Healthcare

Amends the Illinois Insurance Code. Sets forth provisions requiring an individual or group policy of accident and health insurance amended, delivered, issued, or renewed in this State on or after January 1, 2028 to provide coverage for up to a 12-month supply of prescription hormone therapy, and the necessary supplies for self-administration, that is prescribed by a network provider within the provider's scope of practice and dispensed at one time for an enrollee by a provider or pharmacist, or at a location licensed or otherwise authorized to dispense drugs or supplies. Amends the Pharmacy Practice Act. Provides that, notwithstanding any other provision of law, a dispensing provider or pharmacist shall dispense, at a patient's request, up to a 12-month supply of a prescription hormone therapy and the necessary supplies for self-administration pursuant to a valid prescription that specifies an initial quantity followed by periodic refills, except as specified. Amends the State Employees Group Insurance Act of 1971 and the Illinois Public Aid Code to require coverage under the provisions of those Acts.

Amends the Fair Patient Billing Act. Makes changes to findings and defined terms provisions. Provides that a hospital shall not deny any protection or benefit of the Act on the basis of a patient's citizenship or immigration status or assets or prospective assets. Provides that a patient who inquires about a denial of financial assistance in whole or in part must be permitted to appeal the decision within at least 90 days. Requires a hospital to use only a uniform financial assistance form developed and provided by the Attorney General no later than December 31, 2026. Provides that every hospital bill and every collection notice must notify the patient, in the patient's preferred language, of the availability of hospital financial assistance and charity care. Establishes further provisions concerning hospitals pursuing collection actions; outsourced health care services; patient responsibilities; and applicability of the Act. Amends the Hospital Uninsured Patient Discount Act. Sets forth provisions concerning uninsured patient discounts for specified income levels. Prohibits hospitals from making the availability of a discount under the Act contingent upon the uninsured patient first applying for coverage under public health insurance programs. Provides that patients may not be denied a discount under the Act on the basis of citizenship or immigration status or assets or prospective assets. Makes other changes concerning uninsured patient discounts, outsourcing health care services, and patient responsibilities. Effective immediately.

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 Fair Patient Billing Act. In provisions concerning hospitals and their agents pursuing collection actions, provides that, for any legal action initiated against a patient for unpaid medical debt, a hospital may not file for or be granted a lien upon that patient's primary residence or on any other real property owned by the patient. Effective January 1, 2027.

Creates the Reproductive Health Records Privacy Act. Requires health information exchanges to implement policies and technical capabilities by July 1, 2027, to segregate medical information related to abortion care, restrict access by out-of-state entities, and limit disclosure. Provides enforcement through private actions and civil actions by the Attorney General, including injunctive relief and civil penalties. Defines terms. Amends the Medical Patient Rights Act to clarify patient privacy rights and allow segregation of abortion-related information in health information exchanges. Provides for severability.

Amends the Medical Practice Act of 1987. Provides that a pediatric neurologist or any other physician who diagnoses autism in a child must provide to the child's family, at a follow-up appointment, a pamphlet listing autism-specific support services in the area.

Amends the Illinois Insurance Code. Makes changes to defined terms. Provides that a group policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed after January 1, 2026 shall provide coverage for evidence-based cancer imaging for individuals with an increased risk of cancer as recommended by the current National Comprehensive Cancer Network clinical practice guidelines. Provides that this coverage shall be provided without cost-sharing, and the requirements of the Act shall not apply to the extent that providing coverage would disqualify a high-deductible health plan from eligibility for a health savings account.

Amends the Prior Authorization Reform Act and the Illinois Public Aid Code. Provides that a health insurance issuer, the fee-for-service medical assistance program, and a Medicaid managed care organization may not require prior authorization for the following prescription drug types and their therapeutic equivalents approved by the United States Food and Drug Administration: human immunodeficiency virus pre-exposure prophylaxis and post-exposure prophylaxis medication or human immunodeficiency virus treatment medication. Effective January 1, 2027.

Expresses the belief that nursing, social work, professional counseling, marriage and family therapy, physical therapy, occupational therapy, speech-language pathology, audiology, physician assistant practice, public health, and education are professional disciplines that require advanced graduate education, professional licensure, and adherence to rigorous ethical and clinical standards. Lists the graduate degrees that should be considered professional degrees. States that any state agency, public university, or entity receiving state funds should take all necessary steps to avoid discrimination against individuals holding these graduate degrees in hiring, promotion, compensation, professional development funding, or other terms and conditions of employment based on any federal student loan classification. Urges the United States Department of Education to include all graduate degrees in nursing, social work, counseling, therapy, physical therapy, occupational therapy, speech-language pathology, audiology, physician assistant practice, public health, and education in its definition of "professional degrees" for federal student loan purposes. Urges the Illinois Congressional Delegation to advocate for legislation to ensure that graduate students in all health and human services professions have access to adequate federal student loan funding to complete their professional education. Commits to exploring state-level solutions to support graduate education in health and human services professions, including but not limited to scholarships, grants, loan repayment assistance programs, and other workforce development initiatives. Expresses support for the licensed health and human services professionals in Illinois who serve our most vulnerable populations with skill, compassion, and unwavering commitment to the public good.

Reaffirms the State's steadfast commitment to promoting a person-centered, community-based mental health and substance use treatment system that is evidence-backed and recognizes each person's dignity, humanity, and autonomy in determining the best course of care in the least restrictive environment in compliance with the Constitution and laws of the State of Illinois.