Healthcare

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 State Police Law. Provides that, beginning January 1, 2026, all 9-1-1 telecommunicators who provide dispatch for emergency medical conditions shall be required to be trained, utilizing the most current nationally recognized emergency cardiovascular care guidelines, in high-quality telecommunicator cardiopulmonary resuscitation (T-CPR). Defines telecommunicator cardiopulmonary resuscitation for the purposes of the provisions.

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.

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.

Declares May 2025 as ALS Awareness Month and urges all Americans to join in supporting ALS research, advocating for increased funding, and standing in solidarity with those affected by this relentless disease.

Amends the Illinois Health Benefits Exchange Law. Provides that the Illinois Health Benefits Exchange shall allow a special enrollment period for an uninsured taxpayer and the uninsured taxpayer's qualified dependents, if applicable, if the uninsured taxpayer requested health insurance benefit information through the easy enrollment program under the Illinois Income Tax Act and the uninsured taxpayer and the uninsured taxpayer's qualified dependents, if applicable, are eligible to enroll in a qualified health plan through the Exchange. Establishes notification requirements for the Exchange. Provides that the uninsured taxpayer and the uninsured taxpayer's dependents shall have 60 days from the date of the letter to select and enroll in a qualified health plan. Provides that coverage shall be effective the first day of the month that follows the plan selection. Grants the Department of Insurance and the Department of Healthcare and Family Services rulemaking authority to implement an easy enrollment special enrollment period. Effective immediately.

Amends the Assisted Living and Shared Housing Act. Makes changes to assessments for admission to establishments and service plan requirements. Requires an establishment to notify the resident and the resident's representative when there is a significant change in the resident's condition that affects the establishment's ability to meet the resident's needs. Prohibits an establishment from terminating or reducing any service without the consent of the resident or the resident's representative for the purpose of making it more difficult or impossible for the resident to remain in the establishment. Adds new requirements for establishments and the Department of Public Health regarding the involuntary termination of residency. Provides that a resident has the right to not be unlawfully transferred or discharged. Makes other changes. Amends the Nursing Home Care Act. Prohibits a resident from being transferred or discharged in violation of the Act. Provides that a resident has the right not to be unlawfully transferred or discharged. Provides for the assessment of a $2,500 fine for a facility that fails to comply with an order to readmit a resident who wishes to return to the facility and is appropriate for that level of care and services provided. Requires a facility that complies with an order to readmit a resident that has been deemed to have been unlawfully discharged to notify the Department within 10 business days after the resident has been readmitted to the facility. Provides that a facility may involuntarily transfer or discharge a resident because the facility is unable to meet the medical needs of the resident, as documented in the resident's clinical record by the resident's physician. Provides that the Department maintains jurisdiction over the transfer or discharge irrespective of the timing of the notice and discharge. Provides that if the Department determines that a transfer or discharge is not authorized, then the Department shall issue a written decision stating that the transfer or discharge is denied. Makes other changes. Effective immediately.

Declares May 2025 as Prader-Willi Syndrome Awareness Month. Express support for raising awareness and educating the public about Prader-Willi Syndrome and increasing research and funding into the causes and treatments of the disease.

Amends the Burn Victims Relief Act. Dissolves the George Bailey Memorial Fund on June 30, 2025, or as soon thereafter as practical, and assigns any future deposits due to that Fund to the General Revenue Fund. Amends the Illinois Insurance Code. Requires every company licensed to do business in this State that is transacting the kind or kinds of business under Class 1, 2, or 3, as defined in the Code, to establish a customer affairs and information department to respond to policyholder inquiries and complaints. In provisions concerning kinds of agreements requiring approval, provides that the Director of Insurance has the right to request additional filing review and approval of all contracts that contribute to the statutory threshold trigger. Removes provisions concerning a working group related to the treatment and coverage of mental, emotional, nervous, or substance use disorders. Makes other changes. Amends the Dental Care Patient Protection Act. Makes changes concerning preemption of provisions. Amends the Health Maintenance Organization Act. Provides that health maintenance organizations are subject to provisions of the Illinois Insurance Code requiring coverage for certain at-home pregnancy tests and certain medically necessary treatments to address a major injury to the jaw. Amends the Network Adequacy and Transparency Act to make technical and combining changes to conform the changes made by Public Act 103-777 and 103-650. Amends the Limited Health Service Organization Act to make conforming changes. Amends the Criminal Code of 2012. Changes the definition of "insurance company". Effective immediately, except that certain changes to the Illinois Insurance Code are effective January 1, 2026 and certain other changes to the Illinois Insurance Code are effective 60 days after becoming law.