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 Pharmacy Practice Act. Defines "large pharmacy chain" and "retail pharmacy". Provides that a large pharmacy chain operating in the State shall ensure that each of the large pharmacy chain's retail pharmacy locations maintains, at minimum, an inventory that is sufficient to cover the needs of existing patients for up to 14 days without needing to restock. Requires each retail pharmacy location to implement a predictive restocking practice to prevent or mitigate future inventory shortages. Provides that, if a patient attempts to fill a prescription that a retail pharmacy location does not have in stock, the retail pharmacy location shall provide timely mail-order fulfillment, up to and including overnight shipping, if necessary to provide a medication approved by the United States Food and Drug Administration in time to ensure no missed doses.
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that on and after January 1, 2027, the reimbursement rates for all dental services for children shall be increased 50% above the rates in effect on December 31, 2025. Effective January 1, 2027.
Amends the Illinois Income Tax Act. Creates an income tax credit for a qualified employer who makes a qualified contribution toward a health reimbursement arrangement for the qualified taxpayer's employees. Provides that the amount of the credit is $400 per covered employee in the first taxable year and $200 per covered employee in the second taxable year. Effective immediately.
Creates the Lead-Safe Water for Families Act. Provides that the Department of Healthcare and Family Services shall establish and administer a program to provide lead-reducing water filters at no cost to Medicaid-eligible households with children or expectant mothers. Requires outreach, application procedures, and rulemaking. Requires annual reporting to the General Assembly. Declares findings and states the purpose of the Act. Defines terms.
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 Hospital Licensing Act. Requires every hospital to adopt an influenza and pneumococcal immunization policy that includes procedures for identifying patients age 18 or older (rather than 50 or older) for influenza immunization and 50 or older (rather than 65 or older) for pneumococcal immunization.
Amends the Illinois Insurance Code. Requires 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, 2028 to provide coverage for medically necessary assistive technology devices. 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 the provisions of those Acts.
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 Illinois Insurance Code. Provides that no policy of accident or health insurance that is issued, amended, delivered, or renewed on or after January 1, 2027 may limit or otherwise alter coverage available to an insured based solely on that insured's weight or body mass index. Amends the Medical Patient Rights Act. Provides that no physician may make a diagnosis or determination of treatment based solely on a patient's body mass index. Establishes disclosure requirements for hospitals concerning the use of body mass index in diagnosis and treatment. Provides that any physician, medical student, resident, advanced practice registered nurse, registered nurse, physician assistant, licensed behavior analyst, licensed assistant behavior analyst, or clinical psychologist who conducts medical, behavioral, or psychological assessments shall only use methodology recommended by peer-reviewed clinical practice guidelines or methodology established through evidence-based standards that are widely recognized by professional medical, behavioral, or psychological organizations, respective to the form of assessment, when conducting those assessments.
