Healthcare

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that if the United States Supreme Court holds to be unconstitutional a provision under the Patient Protection and Affordable Care Act (Public Law 111-148) that prohibits a group health plan and health insurance issuer from establishing lifetime or annual limits on the dollar value of benefits, or if the holding makes Medicaid eligibility allowed under that specified provision inoperable, then the Department of Healthcare and Family Services shall fully cover the costs of medical assistance for individuals affected by that holding, subject to appropriation. Provides that the Department shall not require individuals receiving medical assistance to work a minimum amount of hours in order to receive benefits.

Creates the Illinois Medicare for All Health Care Act. Provides that all individuals residing in the State are covered under the Illinois Health Services Program for health insurance. Sets forth the health coverage benefits that participants are entitled to under the Program. Sets forth the qualification requirements for participating health providers. Sets forth standards for provider reimbursement. Provides that it is unlawful for private health insurers to sell health insurance coverage that duplicates the coverage of the Program. Provides that investor-ownership of health delivery facilities is unlawful. Provides that the State shall establish the Illinois Health Services Trust to provide financing for the Program. Sets forth the requirements for claims billing under the Program. Provides that the Program shall include funding for long-term care services and mental health services. Provides that the Program shall establish a single prescription drug formulary and list of approved durable medical goods and supplies. Creates the Pharmaceutical and Durable Medical Goods Committee to negotiate the prices of pharmaceuticals and durable medical goods with suppliers or manufacturers on an open bid competitive basis. Sets forth provisions concerning patients' rights. Provides that the employees of the Program shall be compensated in accordance with the current pay scale for State employees and as deemed professionally appropriate by the General Assembly. Effective January 1, 2026.

Creates the Access to Medically Necessary Vaccinations Act. Provides that any health care provider in this State must provide a vaccination to a patient if: the patient has requested the specific vaccination to be administered; the health care provider has determined that the vaccination is medically necessary; and the health care provider has a stock of one or more doses of the vaccination that have not been reserved for another patient. Prohibits a health care provider from preventing a medically necessary vaccination from being administered to a patient by keeping separate stocks of the vaccination for patients with private insurance and stocks of the vaccination for patients with Medicaid.

Amends the Public Employee Disability Act, the Line of Duty Compensation Act, and the Public Safety Employee Benefits Act. Includes mental health professionals within the scope of the Acts. Defines "mental health professional" as any person employed and dispatched by a unit of local government to respond to crisis calls received on public emergency service lines instead of or in conjunction with law enforcement.

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.

Creates the Psychiatric Residential Treatment Facilities (PRTF) Act. Requires the Department of Healthcare and Family Services to establish an Illinois Psychiatric Residential Treatment Facilities (PRTF) program that is family-driven, youth-guided, and trauma-informed, and includes youth and family involvement in all aspects of care planning. Requires the Department to submit a State Plan Amendment, by January 1, 2026, to the Centers for Medicare and Medicaid Services to establish coverage of federally authorized, medically necessary inpatient psychiatric services delivered by a certified PRTF to medical assistance beneficiaries under 21 years of age. Provides that the Department shall adopt rules to implement the PRTF program that at a minimum shall include: (i) certification and participation requirements for PRTF providers in compliance with all applicable federal laws, regulations, requirements, and policies; (ii) monitoring and oversight of PRTF services; (iii) a limit on allowable beds at any one PRTF, not to exceed 40 total beds; and other matters. Requires the Department to establish, and update as needed, a methodology for completing a statewide PRTF capacity analysis for the purposes of identifying capacity needs for PRTF services under the Illinois Medical Assistance Program. Requires the Department to establish a PRTF Advisory Committee responsible for reviewing and providing guidance on the Department's policies and implementations of the PRTF program. Requires the Department to publish on its website counts of reported emergency safety interventions and serious occurrences by State fiscal year and quarter. Makes conforming changes to the Specialized Mental Health Rehabilitation Act of 2013, the Child Care Act of 1969, and other various Acts. Effective immediately.

Amends the Illinois Income Tax Act. Creates an income tax deduction in an amount equal to the out-of-pocket costs incurred by a taxpayer during the taxable year for expenses associated with long-term care for the taxpayer or the taxpayer's family member. Effective immediately.

Amends the Department of Professional Regulation Law of the Civil Administrative Code of Illinois. Provides that for any license of a health care professional that expires during a public health emergency declared by the Governor, the Department of Financial and Professional Regulation shall extend the expiration date of that license by 3 months. Provides that the fees for renewal of that license and the expiration date of the renewed license shall be the same fees and expiration date as though the license was renewed on the original expiration date. Defines "health care professional". Effective immediately.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Expands the classes of persons eligible for medical assistance to include, beginning January 1, 2027 and subject to any federal waivers or approvals necessary for implementation, persons licensed under the Clinical Psychologist Licensing Act, the Clinical Social Work and Social Work Practice Act, the Illinois Dental Practice Act, the Medical Practice Act of 1987, the Licensed Certified Professional Midwife Practice Act, the Nurse Practice Act, the Physician Assistant Practice Act of 1987, or the Registered Surgical Assistant and Registered Surgical Technologist Title Protection Act. Permits such licensed persons to apply for medical assistance by submitting an application to the Department of Healthcare and Family Services between January 1 and March 31. Requires the Director of Healthcare and Family Services to determine the form and manner of submitting an application. Requires the Department to post application instructions on its website. Requires an eligible person who satisfies all application requirements to pay a premium for medical assistance coverage that shall be no higher than 5% of the person's annual income. Provides that any premiums paid shall be automatically allocated to the Department's medical assistance budget for the next fiscal year. Requires the Department to adopt rules.

Creates the Health Care Facility Fee Transparency Act. Sets forth provisions concerning notice requirements for a hospital or health system that charges a facility fee using a current procedural terminology evaluation code or assessment and management code for outpatient services provided at a hospital-based facility where a professional fee is also expected to be charged. Provides notice requirements for hospital-based facilities created or acquired through a business transaction. Establishes limitations on facility fees. Sets forth provisions concerning facility fee billing statements, reporting of facility fees charged by each hospital and health system, and enforcement of the Act by the Department of Public Health. Amends the Consumer Fraud and Deceptive Business Practices Act. Provides that it is an unlawful practice if, from the date of the transaction, a hospital, health system, or hospital-based facility does not wait at least 30 days after the written notice has been mailed to the patient or a copy of the notice has been filed with the Department of Public Health to collect a facility fee for services provided at a hospital-based facility.