Creates the Transparency in Downcoding Act. Provides that the Act applies to certain policies of health insurance amended, delivered, issued, or renewed on or after the effective date of the Act, except for employee or employer self-insured health benefit plans under the federal Employee Retirement Income Security Act of 1974 and health care provided pursuant to the Workers' Compensation Act or the Workers' Occupational Diseases Act. Prohibits a health insurance issuer from using an automated process, system, or tool to downcode a claim; from downcoding a claim based solely on the reported diagnosis codes; and from using downcoding practices in a targeted or discriminatory manner against physicians who routinely treat patients with complex or chronic conditions. Requires downcoding decisions to be made by a physician licensed to practice medicine in all its branches in any United States jurisdiction and of the same or similar specialty as a physician who typically manages the medical condition or disease. Sets forth provisions concerning notification requirements for downcoded claims; the appeal process for downcoded claims; enforcement by the Department of Insurance; and penalties. Provides that any pattern or practice of discriminatory downcoding identified by the Director of Insurance or another regulatory authority shall be subject to enforcement actions, including fines, restitution, or suspension of the health insurance issuer's license in this State. Effective immediately.
Amends the Evaluation of Certified Employees Article of the School Code. Prohibits an evaluator from using an artificial intelligence tool to assign a numerical score or qualitative rating for any component of a teacher's evaluation or any evaluation task that requires professional judgment. However, allows an artificial intelligence tool to be used to support the evaluator in administrative tasks.
Amends the Illinois Health Insurance Portability and Accountability Act. Defines "grandfathered health plan". Provides that, except for grandfathered health plans, a health insurance issuer in the individual, small group, or large group market shall not deny coverage to an individual or employer due to the individual's or employer's failure to pay premiums owed under a prior policy, certificate, or contract of insurance. Specifies that nothing in the provisions concerning past-due premiums prohibits a health insurance issuer from pursuing the collection of past-due premiums from an individual or employer by any other means permitted by law. Effective immediately.
Amends the Health Care Violence Prevention Act. Makes changes to defined terms. In provisions concerning workplace safety, provides that a health care worker may not be discouraged from contacting law enforcement or the Department of Public Health regarding workplace violence and a health care provider may not hold a policy that limits such contact. Adds additional requirements to the workplace violence prevention program, including reporting requirements and identifying the need for additional security and alarms, adequate exit routes, monitoring systems, barrier protections, lighting, entry procedures, and systems to identify and flag persons who have previously committed violent acts in the health care provider space. Sets forth provisions concerning violent incident investigations and recordkeeping and reporting requirements for health care providers regarding violent incidents. Establishes penalties for failure to comply with the Act. Amends the Freedom of Information Act. Exempts from public disclosure workplace violence records maintained by health care providers as required under a specified provision of the Health Care Violence Prevention Act.
Amends the Smart Start Illinois Act. Expands eligibility under the Smart Start Child Care Workforce Compensation Program to Head Start and Early Head Start programs.
Urges the Illinois Department of Human Services and the Pritzker Administration to delay cuts to Direct Service Professional (DSP) service hours set to begin January 1,2026, until such time as the State is prepared to implement the "Zero Hour" Staffing Model, to protect the services depended on by individuals with intellectual and developmental disabilities (I/DD).
Creates the Educator Health Insurance Task Force to study the feasibility of creating regional health insurance purchasing pools of school districts accessible to all public educators in school districts that have a population of less than 500,000.
Amends the Workplace Transparency Act. Provides that no contract, agreement, clause, covenant, waiver, or other document shall prohibit, prevent, or otherwise restrict an employee, prospective employee, or former employee from engaging in concerted activities to address work-related issues. Provides that any agreement, clause, covenant, or waiver that is a mutual condition of employment or continued employment may include provisions that would otherwise be against public policy if it acknowledges the right of the employee or prospective employee to engage in concerted activities to address work-related issues. Provides that an employee, prospective employee, or former employee and an employer may enter into a valid and enforceable settlement or termination agreement that includes promises of confidentiality related to alleged unlawful employment practices if the confidentiality provision expires no later than 5 years after the alleged unlawful employment practices occurred. Provides for the recovery of consequential damages incurred in challenging a contract for violation of the Act. Makes other changes.
Amends the School Safety Drill Act. Requires a school district to provide training on school evacuation drills and law enforcement lockdown drills to all school personnel serving in a substitute capacity.
Amends the Health Care Violence Prevention Act. Makes changes to defined terms. In provisions concerning workplace safety, provides that a health care worker may not be discouraged from contacting law enforcement or the Department of Public Health regarding workplace violence, and a health care provider may not hold a policy that limits such contact. Adds additional requirements to the workplace violence prevention program, including reporting requirements and identifying the need for additional security and alarms, adequate exit routes, monitoring systems, barrier protections, lighting, entry procedures, and systems to identify and flag persons who have previously committed violent acts in the health care provider space. Sets forth provisions concerning violent incident investigations, and recordkeeping and reporting requirements for health care providers regarding violent incidents. Establishes penalties for failure to comply with the Act. Amends the Freedom of Information Act. Exempts from public disclosure workplace violence records maintained by health care providers as required under a specified provision of the Health Care Violence Prevention Act.
