Healthcare

Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2026 shall provide coverage for the cost of a karyotype test or related hormone testing to diagnose Klinefelter syndrome. 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 Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Provides that the Department of Public Health is vested with the duty and responsibility for oversight and training connected with the use of the Department of Public Health Uniform POLST form at all hospitals, healthcare facilities, and other facilities and providers that use the Department of Public Health Uniform POLST form. Provides that the Department of Public Health shall develop, in consultation with stakeholders determined by the Director of Public Health, training resources to support informed decisions and accurate completion of the Department of Public Health Uniform POLST form. Provides that the Department of Public Health shall establish a simple, efficient, and effective process to ensure oversight of and accountability for training to support informed decisions and accurate completion of the Department of Public Health Uniform POLST form at all hospitals, healthcare facilities, and other facilities and providers that use the Department of Public Health Uniform POLST form. Provides that, in consultation with various organizations, the Department of Public Health shall adopt rules implementing these policies no later than 2 years after the effective date of this amendatory Act. Provides that the Department of Public Health, in connection with implementing these policies, may also consult with the Office of the Secretary of State with respect to the Advance Directive Registry established by the Secretary of State.

Creates the Psychiatric Residential Treatment Facilities (PRTF) Act. Requires the Department of Healthcare and Family Services to establish an Illinois Psychiatric Residential Treatment Facilities (PRTF) program that is family-driven, youth-guided, and trauma-informed, and includes youth and family involvement in all aspects of care planning. Requires the Department to submit a State Plan Amendment, by January 1, 2026, to the Centers for Medicare and Medicaid Services to establish coverage of federally authorized, medically necessary inpatient psychiatric services delivered by a certified PRTF to medical assistance beneficiaries under 21 years of age. Provides that the Department shall adopt rules to implement the PRTF program that at a minimum shall include: (i) certification and participation requirements for PRTF providers in compliance with all applicable federal laws, regulations, requirements, and policies; (ii) monitoring and oversight of PRTF services; (iii) a limit on allowable beds at any one PRTF, not to exceed 40 total beds; and other matters. Requires the Department to establish, and update as needed, a methodology for completing a statewide PRTF capacity analysis for the purposes of identifying capacity needs for PRTF services under the Illinois Medical Assistance Program. Requires the Department to establish a PRTF Advisory Committee responsible for reviewing and providing guidance on the Department's policies and implementations of the PRTF program. Requires the Department to publish on its website counts of reported emergency safety interventions and serious occurrences by State fiscal year and quarter. Makes conforming changes to the Specialized Mental Health Rehabilitation Act of 2013, the Child Care Act of 1969, and other various Acts. Effective immediately.

Amends the Illinois Insurance Code. Provides that 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 shall provide coverage for medically necessary general anesthesia, regardless of the duration, for any procedure covered by the policy, and that medical necessity shall be determined by the attending anesthesiologist or licensed anesthesia provider. Provides that an individual or group policy of accident and health insurance is prohibited from denying payment or reimbursement for anesthesia services solely because the duration of care exceeded a preset time limit. 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 Services Plans Act, and the Illinois Public Aid Code to require coverage under those provisions. Effective immediately.

Amends the Hospital Licensing Act. Provides that a hospital licensed under the Act must, at the time a patient is being checked in, give the patient an opportunity to designate an emergency contact to be notified if the patient dies or experiences a significant change in condition. If an emergency contact is designated, hospital staff must communicate with the emergency contact and ask whether the emergency contact would prefer to be notified by telephone call, by hospital staff when the emergency contact reaches the hospital, or by some other method.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Repeals provisions that require: (i) the Department of Healthcare and Family Services to consult with stakeholders and General Assembly members for input on a plan to develop enhanced Medicaid rates for substance use disorder treatment and mental health treatment in underserved communities; and (ii) the Department of Healthcare and Family Services and the Department of Human Services to collaborate to review coverage and billing requirements for substance use prevention and recovery and mental health services with the goal of identifying disparities and streamlining coverage and billing requirements to reduce the administrative burden for providers and medical assistance beneficiaries. Effective January 1, 2026.

Amends the Nursing Mothers in the Workplace Act. Provides that an employer shall provide 30 minutes of paid break time (rather than reasonable break time) to an employee who needs to express breast milk for her nursing infant child each time the employee has the need to express milk for one year after the child's birth. Provides that the employee may use other paid break time or meal time for any time needed in excess of 30 minutes. Provides that an employer shall provide paid break time (rather than reasonable break time) as needed by the employee unless to do so would create an undue hardship.

Amends the Accident and Health Article of the Illinois Insurance Code. Provides that no health insurer may charge a patient out-of-network rates for neonatal care at any hospital.

Amends the College Student Immunization Act. Provides that, beginning with the 2025-2026 academic year, for a tetanus, diphtheria, and pertussis vaccine (Tdap) requirement, if a student who enrolls in a post-secondary educational institution cannot provide the dates on which the student received 3 or more doses of a diphtheria, tetanus, and pertussis containing vaccine, then the student must provide at least one date on which the student received a dose of the vaccine not more than 10 years prior to the beginning of the term of current enrollment. Provides that additional doses of either a Tdap vaccine or a tetanus and diphtheria vaccine shall be administered in accordance with the Centers for Disease Control and Prevention catch-up schedule, as needed, to complete a series of at least 3 doses, including any prior doses of specified vaccines. Effective immediately.

Amends the Illinois Local Library Act. Provides that all libraries open to the general public in the State shall maintain a supply of opioid antagonists in an accessible location. Provides that any authorized personnel may administer an opioid antagonist to any person whom the authorized personnel believes, in good faith, to be having an opioid overdose (i) on library grounds; (ii) in the immediate vicinity of the library; or (iii) at a library-sponsored event. Requires libraries to ensure that during all operating hours, there is at least one person present in the library who has completed training in how to recognize and respond to an opioid overdose, including the administration of an opioid antagonist. Requires the Director of the Department of Public Health to identify organizations qualified to offer the training. Provides that the health department of any county where a Library is located may provide, either directly or through providing necessary funds, a supply of opioid antagonists to the library. Allows the Department to adopt rules to implement the provisions. Makes conforming changes in the Pharmacy Practice Act.