Healthcare

Creates the Screen Illinois Initiative Act. Authorizes the Department of Public Health to establish the Screen Illinois Initiative to increase the number of mobile health screening unit hubs in the State. Provides that the Screen Illinois Initiative funding shall be used to support the operations of the mobile health screening units by covering purchases, maintenance, salaries, and costs under the Act. Establishes requirements regarding the mobile health screening units and the protocols for follow-up care and appointments. Requires the Department of Public Health to adopt rules. Defines terms. Makes other conforming changes.

Amends the Department of Central Management Services Law of the Civil Administrative Code of Illinois. Creates the Disability Benefits Maximization Program. Provides that, within 6 months after the effective date of the amendatory Act, the Department of Central Management Services, in conjunction with the 5 State-funded retirement systems, shall enter into a contract with an administrator to establish and conduct a Disability Benefits Maximization Program to identify individuals eligible for but not enrolled in Medicare, and to assist those individuals with enrolling in Social Security and Medicare. Provides that the Disability Benefits Maximization Program shall conduct an annual audit of the State health benefits program for everyone covered under the State Employees Group Insurance Program, the Teachers' Retirement Insurance Program, and the College Insurance Program for the purpose of identifying participants and their dependents who are eligible for Medicare under federal law and shall also ensure that those annuitants, retirees, benefit recipients, survivors, and dependents who are eligible for Medicare are enrolled in Medicare with Medicare as their primary health care benefits coverage and the State health benefits program being the secondary provider of their health care benefits coverage. Provides that the Disability Benefits Maximization Program shall assist annuitants, retirees, benefit recipients, and their survivors and dependents who become disabled and are not enrolled in Social Security Disability Insurance and Medicare with enrolling in and obtaining Social Security Disability Insurance and Medicare benefits. Provides that the administrator of the Disability Benefits Maximization Program shall provide the Department, the 5 State-funded retirement systems, and the General Assembly with an annual report. Effective January 1, 2027.

Amends the Pharmacy Practice Act. Provides that a pharmacist who is exercising his or her professional judgment may add missing non-pharmaceutical devices or durable medical equipment that aid in the appropriate clinical usage of a medication or in achieving a positive therapeutic outcome to a prescription. Provides that a pharmacist may complete missing information on a prescription if there is evidence to support the change. Requires any adaptations to a prescription to be documented in the patient's record. In provisions concerning the distribution of a prescription drug for less than its fair market value, provides that it shall be unlawful to require a pharmacist or pharmacy to dispense a prescription drug for less than its fair market value, including the cost of dispensing. Provides that a payor that reimburses a pharmacy for less than fair market value, including the cost of dispensing, shall not be able to include the pharmacy toward any network adequacy requirements and shall not be deemed in compliance with any willing provider provisions.

Amends the Illinois Insurance Code. Removes language providing that provisions concerning reimbursement for certain telehealth services are inoperative on and after January 1, 2028.

Amends the Hospital Services Trust Fund Article of the Illinois Public Aid Code. In provisions requiring the Department of Healthcare and Family Services to pay safety-net hospitals a low volume add-on payment of $200 for each inpatient General Acute and Psychiatric day of care, removes the December 31, 2026 sunset date for such add-on payments. Effective immediately.

Amends the Nurse Practice Act. In provisions concerning registered professional nurse licensure by examination, provides that, prior to September 1, 2029 (rather than September 1, 2026), no professional nursing program shall be placed on probationary status for failing to reach a licensure examination passage rate of less than 75%.

Amends the School Code. Provides that, subject to appropriation, the State Board of Education, in consultation with the Department of Public Health, shall develop an educational document explaining, at a minimum, the values of good indoor air quality and shall supply the document to school districts. Provides that, subject to funding from the State Board, a school district shall ensure that all active classrooms are equipped with an air quality monitor.

Creates the Preventing Crisis Cost Shifting to Medicaid Act. Provides that the General Assembly finds that (i) behavioral health crisis services, including crisis call centers, mobile crisis response, and crisis stabilization and receiving services, function as essential public health infrastructure and must be available statewide without regard to insurance status; and (ii) commercial health insurance policies issued or administered in the State generally do not provide comprehensive coverage for the full continuum of behavioral health crisis services, resulting in the cost of such services being disproportionately borne by Medicaid, local governments, and taxpayers. Requires specified entities (surcharge payors) that are authorized to issue or administer a policy or contract of accident and health insurance or a health maintenance organization contract in the State to pay a behavioral health crisis assessment to the Department of Human Services for deposit into the Statewide 9-8-8 Trust Fund. Exempts Medicaid managed care organizations from paying the behavioral health crisis assessment. Permits the Department to update the total behavioral health crisis assessment amount as necessary to ensure the continued availability, quality, or geographic equity of the statewide behavioral health crisis system. Requires the Department to establish an appropriate mechanism for enforcing a surcharge payor's liability, which may include accrued interest on unpaid liabilities at a rate not to exceed 18% per annum and late fees or penalties at a rate not to exceed 5% per month. Provides that the enforcement mechanism may also include notification to the Department of Healthcare and Family Services to offset payments on the surcharge payor's claims. Provides that the Department of Human Services shall not direct the Department of Healthcare and Family Services to offset claims payments unless the surcharge payor has maintained an outstanding liability to the Statewide 9-8-8 Trust Fund for a period longer than 45 days and has received proper notice of pending enforcement.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that, on and after January 1, 2027, certain services shall be eligible for reimbursement at approved programs through the Brain Injury waiver for eligible individuals over the age of 21, including, but not limited to: (1) case management; (2) nursing services; (3) medical oversight by consulting medical director; (4) physical therapy; and (5) occupational therapy. Requires the Department of Human Services to reimburse approved programs at the rates in effect for the Home and Community-Based Services Waiver program most recently approved. Effective January 1, 2027.

Amends the Illinois Power of Attorney Act. Creates rights for patients with a health power of attorney. Provides that all individuals undergoing surgery, hospitalization, or any medical procedure shall have the right to designate a designated representative in a health care power of attorney on their behalf in the event of incapacitation. Provides that patients and their designated representatives are guaranteed the following rights: (1) the right to receive clear, comprehensive information about proposed treatments, including risks, benefits, and alternatives, in a language and format they understand, before agreeing to any procedure; (2) the right to view, request, and receive copies of all medical records, and the assurance of confidentiality in accordance with Health Insurance Portability and Accountability Act and related privacy laws; (3) the right to appeal medical decisions, including denial of treatment, discharge, or transfer; (4) the right to request and receive a second opinion from another qualified medical professional or specialist, including those outside the treating facility, without fear of delay, retaliation, or obstruction; and (5) the right to medical interpretation services for patients or their designated representative who do not speak or understand English fluently, including access to certified medical translators and translated documents, at no cost to the patient. Creates a State Patient Rights and Advocacy Commission to oversee implementation of the Act, monitor compliance by health care providers, and respond to violations. Provides that any health care provider or institution found to be in violation of the Act is subject to disciplinary sanctions, which may include: civil fines; suspension or revocation of professional licenses; facility accreditation review or suspension; and mandatory corrective action plans and staff retraining.