Healthcare

Amends the Hospital Services Trust Fund Article in the Illinois Public Aid Code. In provisions concerning annual funding for the health care transformation program, provides that funds that had been budgeted but unexpended in State fiscal years 2021 through 2027 may be allocated in State fiscal year 2028 in an amount not to exceed $150,000,000.

Amends the Medicaid Technical Assistance Act. Requires the Medicaid Technical Assistance Center to collaborate with public and private partners throughout the State to identify, establish, and maintain best practices necessary for health providers to ensure their capacity to participate in the Illinois Medical Assistance Program (rather than ensure their capacity to participate in HealthChoice Illinois or YouthCare). Requires the Medicaid Technical Assistance Center to promote equitable delivery systems, remaining committed to the principle that all Medicaid recipients have accessible and equitable physical and mental health care services. Removes provisions concerning the Medicaid Technical Assistance Center's administration of network adequacy reports, and instead requires the Medicaid Technical Assistance Center to administer a network recruitment plan. Provides that by using reports and data provided by the Department of Healthcare and Family Services’ External Quality Review Organization on network adequacy, provider service deserts, and health care disparities by race and ethnicity, the Medicaid Technical Assistance Center shall propose for Department review and approval an annual plan for recruiting providers to participate in the Illinois Medical Assistance Program and report on outcomes of its recruitment efforts to the Department for continuous improvement. Repeals a provision requiring the Department to maximize federal financial participation for any moneys appropriated to the Department for the Medicaid Technical Assistance Center and to deposit all federal financial participation funds into the Medicaid Technical Assistance Center Fund. Repeals a provision creating the Medicaid Technical Assistance Center Fund. Amends the State Finance Act. Provides for the dissolution of the Medicaid Technical Assistance Center Fund on July 1, 2026, or as soon thereafter as practical, after the transfer of all remaining funds into the Healthcare Provider Relief Fund. Effective July 1, 2026.

Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Requires the Department of Public Health to establish the Abortion Access Fund Grant Program to award grants from the Abortion Access Fund to support access to abortion care services throughout the State. Provides that grants awarded under the Program shall only be used to fund abortion services for which the use of federal funds is prohibited for patients who are uninsured or underinsured with respect to those services. Allows the Department to establish rules necessary to implement the Abortion Access Fund Grant Program, including eligibility criteria, grant limits, application standards, requirements for the distribution and obligation of grant funds, accounting for the use of the funds, and standards for monitoring compliance with the requirements of the Program. Amends the State Finance Act to create the Abortion Access Fund as a special fund in the State treasury. Amends the Illinois Health Benefits Exchange Law. Requires specified health insurance issuers that have offered one or more qualified health plans through the Illinois Health Benefits Exchange to report to the Department of Insurance an accounting of receipts, disbursements, transfers of funds between accounts, total dollar claims paid, accrued interest, and the year-end balance for each reporting year for the separate allocation accounts that the issuer has established under specified provisions of federal law for abortion services for which federal funding is prohibited. Establishes further reporting requirements for health insurance issuers. Provides that, if the amount of premiums collected during the plan year for abortion services for which federal funding is prohibited exceeds total claims paid for such services rendered during the plan year, the Director of Insurance shall order the health insurance issuer to transfer funds, and the issuer shall complete the transfer, to the Abortion Access Fund. Makes other changes. Effective immediately.

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).

Amends the Illinois Insurance Code. Establishes reimbursement rates for mental health and substance use disorder treatment services for all group or individual policies of accident and health insurance or managed care plans that are amended, delivered, issued, or renewed on or after January 1, 2027 or for any contracted third party administering the behavioral health benefits for the insurer. Requires a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2026 or any contracted third party administering the behavioral health benefits for the insurer to cover certain medically necessary mental health and substance use disorder treatment services. Provides that, if the Department of Insurance determines that an insurer or a contracted third party administering the behavioral health benefits for the insurer has violated a provision concerning mental health and substance use parity, the Department shall by order assess a civil penalty of $1,000 for each violation. Excludes certain health care plans serving Medicaid populations who are enrolled under the Illinois Public Aid Code or under the Children's Health Insurance Program Act from provisions concerning mental health and substance use parity. Requires the Department to review the impact of the proposed mental health and substance abuse mandate on network adequacy for mental health and substance use disorder treatment and access to affordable mental health and substance use care. Permits the Department to examine out-of-network utilization and out-of-pocket costs for insureds for mental health and substance use treatment and services for all plans to compare with in-network utilization. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, and the School Code to require coverage under those provisions. Effective immediately.

Amends the Public Higher Education Act. Provides that, beginning with the 2025-2026 school year, each public institution of higher education with student health services shall provide enrolled students with access to health care professionals authorized under State law to prescribe contraception. Provides that, beginning with the 2025-2026 school year, if the public institution of higher education's student health services includes a pharmacy, the pharmacy on campus shall dispense contraception to enrolled students who wish to fill their prescriptions at the university pharmacy. Provides that, beginning with the 2025-2026 school year, each public institution of higher education with student health services shall provide enrolled students with access to health care professionals authorized under State law to prescribe medication abortion. Provides that a public institution of higher education that dispenses medication abortion from the university pharmacy shall enter into a referral agreement with a tertiary care facility with obstetrics and gynecological services in the event of complication from medication abortion or suspected complicated pregnancy prior to dispensing medication abortion. Requires each public institution of higher education to report annually to the Board of Higher Education that policies under the provisions have been adopted. Requires the Board to post to its website annually each public institution of higher education's compliance with the policies under the provisions. Effective immediately.

Amends the Mental Health Early Action on Campus Act. Provides that the expert panel designated by the board of trustees to develop and implement policies and procedures shall be comprised of at least 2 administrators, 2 members of faculty, and one mental health professional. Requires each public college or university to provide at least 3 on-site licensed clinical professional counselors or licensed clinical social workers.

Amends the Clinical Psychologist Licensing Act, the Clinical Social Work and Social Work Practice Act, the Marriage and Family Therapy Licensing Act, the Music Therapy Licensing and Practice Act, and the Professional Counselor and Clinical Professional Counselor Licensing and Practice Act. Allows an applicant for licensure under those Acts to temporarily practice under supervision while the applicant's application for licensure is pending under specified circumstances. Removes good moral character standards as qualification requirements for the licensing of social workers and music therapists. Creates procedures for placing a license on inactive status for social workers and professional counselors. Provides that the Department of Financial and Professional Regulation must allow reasonable exam accommodations for licensed marriage and family therapists and clinical psychologists whose primary language is not English if a test in the therapist's or psychologist's primary language is not available.

Amends the Illinois Drug Reuse Opportunity Program Act. Requires the Illinois Department of Public Health: (1) to develop, maintain, and publish on its website information regarding the names and locations of pharmacies participating in the program; (2) to educate pharmacies in the State about the program and how to participate in it voluntarily; (3) to develop and publish educational materials to allow program participants and the Department to inform the general public about the purposes and benefits of the program; and (4) to collect information from participants and publish the information in an annual report to the General Assembly by December 31 of each calendar year, beginning December 31, 2026. Specifies that records maintained under the Act are subject to access by the Department upon request. Defines "Department".

Amends the Department of Early Childhood Act. Expands the definition of "eligible infants and toddlers" to list infants having a birth weight less than 1,000 grams. Requires the Department of Early Childhood, as the designated lead agency to administer the system of early intervention services on and after July 1, 2026, to develop informational materials and handouts for hospitals to distribute to the parents or legal guardians of severely premature infants, explaining that infants having a birth weight of less than 1,000 grams automatically qualify for early intervention services up until their 3rd birthday. Provides that the informational materials and handouts shall also contain information on the benefits of early intervention services for severely premature infants, the website addresses and phone numbers that parents and legal guardians can access to obtain more information on early intervention services, and the contact information of the early intervention regional intake entity designated to coordinate services for eligible infants. Requires the statewide system of coordinated, comprehensive, interagency and interdisciplinary early intervention programs to include in its public awareness program, a special focus on the early identification of infants who automatically qualify for early intervention services on account of having a birth weight less than 1,000 grams. Amends the Hospital Licensing Act. Requires hospitals to distribute, free of charge, to the parents or legal guardians of each severely premature infant having a birth weight of less than 1,000 grams informational materials and handouts developed by the Department of Early Childhood on the availability of early intervention services for severely premature infants. Requires a nurse or physical therapist to review the proffered materials with the infant's parents or legal guardians prior to discharge and explain that premature infants having a birth weight of less than 1,000 grams automatically qualify for early intervention services up until their 3rd birthday, including speech, physical, occupational, and other therapies.