health and safety through the current system of state licensure. The Compact contains provisions concerning definitions; state participation in the Compact; Compact privilege; obtaining a new home state license by virtue of Compact privileges; active duty military personnel and their spouses; adverse actions; establishment of the Occupational Therapy Compact Commission; a data system; rulemaking; oversight, dispute resolution, and enforcement; date of implementation of the Interstate Commission for Occupational Therapy Practice and associated rules, withdrawal, and amendment; construction and severability; and the binding effect of the Compact and other laws.

Amends the Assisted Living and Shared Housing Act. Provides that the comprehensive assessment of a patient prior to the patient's admission to an establishment shall be completed by a physician or a nurse practitioner or physician assistant. In provisions concerning licensure of an establishment, changes education requirements for the full-time director of an establishment. Makes changes to the definition of "medication administration" in provisions concerning service requirements. Provides that a licensed health care professional may be employed (instead of may not be employed) by the owner or operator of the establishment, its parent entity, or any other entity with ownership common to either the owner or operator of the establishment or parent entity, including, but not limited to, an affiliate of the owner or operator of the establishment, if the resident chooses to utilize the services of the licensed health care professional working within the scope of the professional's practice. Sets forth provisions concerning an emergency plan and disaster preparedness. Provides that incidents must be reported to the Department of Public Health within 24 hours after the incident or by the end of the next business day. Provides that staff in an establishment may be trained to assist in a nonemergency lift of a resident. Provides that repeated technical infractions by an establishment within a calendar year may result in a Type 3 violation.

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.

Amends the Illinois Insurance Code. Creates the Vision Benefit Managers Article. Beginning on July 1, 2026, requires a vision benefit manager to be registered with the Department of Insurance, as specified, to conduct business in the State. Requires amounts collected under provisions concerning vision benefit manager registration requirements to be deposited into the Low-Income Student Vision Examination Fund, which is created as a special fund in the State treasury. Grants the Director or the Director's designee the authority to examine a registered vision benefit manager related to all of its lines of business. Amends the Vision Care Plan Regulation Act. Changes the name of the Act to the Vision Benefit Manager Regulation Act. Establishes the legislative intent of the Act. Makes changes to defined terms. Throughout the Act, replaces references to vision care plans with vision benefit plans and vision benefit discount plans and vision care organizations with vision benefit managers. Sets forth provisions concerning required actions for noncovered services; fee schedules for eye care providers; reimbursement paid by a vision benefit manager to an eye care provider; application of the Act to a specified limited health service organization; an eye care provider's choice of vendors and affiliations; the modification of a plan; audits of an eye care provider; prohibited conduct impacting patient access and choice; credentialing; termination of agreements; prohibition on security interests; arbitration costs; nonretaliation; and private rights of action. Amends the Consumer Fraud and Deceptive Business Practices Act and the State Finance Act to make conforming changes. Effective January 1, 2027.

Amends the Developmental Disability and Mental Disability Services Act. Provides that in one's "own home" means that an adult with a mental disability lives alone; or that an adult with a mental disability is in full-time residence with his or her parents, legal guardian, or other relatives; or that an adult with a mental disability is in full-time residence in a setting not subject to licensure under the Nursing Home Care Act, the Specialized Mental Health Rehabilitation Act of 2013, the ID/DD Community Care Act, the MC/DD Act, or the Child Care Act of 1969 with 5 (rather than 3) or fewer other adults unrelated to the adult with a mental disability who do not provide home-based services to the adult with a mental disability.

Amends the Ambulatory Surgical Treatment Center Act. Removes a provision which provides that, in ambulatory surgical treatment centers, anesthesia service shall be under the direction of a physician who has had specialized preparation or experience in the area or who has completed a residency in anesthesiology. Specifies that with respect to anesthesia service in an ambulatory surgical treatment center, a certified registered nurse anesthetist shall seek consultation regarding development of an anesthesia plan and treatment of patients as is appropriate to the certified registered nurse anesthetist's level of expertise and scope of practice and as is warranted by the needs of the patient. Removes a requirement that an anesthesiologist participate through discussion of and agreement with the anesthesia plan and remain physically present and be available on the premises. Provides that a certified registered nurse anesthetist with clinical privileges may perform acts of advanced assessment and diagnosis and may provide such functions for which the certified registered nurse anesthetist is educationally and experientially prepared. Makes conforming changes to the Hospital Licensing Act. Amends the Medical Practice Act of 1987. Provides that a written collaborative agreement shall be adequate with respect to collaboration with certified registered nurse anesthetists if all of the following apply: (1) the agreement is written to promote exercise of professional judgment by the certified registered nurse anesthetist commensurate with his or her education and experience; (2) the certified registered nurse anesthetist provides service based on a written collaborative agreement with the collaborating physician; and (3) methods of communication are available with the collaborating physician in person or through telecommunications for consultation, collaboration, and referral as needed to address patient care needs. Amends the Nurse Practice Act. Provides that an Illinois-licensed advanced practice registered nurse certified as a certified registered nurse anesthetist shall be deemed by law to possess the ability to practice without a written collaborative agreement. Sets forth requirements of a certified registered nurse anesthetist. Makes conforming changes in the Illinois Dental Practice Act. Effective immediately.

Amends the Community-Integrated Living Arrangements Licensure and Certification Act. In provisions concerning per diem reimbursement for a community-integrated living arrangement provider, provides that, if it is determined by third-party medical personnel that a resident that required a medical absence is unable to return to the community-integrated living arrangement, or if the resident dies during the medical absence, the provider shall receive 100% of the per diem reimbursement for up to 20 medical absence days. Effective immediately.

Amends the Hospital Licensing Act. In the definition of "professional judgment", removes language providing that situations in which an employing entity does not interfere with an employed physician's professional judgment includes reasonable referral restrictions that do not, in the reasonable professional judgment of the physician, adversely affect the health or welfare of the patient. Effective immediately.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to adopt rules that require managed care organizations (MCOs) to utilize a universal provider application developed by a council for affordable quality healthcare, as defined, for the purpose of credentialing a health care professional or a health care provider who seeks to participate in an MCO's provider network. Provides that the rules shall also require the use of a CAQH application for the renewal of credentials; and that the Department may revise the CAQH universal provider application or the application for renewal of credentials to conform to industry or national standards for credentialing health care professionals or health care providers. Provides that within 180 days after the adoption of rules, health and dental plan carriers must accept the universal provider application and the application for the renewal of credentials approved by the Department. Requires all MCOs to provide a provider network consultant to act as a liaison between a health care provider and the MCO. Require the Department to employ provider enrollment consultants to assist health care providers with enrollment in the Illinois Medicaid Program Advanced Cloud Technology system, help navigate the enrollment and provider credentialing process by serving as the liaison between health care providers and MCOs, and other matters. Amends the Illinois Insurance Code. In provisions concerning recoupments, requires a health care professional or health care provider to be provided a remittance advice that includes an explanation of a recoupment or offset taken by a managed care organization. Removes provisions permitting insurers contracted with the Department of Healthcare and Family Services to recoup or offset payments due to a federal Medicaid requirement. Provides that no contract between an MCO and health care professional or provider may provide for recoupments in violation of the Code. Effective January 1, 2027.

Creates the Physician Assistant Licensure Compact Act. Provides that, one year after the effective date of the Act, the State of Illinois enters into the PA Licensure Compact in substantially the form provided in the Act with all other states joining the Compact. Provides that the purpose of the Compact is for participating states of the Compact to have allied in common purpose to develop a comprehensive process that complements the existing authority of state licensing boards to license and discipline physician assistants and to seek to enhance the portability of a license to practice as a physician assistant while safeguarding the safety of patients. Contains provisions relating to requirements for state participation in the contract. Includes the procedures a licensee must follow to apply for and obtain compact privilege. Provides that a participating state in which a licensee is licensed under the Compact shall have exclusive power to impose adverse action against the qualifying license issued by that participating state. Provides for the creation of a PA Licensure Compact Commission, including a delegate selected by each participating state's licensing board. Includes other provisions relating to the operation of the Commission, including when the Commission is implemented, the data system used by the Commission, and Commission rules. Includes provisions relating to oversight, dispute resolution, and enforcement; construction and severability; and the binding effect of the Compact. Amends the Physician Assistant Practice Act of 1987. Requires, no later than 3 months after the effective date of the amendatory Act, the Department of Financial and Professional Regulation to (i) submit a report to the Governor and General Assembly describing all rule and statutory changes necessary to comply with the PA Licensure Compact and (ii) begin rulemaking procedures necessary to modify its rules to conform with the requirements of the PA Licensure Compact.