Healthcare

Amends the Mental Health and Developmental Disabilities Administrative Act and the Rehabilitation of Persons with Disabilities Act. Required the Department of Human Services to provide informational materials about the Senator Scott Bennett ABLE Program to: persons who are placed in a facility licensed under the ID/DD Community Care Act, the MC/DD Act, or the Specialized Mental Health Rehabilitation Act of 2013; persons with disabilities who receive services funded by or administered in conjunction with the Department, including, but not limited to, home and community based services, home-based support services, PUNS services, home care services, and services at a Center for Independent Living. Provides that the informational materials shall be provided when a person first enrolls for such services and as part of any annual process required for the person to maintain eligibility for such services. Requires the Office of the State Treasurer to prepare and deliver the informational materials in an electronic format to the Department and distribute the materials to eligible persons.

Amends the Medicare-Medicaid Alignment Initiative (MMAI) Nursing Home Residents' Managed Care Rights Law of the Illinois Public Aid Code. Provides that the Article applies to a fully integrated dual eligible special needs plan and any managed care plan for persons who are dually eligible for Medicare and Medicaid. Adds to the definition of "Demonstration Project", a fully integrated dual eligible special needs plan and any managed care plan for persons who are dually eligible for Medicare and Medicaid. Provides that the Department of Healthcare and Family Services shall provide each managed care organization with the quarterly facility-specific nursing component (instead of RUG-IV nursing component) per diem along with any add-ons for enhanced care services, support component per diem, and capital component per diem effective for each nursing home under contract with the managed care organization. Effective immediately.

Amends the Mental Health and Developmental Disabilities Administrative Act and the Rehabilitation of Persons with Disabilities Act. Required the Department of Human Services to provide informational materials about the Senator Scott Bennett ABLE Program to: persons who are placed in a facility licensed under the ID/DD Community Care Act, the MC/DD Act, or the Specialized Mental Health Rehabilitation Act of 2013; persons with disabilities who receive services funded by or administered in conjunction with the Department, including, but not limited to, home and community based services, home-based support services, PUNS services, home care services, and services at a Center for Independent Living. Provides that the informational materials shall be provided when a person first enrolls for such services and as part of any annual process required for the person to maintain eligibility for such services. Requires the Office of the State Treasurer to prepare and deliver the informational materials in an electronic format to the Department and distribute the materials to eligible persons.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides medical assistance coverage for sickle cell disease (rather than sickle cell anemia).

Amends the Emergency Medical Services (EMS) Systems Act. Makes changes to defined terms. Replaces references to Primary Stroke Centers with Stroke Centers. Provides that a hospital that no longer meets nationally recognized, evidence-based standards for Stroke Centers, loses its Stroke Center certification, or has any change to its designation level shall notify the Department of Public Health and the Regional EMS Advisory Committee within 5 business days. Requires the Department to consult with the State Stroke Advisory Subcommittee for the adoption or deletion of approved stroke designation levels. Provides that the approved stroke designation levels shall coincide with the stroke designation levels recognized by Department-approved certifying bodies. Requires the Department to establish reporting requirements for designated Stroke Centers to capture information using new or existing electronic reporting tools for statewide data collection and certification purposes. Removes provisions concerning previous Stroke Center designations. Makes other changes.

Amends the Nursing Home Care Act and the Assisted Living and Shared Housing Act. Requires the Department of Public Health to hold semiannual joint training sessions for surveyors, nursing home providers, and assisted living establishment providers. Provides that the Department shall include the State long-term care ombudsman, or the State long-term care ombudsman's designee, and representatives of each nursing home provider association and assisted living provider association in the State in the planning process to create the topics and content of the joint training sessions as well as the coordination and presentations for the joint training sessions. Provides that, at least annually, a joint training session shall include, but not be limited to, regional citation patterns relating to complaints, standards, and outcomes in the nursing home and assisted living survey process. Requires the Department to develop standardized training for establishments to prevent common citations in the assisted living survey process.

This bill nominates Anusha Thotakura to serve as a member of the Illinois Health Benefits Exchange Advisory Committee. If approved, Ms. Thotakura would join the committee responsible for advising on health benefits exchange matters in Illinois.

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 that provides coverage for: habilitative services shall provide coverage for habilitative speech therapy as a treatment for stuttering, regardless of whether the stuttering is classified as developmental; rehabilitative services shall provide coverage for rehabilitative speech therapy as a treatment for stuttering; or habilitative services and rehabilitative services shall provide coverage for habilitative speech therapy as a treatment for stuttering, regardless of whether the stuttering is classified as developmental, and shall provide coverage for rehabilitative speech therapy as a treatment for stuttering. Sets forth requirements and limitations for the coverage. 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 State Mandates Act to require implementation without reimbursement. Effective January 1, 2027.

Amends the Mental Health Early Action on Campus Act. Provides that the expert panel designated by the board of trustees to develop and implement policies and procedures shall be comprised of at least 2 administrators, 2 members of faculty, and one mental health professional. Requires each public college or university to provide at least 3 on-site licensed clinical professional counselors or licensed clinical social workers.

Amends the Managed Care Reform and Patient Rights Act. Provides that a health care plan shall provide annually to enrollees and prospective enrollees, upon request, a statement of all basic health care services and all specific benefits and services mandated to be provided to enrollees by State law or administrative rule, highlighting any newly enacted State law or administrative rule. Provides that this requirement can be fulfilled by providing enrollees the most up-to-date accident and health checklist submitted to the Department of Insurance, reflecting statutory health care coverage compliance by the health care plan. Requires the Office of Consumer Health Insurance to post in a prominent location on the Department's publicly accessible website an annual report on the development and implementation of federal, State, and local laws, regulations, and other governmental policies and actions that pertain to the adequacy of health care plans, facilities, and services in the State and summary of all State health insurance benefit related legislation enacted in the prior calendar year that includes, at minimum, a link to the Public Act, the statutory citation, the subject, a brief summary, and the effective date. Amends the Uniform Health Care Services Benefit Information Card Act. Adds a health benefit plan offering dental coverage to the list of plans required to issue a health care benefit information card. Specifies health care benefit information cards may be electronic or physical. Requires uniform health care benefit information to display on the back of the card a statement indicating whether the plan is self-insured or fully funded and if the plan is subject to regulation by the Department of Insurance. Makes other changes.