Healthcare

Amends the Illinois Insurance Code. Makes changes to defined terms. Provides that a group policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed after January 1, 2026 shall provide coverage for evidence-based cancer imaging for individuals with an increased risk of cancer as recommended by the current National Comprehensive Cancer Network clinical practice guidelines. Provides that this coverage shall be provided without cost-sharing, and the requirements of the Act shall not apply to the extent that providing coverage would disqualify a high-deductible health plan from eligibility for a health savings account.

Creates the Illinois Health Care and Public Benefits Stakeholder Council Act. Provides that the Illinois Health Care and Public Benefits Stakeholder Council is created to ensure that residents impacted by Illinois health care systems and public aid benefits have a voice in the State's implementation of various programs across State agencies. Sets forth the Council's objectives and duties which include: (i) identifying current shortfalls in the various public assistance, health care, and child care programs implemented at the State level; and (ii) recommending an overarching organizational structure to ensure coordination, alignment, and progress to assist all Illinoisans in accessing benefits at the State level. Contains provisions concerning Council membership. Requires the Council to meet at the call of the Chair at least 4 times beginning January 1, 2026; and for specified State agencies to attend at least 2 Council hearings in an advisory role. Requires the Council to submit a report of its findings and recommendations to the General Assembly and the Governor by July 1, 2027. Provides that the Council is dissolved, and the Act is repealed, on July 1, 2028. Effective immediately.

Creates the Rural Hospital Task Force Act. Establishes the Rural Hospital Task Force within the Department of Public Health for the purpose of investigating the current state of rural hospitals and providing recommendations to prevent further closures of rural hospitals and to potentially expand rural hospital services. Provides that the Task Force shall convene to conduct business on at least 4 separate days. Requires the Department of Public Health to provide administrative and other support to the Task Force. Requires each agency and entity represented on the Task Force to share with the Task Force any data of the agency or entity necessary to achieve the purpose of the Task Force. Provides that all findings and recommendations made by the Task Force must be reported to the General Assembly before January 1, 2027. Provides that the Task Force is dissolved, and the Act is repealed, on January 1, 2027

Urges full restoration of all eliminated direct support professionals (DSP) hours in the final FY26 State budget to protect the services individuals with intellectual/developmental disabilities (I/DD) depend on.

Creates the Health Care Availability and Access Board Act. Establishes the Health Care Availability and Access Board to protect State residents, State and local governments, commercial health plans, health care providers, pharmacies licensed in the State, and other stakeholders within the health care system from the high costs of prescription drug products. Contains provisions concerning Board membership and terms; staff for the Board; Board meetings; circumstances under which Board members must recuse themselves; and other matters. Provides that the Board shall perform the following actions in open session: (i) deliberations on whether to subject a prescription drug product to a cost review; and (ii) any vote on whether to impose an upper payment limit on purchases, payments, and payor reimbursements of prescription drug products in the State. Permits the Board to adopt rules to implement the Act and to enter into a contract with a qualified, independent third party for any service necessary to carry out the powers and duties of the Board. Creates the Health Care Availability and Access Stakeholder Council to provide stakeholder input to assist the Board in making decisions as required by the Act. Contains provisions concerning Council membership, member terms, and other matters. Provides that the Board shall adopt the federal Medicare Maximum Fair Price as the upper payment limit for a prescription drug product intended for use by individuals in the State. Prohibits the Board from creating an upper payment limit that is different from the Medicare Maximum Fair Price for the prescription drug product that has a Medicare Maximum Fair Price. Requires the Board to implement an upper payment limit that is the same as the Medicare Maximum Fair Price no sooner than the Medicare implementation date. Provides that Medicare Part C and D plans are not required to reimburse at the upper payment limit. Provides that the Attorney General may enforce the Act and may pursue any available remedy under State law when enforcing the Act. Effective 180 days after becoming law.

Amends the Criminal Code of 2012. Provides that a person commits aggravated battery when, in committing a battery, other than by discharge of a firearm, he or she knows the individual battered to be a health care worker (rather than a nurse) while in the performance of his or her duties as a health care worker (rather than a nurse). Provides that "health care worker" has the meaning provided in the Health Care Violence Prevention Act.

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 all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia, in accordance with the U.S. Food and Drug Administration label, as determined by a physician licensed to practice medicine in all its branches. Provides that coverage of U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia shall not be subject to step therapy. Amends the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, and the Voluntary Health Services Plans Act to require coverage under those provisions. Effective immediately.

Creates the Domestic Violence Survivor Health Care Billing Act. Provides that a domestic violence survivor who is not the subscriber or primary policyholder of a health insurance plan may opt out of billing the health insurer for medical forensic services related to domestic violence if the domestic violence survivor provides a sworn statement or affidavit attesting to the domestic violence and any additional documentation to support the claim of domestic violence, which may include, but is not limited to, a police report, a protective order, or documentation from a domestic violence shelter or program that the health care practitioner may request. Provides that if the domestic violence survivor chooses to not have the health insurer billed, the health care practitioner shall instead submit the bill for the medical forensic services to the Department of Human Services for reimbursement through the Domestic Violence Prevention and Intervention Program or a similar program administered by the Department of Human Services. Provides that reimbursement may be provided regardless of when the incident of domestic violence occurred and is limited to medical forensic services that are directly related to an incident of domestic violence. Defines terms and sets forth provisions concerning rulemaking.

Amends the Nursing Home Care Act and the Specialized Mental Health Rehabilitation Act of 2013. Provides that residents of nursing home facilities have the right to outdoor access. Provides that residents of nursing home facilities and consumers served by mental health rehabilitation facilities shall be free to enter and leave the facilities as they choose. Provides that a facility may suspend this right only if the resident's or consumer's physician examines the resident or consumer and determines that leaving the facility would pose a danger to other residents or consumers or an immediate and substantial danger to the resident's or consumer's safety and well-being, which shall be explained to the resident or consumer and documented in the resident's or consumer's medical chart.

Honors the life and legacy of Henrietta Lacks, an African American woman, whose contributions to medical science have had a lasting impact though her name is not widely known. Recognizes Alfred "Lacks" Carter Jr. for his work to preserve Henrietta Lacks' legacy and for his contributions in the fight against cervical cancer. Urges support for community-based research and education programs, which are vital to educating and empowering community members so they can make informed decisions about being involved in clinical research and the research process. Urges support for clinical research to reduce health disparities, to save lives, to gain insights about the safety and effectiveness of drugs and other medical treatments, and to discover treatments for various diseases.