Amends the Illinois Insurance Code. Provides that every insurer that amends, delivers, issues, or renews a group or individual policy of accident and health insurance or a qualified health plan offered through the health insurance marketplace in the State and Medicaid managed care organizations providing coverage for hospital or medical treatment shall provide coverage for medically necessary treatment of mental, emotional, nervous, or substance use disorders or conditions. Provides that an insurer shall not limit benefits or coverage for medically necessary services on the basis that those services should be or could be covered by a public program. Provides that an insurer shall base any medical necessity determination or the utilization review criteria on current generally accepted standards of mental, emotional, nervous, or substance use disorder or condition care. Provides that in conducting utilization review of covered health care services and benefits for the diagnosis, prevention, and treatment of mental, emotional, and nervous disorders or conditions in children, adolescents, and adults, an insurer shall exclusively apply the criteria and guidelines set forth in the most recent versions of the treatment criteria developed by the nonprofit professional association for the relevant clinical specialty. Provides that an insurer shall not apply different, additional, conflicting, or more restrictive utilization review criteria than the criteria and guidelines set forth in the treatment criteria. Provides that the Director may, after appropriate notice and opportunity for hearing, assess a civil penalty between $5,000 and $20,000 for each violation. Amends the Health Carrier External Review Act. Provides that the independent review organization shall comply with specified requirements for an adverse determination or final adverse determination involving mental, emotional, nervous, or substance use disorders or conditions. Makes other changes. Effective immediately. House Floor Amendment No. 1 In provisions concerning mental and emotional disorders, provides that an insurer shall not set a specific limit on the duration of benefits or coverage of medically necessary treatment of mental, emotional, nervous, or substance use disorders or conditions or limit coverage only to alleviation of the insured's current symptoms. Provides that nothing shall require the insurer to cover a treatment when the authorization was granted based on a material misrepresentation by the insured, the policyholder, or the provider. Provides that an insurer may apply specified utilization review criteria to health care services and benefits for mental, emotional, and nervous disorders or conditions that are outside the scope of specified criteria and guidelines or relate to advancements in technology or types of care that are not covered in the most recent versions of specified sources. Provides that if the Director of Insurance determines that an insurer has violated the provisions, the Director may assess a civil penalty between $1,000 and $5,000 for each violation (rather than between $5,000 and $20,000). Removes language that provides that changes in terminology, organization, or classification of mental, emotional, nervous, substance use disorder or condition in future versions of specified publications shall not affect the conditions covered by provisions concerning mental and emotional disorders as long as a condition is commonly understood to be a mental, emotional, nervous, or substance use disorder or condition by health care providers practicing in relevant clinical specialties. Removes language that provides that an insurer shall not limit benefits or coverage for mental, emotional, nervous, or substance use disorders or conditions to short-term or acute treatment at any level of placement. Makes other changes. Changes the effective date to January 1, 2022 (rather than an immediate effective date). Senate Committee Amendment No. 1 Adds reference to: 215 ILCS 5/370c.1 Replaces everything after the enacting clause with the provisions of the engrossed bill with the following changes. Provides that every insurer that amends, delivers, issues, or renews a group or individual policy of accident and health insurance or a qualified health plan offered through the health insurance marketplace in the State and Medicaid managed care organizations providing coverage for hospital or medical treatment shall provide coverage for medically necessary treatment of mental, emotional, nervous, or substance use disorders or conditions on or after January 1, 2023 (rather than January 1, 2022). Provides that an insurer or Medicaid managed care organization shall not be required to pay for services if the individual was not the insurer's enrollee or eligible for Medicaid at the time the service was rendered. Provides that an insurer shall not be required to cover benefits that have been authorized and provided for a covered person by a public entitlement program. Provides that for medical necessity determinations (rather than in conducting utilization review of covered health care services and benefits) relating to level of care placement, continued stay, and transfer or discharge of insureds diagnosed with mental, emotional, and nervous disorders or conditions, insurers and Medicaid managed care organizations shall apply specified patient placement criteria. Makes various changes to provisions concerning requirements for insurers regarding education of the insurer's staff and other stakeholders, publishing of utilization review criteria, and documentation of interrater reliability testing and remediation actions. Further amends the Illinois Insurance Code. In provisions concerning mental, emotional, nervous, or substance use disorder or condition parity, provides that not later than January 1 (rather than August 1) of each year, the Department of Insurance shall issue a joint report to the General Assembly and provide an educational presentation to the General Assembly. Removes language that provides that insurers shall base the duration of treatment on the insured's individual needs; that an insurer shall only engage applicable qualified providers in the treatment of mental, emotional, nervous, or substance use disorders or conditions or the appropriate subspecialty and who possess an active professional license or certificate to review, approve, or deny services; and that every insurer shall sponsor a formal education program by nonprofit clinical specialty associations. Makes other changes. Effective January 1, 2022, except that specified provisions take effect immediately.
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Amends the Department of State Police Law, the State Finance Act, the State Property Control Act, the Firearm Dealer License Certification Act, the Illinois Vehicle Code, the Criminal and Traffic Assessment Act, and the Unified Code of Corrections. Provides for the transfer of the remaining balance from various specified Funds into other specified Funds. Dissolves the transferring Funds. Provides that any future deposits due to and any outstanding obligations or liabilities of the transferring Funds shall pass to the receiving Funds. Makes conforming and other changes. Effective immediately.
Amends the Student Online Personal Protection Act. Makes a technical change in a Section concerning the short title. Senate Floor Amendment No. 1 Deletes reference to: 105 ILCS 85/1 Adds reference to: 105 ILCS 5/2-3.62 from Ch. 122, par. 2-3.62 105 ILCS 5/27-9.1a new 105 ILCS 5/27-9.1b new 105 ILCS 5/27A-5 105 ILCS 5/34-18.8 from Ch. 122, par. 34-18.8 105 ILCS 110/3 105 ILCS 5/27-9.1 rep. 105 ILCS 5/27-9.2 rep. 105 ILCS 5/27-11 rep. Replaces everything after the enacting clause. Amends the School Code. In the Courses of Study Article, repeals the sex education, family life, and instruction on diseases provisions. Instead, beginning no later than July 1, 2023, requires a school district, including a charter school, to provide comprehensive personal health and safety education in kindergarten through the 5th grade and comprehensive sexual health education in the 6th through 12th grades in all public schools. Sets forth the criteria that all classes that teach comprehensive personal health and safety and comprehensive sexual health education must satisfy. Contains, among other provisions, provisions concerning guest lecturers or resource persons, participation, the review of instructional materials, learning standards, resource materials, and reporting. Requires a school district, including a charter school, to provide age and developmentally appropriate consent education in the 3rd through 12th grades; sets forth what the instruction and materials must include. Makes changes in the Chicago School District Article concerning AIDS training. Amends the Critical Health Problems and Comprehensive Health Education Act to make changes concerning the program established under the Act. Effective immediately. Senate Floor Amendment No. 2 Replaces everything after the enacting clause. Reinserts the contents of the bill as amended by Senate Amendment No. 1, with the following changes. Makes changes to the definitions of "complete", "comprehensive personal health and safety education", and "comprehensive sexual health education" and the learning standards. Provides that the annual report to the General Assembly must be submitted for a period of 2 (rather than 5) years. Requires age and developmentally appropriate consent education to be provided in kindergarten (rather than the 3rd grade) through the 12th grade. Corrects a grammatical error. Effective immediately. Senate Floor Amendment No. 3 Deletes reference to: 105 ILCS 110/3 Removes provisions concerning the comprehensive health education program. Senate Floor Amendment No. 4 Replaces everything after the enacting clause. Reinserts the contents of the bill as amended by Senate Amendments Nos. 2 and 3, with the following changes. In provisions requiring the State Board of Education to develop and adopt learning standards, specifies that the comprehensive personal health and safety education learning standards shall be adopted for pupils in kindergarten through the 5th grade and the comprehensive sexual health education learning standards shall be adopted for pupils in the 6th through 12th grades. Removes a provision requiring school districts to provide comprehensive personal health and safety education and comprehensive sexual health education by no later than July 1, 2023. Provides that the annual report to the General Assembly must be submitted for a period of 5 (rather than 2) years. Provides that a school district may (rather than shall) provide age and developmentally appropriate consent education in kindergarten through the 12th grade. Makes grammatical and typographical changes. Effective immediately. Balanced Budget Note (Office of Management and Budget) Please be advised that the Balanced Budget Note Act does not apply to Senate Bill 818 as il is not a supplemental appropriation that increases or decreases appropriations. Under the Act, a balanced budget note must be prepared only for bills that change a general funds appropriation for the fiscal year in which the new bill is enacted. Judicial Note (Admin Office of the Illinois Courts) This legislation would neither increase nor decrease the number of judges needed in the state of Illinois. Home Rule Note (Dept. of Commerce & Economic Opportunity) This bill does not pre-empt home rule authority. Pension Note (Government Forecasting & Accountability) SB 0818, as engrossed, will not impact any public pension fund or retirement system in the State of Illinois. State Debt Impact Note (Government Forecasting & Accountability) SB 0818, as Engrossed, would not change the amount of authorization for any type of State-issued bond, and, therefore, would not affect the level of State indebtedness. Housing Affordability Impact Note (Housing Development Authority) This bill will have no effect on the cost of constructing, purchasing, owning, or selling a single-family residence. Fiscal Note (Dept. of Human Services) No fiscal impact to IDHS related to the changes proposed in SB 818. State Mandates Fiscal Note (Dept. of Commerce & Economic Opportunity) This bill does not create a State mandate. Correctional Note (Dept of Corrections) This amendment has no fiscal impact or population impact on the department. Fiscal Note (Dept. of Public Health) SB 818 would not pose any fiscal cost aside from standard staff time helping ISBE develop standards, where the cost would be negligible. Land Conveyance Appraisal Note (Dept. of Transportation) No land conveyances are included in Senate Bill 818; therefore, there are no appraisals to be filed. Fiscal Note (State Board of Education) SB 818 will have a fiscal impact of $2,175,588.61 over 3 fiscal years.
Amends various Acts to revise statutory law to conform the statutes to the reorganization of the executive branch taking effect under Executive Order 2019-12. Makes other changes concerning the Illinois State Police and makes technical and stylistic changes. Effective immediately. Senate Committee Amendment No. 1 Provides that the Office of the Statewide 9-1-1 Administrator is within the Division of Statewide 9-1-1. Senate Floor Amendment No. 2 Deletes reference to: 720 ILCS 648/10 720 ILCS 649/10 720 ILCS 649/15 720 ILCS 649/20 720 ILCS 649/25 730 ILCS 154/11 740 ILCS 175/8 750 ILCS 50/12.3 Replaces references to the Office of the Statewide 9-1-1 Administrator with references to the Division of Statewide 9-1-1. Deletes new language that duplicates language in existing law. Removes the text of statutes that are not amended by the bill. Corrects a typographical error in existing law.
Amends the Illinois Vehicle Code. Provides that an automotive parts recycler, in addition to a scrap processor, may submit a Junk Vehicle Notification to the Secretary of State.
Amends the Illinois Credit Union Act. In provisions concerning service to the economically disadvantaged, provides that members of a targeted population may be admitted to membership in a credit union. Provides that notice of a meeting of credit union members may be posted on the credit union's website. Provides that unless expressly prohibited by the articles of incorporation or bylaws, the board of directors may provide by resolution that members may attend, participate in, act in, and vote at any annual meeting or special meeting through the use of a conference telephone or interactive technology, subject to specified conditions. Sets forth provisions concerning appointment of associate directors. In provisions concerning compensation of officials, provides that if the Department of Financial and Professional Regulation determines the payment of director or committee member compensation creates a safety and soundness issue for a credit union, the Department may take an enforcement action to reduce or suspend the compensation. Provides that the board of directors shall hold regular meetings at least once each month; however, upon approval of an amendment to the bylaws of the credit union, the board of directors may hold meetings less frequently than once each month but at least once each quarter. Provides that a credit union shall select an annual reporting period, complete an external audit report, agreed-upon procedures report, and internal audit report, and deliver copies to the Secretary of Financial and Professional Regulation no later than 120 days after the end of the annual reporting period. In provisions concerning loan programs and provisions concerning investment of funds, allows a credit union to make loans to or invest in credit union service organizations in a total amount not exceeding the greater of 6% (rather than 3%) of specified amounts. Provides that a surviving credit union may identify the merging credit union as a division, branch, unit, or other descriptive reference. Provides that the network credit union board of directors shall require each advisory board member to sign a confidentiality or non-disclosure agreement. Defines "target market". Makes other changes. House Floor Amendment No. 1 Deletes reference to: 205 ILCS 305/16.1 205 ILCS 305/29 Replaces everything after the enacting clause with the provisions of the introduced bill with the following changes. Changes a reference from "agreed-upon procedures report" to "agreed-upon procedures engagement". Removes provisions concerning service to the economically disadvantaged and provisions concerning meetings of members of the board of directors of a credit union. Makes other changes. Effective immediately.
Amends the Drug Asset Forfeiture Procedure Act. Deletes provision that when the property seized for forfeiture is a vehicle, the law enforcement agency seizing the property shall immediately notify the Secretary of State that forfeiture proceedings are pending regarding the vehicle.
Creates the Prior Authorization Reform Act. Provides requirements concerning disclosure and review of prior authorization requirements, denial of claims or coverage by a utilization review organization, and the implementation of prior authorization requirements or restrictions. Provides requirements concerning a utilization review organization's obligations with respect to prior authorizations in nonurgent circumstances, urgent health care services, and emergency health care services. Provides that a utilization review organization shall not require prior authorization under specified circumstances. Provides requirements concerning the length of prior authorizations. Provides that health care services are automatically deemed authorized if a utilization review organization fails to comply with the requirements of the Act. Provides that the Director of Insurance may impose an administrative fine not to exceed $250,000 for violations of the Act. Defines terms. Amends the Illinois Insurance Code to change the definition of "emergency medical condition". Amends the Managed Care Reform and Patient Rights Act to provide that companies that transact accident and health insurance shall comply with specified requirements of the Managed Care Reform and Patient Rights Act. Amends the Illinois Public Aid Code to provide that all managed care organizations shall comply with the requirements of the Prior Authorization Reform Act. Makes other changes. Effective January 1, 2022. House Floor Amendment No. 1 Replaces everything after the enacting clause with the provisions of the introduced bill with the following changes. Changes references from "utilization review organization" to "health insurance issuer" or "health insurance issuer or its contracted utilization review organization". Provides that a health insurance issuer or its contracted utilization review organization must ensure that all adverse determinations are made by a physician when the request is by a physician or a representative of a physician. Provides that a health insurance issuer shall periodically review its prior authorization requirements and consider removal of prior authorization requirements in specified circumstances (rather than a utilization review organization shall not require prior authorization in specified circumstances). In provisions concerning length of prior authorization approval, provides that a prior authorization approval shall be valid for the lesser of 12 months after the date the health care professional or health care provider receives the prior authorization approval or the length of treatment as determined by the patient's health care professional. In provisions concerning clinical review criteria of prior authorization requirements, removes language that provides that a utilization review organization shall seek input from actively practicing physicians representing major areas of the specialty who are not employees of the utilization review organization or consultants to the utilization review organization before establishing or substantially or materially altering written clinical review criteria. Removes language that provides that a utilization review organization shall not deny prior authorization of a health care service solely based on the grounds that a health care professional or health care provider judges a service, product, or procedure is medically appropriate for his or her patient even if it has not been formally approved for the specific condition being treated. In provisions concerning statistics that shall be made available regarding prior authorization approvals and denials, removes specified categories of information. In provisions concerning requirements applicable to the physician who can review consultations and appeals, removes language that provides that the physician must not be employed by a utilization review organization, be under contract with the utilization review organization other than to participate in one or more of the utilization review organization's health care professional networks or to perform reviews of appeals, or otherwise have any financial interest in the outcome of the appeal. Makes other changes. Effective January 1, 2022. House Floor Amendment No. 2 Deletes reference to: 215 ILCS 134/65 Adds reference to: 215 ILCS 5/155.36 Replaces everything after the enacting clause with the provisions of the introduced bill, and makes the following changes: In the Prior Authorization Reform Act, deletes a Section concerning obligations with respect to prior authorization concerning emergency health care services, and makes changes in provisions governing applicability; definitions; disclosure and review of prior authorization requirements; obligations with respect to prior authorizations; personnel qualified to make adverse determinations of a prior authorization request; adverse determinations; review of appeals; denials; length of prior authorization approval; continuity of care; effect of failure to comply with the Act; and administration and enforcement. Makes further changes in the Illinois Insurance Code in a Section concerning obligations under the Managed Care Reform and Patient Rights Act. Deletes changes made to the Managed Care Reform and Patient Rights Act in a Section concerning emergency services prior to stabilization. Effective January 1, 2022.
Amends the Counties Code. Provides that, in counties with a population over 3,000,000, the Public Defender, without fee or appointment and with the approval of the county board, may act as attorney to noncitizens in immigration cases related to or resulting from an underlying court matter in which the Public Defender served as attorney before he or she became the Public Defender. Provides that representation by the Public Defender in immigration cases is limited to those arising in immigration courts located within the geographical boundaries of the county where the Public Defender has been appointed to office unless the board authorizes the Public Defender to provide representation outside the county. House Committee Amendment No. 1 Deletes reference to: 55 ILCS 5/3-4004.2 55 ILCS 5/3-4004.5 new Adds reference to: 55 ILCS 5/3-4006 from Ch. 34, par. 3-4006 Replaces everything after the enacting clause. Amends the Counties Code. Provides that, in counties with a population over 3,000,000, the public defender, without fee or appointment and with the concurrence of the county board, may act as attorney to noncitizens in immigration cases. Provides that representation by the public defender in immigration cases shall be limited to those arising in immigration courts located within the geographical boundaries of the county where the public defender has been appointed to office unless the board authorizes the public defender to provide representation outside the county.
Amends the Managed Care Reform and Patient Rights Act. Requires health insurance carriers that provide coverage for prescription drugs to ensure that, within service areas and levels of coverage specified by federal law, at least half of individual and group plans meet one or more of the following criteria: apply a pre-deductible and flat-dollar copayment structure to the entire drug benefit, limit a beneficiary's monthly out-of-pocket financial responsibility for prescription drugs to a specified amount, or limit a beneficiary's annual out-of-pocket financial responsibility for prescription drugs to a specified amount. Provides that all plans for prescription drugs offered under the amendatory Act must be clearly and appropriately named, marketed in the same manner as other plans offered by the health insurance carrier, and offered for purchase to any individual and group plan sponsor. Effective January 1, 2022. House Committee Amendment No. 1 Replaces everything after the enacting clause. Amends the Managed Care Reform and Patient Rights Act. In provisions concerning individual health plans that provide coverage for prescription drugs, provides that beginning January 1, 2023, health insurance carriers shall ensure that at least 10% of individual health care plans offered in each applicable service area apply a flat-dollar copayment structure to the entire drug benefit; and beginning January 1, 2024, health insurance carriers shall ensure that at least 25% of individual health care plans offered in each applicable service area apply a flat-dollar copayment structure to the entire drug benefit. In provisions concerning group health plans that provide coverage for prescription drugs, provides that beginning January 1, 2023, health insurance carriers shall offer at least one group health plan in each applicable service area that applies a flat-dollar copayment structure to the entire drug benefit; and beginning January 1, 2024, health insurance carriers shall offer at least 2 group health plans in each applicable service area that apply a flat-dollar copayment structure to the entire drug benefit. Provides that the flat-dollar copayment structure for prescription drugs must be applied pre-deductible and be reasonably graduated and proportionately related in all tier levels such that the copayment structure as a whole does not discriminate against or discourage the enrollment of individuals with significant health care needs. Requires the health insurance carriers to clearly and appropriately name the plans to aid in individual or group plan selection. Requires the health insurance carriers to market the plans in the same manner as their other plans. Requires the Department of Insurance to adopt rules necessary to implement and enforce the provisions. Effective January 1, 2023.