Healthcare

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the amendatory Act may be referred to as the Sara Lynn Act. Requires the Department of Healthcare and Family Services to establish and administer a Seniors Deserve Dignity Program that provides monthly supplemental personal needs payments to persons residing in supportive living facilities who receive medical assistance and a personal needs allowance as specified in the Illinois Administrative Code. Provides that, beginning July 1, 2025, a qualifying person shall receive a monthly supplemental personal needs payment in the amount of $30 so that the person's total monthly personal needs allowance is no less than $120. Provides that the monthly supplemental personal needs payments shall not be considered income for purposes of determining eligibility or the amount of assistance for any public aid benefit provided under State law. Grants the Department rulemaking authority. Effective July 1, 2025.

Amends the Mental Health and Developmental Disabilities Code. Expands the definition of "developmental disability" to include a disability attributable to Prader-Willi syndrome. Amends the Developmental Disability and Mental Disability Services Act. Expands the definition of "severe and multiple impairments" to include a substantial disability attributable to Prader-Willi syndrome. Exempts persons diagnosed with Prader-Willi syndrome from any assessment or evaluation to measure cognitive functioning or IQ for purposes of making determinations on whether such persons have severe and multiple impairments eligible for home-based and community-based services. Amends the Mental Health and Developmental Disabilities Administrative Act. Requires the Department of Human Services to include Prader-Willi syndrome as a developmental disability in any rule defining the term "developmental disability" and in any rule listing specific medical conditions or disabilities eligible for developmental disability services provided by the Department. Amends the Statute on Statutes. Provides that, except where the context indicates otherwise: (i) in any rule, contract, or other document the term "developmental disability" shall include a disability attributable to Prader-Willi syndrome; and (ii) whenever there is a reference in any Act to "development disability" the term shall be construed to include a disability attributable to Prader-Willi syndrome.

Amends the Code of Criminal Procedure of 1963 concerning a defendant's commitment for mental health treatment. Provides that if the Department of Human Services does not provide placement within the 20 days of transmittal from the circuit court clerk, the Department shall provide payment to the sheriff, as prescribed by the sheriff, including, but not limited to, housing and mental health services for each day after 20 days have passed from the time the defendant was first placed in the sheriff's custody. Provides that the sheriff shall not be held liable for any issues encountered after the 20th day the defendant remains in his or her care. Deletes provision that Department shall admit the defendant to a secure facility within 60 days of the transmittal of the court's placement order, unless the Department can demonstrate good faith efforts at placement and a lack of bed and placement availability. Deletes if placement cannot be made within 60 days of the transmittal of the court's placement order and the Department has demonstrated good faith efforts at placement and a lack of bed and placement availability, the Department shall provide an update to the ordering court every 30 days until the defendant is placed.

Amends the Regulatory Sunset Act. Changes the repeal date of the Illinois Dental Practice Act from January 1, 2026 to January 1, 2036. Amends the Illinois Dental Practice Act. In the definition of "branches of dentistry", adds oral and maxillofacial pathology, dental public health, oral medicine, and orofacial pain to the included specialties. Creates a temporary dental hygiene license for dental students who meet certain requirements. Provides that a licensee holding a temporary dental hygiene license must practice under the supervision of a dentist. Provides that the temporary dental hygiene license is active for one year from its issuance date. Changes the implementation deadline for an order regarding the services that are necessary to be performed on a patient who is in a State or federal prison and who cannot travel to a dental office to 180 days of the order's issuance (rather than 45 days of the order's issuance). Removes language providing that provisions concerning public health dentistry are inoperative on and after January 1, 2026. Effective immediately.

Amends the Illinois Health Benefits Exchange Law. Provides that the Illinois Health Benefits Exchange shall allow a special enrollment period for an uninsured taxpayer and the uninsured taxpayer's qualified dependents, if applicable, if the uninsured taxpayer requested health insurance benefit information through the easy enrollment program under the Illinois Income Tax Act and the uninsured taxpayer and the uninsured taxpayer's qualified dependents, if applicable, are eligible to enroll in a qualified health plan through the Exchange. Establishes notification requirements for the Exchange. Provides that the uninsured taxpayer and the uninsured taxpayer's dependents shall have 60 days from the date of the letter to select and enroll in a qualified health plan. Provides that coverage shall be effective the first day of the month that follows the plan selection. Grants the Department of Insurance and the Department of Healthcare and Family Services rulemaking authority to implement an easy enrollment special enrollment period. Effective immediately.

Amends the Illinois Physical Therapy Act. Provides that initial physical therapy evaluations without a referral or an established diagnosis may be performed by a licensed physical therapist via telehealth when the physical therapist determines that an in-person examination is not required based on the physical therapist's clinical judgment and the applicable standard of care (rather than cannot be performed via telehealth unless necessary to address a documented hardship). Provides that a physical therapist or a licensed physical therapy assistant may require the patient to undergo an in-person visit instead of providing telehealth services (rather than the use of telehealth as a primary means of delivering physical therapy must be an exception and documentation must support the clinical justification). Provides that a physical therapist providing telehealth must have the capacity to provide or be able to facilitate a referral to in-person care within the State (rather than must only have the capacity to provide in-person care). Provides that the standard of care for a patient receiving physical therapy through telehealth is equal to the standard of care for in-person care.

Amends the Mental Health and Developmental Disabilities Administrative Act. Provides that within 6 months of learning that an adult with a developmental disability has lost a parental guardian while living with that parental guardian or independently, the Department of Human Services shall request a wellness check from the designated adult protective services agency or provider agency as defined in the Adult Protective Services Act to: (1) verify that the adult with a developmental disability is not experiencing or at imminent risk of abuse, neglect, exploitation, or self-neglect; and (2) establish mandatory standards for the provision of emergent casework and follow-up services to mitigate the risk of harm or death to the adult with a developmental disability.

Amends the Use Tax Act, the Service Use Tax Act, the Service Occupation Tax Act, and the Retailers' Occupation Tax Act. Provides that, beginning on July 1, 2025, "prescription and nonprescription medicines and drugs" includes cannabis purchased by a qualified registered patient, provisional patient, or designated caregiver from a dispensing organization registered under the Compassionate Use of Medical Cannabis Program Act or the Cannabis Regulation and Tax Act. Amends the Compassionate Use of Medical Cannabis Program Act. Adds, changes, and provides for the repeal of certain definitions. Makes conforming changes to terms in the Act. Sunsets certain provisions on June 30, 2025. Adds references to the Cannabis Regulation and Tax Act, supplanting certain provisions in the Act on July 1, 2025. Provides for repeal of certain provisions on January 1, 2026, subjecting certain activities to the Cannabis Regulation and Tax Act. Repeals certain provisions. Amends the Cannabis Regulation and Tax Act. Adds and changes definitions. Makes conforming changes to terms in the Act. Removes certain references and provides for repeal of certain provisions related to the Compassionate Use of Medical Cannabis Program Act. Makes provisions regarding mergers of certain licenses and medical patient prioritization. Provides for Adult Use Dispensing Organization licensee relocation. Provides for rescission of a conditional license, with certain requirements. Makes changes to provisions regarding Adult Use Dispensing Organization Licenses. Adds to requirements for Responsible Vendor Program Training modules. Adds new prohibitions and exceptions to provisions regarding changes to a dispensing organization. Requires prioritizing qualifying patients, provisional patients, and dedicated caregivers, with certain requirements. Adds certain State agencies and local health officials to provisions regarding investigations. Makes changes to provisions regarding Cultivation Center Licenses. Makes other changes.

Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions concerning PDPM STRIVE staffing ratio calculations for nursing facilities, provides that beginning January 1, 2025, the staffing percentage used in the calculation of the per diem staffing add-on shall be its PDPM STRIVE Staffing Ratio which equals: its Reported Total Nurse Staffing Hours Per Resident Per Day as published in the most recent federal staffing report (the Provider Information file), divided by the facility's PDPM STRIVE Staffing Target. Provides that each facility's PDPM STRIVE Staffing Target is equal to .76 times the facility's Illinois Adjusted Facility Case-Mix Hours Per Resident Per Day. Provides that a facility's Illinois Adjusted Facility Case-Mix Hours Per Resident Per Day is equal to its Nursing Case-Mix (as published in the most recent federal Provider Information file) divided by 1.4627 times 3.79 (which is the Reported Total Nurse Staffing Hours Per Resident Per Day for the Nation as reported in the January 2024 State US Averages file). Effective July 1, 2025.

Amends the Illinois Insurance Code to create the Consumer Protection from Surprise Health Care Billing Act. Provides that, on or after July 1, 2025, notwithstanding any other applicable provision, when a beneficiary, insured, or enrollee receives services from a nonparticipating ground ambulance service provider, the health insurance issuer shall ensure that the beneficiary, insured, or enrollee shall incur no greater out-of-pocket costs than the beneficiary, insured, or enrollee would have incurred with a participating ground ambulance service provider. Provides that any cost-sharing requirements shall be applied as though the services provided by the nonparticipating ground ambulance service provider had been provided by a participating ground ambulance service provider. Sets forth provisions concerning payment for ground ambulance services; calculating the recognized amount; limitations for the cost sharing amount for any occurrence in which a ground ambulance service is provided to a beneficiary; appeals for payments made by health insurance issuers; the maximum allowable payment amounts, by individual service types, for nonparticipating ground ambulance service providers owned, operated, or controlled by a private organization; and payments to nonparticipating ground ambulance service providers owned, operated, or controlled, by a unit of government which participates in the Ground Emergency Medical Transportation program administered by the Department of Healthcare and Family Services. Makes conforming changes. Provides that the failure by a health insurance issuer to comply with the specified requirements constitutes an unlawful practice under the Consumer Fraud and Deceptive Business Practices Act and enforcement authority is granted to the Attorney General. Amends the Health Maintenance Organization Act and the Consumer Fraud and Deceptive Business Practices Act to make corresponding changes. Effective July 1, 2025.