Healthcare

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.

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 shall provide coverage for one crib and one car seat for each postpartum individual covered under the policy. Provides that the postpartum individual must be covered by the insurance policy at the time of child birth and must submit a claim within 6 months after the birth. Provides that the insurer must either reimburse the postpartum individual for the purchase of an approved crib and car seat upon submission of a valid receipt or provide a car seat and crib to the postpartum individual that complies with all federal and State safety standards. 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 Nursing Mothers in the Workplace Act. Changes the name of the Act to the Nursing in the Workplace Act. Provides that an employee who has been denied any rights under the Act may bring an action to enjoin future denials of those rights. Provides that, if the employee prevails in that action, the employee shall be awarded reasonable attorney's fees and costs. Makes other changes. Effective immediately.

Amends the Telehealth Act. Adds acupuncturist to providers included in the meaning of "health care professional". Amends the Acupuncture Practice Act. Provides that the standard of care for a patient under the Act shall be the same whether a patient is seen in person, through telemedicine, or through another method of electronically-enabled health care. Requires the Department of Financial and Professional Regulation, by rule, to determine the appropriate acupuncture services allowed via telemedicine in consultation with the Board of Acupuncture. Provides that a person who engages in the practice of telemedicine without a license issued under the Act shall be subject to the penalties provided in the Act. Provides that, if the Department has reason to believe that a person has violated the provisions regarding telemedicine, the Department may issue a rule to show cause stating the reasons why an order to cease and desist should not be entered against the person. Provides that the rule shall clearly set forth the grounds relied upon by the Department and shall provide the person with a period of 7 days after the date of the rule to file an answer to the satisfaction of the Department. Provides that failure to answer to the satisfaction of the Department shall cause an order to cease and desist to be issued immediately. Provides that a person residing out-of-state that provides services through telemedicine to a patient residing in the State submits himself or herself to the jurisdiction of the Department and the courts of the State.