Healthcare

Amends the Nursing Home Care Act. Replaces reporting requirement provisions for the Department of Public Health concerning nurse surveyors. Provides that, in addition to the listed information, the Department's annual report on all survey activity from the preceding fiscal year shall include: (i) the total number of authorized nursing home surveyor positions within the Department, (ii) the total number of filled and vacant nursing home surveyor positions, (iii) the average length of tenure for nursing home surveyors employed by the Department at the time the report is created, and (iv) any additional information the Department deems relevant regarding nursing home surveyor recruitment, retention, or workload.

Amends the Substance Use Disorder Act. In provisions requiring the Department of Human Services to establish a public education program regarding gambling disorders, requires the program to (i) promote public awareness regarding the impact of gambling disorders on individuals, families, and communities and the stigma that surrounds gambling disorders and (ii) use screening, crisis intervention, treatment, public awareness, prevention, in-service training, and other innovative means to decrease the incidence of suicide attempts related to gambling disorders or gambling issues. Requires the Department to select the statement regarding obtaining assistance with a gambling disorder, which each licensed gambling establishment owner shall post, and each master sports wagering licensee shall include, on the master sports wagering licensee's portal, Internet website, or computer or mobile application. Permits the Department to provide advice to State and local officials on gambling disorders; to support gambling disorder prevention, recognition, treatment, and recovery projects; to collaborate with other community-based organizations, substance use disorder treatment centers, or other health care providers engaged in treating individuals who are experiencing gambling disorders; and to perform other actions. Allows the Department to award grants to create or support local gambling prevention, recognition, and response projects. Makes other changes.

Amends the Illinois Insurance Code. In a provision concerning coverage of certain cancer screenings, adds having a high level of CA-125, as indicated by a blood test screening, to the definition of "at risk for ovarian cancer". Provides that "surveillance tests for ovarian cancer" means all medically viable methods for the detection and diagnosis of ovarian cancer, including, but not limited to, ultrasounds, magnetic resonance imagings (MRIs), x-rays, computed tomography (CT) scans, and CA-125 blood test screenings (instead of an annual screening using (i) CA-125 serum tumor marker testing, (ii) transvaginal ultrasound, (iii) pelvic examination). Effective January 1, 2028.

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 Illinois Controlled Substances Act. Provides that each prescriber or the prescriber's designee shall document an attempt to access patient information in the Prescription Monitoring Program to assess patient access to controlled substances when providing a (rather than an initial) prescription for Schedule II and IV controlled substances (rather than narcotics such as opioids), except for prescriptions for oncology treatment or palliative care, or a 7-day or less supply provided by a hospital emergency department when treating an acute, traumatic medical condition.

Amends the Illinois Insurance Code. Provides that an individual or group policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2027 that provides coverage for durable medical equipment that is authorized or prescribed by a physician licensed to practice medicine in all its branches shall provide the same level of coverage for durable medical equipment that is authorized or prescribed by a different health care practitioner who lawfully prescribes or orders home medical equipment and services or uses home medical equipment and services to treat the health care practitioner's patients. 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 establish the same requirement under the provisions of those Acts. Effective immediately.

Amends the Pharmacy Practice Act. Provides that "practice of pharmacy" includes the monitoring of medication recalls, including notifying patients of applicable medication recalls at the point of sale.

Amends the Hospital Licensing Act. Defines "pathogens of epidemiological concern". Provides that each hospital shall develop and implement comprehensive interventions to prevent and control pathogens of epidemiological concern (instead of multidrug-resistant organisms) that take into consideration guidelines of the U.S. Centers for Disease Control and Prevention or recommendations from the Infectious Disease Society of America, the Society for Healthcare Epidemiology of America, the Association for Professionals in Infection Control and Epidemiology, or the Pediatric Infectious Disease Society for the management of multidrug-resistant organisms in health care settings. Within 12 months after the effective date of the amendatory Act, requires each hospital to adopt a policy for preventing and controlling the transmission of pathogens of epidemiological concern. Establishes reporting requirements for hospitals with patients carrying pathogens of epidemiological concern. Repeals the MRSA Screening and Reporting Act.

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 Illinois Insurance Code. Prohibits an insurer, dental service plan corporation, professional service corporation, insurance network leasing company, or any other company or its contracted vendor that amends, delivers, issues, or renews an individual or group policy of accident and health insurance on or after the effective date of the amendatory Act from requiring a dental care provider to only accept payment from a credit card or electronic funds transfer, in addition to the existing prohibition on incurred fees to access and obtain payment or reimbursement for services provided. Provides that any insurer, dental service plan corporation, professional service corporation, insurance network leasing company, or any other company or its contracted vendor that amends, delivers, issues, or renews an individual or group policy of accident and health insurance may initiate or change payment methodology to a dental care provider using electronic funds transfer payments, including virtual credit card payments, if the specified conditions are met. Sets forth provisions concerning claim payment methodologies and fees for transmitting payments. Provides that the specified dental coverage reimbursement provisions shall not be waived by contract. Effective January 1, 2027.