Healthcare

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 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 Personnel Code. Provides that certain provisions related to probationary separation, term appointments, and veterans hospital visits are subject to Jurisdiction B. Changes references to "veterans hospital visits" to references to "veterans medical appointments". Provides that an employee who is also a veteran shall be permitted 4 days per year to receive medical care authorized by the U.S. Department of Veterans Affairs, at any type of health care provider or health care facility (rather than permitted 4 days per year to visit a veterans hospital or clinic), for examination or treatment (rather than for examination) of a military service-connected condition (rather than service-connected disability).

Creates the First Responder Trauma-Informed Response Training Act, which may be referred to as Anna's Law. Provides that, prior to the onboarding processes of a first responder, the individual must complete mandatory pass or fail trauma-informed response training, as established by the Department of Public Health. Provides that a first responder must also complete the pass or fail trauma-informed response training every 18 months after beginning work as a first responder. Provides that, if more than 18 months have elapsed after beginning work as a first responder and the first responder has not completed the retraining, the first responder may not perform trauma-related duties, such as responding to emergency calls, taking statements from victims, or interviewing victims. Provides that, if a first responder who is certified or licensed by the State or a subdivision of the State has not completed the required trauma-informed response retraining, the first responder may be decertified by the certifying entity or the first responder's license may be revoked by the licensing entity if retraining is not completed. Limits the concurrent exercise of home rule powers. Defines terms. Makes conforming changes in the Illinois Police Training Act and the Emergency Medical Services (EMS) Systems Act, including requiring the Department of Public Health to adopt rules to implement the trauma-informed response training and providing that the rules may allow or require the use of a training program from a university, college, or not-for-profit entity.

Amends the Illinois Insurance Code. Provides that no provision of the Illinois Insurance Code, or any other law, prohibits assignability rights to an insured under any policy of dental insurance (in addition to accident and health insurance). Provides that if an enrollee or insured of an insurer, health maintenance organization, managed care plan, health care plan, preferred provider organization, dental service plan corporation, dental insurer, or third party administrator assigns a claim to a health care professional, or health care facility, a dental care provider, or a dental care facility, then payment shall be made directly to the health care professional, or health care facility, dental care provider, or dental care facility, including any required interest. Effective immediately.

Amends the Community Emergency Services and Support Act. Modifies legislative findings. Provides that appropriate mobile response services must, among other things, subject to the care decisions of the individual receiving care, coordinate transportation for any individual experiencing a mental or behavioral health emergency to the least restrictive setting feasible (rather than provide transportation for any individual experiencing a mental or behavioral health emergency). Provides that adequate mobile mental health relief provider training includes, among other things, training in recognizing and working with people with neurodivergent and developmental disability diagnoses and in the techniques available to help stabilize and connect them to further services and training in the involuntary commitment process, in identification of situations that meet the standards for involuntary commitment, and in cultural competencies and social biases to guard against any group being disproportionately subjected to the involuntary commitment process or the use of the process not warranted under the legal standard for involuntary commitment. Provides that mobile mental health relief providers may only participate in the involuntary commitment process to the extent permitted under the Mental Health and Developmental Disabilities Code. Requires the system for gathering information developed by the Statewide Advisory Committee to determine the number of instances of mobile mental health relief providers initiating petitions for involuntary commitment. Provides that the exemption from civil liability for emergency care provided in the Good Samaritan Act applies to anyone providing care under the Act. Provides that each 9-1-1 public safety answering point and emergency service dispatched through a 9-1-1 public safety answering point must begin coordinating its activities with the mobile mental and behavioral health services established by the Division of Mental Health once all 3 of the following conditions are met, but not later than July 1, 2027 (rather than July 1, 2025). Adds definitions and modifies existing definitions. Effective immediately.

Amends the Illinois Insurance Code to create the Consumer Protection from Surprise Health Care Billing Act. Provides that, on or after July 1, 2025, notwithstanding any other applicable provision, when a beneficiary, insured, or enrollee receives services from a nonparticipating ground ambulance service provider, the health insurance issuer shall ensure that the beneficiary, insured, or enrollee shall incur no greater out-of-pocket costs than the beneficiary, insured, or enrollee would have incurred with a participating ground ambulance service provider. Provides that any cost-sharing requirements shall be applied as though the services provided by the nonparticipating ground ambulance service provider had been provided by a participating ground ambulance service provider. Sets forth provisions concerning payment for ground ambulance services; calculating the recognized amount; limitations for the cost sharing amount for any occurrence in which a ground ambulance service is provided to a beneficiary; appeals for payments made by health insurance issuers; the maximum allowable payment amounts, by individual service types, for nonparticipating ground ambulance service providers owned, operated, or controlled by a private organization; and payments to nonparticipating ground ambulance service providers owned, operated, or controlled, by a unit of government which participates in the Ground Emergency Medical Transportation program administered by the Department of Healthcare and Family Services. Makes conforming changes. Provides that the failure by a health insurance issuer to comply with the specified requirements constitutes an unlawful practice under the Consumer Fraud and Deceptive Business Practices Act and enforcement authority is granted to the Attorney General. Amends the Health Maintenance Organization Act and the Consumer Fraud and Deceptive Business Practices Act to make corresponding changes. Effective July 1, 2025.

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, 2027 shall provide coverage for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia, in accordance with the U.S. Food and Drug Administration label, as determined by a physician licensed to practice medicine in all its branches. Provides that coverage of U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia shall not be subject to step therapy. Amends the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, and the Voluntary Health Services Plans Act to require coverage under those provisions. Effective immediately.