Amends the Community Mental Health Act. Makes a technical change in a Section concerning the short title. Senate Floor Amendment No. 2 Deletes reference to: 405 ILCS 20/0.1 from Ch. 91 1/2, par. 300.1 Adds reference to: 5 ILCS 375/6.11 20 ILCS 1305/10-23 new 20 ILCS 2310/2310-222 20 ILCS 2310/2310-470 new 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.4b new 215 ILCS 5/356z.40 new 215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2 215 ILCS 165/10 from Ch. 32, par. 604 305 ILCS 5/5-2 from Ch. 23, par. 5-2 305 ILCS 5/5-5 from Ch. 23, par. 5-5 305 ILCS 5/5-5.24 305 ILCS 5/5-18.10 new Replaces everything after the enacting clause. Provides that the amendatory Act may be referred to as the Improving Health Care for Pregnant and Postpartum Individuals Act. Amends the Department of Human Services Act. Requires the Department of Human Services to expand and update its maternal child health programs to serve any pregnant or postpartum individuals identified as high-risk using criteria established by a multi-agency working group. Contains other provisions. Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. In provisions regarding obstetric hemorrhage and hypertension training, requires the Department of Public Health to ensure that all birthing facilities have a written policy for providers and staff of obstetric medicine and of the emergency department and other staff that may care for pregnant or postpartum women. Requires the Department on or before June 1, 2024, in collaboration with the Department of Human Services and specified entities, to revise or add to the rules of the Maternal and Child Health Services Code that govern the High Risk Infant Follow-up, using current scientific and national and State outcomes data, to expand existing services to improve both maternal and infant outcomes overall and to reduce racial disparities in outcomes and services provided. Contains other provisions. Amends the Illinois Insurance Code. Provides that an individual or group policy of accident and health insurance or qualified health plan that is amended, delivered, issued, or renewed on or after the amendatory Act's effective date shall allow hospitals separate reimbursement for a long-acting reversible contraceptive device provided immediately postpartum in the inpatient hospital setting before hospital discharge. Provides that an individual or group policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed on or after the amendatory Act's effective date shall provide coverage for pregnancy and newborn care in accordance with specified federal provisions regarding essential health benefits. Contains requirements for pregnancy and postpartum coverage benefits. 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, and the Voluntary Health Services Plans Act. Amends the Illinois Public Aid Code. Provides that, on or after July 1, 2022, individuals who are otherwise eligible for medical assistance under specified provisions shall receive coverage for perinatal depression screenings for the 12-month period beginning on the last day of their pregnancy, subject to specified conditions. Provides that within 90 days of the amendatory Act's effective date, the Department of Healthcare and Family Services shall seek federal approval of a State Plan amendment to expand coverage for family planning services that includes presumptive eligibility to individuals whose income is at or below 208% of the federal poverty level. Provides that the Department shall establish a medical assistance program to cover a universal postpartum visit within the first 3 weeks after childbirth and a comprehensive visit within 4 to 12 weeks postpartum for persons who are otherwise eligible for medical assistance under specified provisions. Makes other changes. Effective immediately. Governor Amendatory Veto Message Recommends that coverage for specified family planning services including presumptive eligibility to individuals whose income is at or below 208% of the federal poverty level shall be effective beginning no later than December 1, 2022 (rather than beginning July 1, 2022).
Sponsored bills
Amends the State Treasurer Act. Provides that for purposes of the ABLE account program, a designated beneficiary means the ABLE account owner. Provides that upon the death of a designated beneficiary, proceeds from an account may be transferred pursuant to a payable on death account agreement. Provides that upon the death of a designated beneficiary, the State Treasurer may require verification that the funeral and burial expenses of the designated beneficiary have been paid. Makes conforming changes. Effective immediately. House Committee Amendment No. 1 Deletes reference to: 15 ILCS 505/16.6 Adds reference to: 20 ILCS 5/5-15 was 20 ILCS 5/3 Replaces everything after the enacting clause. Amends the Civil Administrative Code of Illinois. Makes a technical change in a Section creating the civil administrative agencies. House Floor Amendment No. 2 Deletes reference to: 20 ILCS 5/5-15 Adds reference to: 5 ILCS 420/1-102.5 new 5 ILCS 420/1-104.3 new 5 ILCS 420/1-104.4 new 5 ILCS 420/1-104.5 new 5 ILCS 420/1-105.2 new 5 ILCS 420/1-105.3 new 5 ILCS 420/1-105.5 new 5 ILCS 420/1-105.6 new 5 ILCS 420/1-105.7 new 5 ILCS 420/1-109 from Ch. 127, par. 601-109 5 ILCS 420/1-110 from Ch. 127, par. 601-110 5 ILCS 420/1-112.5 new 5 ILCS 420/1-113.6 new 5 ILCS 420/1-113.7 new 5 ILCS 420/2-101 from Ch. 127, par. 602-101 5 ILCS 420/3A-50 new 5 ILCS 420/4A-102 from Ch. 127, par. 604A-102 5 ILCS 420/4A-103 from Ch. 127, par. 604A-103 5 ILCS 420/4A-107 from Ch. 127, par. 604A-107 5 ILCS 420/4A-108 5 ILCS 420/4A-104 rep. 5 ILCS 430/5-40 5 ILCS 430/5-45 5 ILCS 430/20-20 5 ILCS 430/20-95 5 ILCS 430/25-5 5 ILCS 430/25-10 5 ILCS 430/25-15 5 ILCS 430/25-20 5 ILCS 430/25-85 10 ILCS 5/1A-14 from Ch. 46, par. 1A-14 10 ILCS 5/9-1.8 from Ch. 46, par. 9-1.8 10 ILCS 5/9-3.5 new 10 ILCS 5/9-8.5 25 ILCS 115/1 from Ch. 63, par. 14 25 ILCS 170/2 from Ch. 63, par. 172 25 ILCS 170/3 from Ch. 63, par. 173 25 ILCS 170/4.5 25 ILCS 170/4.7 25 ILCS 170/5 25 ILCS 170/6 from Ch. 63, par. 176 25 ILCS 170/8 from Ch. 63, par. 178 25 ILCS 170/11.2 Replaces everything after the enacting clause. Amends the Illinois Governmental Ethics Act. Creates a uniform statement of economic interest form that must be completed by all persons who are required to file that form under the Act. Changes the nature of the required disclosures that must be made. Requires the Secretary of State to adjust specified amounts that prompt disclosure under the Act for purposes of inflation, and requires the Secretary to make conforming changes to the statement of economic interest form. Requires candidates filing for supreme court justice, appellate court judge, circuit court judge, or judicial retention to file their statement of economic interests in written or printed form. Modifies requirements concerning legislator restricted activities and the code of conduct. Prohibits a person appointed to an affected office from serving as an officer of a candidate political committee under specified circumstances. Amends the State Officials and Employees Ethics Act. Restricts fundraising during sessions of the General Assembly, regardless of county. Modifies provisions concerning procurement and revolving door prohibitions concerning the fiscal administration of State contracts. Provides further revolving door requirements for executive branch officers and members of the General Assembly concerning lobbying. Modifies requirements concerning the Executive Ethics Commission and the Legislative Ethics Commission. Modifies requirements for Executive Inspectors General and the Legislative Inspector General. Provides that all investigatory files and reports of the Office of an Executive Inspector General are, among other exemptions, privileged. Amends the Election Code. Prohibits a member of the State Board of Elections from contributing to a political committee, serving as an officer of a political committee, or being a candidate supported by a candidate political committee. Prohibits a limited activity committee from accepting contributions except under specified circumstances. Provides that a limited activity committee may only make specified expenditures. Amends the General Assembly Compensation Act. Provides that the compensation to be paid per year to members of the General Assembly shall be paid bi-monthly. Provides for member compensation on a prorated basis. Amends the Lobbyist Registration Act. Applies the requirements of the Act to municipalities, counties, and officials thereof, and other specified State officials. Provides for home rule preemption under the Act. Defines terms. Makes conforming changes. Adds an applicability clause. Effective January 1, 2022. Governor Amendatory Veto Message Recommends: (i) deleting new language providing that the Executive Inspectors General have the duty to "receive and investigate, without advance approval of the Executive Ethics Commission, allegations of violations of this Act and other wrongful acts within his or her jurisdiction based on a complaint" and that an "investigation may not be initiated more than one year after the alleged wrongful act or the most recent act of a series of alleged wrongful acts based on the same wrongful conduct except if there is reasonable cause to believe that fraudulent concealment has occurred"; and (ii) restoring existing law providing that the Executive Inspectors General have the duty to "receive and investigate allegations of violations of this Act" and that an "investigation may not be initiated more than one year after the most recent act of the alleged violation or of a series of alleged violations except where there is reasonable cause to believe that fraudulent concealment has occurred".
Amends the Higher Education Student Assistance Act. Allows the Illinois Student Assistance Commission to award Post-Master of Social Work School Social Work Professional Educator License scholarships to an individual who has a valid Illinois-licensed clinical social work license or social work license and a Master of Social Work degree for the purpose of obtaining a Professional Educator License with an endorsement in social work. Sets forth various terms and conditions of the scholarship, including that a recipient of the scholarship must work at a public or nonpublic not-for-profit preschool, elementary school, or secondary school located in this State for at least 2 of the 5 years immediately following the recipient's graduation or termination of studies. Effective January 1, 2022. Senate Floor Amendment No. 1 Replaces everything after the enacting clause. Reinserts the contents of the bill with the following changes. Provides for scholarship awards beginning with the 2022-2023 academic year. Removes certain provisions concerning rulemaking. Provides that the Illinois Student Assistance Commission shall give priority to those applicants who are members of a racial minority (rather than those applicants who are members of underrepresented communities in the school social work field in Illinois); defines "racial minority". Provides that each scholarship shall be applied to the payment of tuition and mandatory fees (rather than applied only to tuition). Makes other changes concerning the application and payment of a scholarship. Requires a scholarship recipient to work as a school social worker at a school (rather than work at a school). Effective January 1, 2022. House Floor Amendment No. 2 Replaces everything after the enacting clause. Reinserts the contents of the bill with the following changes. Adds provisions concerning the priority in the award of scholarships for a fiscal year in which the amount of an appropriation is insufficient to provide scholarships to all qualified candidates. Makes changes concerning priority consideration to those applicants who are members of a racial minority. Removes a reference to "private or parochial school". Requires the repayment of amounts received if a recipient fails to fulfill the work obligation required under the terms of the scholarship, with exceptions. Effective January 1, 2022.
Amends the Property Tax Code. Provides that for taxable year 2020, the maximum income limitation under the senior citizens assessment freeze homestead exemption is $75,000 for counties with 3,000,000 or more inhabitants (currently, $65,000). Provides that, for taxable year 2021 and thereafter, the maximum income limitation under the senior citizens assessment freeze homestead exemption is $75,000 for all counties (currently, $65,000). Amends the Senior Citizens Real Estate Tax Deferral Act. Provides that the income limitation is $75,000 for tax year 2019 and thereafter. Effective immediately. Senate Committee Amendment No. 1 Removes the effective date from the bill. House Floor Amendment No. 1 Deletes reference to: 35 ILCS 200/15-172 Adds reference to: 320 ILCS 30/3 from Ch. 67 1/2, par. 453 Replaces everything after the enacting clause. Amends the Senior Citizens Real Estate Tax Deferral Act. Provides that the income limitation under the Act is $65,000 for tax years 2022 through 2025 and $55,000 for tax year 2026 and thereafter (currently, $55,000). Provides that, for tax years 2022 through 2025, the total amount of any such deferral shall not exceed $7,500 per taxpayer in each tax year (currently, $5,000). Provides that, beginning again in tax year 2026, the total amount of any such deferral shall not exceed $5,000. Effective immediately.
Amends the Higher Education Student Assistance Act. Creates the School Social Work Shortage Loan Repayment Program. Provides that the Illinois Student Assistance Commission shall, each year, receive and consider applications from eligible social workers who are employed by a public elementary or secondary school in this State to encourage a grant recipient to use the financial assistance for the repayment of educational loans. Sets forth eligibility and other requirements. Effective July 1, 2022. Senate Floor Amendment No. 1 Provides that the Illinois Student Assistance Commission shall give priority to those applicants who are members of a racial minority (rather than to an applicant who is a member of an underrepresented community in the school social work field in Illinois); defines "racial minority". House Committee Amendment No. 1 Replaces everything after the enacting clause. Reinserts the contents of the bill with the following changes. Adds provisions concerning the priority for the award of grants for years in which the amount of the appropriation allocated to the program is insufficient to provide grants to all qualified candidates. Sets forth the purpose for giving priority under the program to applicants who are members of a racial minority. Effective July 1, 2022.
Amends the Nursing Home Care Act. Provides that the Department of Public Health shall require each long-term care facility in the State, as a condition of facility licensure, to adopt and implement written policies, provide for the availability of technology to facility residents, and ensure that appropriate staff and other capabilities are in place to prevent the social isolation of facility residents. Contains specified requirements for the social isolation prevention policies. Provides that the Department shall distribute civil monetary penalty funds, as approved by the federal Centers for Medicare and Medicaid Services, and any other available federal and State funds, upon request, to facilities for communicative technologies and accessories needed for the purposes of the provisions. Provides that whenever the Department conducts an inspection of a long-term care facility, the Department's inspector shall determine whether the long-term facility is in compliance with the provisions and the policies, protocols, and procedures adopted pursuant to the provisions. Requires the Department to adopt rules necessary to implement the provisions within 60 days after the amendatory Act's effective date (and makes conforming changes in the Illinois Administrative Procedure Act). Contains other provisions. Effective immediately. Senate Committee Amendment No. 1 Replaces everything after the enacting clause with the provisions of the introduced bill with the following changes. Removes language providing that the Department of Public Health shall require each long-term care facility in the State to perform specified actions as a condition of facility licensure. Provides that the social isolation prevention policies shall not be interpreted as a substitute for in person visitation, but shall be wholly in addition to the existing in person visitation policies. Provides that a resident's individualized visitation plan shall give priority to the resident's preferences over the preferences of the resident's representative. Provides that a long-term care facility may apply for (rather than the Department shall distribute) civil monetary penalty fund grants, and may request other available federal and State funds to obtain assistive and supportive technologies and related accessories that would facilitate communication between residents and other family members, friends, and external support systems. Provides that the Department (rather than the Department's inspector) shall determine whether a long-term care facility is in compliance with the provisions whenever the Department conducts an annual licensure and certification survey, when a complaint is received, or as frequently as may be necessary (rather than whenever the Department conducts an inspection of a long-term care facility). Provides that a noncompliant long-term care facility shall be liable to pay an administrative penalty as a Type "C" violation. Provides that implementation of an administrative penalty as a Type "C" violation under the provisions shall not be imposed prior to January 1, 2023. Makes other changes. Effective immediately. Senate Floor Amendment No. 2 In provisions amending the Nursing Home Care Act, provides that the social isolation prevention policies adopted by each long-term care facility shall be consistent with the rights and privileges guaranteed to residents and constraints provided under specified provisions of the Nursing Home Care Act. House Floor Amendment No. 2 Replaces everything after the enacting clause with the provisions of the engrossed bill with the following changes. Adds provisions regarding legislative findings. Replaces references to specified types of equipment with references to assistive and supportive technology and devices. Requires appropriate staff to develop and update an individualized virtual visitation schedule while taking into account the individual's requests and preferences (rather than to assess and regularly reassess the individual needs and preferences of facility residents). Requires appropriate staff to develop an individualized virtual visitation schedule (rather than an individualized visitation plan) with specified requirements. Provides that specific protocols and procedures shall be developed to ensure that the quantity of assistive and supportive technology and devices maintained on-site at a facility remains sufficient, at all times, to meet the assessed social and activity needs and preferences of each facility resident. Makes other changes. Effective immediately.
Amends the Community Benefits Act. Provides that the Act applies to all nonprofit and public hospitals licensed under the Hospital Licensing Act or operated under the University of Illinois Hospital Act (rather than not applying to a hospital operated by a unit of government, a hospital located outside of a metropolitan statistical area, or a hospital with 100 or fewer beds). Requires community benefits plans to describe activities the hospital is undertaking to address health equity, reduce health disparities, and improve community health. Provides that, in order to increase transparency and accessibility of charity care and financial assistance data, the Attorney General shall post on the Attorney General's website: all community benefits plans contained in reports submitted by hospitals; and a compiled report that summarizes information from completed community benefits plans. Provides that an electronic version of the compiled report shall be sent to the Governor and each member of the General Assembly. Provides a late filing fee for nonprofit hospitals for community benefits plans of $2,500 per month that the report is late (rather than $100). Makes other changes. Amends the Hospital Uninsured Patient Discount Act. Provides that a hospital, other than a rural hospital or a Critical Access Hospital, shall provide a discount from charges to specified uninsured patients for all medically necessary health care services exceeding $150 (rather than $300) in any one inpatient admission or outpatient encounter. Provides for civil monetary penalties of $1,000 to $5,000 (rather than $500) for a violation. Requires the Attorney General to publish an annual report that outlines complaints received related to hospital uninsured discount programs and financial assistance applications. Makes other changes. Effective immediately. Senate Floor Amendment No. 1 Deletes reference to: 210 ILCS 76/5 210 ILCS 76/25 Replaces everything after the enacting clause with the provisions of the introduced bill and makes the following changes. Removes language specifying that the Act applies to all nonprofit and public hospitals licensed under the Hospital Licensing Act or operated under the University of Illinois Hospital Act. Removes language changing the provisions concerning a nonprofit hospital that fails to make a report of the community benefits plan. Removes language increasing civil monetary penalties. Provides that hospitals shall permit an uninsured patient to apply for a discount within 90 days (rather than 60 days) of the date of discharge or date of service. Provides that hospitals shall offer uninsured patients who receive community-based primary care provided by a community health center or a free and charitable clinic, are referred by such an entity to the hospital, and seek access to nonemergency hospital-based health care services with an opportunity to be screened for and assistance with applying for public health insurance programs if there is a reasonable basis to believe that the uninsured patient may be eligible for a public health insurance program. Changes the effective date from immediate to January 1, 2022. Makes other changes. House Committee Amendment No. 1 In provisions of the Hospital Uninsured Patient Discount Act regarding patient responsibility, provides that hospitals may make the availability of a discount and the maximum collectible amount under the Act contingent upon the uninsured patient first applying for coverage under public health insurance programs (rather than public programs) if there is a reasonable basis to believe that the uninsured patient may be eligible for such program.
Creates the Community Emergency Services and Supports Act. Provides that the Act applies to every unit of local government that provides or coordinates ambulance or similar emergency medical response or transportation services for individuals with emergency medical needs. A home rule unit may not respond to or provide services for a mental or behavioral health emergency, or create a transportation plan or other regulation, relating to the provision of mental or behavioral health services in a manner inconsistent with this Act. Provides that one plan shall describe how the EMS Region will provide mobile emergency mental and behavioral health services to individuals who do not present as a threat to the responders, and are not involved in criminal activity at the time of the response. Provides that the plan shall conform to the requirements of the Act and, recognizing the variety of systems, services, and needs across the State, provide the specific requirements and guidance appropriate for that region. Provides that the plan shall be identified as the region's community emergency services and supports plan. Provides that the second plan shall describe the manner and extent to which responders operating under the region's Community Emergency Services and Supports Plan coordinate with law enforcement when responding to individuals who appear to be in a mental or behavioral health emergency while engaged in conduct alleged to constitute a non-violent misdemeanor. Provides that the plan shall be identified as the region's Non-Violent Misdemeanor Coordination Plan. Amends the Emergency Telephone System Act to make conforming changes. Effective immediately. Fiscal Note (Dept. of Human Services) The fiscal impact to IDHS to provide for the establishment and oversight on the committees would be minimal. House Floor Amendment No. 1 Replaces everything after the enacting clause. Creates the Community Emergency Services and Support Act. Provides that each 9-1-1 call center and provider of emergency services dispatched through a 9-1-1 system must coordinate with the mobile mental and behavioral health services established by the Division of Mental Health of the Department of Human Services so that the following State goals and State prohibitions are met whenever a person interacts with one of these entities for the purpose seeking emergency mental and behavioral health care or when one of these entities recognizes the appropriateness of providing mobile mental or behavioral health care to an individual with whom they have engaged. Provides that the Division of Mental Health is also directed to provide guidance regarding whether and how these entities should coordinate with mobile mental and behavioral health services when responding to individuals who appear to be in a mental or behavioral health emergency while engaged in conduct alleged to constitute a non-violent misdemeanor. Provides that 9-1-1 call centers, emergency services dispatched through 9-1-1 call centers, and the mobile mental and behavioral health service established by the Division of Mental Health must coordinate their services so that certain specified State prohibitions are avoided. Provides that the Division of Mental Health shall establish regional advisory committees in each EMS Region to advise on emergency response systems for mental and behavioral health. Provides that the Act applies to persons of all ages, both children and adults. Provides that the Act does not limit an individual's right to control his or her own medical care. No provision of this Act shall be interpreted in such a way as to limit an individual's right to choose his or her preferred course of care or to reject care. Provides that no provision of this Act shall be interpreted to promote or provide justification for the use of restraints when providing mental or behavioral health care. Amends the Emergency Telephone System Act to make conforming changes. Senate Committee Amendment No. 1 Deletes reference to: 50 ILCS 750/4 Replaces everything after the enacting clause. Creates the Community Emergency Services and Support Act. Provides that each 9-1-1 call center and provider of emergency services dispatched through a 9-1-1 system must coordinate with the mobile mental and behavioral health services established by the Division of Mental Health of the Department of Human Services so that the following State goals and State prohibitions are met whenever a person interacts with one of these entities for the purpose seeking emergency mental and behavioral health care or when one of these entities recognizes the appropriateness of providing mobile mental or behavioral health care to an individual with whom they have engaged. The Division of Mental Health is also directed to provide guidance regarding whether and how these entities should coordinate with mobile mental and behavioral health services when responding to individuals who appear to be in a mental or behavioral health emergency while engaged in conduct alleged to constitute a non-violent misdemeanor. Provides that 9-1-1 PSAPs, emergency services dispatched through 9-1-1 PSAPs, and the mobile mental and behavioral health service established by the Division of Mental Health must coordinate their services so that the State goals listed in this Section are achieved. Appropriate mobile response service for mental and behavioral health emergencies shall be available regardless of whether the initial contact was with 9-8-8, 9-1-1 or directly with an emergency service dispatched through 9-1-1. Provides that the Division of Mental Health shall establish a Statewide Advisory Committee to review and make recommendations for aspects of coordinating 9-1-1 and the 9-8-8 mobile mental health response system most appropriately addressed on a State level. Provides that the Division of Mental Health shall establish Regional Advisory Committees in each EMS Region to advise on regional issues related to emergency response systems for mental and behavioral health. Provides that the exemptions from civil liability in the Emergency Telephone Systems Act apply to any act or omission in the development, design, installation, operation, maintenance, performance, or provision of service directed by the Act. Provides that the Act applies to persons of all ages, both children and adults. This Act does not limit an individual's right to control his or her own medical care. No provision of this Act shall be interpreted in such a way as to limit an individual's right to choose his or her preferred course of care or to reject care. No provision of this Act shall be interpreted to promote or provide justification for the use of restraints when providing mental or behavioral health care. Senate Floor Amendment No. 2 Make technical and stylistic changes in the bill as amended by Senate Amendment No. 1. Adds additional responsibilities for 9-1-1 Public Safety Answering Point telecommunicators and emergency service providers. Places the applicability and home rule preemption provisions in a separate Section of the bill.
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.
Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or managed care plan that offers a program for wellness coverage must not provide a total incentive that exceeds 30% (rather than 20%) of the cost of self-only or employee-only coverage (rather than only employee-only coverage). Provides that the incentive may be increased by up to an additional 20%, for a total incentive of 50%, to the extent that the additional percentage is in connection with a program designed to prevent or reduce tobacco use. Amends the Navigator Certification Act. Provides that certified application counselors are subject to the same certification requirements as navigators. Provides that navigators or certified application counselors may not engage in any unfair method of competition or any fraudulent, deceptive, or dishonest act or practice related to the health insurance marketplace or to that individual's or entity's absence of a conflict of interest in connection with the enrollment of any individuals or employees in a particular private health benefit plan. Provides that a navigator or certified application counselor who fails to timely file for certificate renewal shall be charged a late fee in an amount prescribed by the Director of Insurance. Revises the meaning of the terms "certified application counselor" and "navigator". Makes other changes. Effective immediately.