Rep. Dee Avelar

Amends the Accident and Health Article of the Illinois Insurance Code. Provides that an individual or group policy of accident and health insurance that is amended, delivered, issued, or renewed on or after January 1, 2028 shall cover a medically necessary coronary calcium scan and scoring every 36 months for individuals over the age of 40. Defines "coronary calcium scan and scoring". Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Medical Assistance Article of the Illinois Public Aid Code. Effective January 1, 2027.

Creates the Protective Medical Equipment Freedom Act. Provides that all individual in the State have the right to wear protective medical equipment in any place of public accommodation where they have a lawful right to be without obligation to disclose health status or any other protected information, and no person, entity, or authority shall deny, restrict, or infringe upon this right. Provides that operators and public officials shall not discriminate against or penalize medical device wearers for exercising their right to wear protective medical equipment. Provides that discrimination under the Act includes, but is not limited to: denial of service; eviction from premises; any form of harassment to remove or refrain from wearing such equipment for any amount of time; specified actions taken by employers; and provision of unequal goods, services, facilities, advantages, or accommodations. Sets forth provisions concerning the protection against retaliation, the exceptions for security requirements, operational safety, age and identity restricted products, and financial institution customer identification, and an undue hardship exemption. Effective immediately.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that any person who was initially determined to be eligible for medical assistance and is receiving institutional services or home and community-based services as authorized under the Article shall be presumed eligible for a continuation of coverage for such services during any redetermination process, unless the person experiences a material change in financial circumstances that results in the loss of eligibility. Requires any person who experiences a material change in financial circumstances that results in the loss of eligibility to notify the Department of Healthcare and Family Services. Permits the Department to conduct a redetermination of eligibility. Requires the Department to notify the person before the commencement of any redetermination and after the redetermination is concluded along with the results of the redetermination and the effective date of any eligibility change. Requires the Department to seek federal authorization, no later than January 1, 2028, to exempt persons with disabilities who are otherwise eligible for medical assistance from annual eligibility redeterminations, except that a full redetermination shall be conducted at least once every 5 years, regardless of whether a material change in financial circumstances has occurred.

Creates the Wetlands Protection Act. Provides that no person may discharge dredged or fill material into a State jurisdictional wetland except with a permit issued by the Department of Natural Resources. Exempts certain activities from the requirements of the Act. Sets forth procedures for individual permit applications and other related procedural requirements. Provides that the Department shall not issue an individual permit unless the Environmental Protection Agency certifies to the Department that there will not be a violation of State water quality standards. Provides that the Department may issue an after-the-fact permit in certain emergency circumstances. Sets forth financial assurance requirements. Authorizes the Department to adopt general permits under the Act. Provides that any person who intends to conduct a regulated activity may do so in accordance with a general permit issued by the Department, which pre-authorizes a category of activities with minimal adverse effects. Provides procedures and requirements regarding preconstruction notifications. Provides that certain entities may establish and operate a mitigation bank or in lieu fee program. Describes procedures and requirements for mitigation banks. Grants the Department rulemaking powers. Provides that the Department shall prepare certain reports and studies. Provides for the review of final decisions of the Department. Provides for investigations by the Department and enforcement by a State's Attorney or the Attorney General. Provides for a civil penalty not to exceed $10,000 per day of violation, with interest after judgment, and with certain costs, fees, and expenses, payable to the Wetlands Protection Fund. Provides that any person may file a complaint with the Illinois Pollution Control Board concerning a violation of the Act, a rule adopted under the Act, a condition of a permit issued under the Act, or an order of the Pollution Control Board issued under the Act. Provides for county and special district stormwater program authorities to control or regulate activities in any wetlands within their jurisdiction. Establishes the Wetlands Protection Fund. Provides that a permit review fee for all permit applications is to be set by the Department by rule. Makes corresponding changes to the State Finance Act. Makes findings. Defines terms. Effective immediately.

Declares May 2026 as ALS Awareness Month in the State of Illinois. Calls upon all Illinoisans to engage in supporting amyotrophic lateral sclerosis (ALS) research, advocating for increased funding, and standing in solidarity with those affected by this relentless disease.

Provides that the amendatory Act may be referred to as the Strengthen Linkage to Follow-Up Care after a Behavioral Health Crisis Act. Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that for purposes of timely linking an individual to follow-up mental health care immediately after a behavioral health crisis, when mobile crisis response services are provided to someone in a behavioral health crisis, the Illinois Medicaid-Crisis Assessment Tool approved by the Department of Healthcare and Family Services shall enable the delivery of community support services, medication monitoring, and other specified services when delivered by the same provider, for up to 30 days without beginning, performing, or completing an integrated assessment and treatment plan. Provides that such services shall be billed separate from mobile crisis response services. Prohibits the Department from imposing more stringent requirements on its Illinois Medicaid-Crisis Assessment Tool than those requirements that exist on the effective date of the amendatory Act, as long as the services provided are delivered under the supervision of a licensed practitioner of the healing arts. Requires the Department to file any rules necessary to implement the amendatory Act. Effective immediately.

Declares April 11-17, 2025 as Black Maternal Health Week. Recognizes that Black women are experiencing high, disproportionate rates of maternal mortality and morbidity in the State of Illinois. Recognizes that the alarmingly high rates of maternal mortality among Black women are unacceptable and unjust. States what the Black community needs to mitigate the effects of systemic and structural racism. States that in order to improve maternal health outcomes we must fully support and encourage policies grounded in the racial justice, reproductive justice, birth justice, and human rights frameworks that address Black maternal health inequity. States that Black women and birthing people must be active participants in the policy decisions that impact their lives. States that in order to ensure access to safe and respectful maternal health care for Black birthing people, the Black Maternal Health Momnibus Act and other legislation rooted in human rights that seeks to improve maternal care and outcomes must be passed. States the goals of Black Maternal Health Week.

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 the Department of Healthcare and Family Services must incorporate minimum standards governing behavioral health pre-payment and post-payment reviews into MCO contracts effective for all services covered on and after January 1, 2027. Requires the Department to develop or adopt behavioral health-specific pre-payment and post-payment review guidelines and incorporate such guidelines by reference into MCO contracts. Provides that the Department-issued guidelines must: (1) define the documentation and clearly specify the discrete data elements that may be requested prior to and during a pre-payment or post-payment review, and applicable response timeframes, ensuring that all requests are specific, reasonable, and directly tied to the review objectives; (2) identify regulatory, statutory, and contractual standards applicable to behavioral health services; (3) establish uniform evaluation criteria and checklists; and (4) be publicly available and updated as necessary. Contains provisions on MCO contracts and required contract terms; pre-payment and post-payment review processes and notice requirements; timeframes for providers to respond to a documentation request; communication protocols; contract transparency and extrapolation from a statistical sampling of claims; the timeliness and closure of claims reviews; submission methods; reviewer qualifications; and enforcement. Effective immediately.

Creates the Climate Change Superfund Act. Creates the Illinois Climate Change Superfund as a special fund in the State treasury. Requires at least 40% of the Fund to be spent on projects that directly benefit disadvantaged communities facing climate change impacts. Directs the Environmental Protection Agency to adopt rules within one year, including regarding the apportionment of liability for climate change for payments into the Fund by responsible parties, regarding qualifying expenditures from the Fund, and regarding an Illinois Climate Change Superfund Program. Requires the Agency to establish procedures to challenge its determinations of liability for climate change and provides for judicial review under the Administrative Review Law. Makes findings. Defines terms. Provides that the Act is severable. Makes conforming changes to the State Finance Act.