Healthcare

Amends the Illinois Controlled Substances Act. Provides that interstate data sharing agreements shall be mutual. Provides that the Department of Human Services shall only share data if the reciprocal state provides the opportunity to access data from the reciprocating state to licensed healthcare entities and application vendors regardless of their method of connection to the Prescription Monitoring Program for interstate data sharing as defined in administrative rule. Effective immediately.

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, 2028 shall provide coverage for medically necessary lung cancer screenings, including any medically necessary tests for lung cancer biomarkers, including, but not limited to, anaplastic lymphoma kinase (ALK). Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, and the Illinois Public Aid Code to require coverage under the provisions of those Acts.

Amends the Fair Patient Billing Act. Provides that "artificial intelligence" has the meaning given to that term in the Illinois Human Rights Act. Prohibits all hospitals from using artificial intelligence to set or influence health care pricing or billing.

Amends the Unified Code of Corrections. Provides that the Department of Corrections shall ensure all persons under its care are assessed for substance use disorder, as defined in the Substance Use Disorder Act. Provides that this process includes screening and assessment for opioid use disorders. Provides that for a committed person diagnosed with opioid use disorder, the Department shall offer, or facilitate access to, all medication-assisted treatment options deemed appropriate by an authorized health care professional. Provides that the Department shall not impose limitations on the types of medication assisted treatment that may be recommended by an authorized health care professional as part of a treatment plan. Provides that an individual receiving medication-assisted treatment prior to being committed to a Department of Corrections facility shall be entitled to, upon request, continue such treatment in the medication assisted treatment program for any period of time deemed medically necessary by an authorized health care professional. Provides that no person shall be denied participation in medication-assisted treatment program on the basis of a positive drug screening upon entering the Department's custody; nor shall any person receive a disciplinary infraction for such positive drug screen. Provides that no person shall be denied participation in medication-assisted treatment based on prior success or failure of any medication-assisted treatment program. Provides that for each Parole District, the Department shall develop a plan to facilitate access to medication-assisted treatment for persons diagnosed with opioid use disorder in the community following release. Provides that the Department may adopt rules for the implementation of these provisions. Effective January 1, 2027.

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.

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, issued, delivered, or renewed on or after January 1, 2028 shall provide coverage for medically necessary epinephrine delivery systems. Removes language providing that "epinephrine injector" has the meaning set forth in the Epinephrine Injector Act. Provides that "epinephrine injector" includes an auto-injector approved by the United States Food and Drug Administration for the administration of epinephrine and a pre-filled syringe approved by the United States Food and Drug Administration and used for the administration of epinephrine that contains a pre-measured dose of epinephrine that is equivalent to the dosages used in an auto-injector. Includes epinephrine delivery systems in provisions concerning cost limitations for medically necessary epinephrine injectors.

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, 2027 to cover up to 12 mental health provider visits per plan year, with no visitation restrictions, if a local or State emergency is declared due to immigration enforcement activity and the insured has experienced loss, trauma, or displacement due to such activity. Provides that the coverage shall not be subject to deductibles, copayments, or other forms of cost sharing. Effective immediately.

Amends the Mental Health and Developmental Disabilities Administrative Act. Requires the Department of Human Services to establish reimbursement rates that build toward livable wages for frontline personnel in residential and day programs and service coordination agencies serving persons with intellectual or developmental disabilities. Provides that for community-based providers serving persons with intellectual or developmental disabilities, subject to federal approval of any relevant Waiver Amendment, the rates taking effect for services delivered on or after January 1, 2027 shall include an increase in the rate methodology sufficient to provide a $1.20 per hour wage rate increase for all direct support professionals and all other frontline personnel who are not subject to the Bureau of Labor Statistics' average wage increases and who work in residential and community day services settings. Prohibits community-based providers from using the rate increases for operational or administrative expenses. Requires rate increases that are sufficient to provide wages for all residential non-executive direct care staff. Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the rates for ID/DD and MC/DD facilities for services delivered on or after January 1, 2027 shall include a $1.20 per hour wage increase for all direct support professionals and other frontline personnel who are not subject to the Bureau of Labor Statistics' average wage increases. Provides that changes to the rate methodologies are subject to federal approval. Grants emergency rulemaking authority to the Departments of Human Services and Healthcare and Family Services to implement the rate increases. Effective immediately.

Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions concerning the supportive living facilities program, prohibits a supportive living dementia care setting from limiting a resident's access to the sink, microwave, or refrigerator located within the respective resident's room, provided a comprehensive safety assessment deems the resident's use of the appliances safe. Requires the comprehensive safety assessment to be conducted prior to any resident moving in and at least once per quarter thereafter. Requires social and recreational programming to be provided no less than 3 times daily, including at least one time and location separate from a meal service. Requires newly constructed supportive living dementia care settings to provide no less than 300 square feet for a single occupancy apartment or no less than 450 square feet for a double occupancy apartment, which may include the closets and bathroom. Requires each apartment to include a sink, microwave, and refrigerator within the unit. Provides that any newly constructed supportive living dementia care setting shall provide a common area completely separate from the dining area.

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.