Healthcare

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, 2027 that provides coverage for: habilitative services shall provide coverage for habilitative speech therapy as a treatment for stuttering, regardless of whether the stuttering is classified as developmental; rehabilitative services shall provide coverage for rehabilitative speech therapy as a treatment for stuttering; or habilitative services and rehabilitative services shall provide coverage for habilitative speech therapy as a treatment for stuttering, regardless of whether the stuttering is classified as developmental, and shall provide coverage for rehabilitative speech therapy as a treatment for stuttering. Sets forth requirements and limitations for the coverage. 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 those provisions. Amends the State Mandates Act to require implementation without reimbursement. Effective January 1, 2027.

Amends the Illinois Insurance Code. Defines "health benefit plan" and other terms. Provides that a pharmacy benefit manager or an affiliate acting on the pharmacy benefit manager's behalf is prohibited from conducting spread pricing, from steering a covered individual, and from limiting a covered individual's access to prescription drugs from a pharmacy or pharmacist enrolled with the health benefit plan under the terms offered to all pharmacies in the plan coverage area by unreasonably designating the covered prescription drugs as a specialty drug. Provides that a pharmacy benefit manager or an affiliate acting on the pharmacy benefit manager's behalf must remit 100% of rebates and fees to the health benefit plan sponsor, consumer, or employer. Provides that a pharmacy benefit manager may not reimburse a pharmacy or pharmacist for a prescription drug or pharmacy service in an amount less than the national average drug acquisition cost for the prescription drug or pharmacy service at the time the drug is administered or dispensed, plus a professional dispensing fee. Provides that a contract between a pharmacy benefit manager and an insurer or health benefit plan sponsor must allow and provide for the pharmacy benefit manager's compliance with an audit at least once per calendar year of the rebate and fee records remitted from a pharmacy benefit manager or its contracted party to a health benefit plan. Provides that provisions concerning pharmacy benefit manager contracts apply to any health benefit plan (instead of any group or individual policy of accident and health insurance or managed care plan) that provides coverage for prescription drugs and that is amended, delivered, issued, or renewed on or after July 1, 2020. Requires a pharmacy benefit manager to submit an annual report that includes specified information concerning prescription drugs. Makes other changes. Amends the Freedom of Information Act to make a conforming change. Effective July 1, 2025.

Amends the Interagency Children's Behavioral Health Services Act. Requires the Department of Human Services, in coordination with a statewide association representing a majority of hospitals, to establish and offer a voluntary training that will be recorded and made available on the Department's website to all hospital social workers, clinicians, and administrative staff to inform them of BEACON, a centralized resource for Illinois youth and families seeking services for behavioral health needs, with the goal of encouraging families to seek assistance through BEACON and the Interagency Children's Behavioral Health Services Team. Provides that the training shall include how families and hospital staff can access BEACON, the process once a case is entered into BEACON, and State and community programs accessible through BEACON. Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires a psychiatric hospital to contact a youth or the youth's parents, guardian, or caregiver about the BEACON portal (rather than the Family Support Program and the Specialized Family Support Program) prior to referring the youth to the Department of Children and Family Services because the youth was left at the psychiatric hospital beyond medical necessity. Amends the School Code. Requires the State Board of Education, in consultation with the Children's Behavioral Health Transformation Team in the Office of the Governor and relevant stakeholders, to report its work and make available resource materials, including model policies and guidance informed by a phased approach to implementing universal mental health screening in schools. Requires the State Board of Education to report its work by September 1, 2026. Provides that mental health screenings shall be offered by school districts to students enrolled in kindergarten through grade 12, at least once a year, beginning with the 2027-2028 school year.

Amends the Assisted Living and Shared Housing Act, the Nursing Home Care Act, the MC/DD Act, the ID/DD Community Care Act, and the Illinois Public Aid Code. Provides that the administrator of a facility or establishment under any of those Acts shall ensure that the facility or establishment has an automated external defibrillator and policies and procedures for the rendering of automated external defibrillation in the facility or establishment. Provides course requirements for persons certified to provide automated external defibrillation. Provides that a facility or establishment shall contract with or employ a physician who shall be the automated external defibrillation medical director for the facility or establishment and who shall oversee and coordinate specified requirements.

Amends the Personnel Code. Provides that certain provisions related to probationary separation, term appointments, and veterans hospital visits are subject to Jurisdiction B. Changes references to "veterans hospital visits" to references to "veterans medical appointments". Provides that an employee who is also a veteran shall be permitted 4 days per year to receive medical care authorized by the U.S. Department of Veterans Affairs, at any type of health care provider or health care facility (rather than permitted 4 days per year to visit a veterans hospital or clinic), for examination or treatment (rather than for examination) of a military service-connected condition (rather than service-connected disability).

Amends the Department of Human Services Act. Requires the Department of Human Services to establish and administer, no later than January 1, 2026, a 5-year pilot program that integrates an occupational therapy component into the State's home-delivered meals program, commonly known as Meals on Wheels, authorized under the federal Older Americans Act. Provides that under the pilot program, the Department shall award grants funded under the Section 14(c) transition program to eligible community agencies for the purpose of training and employing qualifying workers with disabilities to accompany Meals on Wheels drivers on their regular delivery routes and assist in the delivery of meals to homebound meal recipients who opt to participate in the pilot program. Provides that at the option of a participating homebound meal recipient, a qualifying worker may remain with the recipient for up to 2 hours after meal delivery to provide an opportunity for social engagement and interaction. Provides that a direct support professional shall travel with and supervise all deliveries made by a worker whose disability makes the worker less independent. Sets forth qualification requirements under the program for workers with disabilities. Provides that all workers with disabilities selected to participate in the pilot program shall be compensated at a rate level consistent with those wage standards applied for workers engaged in competitive integrated employment as defined in the federal Workforce Innovation and Opportunity Act and the Rehabilitation Act of 1973. Requires community agencies selected to receive grant funding under the pilot program to have active or pending subminimum wage certificates authorized under Section 14(c) of the federal Fair Labor Standards Act of 1938 and meet any other eligibility requirements established by the Department by rule. Requires the Department to conduct annual surveys during the duration of the pilot program on participating homebound meal recipients and workers with disabilities to gauge such participants' overall satisfaction with the pilot program and to document any other additional benefits to program participants. Effective July 1, 2025.

Amends the Mental Health and Developmental Disabilities Code. Makes changes to a provision concerning initial Department of Human Services investigations of a facility employee's alleged abuse, neglect, or financial exploitation of a recipient of mental health or developmental disability services. Expands the provision to include allegations of material obstruction of an investigation, physical abuse, sexual abuse, non-de minimis financial exploitation (such as financial exploitation totaling a cumulative value equal to or greater than $100), or egregious neglect. Adds provisions concerning Department investigations where a facility employee is the perpetrator of, at most, neglect, de minimis financial exploitation (such as financial exploitation totaling a cumulative value of less than $100), or mental abuse.

Amends the Unified Code of Corrections. Provides that the Prisoner Review Board shall place no additional restrictions, limitations, or requirements than that provided by the statute creating the procedure for medical release. Provides that upon a determination that the petitioner is eligible for a hearing on medical release, the Prisoner Review Board shall: (1) provide public notice of the petitioner's name, docket number, counsel, and hearing date; and (2) provide a copy of the evaluation and any medical records provided by the Department of Corrections to the petitioner or the petitioner's attorney upon scheduling the institutional hearing. Provides that a hearing on a petitioner's application for medical release is public unless the petitioner requests a non-public hearing. Provides that members of the public shall be permitted to freely attend public hearings on medical release without restriction. Provides that upon denying an eligible petitioner's application for medical release, the Prisoner Review Board shall publish a decision letter outlining the reason for denial. Provides that the decision letter must include an explanation of each statutory factor and the estimated annual cost of the petitioner's continued incarceration, including the petitioner's medical care. Makes technical changes.

Creates the Holistic Overdose Prevention and Equity Act. Creates the Harm Reduction Program Board, with certain requirements. Provides that the Department of Public Health shall issue grants to harm reduction providers, with certain requirements. Establishes a Chief Harm Reduction Officer within the Department. Provides for a place-based approach to harm reduction pilot program. Provides for local government training and continuing education. Provides that naloxone shall be made readily available to all staff and individuals in prisons and jails, with certain requirements. Provides for medication for opioid use disorder and fentanyl testing. Restricts the use of abstinence-only or sobriety requirements to housing, with certain requirements. Limits home rule powers. Makes findings. Defines terms. Amends the Department of Professional Regulation Law of the Civil Administrative Code of Illinois, the Counties Code, the County Jail Act, the Unified Code of Corrections, the Hospital Licensing Act, and the Overdose Prevention and Harm Reduction Act to make conforming changes.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that on and after January 1, 2026, 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, 2026.