Healthcare

Amends the Illinois Insurance Code. In provisions concerning biomarker testing: makes changes to defined terms; requires applicable health insurers, nonprofit health service plans, and health maintenance organizations to update and make publicly available medical policies and coverage guidelines within 90 days after the effective date of the amendatory Act; provides that, if a health insurer or nonprofit health service plan denies a claim for coverage of testing that is supported by any specified evidence, the insurer or nonprofit health service plan shall provide to the requesting entity specific written justification explaining in detail why the claim for coverage was denied as it pertains to the individual for whom the test was ordered; sets forth provisions concerning utilization review and prior authorization; provides that the Department of Insurance may conduct periodic audits and reviews to ensure entity compliance; and makes other changes.

Amends the Community Services Act. Adds community day services to the list of service categories covered under the Act. Defines "community day services" to mean a Home and Community-Based Waiver day program that is certified by the Department of Human Services and provides assistance with gaining, maintaining, or improving skills and functioning to individuals with developmental disabilities. Makes conforming changes to the Mental Health and Developmental Disabilities Administrative Act.

Amends the Illinois Administrative Procedure Act. Provides that, for any law implementing the federal Patient Protection and Affordable Care Act, the Department of Insurance may adopt rules that include incorporations by reference of federal rules and regulations without identifying the incorporated matter by date and without including a statement that the incorporation does not include later amendments. Amends the Illinois Insurance Code. Makes changes concerning the assignment or transfer of property and casualty policies; formatting requirements for the insurance company supplier diversity report; and insurance coverage for dependent parents. Provides that the Director of Insurance shall maintain as confidential any records or information received from the National Association of Insurance Commissioners or other state, federal, and international regulatory agencies (instead of insurance regulatory officials of other states) that are confidential in that other jurisdiction. Provides that the Department may waive registration and course certification fees if the pre-licensing or continuing education course is provided by a government entity free of charge. Amends the Network Adequacy and Transparency Act. In applicability provisions, removes language concerning exemptions for short-term, limited-duration health insurance coverage with a network plan. Repeals the Health Care Purchasing Group Act. Effective immediately.

Amends the Illinois Insurance Code. In provisions concerning the payment of nonparticipating ground ambulance service providers, makes changes to defined term, removes jurisdictional provisions, and provides that, for nonparticipating ground ambulance service providers owned and operated by (instead of subject to) a unit of local government, a rate shall be paid that is equal to the rate established or approved by the governing body of the unit of local government providing the ground ambulance service. Establishes a rate of pay for nonparticipating ground ambulance service providers that are not owned and operated by (instead of subject to the jurisdiction of) a unit of local government. Amends the Health Maintenance Organization Act. Replaces provisions concerning coverage for emergency transportation by ambulance with provisions concerning coverage for ground ambulance service.

Amends the Hospital Licensing Act. Requires every hospital to adopt an influenza and pneumococcal immunization policy that includes procedures for identifying patients age 18 or older (rather than 50 or older) for influenza immunization and 50 or older (rather than 65 or older) for pneumococcal immunization.

Creates the Kidney Disease Treatment Delegation Act. Provides that, notwithstanding any provision of the Nurse Practice Act or any rule of the Department of Financial and Professional Regulation to the contrary, delegation, including, but not limited to, delegation of the performance of central venous catheter procedures in a kidney disease treatment center, shall only be allowed if the individual receiving delegation is a licensed practical nurse who has obtained the proper training, education, and experience or a certified dialysis technician who currently holds, or is in the process of acquiring, the necessary experience to apply for and obtain certification as a certified clinical hemodialysis technician by the Nephrology Nursing Certification Commission or a Certified Hemodialysis Technologist/Technician by the Board of Nephrology Examiners Nursing and Technology. Sets forth additional provisions concerning delegation of duties in a kidney disease treatment center. Provides that the Department is authorized to adopt rules for the administration and enforcement of the Act, and the rules may define standards and criteria for the necessary training, education, and experience for licensed practical nurses to obtain before receiving delegation under the Act. Amends the Nurse Practice Act. Provides that a violation of the Kidney Disease Treatment Delegation Act is grounds for disciplinary action. Effective immediately.

Creates the Expanded Access to Lung Cancer Screening Act. Provides that the Department of Public Health shall require information and counseling concerning lung cancer screening to be made available to individuals accessing the tobacco quitline. Allows the Department to enter into contracts and agreements and award grants to persons operating the tobacco quitline. Requires the Department to develop signage that discloses referral information for lung cancer screening. Requires the Department to develop an educational insert to accompany the sale of tobacco products and nicotine replacement therapies by retailers. Provides that a retailer of tobacco products or nicotine replacement therapies who intentionally violates these provisions is guilty of a petty offense. Requires the Department to adopt rules. Defines terms.

Amends the Illinois Insurance Code. Provides that a group or individual plan of accident and health insurance or managed care plan amended, delivered, issued, or renewed on or after January 1, 2027 shall provide coverage for medically prescribed seizure detection devices. Requires all covered seizure detection devices to be approved for use by individuals, and for the choice of device to be made based upon the individual's circumstances and medical needs in consultation with the individual's medical provider. Sets forth provisions prohibiting prior authorization and cost-sharing, as specified. Amends 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 Illinois Public Aid Code to require coverage under the provisions of those Acts. Effective immediately.

Amends the Assisted Living and Shared Housing Act. Provides that an assisted living establishment or a shared housing establishment shall only make referrals to its residents for home services providers that are licensed under the Home Health, Home Services, and Home Nursing Agency Licensing Act. Establishes penalties for violating the referral requirement. Amends the Assisted Living and Shared Housing Act, the Community Living Facilities Licensing Act, and the Life Care Facilities Act to require that the Department of Public Health to distribute to each establishment or facility a one-page, 8.5 by 11 inch public safety announcement flyer in at least 12-point type and that the each establishment or facility post the flyer in a prominent location for all visitors to see. Effective January 1, 2027.

Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Instructs the Department of Public Health to require a health care practitioner who is treating a patient diagnosed with epilepsy and at elevated risk for sudden unexpected death in epilepsy and who has primary responsibility for the treatment and care of the patient for epilepsy, other than a health care practitioner treating that patient in an emergency situation, to provide that patient with certain written information regarding sudden unexpected death in epilepsy. Requires the Department to provide that written information to health care practitioners and post the information on the Department's website. Requires the Department to ensure that the information is culturally and linguistically appropriate for all recipients. Allows a local or national organization that provides education or services related to epilepsy conditions to request that the Department include on its website the organization's informational material and contact information. Requires the Department to provide guidance to health care practitioners in determining whether a patient is at elevated risk for sudden unexpected death in epilepsy. Requires the Department to adopt rules. Amends the Medical Practice Act of 1987, the Nurse Practice Act, and the Physician Assistance Practice Act to require licensees under the Acts to comply with the amendatory provisions in the Department of Public Health Powers and Duties Law. Provides that certain licensees under the Acts who violate the amendatory provisions shall be issued a warning by the Department of Financial and Professional Regulation and shall suffer no further penalty or discipline for a first offense if the violation was not committed willfully or knowingly. Provides that certain licensees under the Acts who commit a subsequent violation of the amendatory provisions shall pay a civil penalty, as determined by the Department of Financial and Professional Regulation, of no more than $10,000 to the Department of Financial and Professional Regulation for each subsequent violation. Makes other changes.