Healthcare

Amends the Rehabilitation of Persons with Disabilities Act. Requires direct service workers employed by the Department of Human Services, or an agency contracted with the Department, to provide services under the Home Services Program to complete at least 2 hours of dementia training at the start of their employment and annually thereafter. Requires the training to cover subjects concerning Alzheimer's disease and dementia, safety risks, and communication and behavior. Requires the Department to provide contractors with dementia training curriculum on the required subjects. Provides that any other laws or rules that impose more rigorous dementia training for direct service workers under the Home Services Program shall apply. Exempts from the training requirements direct service workers who provide proof that they obtained equivalent dementia training in compliance with another law or rule. For personal assistants covered by a collective bargaining agreement, requires the Department to establish, in consultation with the joint training committee created under the collective bargaining agreement, different parameters and specific topics for curriculum covering dementia training.

Amends the School Code. Allows a school district, public school, charter school, or nonpublic school to authorize a school nurse or trained personnel to: (1) provide undesignated ready-to-use glucagon to authorized personnel to administer ready-to-use glucagon to a student that meets the student's prescription on file; (2) administer undesignated ready-to-use glucagon that meets the prescription on file to any student who has a plan that authorizes the use of ready-to-use glucagon; and (3) administer undesignated ready-to-use glucagon to any person that the school nurse or trained personnel believes in good faith is having a severe hypoglycemia emergency. Makes conforming changes regarding liability, where and when the undesignated ready-to-use glucagon may be administered, supply maintenance, notification of administration to the student's parent or guardian or emergency contact, training, and reports of administration to the State Board of Education, General Assembly, and Department of Public Health.

Amends the Illinois Occupational Therapy Practice Act. Requires a licensed occupational therapist or licensed occupational therapy assistant who intends to provide services for individuals, groups, and populations concerning occupational therapy needs without a referral to do so within the licensee's scope of practice. Provides that a referral is not required for the purpose of providing consultations, habilitation services, screenings, education, wellness services, preventions services, environmental assessments, and work-related ergonomic services. Provides that, except for occupational therapy services within the licensee's scope of practice at the time of evaluation and services provided pursuant to provisions concerning when referrals are not required, an occupational therapist shall refer a patient to the patient's treating health care professional of record, or to a health care professional of the patient's choosing if there is no health care professional of record, if the patient meets certain criteria. Provides that an occupational therapist shall refer a patient to the patient's treating health care professional of record, or to a health care professional of the patient's choosing if there is no health care professional of record if the patient does not demonstrate measurable or function improvement after 10 visits (rather than after 10 visits or 15 business days, whichever occurs first).

Amends the Department of Human Services Act. Requires the Department of Human Services to revise all Department forms and billing codes to remove the term "mental retardation" and replace it with "intellectual disability".

Amends the Department of Public Health Act. Provides that the Breakthrough Therapies for Veteran Suicide Prevention Program Advisory Council created by Public Act 103-8 is continued within the Department of Public Health, with modifications to its duties and composition. Amends the Department of Healthcare and Family Services Law of the Civil Administrative Code of Illinois by repealing provisions regarding the Council.

Amends the Limited Health Service Organization Act. Makes changes to defined terms. In provisions concerning the offering of a point-of-sale contract by a limited health service organization (LHSO), removes a provision requiring the LHSO to include an annual maximum benefit allowance not to exceed $2,500 per year that is separate from any limits or allowances applied to in-plan services. Provides that, if an LHSO expends in any calendar quarter more than 20% of its total limited health services expenditures for all its members for out-of-plan covered services, then specified limitations shall not apply subject to the LHSO minimum capital and surplus requirements applicable to a life, accident, and health insurance company. Makes other changes.

Amends the Illinois Speech-Language Pathology and Audiology Practice Act. Allows a speech-language pathologist to diagnose autism spectrum disorders if: (1) the child is under 3 years of age; and (2) the speech-language pathologist is trained in autism diagnostic evaluation methods as part of the curriculum of an approved program, through worksite training, or through continuing education. Provides that if a diagnosis requires a plan of care that includes elements that are outside the scope of practice of a speech-language pathologist, the speech-language pathologist must refer the patient to the appropriate medical personnel for further evaluation or management. Makes conforming changes in the Medical Assistance Article of the Illinois Public Aid Code, and provisions of the Illinois Insurance Code concerning autism spectrum disorders. Effective July 1, 2027.

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.

Creates the Transparency in Downcoding Act. Provides that the Act applies to certain policies of health insurance amended, delivered, issued, or renewed on or after the effective date of the Act, except for employee or employer self-insured health benefit plans under the federal Employee Retirement Income Security Act of 1974 and health care provided pursuant to the Workers' Compensation Act or the Workers' Occupational Diseases Act. Prohibits a health insurance issuer from using an automated process, system, or tool to downcode a claim; from downcoding a claim based solely on the reported diagnosis codes; and from using downcoding practices in a targeted or discriminatory manner against physicians who routinely treat patients with complex or chronic conditions. Requires downcoding decisions to be made by a physician licensed to practice medicine in all its branches in any United States jurisdiction and of the same or similar specialty as a physician who typically manages the medical condition or disease. Sets forth provisions concerning notification requirements for downcoded claims; the appeal process for downcoded claims; enforcement by the Department of Insurance; and penalties. Provides that any pattern or practice of discriminatory downcoding identified by the Director of Insurance or another regulatory authority shall be subject to enforcement actions, including fines, restitution, or suspension of the health insurance issuer's license in this State. Effective immediately.

Amends the Nurse Practice Act. Makes changes to the requirements for a registered professional nursing education program in provisions concerning the establishment of a new program, program policies, faculty members, training and development, the program's curriculum, the program's use of simulation, the accreditation process, approval by the Board of Nursing, and the program closure process. Makes a conforming change. Provides that the Department of Financial and Professional Regulation may, without hearing, rescind the license of any person who obtain a license after completing a program or obtaining credit from a program that does not meet the requirements of the provisions regarding registered professional nursing education programs. In provisions concerning nursing licensure by examination, removes the provision regarding the good standing period for professional nursing programs on probationary status.