Healthcare

Declares the month of July 2025 as Systemic Juvenile Idiopathic Arthritis (SJIA) Awareness Month in the State of Illinois. Encourages funding for research organizations working towards finding the cause and the cure of SJIA in order to prevent this disease and offer successful treatment options.

Amends the Medical Practice Act of 1987. Provides that sex-reassignment procedures are prohibited for patients younger than 18 years of age. Provides that if sex-reassignment procedures are administered or performed on patients 18 years of age or older, consent must be provided as specified. Provides that the Department of Financial and Professional Regulation shall revoke the license of any physician who willfully or actively violates the prohibition on sex-reassignment procedures for patients younger than 18 years of age. Amends the Hospital Licensing Act and the Ambulatory Surgical Treatment Center Act. Adds a failure to comply with the provisions as grounds for fines, license denial, license suspension or revocation, or refusal to renew a hospital or facility's license. Amends the Illinois Administrative Procedure Act to provide for emergency rulemaking.

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 after January 1, 2026 shall provide coverage for one pair of custom-made retainers and one night guard every 2 years for each family covered by the policy. 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 Fair Patient Billing Act. Removes language providing that a hospital shall provide an itemized bill upon request. Provides instead that the hospital shall provide notice that the patient will be given an itemized statement of charges for inpatient and outpatient services rendered by the hospital unless the patient chooses to opt out of receiving such statement. Allows the itemized statement to be provided in an electronic format. Requires the information regarding the patient's choice to opt out to be prominent, clearly labeled, and provided to the patient before signing any documents relating to itemized billing. Prohibits a patient from being under the influence of any anesthetic or drug that inhibits mental performance when given the documents. Provides that the hospital's failure to comply with the requirements constitutes an unlawful practice under the Consumer Fraud and Deceptive Business Practices Act. Makes a corresponding change in the Consumer Fraud and Deceptive Business Practices Act.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to require Medicaid managed care organizations to reimburse at no less than 100% of the Medical Assistance program's Durable Medical Equipment fee schedule for the same service or item of durable medical equipment, complex rehab technology, prosthetics, orthotics, or supplies. Provides that the reimbursement requirement shall also apply to a Medicaid managed care organization's subcontractors and third-party administrators. Provides that the Department has the authority to implement the reimbursement requirement on and after July 1, 2025 and prior to the completion of any regulatory process undertaken in order to effect such change. Effective July 1, 2025.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that on January 1, 2026 the reimbursement rates for applied behavior analysis services for the treatment of autism spectrum disorder shall be increased by 3.5% above the reimbursement rates in effect on December 31, 2025.

Creates the Ensuring Essential Services Act. Provides that the purpose of the Act is to ensure the State meets its obligation to provide certain essential services for individuals with developmental disabilities at consistent quality levels in accordance with its waiver agreement with the Centers for Medicare and Medicaid Services, all while allocating scarce taxpayer resources. Provides that any contract entered into between the Department of Human Services and an agency shall include a provision assuring the State of the uninterrupted delivery of the contracted-for services. Provides that such assurance shall provide that the agency has entered into a binding labor peace agreement with any labor organization that is the exclusive representative of the agency's frontline and direct support staff or, where no exclusive representation has been established, that the agency has or will enter into an agreement with any labor organization that seeks to become the agency's frontline and direct support staff's exclusive representative. Provides that the assurance shall become a condition of any contract entered into, renewed, or amended on or after the effective date of the Act. Requires the Department of Healthcare and Family Services to, no later than 90 days after the effective date of the Act, apply to the Centers for Medicare and Medicaid Services for a waiver or State Plan amendment to allow implementation of the contracting requirements. Requires the Department of Human Services, no later than 60 days after the effective date of the Act, to adopt rules implementing the requirements of the Act. Contains provisions on contract requirements for Department of Human Services' contracts; enforcement of contractual assurances; remedial actions for noncompliance; and other matters. Effective June 1, 2025.

Creates the Patient Access to Pharmacy Protection Act. Defines terms. Provides that no person, including a pharmaceutical manufacturer, may deny, restrict, prohibit, condition, or otherwise interfere with, either directly or indirectly, the acquisition of a 340B drug by, or delivery of a 340B drug to, a 340B covered entity or a 340B contract pharmacy authorized to receive 340B drugs on behalf of the 340B covered entity unless such receipt is prohibited by federal law. Provides that no person, including a pharmaceutical manufacturer, may impose any restriction on the ability of a 340B covered entity to contract with or designate a 340B contract pharmacy including restrictions relating to the number, location, ownership, or type of 340B contract pharmacy. Provides that no person, including a pharmaceutical manufacturer, may require or compel a 340B covered entity or 340B contract pharmacy to submit or otherwise provide ingredient cost or pricing data pertinent to 340B drugs unless required by State or federal law; institute requirements in any way relating to how a 340B covered entity manages its inventory of 340B drugs that are not required by a State or federal agency, including requirements relating to the frequency or scope of audits of inventory management systems of a 340B covered entity or a 340B contract pharmacy; or submit data or information that is not required by State or federal law as a condition for a 340B covered entity, its 340B contract pharmacy, or a location otherwise authorized by a 340B covered entity to receive 340B drugs. Sets forth provisions concerning enforcement of this Act; preemption of this Act; and severability of this Act. Effective immediately.

Amends the Illinois Public Aid Code. Expands the categories of families eligible for child care assistance to include families with a parent or guardian who is employed as a mental health care worker, teacher, or health care provider and has income below the specified income threshold established for such families. Provides that notwithstanding any other provision of law or administrative rule to the contrary, beginning in State Fiscal Year 2026, for families with a parent or guardian who is employed as a mental health care worker, teacher, or health care provider, the specified income threshold shall be no less than 300% of the then-current federal poverty level for each family size. Defines terms. Effective July 1, 2025.

Condemns the practice of conversion therapy on any population as unethical and fraudulent. Asserts that no licensed professional operating in the State of Illinois should engage in this practice, whether with minors or adults, as it violates the ethical standards of professional behavioral healthcare. Condemns conversion therapy as described herein, regardless of the target population or how the service is marketed or titled. Acknowledges that conversion therapy is not a legitimate form of therapy but is a dangerous and discredited practice that has no place in a professional setting, and that any professional engaging in such practices is in violation of the ethical guidelines governing their licensure. Encourages the Illinois Department of Public Health to launch a statewide public awareness campaign to educate communities about the harms of conversion therapy and its fraudulent nature, to collaborate with the Department of Financial and Professional Regulation to investigate and hold accountable practitioners offering conversion therapy under false pretenses, to develop guidelines for healthcare professionals to recognize, report, and prevent practices associated with conversion therapy, and to support outreach initiatives to connect survivors of conversion therapy with affirming mental health resources.