Healthcare

Creates the Pharmacy Accountability and Access Act. Requires any owner of a pharmacy licensed under the Pharmacy Practice Act to provide written notice to specified governmental authorities no later than 180 calendar days before any pharmacy may be closed. Provides that the notice shall be physically posted at the affected location and prominently posted on the company's website for the entire 180-day period. Requires a report detailing the justification for closure, including any documentation of financial losses, operational inefficiencies, or how closure would otherwise align with the social responsibility commitments of the corporation. Sets forth provisions concerning public meetings, community transition plans, and repayment of tax incentives, subsidies, and other financial benefits provided to that pharmacy. Requires the Department of Public Health to review closures of pharmacies in medically underserved areas. Imposes penalties for failure to comply with the Act.

Declares March 5, 2025 as Rare Disease Day in the State of Illinois in order to raise awareness of rare diseases, support individuals and families who struggle with rare diseases, bring attention to the need for research and funding to support the discovery and development of therapies designed to treat and potentially cure rare diseases, and support the continued work of the Illinois Rare Disease Commission.

Amends the Illinois Insurance Code. Provides that any health insurance issuer carrying on business in this State on or after January 1, 2027 shall develop a plan to provide adequate coverage of and access to a broad spectrum of pain management services, including, but not limited to, nonopioid, nonnarcotic medication for pain management and nonmedication pain management services that serve as alternatives to the prescribing of opioid or narcotic drugs in accordance with guidelines that will be developed by the Department of Insurance. Provides that the Department shall review the plans and consider the adequacy of access to a broad spectrum of pain management services under the issuers plans and whether any policies adopted by the issuer may create unduly preferential coverage of and access to prescription opioids for pain management, without consideration of other pain management services. Provides that Any health insurance issuer carrying on business in the State of Illinois shall distribute educational materials to participating providers about any pain management access plan and post information about the plan on the issuer's publicly accessible website. 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 Emergency Medical Services (EMS) Systems Act. Provides that the Department of Public Health shall allow for an alternative rural staffing model for vehicle service providers that serve a rural or semi-rural population of 10,000 or fewer inhabitants and exclusively use volunteers, paid-on-call, or part-time employees, or a combination thereof (now, the use of part-time employees is not an option). Effective immediately.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that subject to federal approval, for dates of service on and after January 1, 2026, the Department of Healthcare and Family Services shall reimburse diagnostic testing facilities that provide long-term ambulatory electrocardiogram monitoring services at a rate not less than 80% of the Medicare Physician Fee Schedule rate for such services. Defines "long-term ambulatory electrocardiogram monitoring services".

Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions concerning medical assistance for employed persons with disabilities and employed persons with a medically improved disability, provides that, subject to federal approval, the Department of Healthcare and Family Services shall eliminate income eligibility standards for such persons to the extent permitted by federal law and shall eliminate the consideration of assets when determining such persons eligibility for medical assistance to the extent permitted by federal law.

Creates the Wholesale Prescription Drug Importation Program Act. Requires the Department of Public Health to establish the Wholesale Prescription Drug Importation Program. Provides that the Department shall implement the program by: contracting with one or more prescription drug wholesalers and Canadian suppliers to import prescription drugs and provide prescription drug cost savings to consumers in this State; developing a registration process for health benefit plan issuers, health care providers, and pharmacies to obtain and dispense prescription drugs imported under the program; developing a list of prescription drugs, including the prices of those drugs, that meet certain requirements set forth under the Act and publishing the list on the Department's website; establishing an outreach and marketing plan to generate program awareness; ensuring the program and the prescription drug wholesalers that contract with this State comply with certain federal tracking, tracing, verification, and identification requirements; and other actions. Sets forth eligibility criteria for prescription drugs that may be imported into the State under the program. Contains provisions concerning anticompetitive behavior monitoring; program funding; program expansion; audit procedures; annual reporting requirements; the adoption of rules to implement the Act; and federal waiver or authorization requirements. Effective July 1, 2025.

Amends the Clinical Psychologist Licensing Act. In provisions concerning written collaborative agreements, removes a provision prohibiting a prescribing psychologist from prescribing medications to patients who are less than 17 years of age or over 65 years of age. Provides that no prescriptive authority for any Schedule II opioid shall be delegated. Provides that after the collaborating physician files a notice delegating authority to prescribe any nonnarcotic, nonopioid Schedule II through V controlled substances (rather than any nonnarcotic Schedule III through V controlled substances), the licensed clinical psychologist shall be eligible to register for a mid-level practitioner controlled substance license under the Illinois Controlled Substances Act. Defines "opioid". Makes corresponding changes in the Illinois Controlled Substances Act. Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services shall provide coverage and reimbursement for prescription management services provided by prescribing psychologists for persons who are otherwise eligible for medical assistance under the Article. Effective immediately.

Amends the Hospital Provider Funding Article of the Illinois Public Aid Code. In a provision requiring the Department of Healthcare and Family Services to create a pool of funding of at least $50,000,000 annually to be disbursed among safety-net hospitals that maintain perinatal designation from the Department of Public Health, provides that no safety-net hospital eligible for funds shall receive less than $5,000,000 annually.

Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2026 shall provide coverage for medically necessary general anesthesia, regardless of the duration, for any procedure covered by the policy, and that medical necessity shall be determined by the attending anesthesiologist or licensed anesthesia provider. Provides that an individual or group policy of accident and health insurance is prohibited from denying payment or reimbursement for anesthesia services solely because the duration of care exceeded a preset time limit. 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 Services Plans Act, and the Illinois Public Aid Code to require coverage under those provisions. Effective immediately.