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.

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 Regulatory Sunset Act. Changes the repeal date of the Illinois Dental Practice Act from January 1, 2026 to January 1, 2036. Amends the Illinois Dental Practice Act. In the definition of "branches of dentistry", adds oral and maxillofacial pathology, dental public health, oral medicine, and orofacial pain to the included specialties. Creates a temporary dental hygiene license for dental students who meet certain requirements. Provides that a licensee holding a temporary dental hygiene license must practice under the supervision of a dentist. Provides that the temporary dental hygiene license is active for one year from its issuance date. Changes the implementation deadline for an order regarding the services that are necessary to be performed on a patient who is in a State or federal prison and who cannot travel to a dental office to 180 days of the order's issuance (rather than 45 days of the order's issuance). Removes language providing that provisions concerning public health dentistry are inoperative on and after January 1, 2026. Effective immediately.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires hospitals and birthing centers to adopt and maintain written policies and procedures authorizing a patient enrolled in the medical assistance program to select an Illinois Medicaid certified and enrolled doula of the patient's choice to accompany the patient within the facility's premises for the purposes of providing support before, during, and after labor and childbirth, and during the patient's entire postpartum stay. Provides that the doula shall be considered part of the patient's care team and shall not be counted as a support person or against any guest quota. Requires hospitals and birthing centers to provide a written copy of their policies and procedures to maternity patients, the facilities' maternity health care providers, and any other person at the patient's request. Requires publication of the written policies on each facility's website. Contains provisions concerning hospital and birthing center liaisons and doulas certification acknowledgment requirements. Permits the Department of Healthcare and Family Services and the Department of Public Health to establish standing recommendations to meet Centers for Medicare and Medicaid Services requirements and ensure access to preventive services, including Medicaid-covered maternal and reproductive health supports and services.

Creates the Artificial Intelligence Systems Use in Health Insurance Act. Provides that the Department of Insurance's regulatory oversight of insurers includes oversight of an insurer's use of AI systems to make or support adverse determinations that affect consumers. Provides that any insurer authorized to operate in the State is subject to review by the Department in an investigation or market conduct action regarding the development, implementation, and use of AI systems or predictive models and the outcomes from the use of those AI systems or predictive models. Provides that an insurer authorized to do business in Illinois shall not issue an adverse consumer outcome with regard to the denial, reduction, or termination of insurance plans or benefits that result solely from the use or application of any AI system or predictive model. Provides that any decision-making process for the denial, reduction, or termination of insurance plans or benefits that results from the use of AI systems or predictive models shall be meaningfully reviewed, in accordance with review procedures determined by Department rules, by an individual with authority to override the AI systems and determinations. Authorizes the Department to adopt emergency rules to implement the Act and to adopt rules concerning standards for full and fair disclosure of an insurer's use of AI systems. Makes a conforming change in the Illinois Administrative Procedure Act.