Healthcare

Amends the Medical Assistance Article of the Illinois Public Aid Code. Removes provisions requiring the Department of Healthcare and Family Services to: (i) establish benchmarks for hospitals to measure and align payments to reduce potentially preventable hospital readmissions, inpatient complications, and unnecessary emergency room visits; (ii) publish provider-specific historical readmission data and anticipated potentially preventable targets 60 days prior to the start of the program; and (iii) adopt policies and rates of reimbursement for readmission services and other payments.

Creates the Sexual Orientation, Gender Identity, and Gender Expression in Long-Term Care Bill of Rights Act. Establishes rights for a client who lives in a long-term care facility, or who receives home care services from a home care provider, from discrimination on the basis of actual or perceived sex, actual or perceived sexual orientation, actual or perceived gender identity, actual or perceived gender expression, or actual or perceived HIV status. Provides that an aggrieved person may enforce violations of the Act against a long-term care facility or a home care provider and the staff of the long-term care facility or home care provider through a civil action. Sets forth provisions concerning gender identity in client records; required training for all long-term care facilities and home care providers; arbitration agreements; interpretation of the Act; and enforcement of rights, including civil penalties and other administrative actions. Amends the Assisted Living and Shared Housing Act, the Nursing Home Care Act, and the Home Health, Home Services, and Home Nursing Agency Licensing Act to require compliance with the Sexual orientation, Gender Identity, and Gender Expression in Long-Term Care Bill of Rights Act. Amends the Adult Protective Services Act to include intentional misgendering and unlawful discrimination in the definition of "abuse".

Amends the Illinois Insurance Code. Provides that coverage for treatment in a residential treatment center shall include residential coverage for the diagnosis and treatment of substance use disorders. Provides that this coverage shall include unlimited medically necessary treatment for substance use disorder treatment services provided in residential settings. Prohibits the coverage from applying financial requirements or treatment limitations to residential substance use disorder benefits that are more restrictive than the predominant financial requirements and treatment limitations applied to other medical and surgical benefits covered by the policy. Sets forth provisions concerning cost sharing; application of coverage requirements; prior authorization; clinical review; discharge plans; other forms of utilization review; and the criteria for medical necessity determinations.

Amends the Illinois Insurance Code. Provides that any individual or group policy of accident or health insurance that is delivered, extended, renewed, or modified after January 1, 2026 must provide coverage for at least one 6-month supply of each of the following for each infant covered by the policy: an early egg allergen introduction dietary supplement prescribed by a health care practitioner; and an early peanut allergen introduction dietary supplement prescribed by a health care practitioner. Provides that the coverage shall be provided without cost-sharing, except to the extent the cost-sharing limitation would cause a catastrophic plan to fail to be treated as a catastrophic plan under the Patient Protection and Affordable Care Act or would keep a high-deductible health plan from being treated as a high-deductible health plan or to the extent the cost-sharing limitation would disqualify the plan from a health savings account. Amends the State Employees Group Insurance Act of 1971 and the Medical Assistance Article of the Illinois Public Aid Code to require that coverage. Effective immediately.

Amends the Illinois Insurance Code. Provides that a group or individual policy of accident or health insurance that is issued, amended, delivered, or renewed on or after January 1, 2027 shall not charge insured persons a copayment as a method of cost-sharing or include a deductible greater than $1,000. Provides that yearly out-of-pocket expenses for insured persons must be less than or equal to $1,500. 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 those provisions.

Amends the Substance Use Disorder Act. Requires the Department of Human Services to establish a mechanism to collect research and data regarding overdose prevention sites (OPSs) and prepare a report for the General Assembly within 12 months after the effective date of the amendatory Act. Provides that the report shall contain information on (1) current research on the effectiveness of an OPS as an overdose prevention strategy; (2) OPS best practices for staffing, placement, and activities; and (3) the benefits and challenges of different OPS models - structures and settings. Requires the Department, in collaboration with people with lived experience, to develop a pilot service, subject to available funding, aimed at saving the lives of people who use substances that shall include the establishment of at least one OPS. Requires the pilot OPSs to offer people, who are most likely to use drugs in public, unobserved, high-risk, and unsanitary locations, a safe space to use pre-obtained substances and connect to community supports or other existing treatment and recovery programs, harm reduction services, and health care. Contains provisions concerning certain principles pilot OPSs must abide by; OPS staffing and location requirements; pilot OPS services; and other matters. Permits the Department to approve an entity to operate a pilot program in one or more jurisdictions. Grants criminal and civil immunity to persons who use pilot OPSs services; pilot OPS staff; and any real property owner upon which the OPS site is located or operates. Contains provisions on public awareness outreach; OPS reporting requirements; home rule exemption; and other matters. Effective immediately.

Amends the Grocery Initiative Act. Provides that Grocery Initiative Grants may be used to provide access to equipment that is needed to accept payment from the Women, Infant, Children's program (WIC). Makes changes to the definition of "grocery store" to include certain meat retailers, fruit and vegetable retailers, and fish and seafood retailers. Effective July 1, 2025.

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.

Creates the Caring for Caregivers Act. Provides that a taxpayer who is a family caregiver and who incurs eligible expenditures during the taxable year for the care and support of an eligible family member may apply to the Department of Revenue for an income tax credit. Provides that the credit shall be equal to 50% of the eligible expenditures incurred during the taxable year by the family caregiver for the care and support of an eligible family member, subject to certain specified limitations. Amends the Illinois Income Tax Act to make conforming changes. Effective January 1, 2026.

Amends the Illinois Insurance Code. In a provision requiring policies of group accident and health insurance to provide coverage for certain examination and testing services provided to a victim of specified criminal offenses, prohibits the policy from imposing a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage provided, except to the extent that the coverage would disqualify a high-deductible health plan from eligibility for a health savings account under the Internal Revenue Code. Effective January 1, 2026.