Healthcare

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that, beginning January 1, 2026, providers offering pediatric primary care shall be reimbursed at a rate that is no lower than 100% of the Medicare program's rates for preventative and screening services.

Amends the Prior Authorization Reform Act. Provides that, notwithstanding any other provision of law, a health insurance issuer or a contracted utilization review organization may not require prior authorization for preventive health services recommended by a health care professional. Amends the Illinois Insurance Code. Provides that a policy of group health insurance coverage or individual health insurance coverage shall, at a minimum, provide coverage and shall not require prior authorization or impose any cost-sharing requirements, including a copayment, coinsurance, or deductible, for specified preventive health services. Effective January 1, 2027.

Amends the Illinois Insurance Code. Provides that a health benefit plan amended, delivered, issued, or renewed on or after January 1, 2026 that provides prescription drug coverage through a medical or pharmacy health benefit or its contracted pharmacy benefit manager shall not engage in or require an enrollee to engage in specified prohibited acts. Provides that a clinician-administered drug shall meet the supply chain security controls and chain of distribution set by the federal Drug Supply Chain Security Act. Provides that the Department of Insurance may adopt rules as necessary to implement the provisions. Defines terms. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, and the Voluntary Health Services Plans Act to require policies under those Acts to comply with the provisions.

HB 1401 removes specific provisions in Illinois' Health Care Right of Conscience Act that previously provided exemptions for healthcare providers related to COVID-19. It directly affects healthcare providers who may have relied on these temporary exemptions during the pandemic. The bill simply repeals Section 13.5 of the Act, eliminating the COVID-19-related conscience protections from state law. This is a procedural change with no new requirements or funding.

Amends the Mental Health and Developmental Disabilities Administrative Act. Provides that notwithstanding any other law or rule to the contrary, a State-operated developmental center funded, certified, or licensed by the Department of Human Services shall readmit, upon request, any former resident who transferred to and currently receives services at a licensed community-integrated living arrangement, if the former resident consents or if the former resident has a guardian with placement authority and that guardian consents based on a determination that the former resident's medical needs cannot be met by the program of services administered by the community-integrated living arrangement.

Amends the Illinois Emergency Management Agency Act. Specifies that the Illinois Emergency Management Agency and Office of Homeland Security shall not award grants from the IEMA State Projects Fund to those entities whose primary purpose is to provide reproductive health care services (rather than medical or mental health services). Effective immediately.

Declares May 4 through May 10, 2025 as Tardive Dyskinesia Awareness Week (TDAW) in the State of Illinois. Expresses support for TDAW in recognition of the importance of early detection and intervention to improve outcomes for people living with mental health conditions and prescribed antipsychotics. Expresses support towards efforts to raise awareness about the causes and symptoms of tardive dyskinesia (TD) and the importance of routine TD screening.

Amends the Children and Family Services Act. Provides that all youth in care shall be assigned a mental health provider to manage their mental health care needs. Requires a youth's mental health provider to visit the youth and conduct a well-being assessment within 30 days after the youth is removed from his or her home and placed in the temporary custody or guardianship of the Department of Children and Family Services. Provides that additional follow-up visits and well-being checks shall be scheduled and conducted until the youth is no longer under the custody or guardianship of the Department. Provides that any mental health care services provided to the youth shall be in addition to any care or services the youth receives from his or her primary care provider. Grants the Department rulemaking authority.

Amends the State Employees Group Insurance Act of 1971. Prohibits the State from applying for any federal waiver that would reduce or eliminate any protection or coverage required under the Patient Protection and Affordable Care Act (Affordable Care Act) that was in effect on January 1, 2017, including, but not limited to, any protection for persons with preexisting conditions and coverage for services identified as essential health benefits under the Affordable Care Act. Provides that the State or an agency of the executive branch may apply for such a waiver only if granted authorization by the General Assembly through joint resolution. Amends the Illinois Insurance Code. Prohibits the State from applying for any federal waiver that would permit an individual or group health insurance plan to reduce or eliminate any protection or coverage required under the Affordable Care Act that was in effect on January 1, 2017, including, but not limited to, any protection for persons with preexisting conditions and coverage for services identified as essential health benefits under the Affordable Care Act. Provides that the State or an agency of the executive branch may apply for such a waiver only if granted authorization by the General Assembly through joint resolution. Amends the Illinois Public Aid Code. Prohibits the State or an agency of the executive branch from applying for any federal Medicaid waiver that would result in more restrictive standards, methodologies, procedures, or other requirements than those that were in effect in Illinois as of January 1, 2017 for the Medical Assistance Program, the Children's Health Insurance Program, or any other medical assistance program in Illinois operating under any existing federal waiver authorized by specified provisions of the Social Security Act. Provides that the State or an agency of the executive branch may apply for such a waiver only if granted authorization by the General Assembly through joint resolution. Effective immediately.

States that the new Department of Early Childhood and its planning process should prioritize appropriate attention to the facilities needs of our State's mixed-delivery system of early care and education. Additionally states that the State should move expeditiously to award its remaining Early Childhood Construction Grant monies to qualified applicants, to assist providers of critical birth-to-five programs in meeting their growing building-and-repair demands. Finally states that the State should also move as quickly as feasible to replenish Early Childhood Construction Grant resources to help Illinois achieve the long-term vision of the bipartisan Funding Commission for making services "simpler, better, fairer" for young children, their families, and communities statewide.